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Kameda-Smith MM, Ragulojan M, Elliott C, Bliss L, Moore H, Sader N, Alsuwaihel M, Tso MK, Dakson A, Ajani O, Yarascavitch B, Fleming A, Mehta V, Aminnejad M, Farrokhyar F, Singh SK. National multicentered retrospective review of clinical and intraoperative factors associated with the development of cerebellar mutism after pediatric posterior fossa tumor resection. Childs Nerv Syst 2024; 40:1339-1347. [PMID: 38279985 DOI: 10.1007/s00381-024-06292-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/14/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Cerebellar mutism (CM) is characterized by a significant loss of speech in children following posterior fossa (PF) surgery. The biological origin of CM remains unclear and is the subject of ongoing debate. Significant recovery from CM is less likely than previously described despite rigorous multidisciplinary neuro-rehabilitational efforts. METHODS A national multi-centered retrospective review of all children undergoing PF resection in four midsized Canadian academic pediatric institutions was undertaken. Patient, tumor and surgical factors associated with the post-operative development of CM were reviewed. Retrospective identification of PF surgery patients including those developing and those that did not (internal control). RESULTS The study identified 258 patients across the 4 centers between 2010 and 2020 (mean age 6.73 years; 42.2% female). Overall, CM was experienced in 19.5% of patients (N = 50). Amongst children who developed CM histopathology included medulloblastoma (35.7%), pilocytic astrocytoma (32.6%) and ependymoma (17.1%). Intraoperative impression of adherence to the floor of the 4th ventricle was positive in 36.8%. Intraoperative abrupt changes in blood pressure and/or heart rate were identified in 19.4% and 17.8% of cases. The clinical resolution of CM was rated to be complete, significant resolution, slight improvement, no improvement and deterioration in 56.0%, 8.0%, 20.0%, 14.0% and 2.0%, respectively. In the cohort of children who experienced post-operative CM as compared to their no-CM counterpart, proportionally more tumors were felt to be adherent to the floor of the 4th ventricle (56.0% vs 49.5%), intraoperative extent of resection was a GTR (74% vs 68.8%) and changes in heart rate were noted (≥ 20% from baseline) (26.0% vs 15.9%). However, a multiple regression analysis identified only abrupt changes in HR (OR 5.97, CI (1.53, 23.1), p = 0.01) to be significantly associated with the development of post-operative CM. CONCLUSION As a devastating surgical complication after posterior fossa tumor surgery with variable clinical course, identifying and understanding the operative cues and revising intraoperative plans that optimizes the child's neurooncological and clinical outcome are essential.
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Affiliation(s)
- Michelle M Kameda-Smith
- Division of Neurosurgery, McMaster University, Hamilton, ON, Canada.
- Great Ormond Street Hospital for Children, London, England.
- Canadian Neurosurgery Research Collaborative (CNRC), Hamilton, Canada.
- McMaster Pediatric Brain Tumor Study Group (PBTSG), Hamilton, ON, Canada.
| | - Malavan Ragulojan
- McMaster Pediatric Brain Tumor Study Group (PBTSG), Hamilton, ON, Canada
| | - Cameron Elliott
- Canadian Neurosurgery Research Collaborative (CNRC), Hamilton, Canada
- Division of Neurosurgery, University of Alberta, Edmonton, AB, Canada
| | - Lori Bliss
- Division of Neurosurgery, University of Alberta, Edmonton, AB, Canada
| | - Hanna Moore
- Division of Neurosurgery, University of Alberta, Edmonton, AB, Canada
| | - Nicholas Sader
- Division of Neurosurgery, University of Calgary, Calgary, AB, Canada
| | | | - Michael K Tso
- Canadian Neurosurgery Research Collaborative (CNRC), Hamilton, Canada
- Division of Neurosurgery, University of Calgary, Calgary, AB, Canada
| | - Ayoub Dakson
- Canadian Neurosurgery Research Collaborative (CNRC), Hamilton, Canada
- Division of Neurosurgery, Dalhousie University, Halifax, NS, Canada
| | - Olufemi Ajani
- Great Ormond Street Hospital for Children, London, England
- McMaster Pediatric Brain Tumor Study Group (PBTSG), Hamilton, ON, Canada
| | - Blake Yarascavitch
- Division of Neurosurgery, McMaster University, Hamilton, ON, Canada
- McMaster Pediatric Brain Tumor Study Group (PBTSG), Hamilton, ON, Canada
| | - Adam Fleming
- McMaster Pediatric Brain Tumor Study Group (PBTSG), Hamilton, ON, Canada
| | - Vivek Mehta
- Division of Neurosurgery, University of Alberta, Edmonton, AB, Canada
| | - Minoo Aminnejad
- McMaster Pediatric Brain Tumor Study Group (PBTSG), Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Forough Farrokhyar
- Division of Neurosurgery, McMaster University, Hamilton, ON, Canada
- McMaster Pediatric Brain Tumor Study Group (PBTSG), Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Sheila K Singh
- Division of Neurosurgery, McMaster University, Hamilton, ON, Canada
- McMaster Pediatric Brain Tumor Study Group (PBTSG), Hamilton, ON, Canada
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Thivel D, Oustric P, Beaulieu K, Moore H, Bonjean L, Loglisci J, Georges M, Miyashita M, Boirie Y, Pereira B, Finlayson G. Development, sensitivity and reliability of a French version of the Leeds Food Preference Questionnaire (LFPQ-fr) for the evaluation of food preferences and reward. Physiol Behav 2023; 267:114187. [PMID: 37080481 DOI: 10.1016/j.physbeh.2023.114187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/14/2022] [Revised: 04/02/2023] [Accepted: 04/09/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND . There is a growing global interest in the evaluation of food reward, necessitating the adaptation of culturally appropriate instruments for use in empirical studies. This work presents the development and validation of a culturally adapted French version of the Leeds Food Preference Questionnaire (LFPQ-fr). METHODS . The LFPQ-fr was developed and validated in healthy-weight adults using the following systematic approach: i) selection and validation of appropriate food pictures; ii) linguistic translation of liking and wanting constructs in the target population (n=430; 81% female; 42.2 ± 12.7 years); iii) validation of the sensitivity and reliability of the task performed in a fasted state and in response to a standardized test meal (n=50; 50% female; 30.0 ± 8.4 years). RESULTS . During the first and second phases, the nutritional and perceptual validation of culturally appropriate food pictures and pertinent reward constructs, respectively, was demonstrated in a healthy-weight French sample. Findings from the third phase indicated that all food reward components were sensitive to the test meal and showed moderate to high agreement in both fasted (Lin's CCC =.72-.94) and fed (Lin's CCC = .53-.80) appetitive states between visit 1 (V1) and visit (V2). Except for explicit liking fat bias, all primary outcomes were statistically consistent in fasted and fed states between V1 and V2. Changes in fat and taste biases in response to a standardized meal for all primary outcomes were also consistent between V1 and V2 except for explicit liking fat bias (Lin's CCC = .49- .72). CONCLUSION . The LFPQ-fr developed and tested in this study is a reproducible and reliable method to assess food reward in both the fasted and fed states in a healthy-weight French population.
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Affiliation(s)
- D Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, Clermont-Ferrand, France..
| | - P Oustric
- Appetite Control Energy Balance Group, School of Psychology, University of Leeds, Leeds LS2 9JT, UK
| | - K Beaulieu
- Appetite Control Energy Balance Group, School of Psychology, University of Leeds, Leeds LS2 9JT, UK
| | - H Moore
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, Clermont-Ferrand, France
| | - L Bonjean
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, Clermont-Ferrand, France
| | - J Loglisci
- Department of Pulmonary Medicine and Intensive Care Unit, Constitutive Reference Center for Rare Pulmonary Diseases, University Hospital, Bourgogne-Franche-Comté, Burgundy University, Dijon, France; Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS UMR6265, INRAE UMR 1324, Université de Bourgogne Franche Comté, Dijon, France
| | - M Georges
- Department of Pulmonary Medicine and Intensive Care Unit, Constitutive Reference Center for Rare Pulmonary Diseases, University Hospital, Bourgogne-Franche-Comté, Burgundy University, Dijon, France; Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS UMR6265, INRAE UMR 1324, Université de Bourgogne Franche Comté, Dijon, France
| | - M Miyashita
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan
| | - Y Boirie
- CSO-CALORIS, CHU Clermont-Ferrand, Clermont-Ferrand, France; Department of Human Nutrition, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - B Pereira
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - G Finlayson
- Appetite Control Energy Balance Group, School of Psychology, University of Leeds, Leeds LS2 9JT, UK
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Gonzales T, Moore H, Sehgal C, Benjamin J. Disaster preparedness: gaining a wholistic understanding of caregiver’s perspectives of children and youth with special health care needs in developing future interventions. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00528-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Moore H, Zheng A, Cairns A, Lillaney P, Black J. Enhancement of a Machine Learning Algorithm to Alert Sleep Clinicians of Patients at Risk for Narcolepsy, Using Nocturnal Polysomnography in General Sleep Medicine Clinics. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.429] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Sader N, Mehta V, Hart S, Bliss L, Moore H, DaSilva M, Rashid R, Riva-Cambrin J. Quality of life and satisfaction in surgical versus conservative treatment of nonsyndromic children with craniosynostosis. J Neurosurg Pediatr 2022; 29:60-65. [PMID: 34653978 DOI: 10.3171/2021.5.peds2136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/21/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Craniosynostosis represents the second most common reason for referral to pediatric neurosurgery. However, the quality of life and neurodevelopmental impact of leaving this physical disorder uncorrected is poorly understood. METHODS This multicenter cross-sectional study identified previously managed nonsyndromic infants (< 24 months of age) with single-suture craniosynostosis at both pediatric neurosurgical centers in Alberta, Canada. The primary variable of interest was the allocated treatment (surgical vs conservative). The primary outcome was the Pediatric Quality of Life Inventory (PedsQL), a validated measure of quality of life examining physical, emotional, social, and school functioning. Treatment decision satisfaction and the reasons for selected management were quantified and collected directly from caregivers. RESULTS One hundred fourteen children met the inclusion criteria: 78% underwent surgery and 22% had conservative treatment. The most common suture affected was sagittal (54%), followed by metopic (33%), coronal (10%), and lambdoid (3%). Caregivers most commonly opted for surgery because of severe appearance (80%). Seventy-six percent and 72% of the caregivers of children with conservative management did so due to concerns of surgical risks and mild appearance, respectively. There was a statistically significant relationship between both the parents' (p < 0.001) and the surgeon's (p = 0.001) impression of a severe head shape and surgical management. Parental satisfaction with their child's appearance as well as satisfaction with their treatment decision did not differ between management types. Regarding quality of life, on univariate analysis, the conservative group had a statistically higher physical summary score (p = 0.01), psychosocial summary score (p = 0.004), and mean total scale score (p = 0.003) compared to the surgical group. However, after adjusting for severity and age at consult, no significant independent associations between management type and any of the PedsQL summary scores were found. CONCLUSIONS Alberta families have a high number of children with craniosynostosis treated with conservative management. Conservatively managed infants were largely minimally affected patients, particularly those with metopic synostosis. The study found no independent association between management type (surgery vs conservative) and quality of life when adjusted for important patient factors.
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Affiliation(s)
- Nicholas Sader
- 1Department of Clinical Neurosciences, Alberta Children's Hospital, University of Calgary, Alberta
| | - Vivek Mehta
- 2Department of Neurosurgery, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta; and
| | - Shannon Hart
- 3Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Lori Bliss
- 2Department of Neurosurgery, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta; and
| | - Hanna Moore
- 2Department of Neurosurgery, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta; and
| | - Melissa DaSilva
- 2Department of Neurosurgery, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta; and
| | - Ruksana Rashid
- 1Department of Clinical Neurosciences, Alberta Children's Hospital, University of Calgary, Alberta
| | - Jay Riva-Cambrin
- 1Department of Clinical Neurosciences, Alberta Children's Hospital, University of Calgary, Alberta
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Liu Y, Dash A, Krez A, Kim HJ, Cunningham M, Schwab F, Hughes A, Carlson B, Samuel A, Marty E, Moore H, McMahon DJ, Carrino JA, Bockman RS, Stein EM. Low volumetric bone density is a risk factor for early complications after spine fusion surgery. Osteoporos Int 2020; 31:647-654. [PMID: 31919536 DOI: 10.1007/s00198-019-05245-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/20/2019] [Indexed: 12/17/2022]
Abstract
UNLABELLED This study aims to investigate lumbar spine (LS) volumetric bone density (vBMD) as a risk factor for complications (pseudoarthrosis, instrumentation failure, adjacent fractures), re-operation, and time to complication after fusion. INTRODUCTION Lumbar spine (LS) fusion surgery is increasingly performed worldwide. Complications after fusion result in significant morbidity and healthcare costs. Multiple factors, including osteoporosis, have been suggested to contribute to risk of complications and re-operation. However, most studies have used DXA, which is subject to artifact in patients with spine pathology, and none have investigated the relationship between BMD and timing of post-operative complications. This study aims to investigate LS volumetric bone density (vBMD) as a risk factor for complications (pseudoarthrosis, instrumentation failure, adjacent fractures), re-operation, and time to complication after fusion. METHODS We evaluated a cohort of 359 patients who had initial LS fusion surgery at our institution, had pre-operative LS CTs and post-operative imaging available for review. Demographic factors, smoking status, vBMD, and details of surgical procedure were related to likelihood and timing of post-operative complications. RESULTS Mean age was 60 ± 14 years, vBMD 122 ± 37 g/cm3. Median follow-up was 11 months. Skeletal complications occurred in 47 patients (13%); 34 patients (10%) required re-operation. Low vBMD (directly measured and estimated using HU) and smoking were associated with increased risk of skeletal complications. Each increase in baseline vBMD of 10 g/cm3 decreased the complication hazard and increased the complication-free duration in time-to-event analysis (hazard ratio 0.91, 95% CI 0.83-0.98, p < 0.02). CONCLUSIONS Low vBMD was a significant risk factor for early post-operative complications in patients undergoing LS fusion. Prospective studies are needed to confirm these findings and to elucidate the optimal timing for follow-up and strategies for prevention of post-operative complications in this population.
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Affiliation(s)
- Y Liu
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
- Department of Medicine, Lahey Clinic, Burlington, MA, USA
| | - A Dash
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
| | - A Krez
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
| | - H J Kim
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - M Cunningham
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - F Schwab
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - A Hughes
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - B Carlson
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
- Department of Orthopedics, University of Kansas Medical Center, Kansas City, KS, USA
| | - A Samuel
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - E Marty
- Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA
| | - H Moore
- Weill Cornell Medical College, New York, NY, USA
| | - D J McMahon
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
| | - J A Carrino
- Department of Radiology, Hospital for Special Surgery, New York, NY, USA
| | - R S Bockman
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
| | - E M Stein
- Division of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.
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Kim J, Miller J, Kotecha R, Chao S, Ahluwalia M, Peereboom D, Mohammadi A, Barnett G, Murphy E, Vogelbaum M, Angelov L, Abraham J, Moore H, Budd G, Suh J. Stereotactic Radiosurgery with Concurrent HER2-directed Therapy is Associated with Improved Objective Response for Breast Cancer Brain Metastasis. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lieberman JA, Girgis RR, Brucato G, Moore H, Provenzano F, Kegeles L, Javitt D, Kantrowitz J, Wall MM, Corcoran CM, Schobel SA, Small SA. Hippocampal dysfunction in the pathophysiology of schizophrenia: a selective review and hypothesis for early detection and intervention. Mol Psychiatry 2018; 23:1764-1772. [PMID: 29311665 PMCID: PMC6037569 DOI: 10.1038/mp.2017.249] [Citation(s) in RCA: 217] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/18/2017] [Accepted: 09/27/2017] [Indexed: 02/07/2023]
Abstract
Scientists have long sought to characterize the pathophysiologic basis of schizophrenia and develop biomarkers that could identify the illness. Extensive postmortem and in vivo neuroimaging research has described the early involvement of the hippocampus in the pathophysiology of schizophrenia. In this context, we have developed a hypothesis that describes the evolution of schizophrenia-from the premorbid through the prodromal stages to syndromal psychosis-and posits dysregulation of glutamate neurotransmission beginning in the CA1 region of the hippocampus as inducing attenuated psychotic symptoms and initiating the transition to syndromal psychosis. As the illness progresses, this pathological process expands to other regions of the hippocampal circuit and projection fields in other anatomic areas including the frontal cortex, and induces an atrophic process in which hippocampal neuropil is reduced and interneurons are lost. This paper will describe the studies of our group and other investigators supporting this pathophysiological hypothesis, as well as its implications for early detection and therapeutic intervention.
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Affiliation(s)
- JA Lieberman
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - RR Girgis
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - G Brucato
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - H Moore
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - F Provenzano
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - L Kegeles
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - D Javitt
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - J Kantrowitz
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - MM Wall
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA,Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - CM Corcoran
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - SA Schobel
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - SA Small
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Department of Radiology, College of Physicians & Surgeons, Columbia University, New York, NY, USA
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Wenzel S, Rhoades H, Moore H, Lahey J, Henwood B, La Motte-Kerr W, Bird M. Life Goals Over Time Among Homeless Adults in Permanent Supportive Housing. Am J Community Psychol 2018; 61:421-432. [PMID: 29537648 PMCID: PMC6217826 DOI: 10.1002/ajcp.12237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Permanent supportive housing (PSH) is a widely-accepted solution to the challenge of chronic homelessness. While housing support and retention, physical health, and healthcare continue to be important for formerly homeless persons in PSH, "higher-order" and humanistic needs such as thriving have received less attention and as a result are less well understood in this population. One important indicator of thriving is the ability to establish and articulate life goals. This study utilizes longitudinal data from 421 formerly homeless adults prior to their move into PSH, and at 3-, 6- and 12-months after move-in (369 respondents completed all four interviews), to examine what life goals are articulated by this population and how those goals change over time. Prior to housing, most respondents articulated housing attainment as their primary life goal, whereas at follow-up interviews health goals, housing relocation, and financial goals became more prevalent. Aspirational goals (e.g., independence, self-improvement, artistic pursuits) were also common, but demonstrated a decrease over time in housing. Relationship goals remained common and consistent over time. Findings indicate that housing is a necessary, but perhaps not sufficient, step for improving thriving among formerly homeless adults. Implications for practice and future research are discussed.
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Affiliation(s)
- S.L. Wenzel
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 1149 S. Hill St., Suite 360, Los Angeles, CA 90015
| | - H. Rhoades
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 1149 S. Hill St., Suite 360, Los Angeles, CA 90015
| | - H. Moore
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 1149 S. Hill St., Suite 360, Los Angeles, CA 90015
| | - J. Lahey
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 1149 S. Hill St., Suite 360, Los Angeles, CA 90015
| | - B. Henwood
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 1149 S. Hill St., Suite 360, Los Angeles, CA 90015
| | - W. La Motte-Kerr
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 1149 S. Hill St., Suite 360, Los Angeles, CA 90015
| | - M. Bird
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 1149 S. Hill St., Suite 360, Los Angeles, CA 90015
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Carvelli L, Neergard Olesen A, Leary EB, Moore H, Schneider LD, Peppard PE, Jennum PJ, Sørensen HB, Mignot E. 0323 Design of a Deep Learning Based Algorithm forAutomatic Detection of Leg Movements During Sleep. Sleep 2018. [DOI: 10.1093/sleep/zsy061.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Carvelli
- Stanford University Center for Sleep Sciences and Medicine, Palo Alto, CA
| | - A Neergard Olesen
- Stanford University Center for Sleep Sciences and Medicine, Palo Alto, CA
| | - E B Leary
- Stanford University Center for Sleep Sciences and Medicine, Palo Alto, CA
| | - H Moore
- Stanford University Center for Sleep Sciences and Medicine, Palo Alto, CA
| | - L D Schneider
- Stanford University Center for Sleep Sciences and Medicine, Palo Alto, CA
| | - P E Peppard
- University of Wisconsin-Madison, Madison, WI
| | - P J Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Glostrup, DENMARK
| | - H B Sørensen
- Department of Electrical Engineering, Technical University of Denmark, Kgs. Lyngby, DENMARK
| | - E Mignot
- Stanford University Center for Sleep Sciences and Medicine, Palo Alto, CA
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Chapman M, Moore E, Moore H, Rochon P, Johnson D. Abstract No. 458 Defining the hemostatic disorders of end-stage renal disease: platelet dysfunction is just the tip of the iceberg. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.503] [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: 10/17/2022] Open
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Leyrer C, Balagamwala E, Reddy C, Berriochoa C, Shah C, Cherian S, Donaldson A, Calhoun B, Stewart R, Moore H, Tendulkar R. The Importance of Treatment and Timing in Metaplastic Breast Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.660] [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: 10/18/2022]
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Kheirbek R, Fokar A, Llorente M, Fletcher R, Moore H. INCIDENCE OF HEART FAILURE IN PREDOMINANTLY MALE U.S VETERAN CENTENARIANS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R. Kheirbek
- Washington DC VA Medical Center, Washington, District of Columbia,
- George Washington School of Medicine and Health Sciences, Washington, District of Columbia,
- Georgetown University Medical School, Washington, District of Columbia
| | - A. Fokar
- Washington DC VA Medical Center, Washington, District of Columbia,
- Georgetown University Medical School, Washington, District of Columbia
| | - M. Llorente
- Washington DC VA Medical Center, Washington, District of Columbia,
- Georgetown University Medical School, Washington, District of Columbia
| | - R. Fletcher
- Washington DC VA Medical Center, Washington, District of Columbia,
- Georgetown University Medical School, Washington, District of Columbia
| | - H. Moore
- Washington DC VA Medical Center, Washington, District of Columbia,
- Uniformed Services University, Bethesda, MD, Washington, District of Columbia,
- Georgetown University Medical School, Washington, District of Columbia
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Frank M, Khodadoust M, Chu M, Kohrt H, Advani R, Alizadeh A, Reddy S, Maeda L, Gupta N, Laport G, Meyer E, Miklos D, Negrin R, Rezvani A, Weng W, Sheehan K, Czerwinski D, Faham M, Okada A, Moore H, Phillips D, Wapnir I, Brody J, Levy R. PHASE I/II CLINICAL TRIAL OF AN ACTIVATED WHOLE TUMOR CELL VACCINE FOLLOWED BY TRANSFER OF IMMUNE T CELLS IN PATIENTS WITH MANTLE CELL LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_72] [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] [Indexed: 11/11/2022]
Affiliation(s)
- M. Frank
- Division of Oncology; Stanford University; Stanford USA
| | - M. Khodadoust
- Division of Oncology; Stanford University; Stanford USA
| | - M. Chu
- Department of Oncology; University of Alberta; Edmonton Canada
| | - H. Kohrt
- Division of Oncology; Stanford University; Stanford USA
| | - R. Advani
- Division of Oncology; Stanford University; Stanford USA
| | - A. Alizadeh
- Division of Oncology; Stanford University; Stanford USA
| | - S. Reddy
- Division of Oncology; Stanford University; Stanford USA
| | - L. Maeda
- Division of Oncology; Stanford University; Stanford USA
| | - N. Gupta
- Division of Oncology; Stanford University; Stanford USA
| | - G. Laport
- Division of Blood and Marrow Transplantation; Stanford University; Stanford USA
| | - E. Meyer
- Division of Blood and Marrow Transplantation; Stanford University; Stanford USA
| | - D. Miklos
- Division of Blood and Marrow Transplantation; Stanford University; Stanford USA
| | - R. Negrin
- Division of Blood and Marrow Transplantation; Stanford University; Stanford USA
| | - A. Rezvani
- Division of Blood and Marrow Transplantation; Stanford University; Stanford USA
| | - W. Weng
- Division of Blood and Marrow Transplantation; Stanford University; Stanford USA
| | - K. Sheehan
- Division of Blood and Marrow Transplantation; Stanford University; Stanford USA
| | - D. Czerwinski
- Division of Oncology; Stanford University; Stanford USA
| | - M. Faham
- Adaptive Biotechnologies, Adaptive Biotechnologies; Seattle USA
| | - A. Okada
- Division of Oncology; Stanford University; Stanford USA
| | - H. Moore
- Division of Oncology; Stanford University; Stanford USA
| | - D. Phillips
- Division of Oncology; Stanford University; Stanford USA
| | - I. Wapnir
- Department of Sugery; Stanford University; Stanford USA
| | - J. Brody
- Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai; New York USA
| | - R. Levy
- Division of Oncology; Stanford University; Stanford USA
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Kruse ML, Raska P, Abraham J, Budd GT, Montero A, Grobmyer S, Moore H. Abstract P2-12-04: Impact of institution of young women's breast cancer clinic on time to treatment and utilization of fertility, genetics and social work consultations in women under age 50 with new diagnosis of early stage breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-12-04] [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
Background: Genetic counseling and fertility resources are often underutilized in young women with early stage breast cancer (ESBC) due, in part, to concerns about treatment delays. At our institution, women newly diagnosed with ESBC typically see a breast surgeon, medical oncologist and radiation oncologist in a multidisciplinary clinic with additional cancer related subspecialist referrals occurring at those providers' discretion. We hypothesized that time to treatment (TTT) and utilization of fertility, genetics and social work consultations would improve after implementing a Young Women's Breast Cancer Clinic. As of January 1, 2015, all patients under age 50 seen at Cleveland Clinic for new diagnosis of ESBC were automatically offered scheduling of appointments with medical genetics, reproductive endocrinology and social work in addition to the usual multidisciplinary team.
Methods: Women under age 50 diagnosed with ESBC seen at Cleveland Clinic from 1/2014-12/2015 were identified using our tumor registry. Demographics, tumor pathology, clinical and treatment histories were obtained through medical chart review as per IRB approved protocol. Time from initial visit in our system to date of treatment initiation was calculated for all patients and compared between the 2014 (pre-intervention) and 2015 (post-intervention) cohorts as was time from diagnosis (biopsy date) to treatment initiation. Completed reproductive endocrinology, genetic counseling and social work consultations were documented. Welch two sample t-test was used to compare time to treatment between groups. Chi squared test was used to compare frequency of subspecialty consultations between groups.
Results: 207 young women with ESBC were identified over the 2 year period, 99 in 2014 and 108 in 2015. Median age was 45 in 2014 and 44 in 2015. Most were diagnosed outside of our hospital system, 58% in 2014 and 76% in 2015. The most common initial treatment was surgery with reconstruction (S+R) (54% and 50% for 2014 and 2015 respectively) followed by chemotherapy (23% and 27%) then surgery without reconstruction (S) (20% and 24%). Median TTT from first encounter was 30 days in 2014 and 28 days in 2015 (p=0.33) and was 36 days versus 33.5 days (p=0.23) when calculated from biopsy date. TTT in the S and S+R groups was 37 vs 28 days (p=0.84) and 36.5 vs 32 days, (p=0.21), respectively. Genetics, reproductive endocrinology and social work consults in 2014 vs 2015 were documented as 89% vs 94%, 4% vs 9% and 58 vs% 55% (p=0.22, 0.32, 0.77). For patients under age 40, 27% in 2014 and 30% in 2015 completed reproductive endocrinology consultations.
Conclusions: Offering upfront scheduling of breast cancer related subspecialty appointments for young women with newly diagnosed ESBC did not significantly improve overall TTT. There was a trend towards improved TTT in those receiving surgery with or without reconstruction as first treatment and no suggestion of delay in TTT. A modest numeric increase in completed genetic counseling and reproductive endocrinology consultations was not statistically significant, but may have been clinically meaningful for affected individuals.
Citation Format: Kruse ML, Raska P, Abraham J, Budd GT, Montero A, Grobmyer S, Moore H. Impact of institution of young women's breast cancer clinic on time to treatment and utilization of fertility, genetics and social work consultations in women under age 50 with new diagnosis of early stage breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-12-04.
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Affiliation(s)
| | - P Raska
- Cleveland Clinic, Cleveland, OH
| | | | - GT Budd
- Cleveland Clinic, Cleveland, OH
| | | | | | - H Moore
- Cleveland Clinic, Cleveland, OH
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Baar J, Abraham J, Silverman P, Budd GT, Vinayak S, Varadan V, Moore H, Montero A, Fu P. Abstract OT2-01-10: Pilot study of carboplatin, nab-paclitaxel and pembrolizumab for metastatic triple-negative breast cancer (ongoing clinical trial). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot2-01-10] [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
BACKGROUND. Triple-negative breast cancer (TNBC) is associated with an aggressive phenotype and decreased survival. TNBC is characterized by tumor-infiltrating lymphocytes (TIL) which predict for a better prognosis and likely reflect immune recognition of tumor-associated antigens by TIL. However, potent immune suppressive signals exist in the tumor microenvironment such as those mediated by PD-1 with its ligand, PD-L1. Therefore, to test the validity of decreasing PD-1/PD-L1-mediated immune suppression, a Phase Ib study of single-agent pembrolizumab in 32 patients with advanced TNBC showed a partial response of 16.1% and stable disease of 9.7%, thereby attesting to the effectiveness of single-agent pembrolizumab in these patients. Other studies have demonstrated that cytotoxic chemotherapy favorably modulates immunity against cancer and there is therefore a strong rationale to combine chemotherapy with an immune modulator such as pembrolizumab for the treatment of mTNBC.
TRIAL DESIGN. This is an investigator-initiated, industry-sponsored (Merck) pilot study of carboplatin (C), nab-paclitaxel (N) and pembrolizumab (P) in 30 patients with metastatic (m) TNBC. Eligible patients will receive 3 cycles of CNP, with each cycle consisting of C (AUC 6 on days 1 of a 21-day cycle), N (100 mg/m2 IV on days 1, 8 and 15 of a 21-day cycle), and P (200 mg IV on day 15 of each cycle). After completion of 3 cycles CNP, patients with responding or stable disease by RECIST 1.1 criteria will be eligible for additional cycle(s) of CNP.
ELIGIBILITY CRITERIA. Patients must have radiologically measurable mTNBC, an ECOG performance status of 0-1, must not have received more than 2 prior therapies for this disease, and must be willing to undergo a preliminary biopsy of a metastatic focus for research purposes. A second post-treatment biopsy will be encouraged but will not be mandated.
SPECIFIC AIMS. The primary objective is to determine overall response rate (ORR) in patients treated with CNP. The secondary objectives are to determine progression-free survival (PFS) and safety/tolerability of CNP. Correlative objectives include the identification of pathologic and genomic correlates of response to CNP.
STATISTICAL METHODS. Clinical response will be scored using RECIST 1.1 criteria. Under the proposed treatment, the expected clinical response is about 35%. With the precision of the 2-sided 95% confidence interval for the response rate set to 0.17 (the distance to the expected response rate of 35%), the sample size required for the study is 30 patients. The true response rate of therapy will be estimated based on the number of responses using a binomial distribution and its confidence intervals will be estimated using Wilson's method. The Kaplan-Meier method will be used to estimate PFS. Factors including pathologic and genomic correlates that predict survival outcomes will be identified by Cox model or extensions of the Cox model.
TARGET ACCRUAL. We plan to enroll 30 patients over 2 years, with the first patient expected to be enrolled in September 2016.
CONTACT INFORMATION. Joseph Baar, MD, PhD. Seidman Cancer Center of University Hospitals Case Medical Center. E-mail: joseph.baar@uhhospitals.org.
Citation Format: Baar J, Abraham J, Silverman P, Budd GT, Vinayak S, Varadan V, Moore H, Montero A, Fu P. Pilot study of carboplatin, nab-paclitaxel and pembrolizumab for metastatic triple-negative breast cancer (ongoing clinical trial) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT2-01-10.
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Affiliation(s)
- J Baar
- Seidman Cancer Center, Cleveland, OH; Taussig Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH
| | - J Abraham
- Seidman Cancer Center, Cleveland, OH; Taussig Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH
| | - P Silverman
- Seidman Cancer Center, Cleveland, OH; Taussig Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH
| | - GT Budd
- Seidman Cancer Center, Cleveland, OH; Taussig Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH
| | - S Vinayak
- Seidman Cancer Center, Cleveland, OH; Taussig Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH
| | - V Varadan
- Seidman Cancer Center, Cleveland, OH; Taussig Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH
| | - H Moore
- Seidman Cancer Center, Cleveland, OH; Taussig Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH
| | - A Montero
- Seidman Cancer Center, Cleveland, OH; Taussig Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH
| | - P Fu
- Seidman Cancer Center, Cleveland, OH; Taussig Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH
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Garzon-Villalba XP, Mbah A, Wu Y, Hiles M, Moore H, Schwartz SW, Bernard TE. Exertional heat illness and acute injury related to ambient wet bulb globe temperature. Am J Ind Med 2016; 59:1169-1176. [PMID: 27779310 DOI: 10.1002/ajim.22650] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The Deepwater Horizon disaster cleanup effort provided an opportunity to examine the effects of ambient thermal conditions on exertional heat illness (EHI) and acute injury (AI). METHODS The outcomes were daily person-based frequencies of EHI and AI. Exposures were maximum estimated WBGT (WBGTmax) and severity. Previous day's cumulative effect was assessed by introducing previous day's WBGTmax into the model. RESULTS EHI and AI were higher in workers exposed above a WBGTmax of 20°C (RR 1.40 and RR 1.06/°C, respectively). Exposures above 28°C-WBGTmax on the day of the EHI and/or the day before were associated with higher risk of EHI due to an interaction between previous day's environmental conditions and the current day (RRs from 1.0-10.4). CONCLUSIONS The risk for EHI and AI were higher with increasing WBGTmax. There was evidence of a cumulative effect from the prior day's WBGTmax for EHI. Am. J. Ind. Med. 59:1169-1176, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Alfred Mbah
- College of Public Health; University of South Florida; Tampa Florida
| | - Yougui Wu
- College of Public Health; University of South Florida; Tampa Florida
| | - Michael Hiles
- College of Public Health; University of South Florida; Tampa Florida
| | - Hanna Moore
- College of Public Health; University of South Florida; Tampa Florida
| | - Skai W. Schwartz
- College of Public Health; University of South Florida; Tampa Florida
| | - Thomas E. Bernard
- College of Public Health; University of South Florida; Tampa Florida
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Warner AW, Moore H, Reinhard D, Ball LA, Knoppers BM. Harmonizing Global Biospecimen Consent Practices to Advance Translational Research: A Call to Action. Clin Pharmacol Ther 2016; 101:317-319. [PMID: 27558027 DOI: 10.1002/cpt.461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 07/27/2016] [Accepted: 08/22/2016] [Indexed: 01/14/2023]
Abstract
One of the many challenges of translational medicine is working with research participants to donate biospecimens through an ethical informed consent framework. The increasingly complex ethical and regulatory differences across jurisdictions translates into limitations on use and potential value of biological specimens and their associated data in clinical research. We introduce a call to action for more uniform global standards for collection of biological specimen informed consent data to enable greater advancements in medical research.
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Affiliation(s)
- A W Warner
- Global Specimen Solutions, Inc, Raleigh, North Carolina, USA
| | - H Moore
- NIH, NCI Biorepositories and Biospecimen Research Branc, Rockville, Maryland, USA
| | - D Reinhard
- Bristol-Myers Squibb, Clinical Sample Strategy & Operation, Pennington, New Jersey, USA
| | - L A Ball
- BioStorage Technologies, Inc, Indianapolis, Indiana, USA
| | - B M Knoppers
- Center of Genomics and Policy, McGill Universit, Montreal, Quebec, Canada
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Williams L, McGovern E, Kimmich O, Molloy A, Beiser I, Butler JS, Molloy F, Logan P, Healy DG, Lynch T, Walsh R, Cassidy L, Moriarty P, Moore H, McSwiney T, Walsh C, O'Riordan S, Hutchinson M. Epidemiological, clinical and genetic aspects of adult onset isolated focal dystonia in Ireland. Eur J Neurol 2016; 24:73-81. [DOI: 10.1111/ene.13133] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/09/2016] [Indexed: 02/06/2023]
Affiliation(s)
- L. Williams
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - E. McGovern
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - O. Kimmich
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - A. Molloy
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - I. Beiser
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - J. S. Butler
- Trinity Centre for Bioengineering; Dublin and School of Mathematical Sciences; Dublin Institute of Technology; Dublin Ireland
| | | | - P. Logan
- Beaumont Hospital; Dublin Ireland
| | | | - T. Lynch
- Mater Misericordiae University Hospital; Dublin Ireland
| | - R. Walsh
- Adelaide and Meath Hospital; Dublin Ireland
| | - L. Cassidy
- Royal Victoria Eye and Ear Hospital; Dublin Ireland
| | - P. Moriarty
- Royal Victoria Eye and Ear Hospital; Dublin Ireland
| | - H. Moore
- Cork University Hospital; Cork Ireland
| | | | - C. Walsh
- Departments of Statistics; Trinity College Dublin; University of Limerick; Limerick Ireland
| | - S. O'Riordan
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - M. Hutchinson
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
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Abstract
OBJECTIVE This prospective longitudinal study aims to determine the risk factors of wandering-related adverse consequences in community-dwelling persons with mild dementia. These adverse consequences include negative outcomes of wandering (falls, fractures, and injuries) and eloping behavior. METHODS We recruited 143 dyads of persons with mild dementia and their caregivers from a veteran's hospital and memory clinic in Florida. Wandering-related adverse consequences were measured using the Revised Algase Wandering Scale - Community Version. Variables such as personality (Big Five Inventory), behavioral response to stress, gait, and balance (Tinetti Gait and Balance), wayfinding ability (Wayfinding Effectiveness Scale), and neurocognitive abilities (attention, cognition, memory, language/verbal skills, and executive functioning) were also measured. Bivariate and logistic regression analyses were performed to assess the predictors of these wandering-related adverse consequences. RESULTS A total of 49% of the study participants had falls, fractures, and injuries due to wandering behavior, and 43.7% demonstrated eloping behaviors. Persistent walking (OR = 2.6) and poor gait (OR = 0.9) were significant predictors of negative outcomes of wandering, while persistent walking (OR = 13.2) and passivity (OR = 2.55) predicted eloping behavior. However, there were no correlations between wandering-related adverse consequences and participants' characteristics (age, gender, race, ethnicity, and education), health status (Charlson comorbidity index), or neurocognitive abilities. CONCLUSION Our results highlight the importance of identifying at-risk individuals so that effective interventions can be developed to reduce or prevent the adverse consequences of wandering.
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Affiliation(s)
- N Ali
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - S L Luther
- VISN 8 Center of Innovation, James A. Haley VA Hospital, Tampa, FL, USA
| | - L Volicer
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - D Algase
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - E Beattie
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - L M Brown
- VISN 8 Center of Innovation, James A. Haley VA Hospital, Tampa, FL, USA.,School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - V Molinari
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - H Moore
- VISN 8 Center of Innovation, James A. Haley VA Hospital, Tampa, FL, USA
| | - I Joseph
- James A. Haley VA Hospital, Tampa, FL
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Kruse ML, Santa-Maria CA, Raska P, Swoboda A, Jain S, Sohal D, Moore H, Budd GT, Abraham J, Montero AJ. Abstract P4-13-24: Impact of genomic medicine on clinical decision making in patients with advanced breast cancer at two academic medical centers. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-24] [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
Background: A deeper molecular understanding of cancer biology has led to the development of therapies targeting driver mutations. Genomic profiling of tumors is commercially available and has become integrated into many clinical practices as part of a paradigm shift towards personalized care of cancer patients. The current impact of genomic profiling on clinical decision making for patients with advanced breast cancer is not well described.
Methods: Patients with metastatic breast cancer (mBC) who had tumors submitted for commercial genomic analysis from 2013-2015 were identified consecutively at two large academic cancer centers with genomic basket trials open for the majority of the collection period. Demographics, tumor pathology, clinical, and treatment histories were extracted through medical chart review as per an IRB approved protocol. Data from genomic analysis reports was extracted including number and type of mutations, FDA approved therapies and clinical trials available. Genomic analysis was determined to have impacted clinical decision making if the next line of therapy was influenced either by accrual to clinical trial, or a decision to prescribe an FDA-approved therapy. The most frequent somatic mutations and their relative frequencies were determined.
Results: A total of 82 patients with mBC who had undergone commercially available genomic testing were identified. The median age was 49 (range: 29-70). 42 patients (51%) had ER-positive HER2-negative disease, 33 (40%) had ER-negative HER2-negative disease, 4 (5%) had ER-negative HER2-positive disease and 3 (4%) had ER-positive HER2-positive disease. The median number of lines of therapy received prior to genomic profiling was 2 (range 0-15). Genomic analysis reports suggested that 61 (74%) of these patients had at least one FDA approved medication available for at least one somatic mutation, and 79 (96%) had at least one clinical trial available (39 (46%) in the same state, 11 (13%) in the same institution). Genomic testing influenced management in 8 patients (10%), with 6 patients (7%) experiencing a change in next line of therapy attributable to genomic information. In 74 patients (90%), genomic testing results did not affect clinical decision-making. The most frequently observed somatic mutations included: TP53, PI3KCA, MYC, CCDN1, FGF, ZNF703, GATA3, ARID1A, MCL1, PTEN, MYST3, and BRCA1.
Conclusions: Genomic testing did not affect management in the vast majority of mBC patients treated at two major academic cancer centers. Furthermore, the most identified mutated genes found were not targetable. The real world clinical utility of genomic analysis remains limited in breast cancer but may influence clinical decision making in a minority of patients.
Citation Format: Kruse ML, Santa-Maria CA, Raska P, Swoboda A, Jain S, Sohal D, Moore H, Budd GT, Abraham J, Montero AJ. Impact of genomic medicine on clinical decision making in patients with advanced breast cancer at two academic medical centers. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-24.
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Affiliation(s)
- ML Kruse
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
| | - CA Santa-Maria
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
| | - P Raska
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
| | - A Swoboda
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
| | - S Jain
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
| | - D Sohal
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
| | - H Moore
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
| | - GT Budd
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
| | - J Abraham
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
| | - AJ Montero
- Cleveland Clinic, Cleveland, OH; Northwestern University, Chicago, IL
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Winter A, Raska P, Ornstein M, Moore H, Montero A, Budd GT, Tullio K, Bailey J, Abraham J. Abstract P1-09-03: Socioeconomic characteristics of African American women with breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-09-03] [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
Background: Breast cancer is the most common cancer among African American (AA) women. Despite having a lower incidence of breast cancer compared to white women (124.4 compared to 127.9 per 100,000), AAs have a higher death rate (30.2 compared to 21.3 per 100,000). One explanation for this discrepancy is that breast cancer in AAs is often detected at a later stage compared to white women. We conducted this retrospective study to examine socioeconomic characteristics among AA women with breast cancer to see if there were factors associated with stage of diagnosis which may contribute to the known disparities. Methods: We identified all AA women diagnosed with any stage breast cancer from 2006-2014 within the Cleveland Clinic Cancer Data Warehouse and classified them into either early or late stage disease at time of diagnosis. Stages 0-II were classified as early and stages III-IV as late. We examined several variables at diagnosis including age, marital status, tobacco use, alcohol use, Medicaid insurance status, and breast cancer subtype which included HER-2 positive (HER+), hormone receptor positive/HER2 negative (HR+/HER-), and triple negative(TN). AA median income was obtained from US census data according to the zip code at diagnosis. We conducted univariate logistic regression for individual estimates and confidence intervals and multiple logistic regression and model selection to determine significant predictors of stage of diagnosis. Results: Of the 771 AA women identified, 108 (14%) were diagnosed at a late stage of disease with a median age of 59 years. Receptor status distribution was 12.4%, 31%, and 16.6% for HER+, HR+/HER-, and TN respectively for early stage, and 15.7%, 27%, and 25% for late stage. Among early stage 50% were current or previous smokers and 2.6% had Medicaid insurance compared to late stage patients where 63% were current or previous smokers and 9.2% had Medicaid insurance. Multiplicative effect estimates and 95% confidence intervals from univariate logistic regressions identified the following significant factors: tobacco use 1.48 [1.11-1.96] and Medicaid 3.73 [1.56-8.51] (p-values<0.01), and TNBC 1.67 [1.02-2.68] (p-value<0.05). In a stepwise model selection, only tobacco use and Medicaid were retained in the model, as well as age at diagnosis. Conclusions: There are socioeconomic differences among AA women with breast cancer. Only tobacco use, Medicaid insurance, and age at diagnosis were predictive of late stage in this study.
Citation Format: Winter A, Raska P, Ornstein M, Moore H, Montero A, Budd GT, Tullio K, Bailey J, Abraham J. Socioeconomic characteristics of African American women with breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-09-03.
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Affiliation(s)
| | - P Raska
- Cleveland Clinic, Cleveland, OH
| | | | - H Moore
- Cleveland Clinic, Cleveland, OH
| | | | - GT Budd
- Cleveland Clinic, Cleveland, OH
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Berriochoa C, Leyrer C, Agrawal S, Donaldson A, Stewart R, Moore H, Tendulkar R, Calhoun B. Metaplastic Breast Cancer: A Clinicopathologic Correlation of Histologic Subtype on Disease Control. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mazarello Paes V, Hesketh K, O'Malley C, Moore H, Summerbell C, Griffin S, van Sluijs EMF, Ong KK, Lakshman R. Determinants of sugar-sweetened beverage consumption in young children: a systematic review. Obes Rev 2015; 16:903-13. [PMID: 26252417 PMCID: PMC4737242 DOI: 10.1111/obr.12310] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 06/17/2015] [Accepted: 06/30/2015] [Indexed: 01/05/2023]
Abstract
Sugar-sweetened beverage (SSB) consumption is associated with adverse health outcomes. Improved understanding of the determinants will inform effective interventions to reduce SSB consumption. A total of 46,876 papers were identified through searching eight electronic databases. Evidence from intervention (n = 13), prospective (n = 6) and cross-sectional (n = 25) studies on correlates/determinants of SSB consumption was quality assessed and synthesized. Twelve correlates/determinants were associated with higher SSB consumption (child's preference for SSBs, TV viewing/screen time and snack consumption; parents' lower socioeconomic status, lower age, SSB consumption, formula milk feeding, early introduction of solids, using food as rewards, parental-perceived barriers, attending out-of-home care and living near a fast food/convenience store). Five correlates/determinants were associated with lower SSB consumption (parental positive modelling, parents' married/co-habiting, school nutrition policy, staff skills and supermarket nearby). There was equivocal evidence for child's age and knowledge, parental knowledge, skills, rules/restrictions and home SSB availability. Eight intervention studies targeted multi-level (child, parents, childcare/preschool setting) determinants; four were effective. Four intervention studies targeted parental determinants; two were effective. One (effective) intervention targeted the preschool environment. There is consistent evidence to support potentially modifiable correlates/determinants of SSB consumption in young children acting at parental (modelling), child (TV viewing) and environmental (school policy) levels.
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Affiliation(s)
- V Mazarello Paes
- Institute of Public Health, University of Cambridge, Cambridge, UK.,Institute of Child Health, University College London, London, UK
| | - K Hesketh
- Institute of Child Health, University College London, London, UK.,MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - C O'Malley
- School of Medicine, Pharmacy and Health, Durham University Queens Campus, Stockton-On-Tees, UK
| | - H Moore
- School of Medicine, Pharmacy and Health, Durham University Queens Campus, Stockton-On-Tees, UK
| | - C Summerbell
- School of Medicine, Pharmacy and Health, Durham University Queens Campus, Stockton-On-Tees, UK
| | - S Griffin
- Institute of Public Health, University of Cambridge, Cambridge, UK.,MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - E M F van Sluijs
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - K K Ong
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - R Lakshman
- Institute of Public Health, University of Cambridge, Cambridge, UK.,MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
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Milekic MH, Xin Y, O'Donnell A, Kumar KK, Bradley-Moore M, Malaspina D, Moore H, Brunner D, Ge Y, Edwards J, Paul S, Haghighi FG, Gingrich JA. Age-related sperm DNA methylation changes are transmitted to offspring and associated with abnormal behavior and dysregulated gene expression. Mol Psychiatry 2015; 20:995-1001. [PMID: 25092244 DOI: 10.1038/mp.2014.84] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 05/14/2014] [Accepted: 06/17/2014] [Indexed: 12/15/2022]
Abstract
Advanced paternal age (APA) has been shown to be a significant risk factor in the offspring for neurodevelopmental psychiatric disorders, such as schizophrenia and autism spectrum disorders. During aging, de novo mutations accumulate in the male germline and are frequently transmitted to the offspring with deleterious effects. In addition, DNA methylation during spermatogenesis is an active process, which is susceptible to errors that can be propagated to subsequent generations. Here we test the hypothesis that the integrity of germline DNA methylation is compromised during the aging process. A genome-wide DNA methylation screen comparing sperm from young and old mice revealed a significant loss of methylation in the older mice in regions associated with transcriptional regulation. The offspring of older fathers had reduced exploratory and startle behaviors and exhibited similar brain DNA methylation abnormalities as observed in the paternal sperm. Offspring from old fathers also had transcriptional dysregulation of developmental genes implicated in autism and schizophrenia. Our findings demonstrate that DNA methylation abnormalities arising in the sperm of old fathers are a plausible mechanism to explain some of the risks that APA poses to resulting offspring.
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Affiliation(s)
- M H Milekic
- Department of Psychiatry, Columbia University and The New York State Psychiatric Institute, New York, NY, USA
| | - Y Xin
- Department of Psychiatry, Columbia University and The New York State Psychiatric Institute, New York, NY, USA
| | - A O'Donnell
- Department of Genetics and Development, Columbia University, New York, NY, USA
| | - K K Kumar
- Department of Psychiatry, Columbia University and The New York State Psychiatric Institute, New York, NY, USA
| | - M Bradley-Moore
- Department of Psychiatry, Columbia University and The New York State Psychiatric Institute, New York, NY, USA
| | - D Malaspina
- 1] Department of Psychiatry, New York University, New York, NY, USA [2] Department of Psychiatry, New York University, and The NY OMH Creedmoor Psychiatric Center, New York, NY, USA
| | - H Moore
- Department of Psychiatry, Columbia University and The New York State Psychiatric Institute, New York, NY, USA
| | - D Brunner
- 1] Department of Psychiatry, Columbia University and The New York State Psychiatric Institute, New York, NY, USA [2] PsychoGenics, New York, NY, USA
| | - Y Ge
- Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA
| | - J Edwards
- Center for Pharmacogenomics, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - S Paul
- Helen & Robert Appel Institute for Alzheimer's Research, Mind and Brain Institute, Weill Cornell Medical School, New York, NY, USA
| | - F G Haghighi
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J A Gingrich
- Department of Psychiatry, Columbia University and The New York State Psychiatric Institute, New York, NY, USA
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Redpath S, Lemyre B, Moore H, Ponnuthurai J, Chan J, Barrowman N. 88: Effectiveness of Therapeutic Hypothermia on Transport within a Large Geographical Area. Paediatr Child Health 2015. [DOI: 10.1093/pch/20.5.e66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Whisson S, Smith S, Moore H, Summerbell C. Exploring service providers' and commissioners' views on a community pharmacy led weight management service. A qualitative study. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.182] [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: 11/17/2022]
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Smith S, Summerbell C, Moore H, O'malley C. Tees Consumption and Activity in Kids Experience (TeesCAKE). Qualitative results. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.181] [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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Agrawal L, Moore H, Vaught J. MC13-0047 Serum and tissue biomarkers for cancer biospecimen integrity. Eur J Cancer 2013. [DOI: 10.1016/s0959-8049(13)70159-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: 10/26/2022]
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Moore H, Engel K. SP035 NCI biospecimen evidence-based practices. Eur J Cancer 2013. [DOI: 10.1016/s0959-8049(13)70113-8] [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: 10/26/2022]
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Thapar A, Moore H, Golden D, Davies A. Peri-operative antithrombotic therapy: bridging the gap. Ann R Coll Surg Engl 2012; 94:142-5. [PMID: 22507714 DOI: 10.1308/003588412x13171221590854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Gibson EL, Kreichauf S, Wildgruber A, Vögele C, Summerbell CD, Nixon C, Moore H, Douthwaite W, Manios Y. A narrative review of psychological and educational strategies applied to young children's eating behaviours aimed at reducing obesity risk. Obes Rev 2012; 13 Suppl 1:85-95. [PMID: 22309067 DOI: 10.1111/j.1467-789x.2011.00939.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Strategies to reduce risk of obesity by influencing preschool children's eating behaviour are reviewed. The studies are placed in the context of relevant psychological processes, including inherited and acquired preferences, and behavioural traits, such as food neophobia, 'enjoyment of food' and 'satiety responsiveness'. These are important influences on how children respond to feeding practices, as well as predictors of obesity risk. Nevertheless, in young children, food environment and experience are especially important for establishing eating habits and food preferences. Providing information to parents, or to children, on healthy feeding is insufficient. Acceptance of healthy foods can be encouraged by five to ten repeated tastes. Recent evidence suggests rewarding healthy eating can be successful, even for verbal praise alone, but that palatable foods should not be used as rewards for eating. Intake of healthier foods can be promoted by increasing portion size, especially in the beginning of the meal. Parental strategies of pressuring to eat and restriction do not appear to be causally linked to obesity, but are instead primarily responses to children's eating tendencies and weight. Moderate rather than frequent restriction may improve healthy eating in children. Actively positive social modelling by adults and peers can be effective in encouraging healthier eating.
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Affiliation(s)
- E L Gibson
- Department of Psychology, University of Roehampton, London, UK.
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Melis M, Marcon F, Masi A, Sarpel U, Miller G, Cohen S, Moore H, Berman R, Pachter H, Newman E. Is the Addition of Grade to the AJCC Staging for Patients Undergoing Pancreaticoduodenectomy Beneficial? J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.751] [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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Luca C, Moore H, Singer C. 1.264 DOPA-RESPONSIVE DYSTONIA PRESENTING AS WRITER'S CRAMP. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70322-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vaught J, Rogers J, Myers K, Lim MD, Lockhart N, Moore H, Sawyer S, Furman JL, Compton C. An NCI Perspective on Creating Sustainable Biospecimen Resources. J Natl Cancer Inst Monogr 2011; 2011:1-7. [DOI: 10.1093/jncimonographs/lgr006] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wright A, Andrews N, Bardsley K, Nielsen JE, Avery K, Pewsey E, Jones M, Harley D, Nielsen AR, Moore H, Gokhale P, Rajpert-De Meyts E, Andrews PW, Walsh J, Harrison NJ. Mapping the stem cell state: eight novel human embryonic stem and embryonal carcinoma cell antibodies. ACTA ACUST UNITED AC 2011; 34:e175-87; discussion e187-8. [PMID: 21651578 DOI: 10.1111/j.1365-2605.2011.01185.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The antigenic profile of human embryonic stem (ES) and embryonal carcinoma (EC) cells has served as a key element of their characterization, with a common panel of surface and intracellular markers now widely used. Such markers have been used to identify cells within the 'undifferentiated state', yet it appears that this categorization may be an oversimplification, because a number of sub-states appear to exist within this state. To increase the resolution of the undifferentiated state, we have generated eight novel monoclonal antibodies, all capable of recognizing undifferentiated human ES and EC cells, and herein describe their characterization. The reactivity of these antibodies against a range of cell lines is reported, as well as their developmental regulation, basic biochemistry and reactivity in immunohistochemistry of testicular germ cell tumours. Our data reveal a range of reactivity for all antibodies against both ES and EC cells, suggesting that these markers will afford recognition of unique sub-states within the undifferentiated stem cell compartment.
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Affiliation(s)
- A Wright
- Centre for Stem Cell Biology and the Department of Biomedical Science, University of Sheffield, Western Bank, Sheffield, UK
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Moore H, Romeril K. Multiple myeloma presenting with a fever of unknown origin and development of thrombotic thrombocytopenic purpura post-bortezomib. Intern Med J 2011; 41:348-50. [DOI: 10.1111/j.1445-5994.2011.02458.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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O'Sullivan JF, Moore H. Gee-Thaysen Disease: Idiopathic Steatorrhoea of Adults and Adolescents in Non-tropical Countries. Br Med J 2011; 1:183-7. [PMID: 20783514 DOI: 10.1136/bmj.1.4179.183] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Corcoran CM, Kimhy D, Parrilla-Escobar MA, Cressman VL, Stanford AD, Thompson J, David SB, Crumbley A, Schobel S, Moore H, Malaspina D. The relationship of social function to depressive and negative symptoms in individuals at clinical high risk for psychosis. Psychol Med 2011; 41:251-261. [PMID: 20444306 PMCID: PMC3376746 DOI: 10.1017/s0033291710000802] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Social dysfunction is a hallmark symptom of schizophrenia which commonly precedes the onset of psychosis. It is unclear if social symptoms in clinical high-risk patients reflect depressive symptoms or are a manifestation of negative symptoms. METHOD We compared social function scores on the Social Adjustment Scale-Self Report between 56 young people (aged 13-27 years) at clinical high risk for psychosis and 22 healthy controls. The cases were also assessed for depressive and 'prodromal' symptoms (subthreshold positive, negative, disorganized and general symptoms). RESULTS Poor social function was related to both depressive and negative symptoms, as well as to disorganized and general symptoms. The symptoms were highly intercorrelated but linear regression analysis demonstrated that poor social function was primarily explained by negative symptoms within this cohort, particularly in ethnic minority patients. CONCLUSIONS Although this study demonstrated a relationship between social dysfunction and depressive symptoms in clinical high-risk cases, this association was primarily explained by the relationship of each of these to negative symptoms. In individuals at heightened risk for psychosis, affective changes may be related to a progressive decrease in social interaction and loss of reinforcement of social behaviors. These findings have relevance for potential treatment strategies for social dysfunction in schizophrenia and its risk states and predict that antidepressant drugs, cognitive behavioral therapy and/or social skills training may be effective.
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Affiliation(s)
- C M Corcoran
- Centre of Prevention and Evaluation, Department of Psychiatry, New York State Psychiatric Institute at Columbia University, New York, NY 10032, USA.
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Brown T, Avenell A, Edmunds LD, Moore H, Whittaker V, Avery L, Summerbell C. Systematic review of long-term lifestyle interventions to prevent weight gain and morbidity in adults. Obes Rev 2009; 10:627-38. [PMID: 19754634 DOI: 10.1111/j.1467-789x.2009.00641.x] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The aim of this article is to determine the effectiveness of long-term lifestyle interventions for the prevention of weight gain and morbidity in adults. Prevention of weight gain is important in adults who are of normal weight, overweight and obese. A systematic review of controlled trials of lifestyle interventions in adults with a body mass index of less than 35 kg m(-2) with at least 2 years of follow-up was carried out. Eleven of 39 comparisons produced significant improvement in weight between groups at 2 years or longer with mean difference weight change ranging from -0.5 to -11.5 kg. Effective interventions included a 600 kcal/day deficit diet deficit/low-fat diet (with and without meal replacements), low-calorie diet, Weight Watchers diet, low-fat non-reducing diet, diet with behaviour therapy, diet with exercise, diet with exercise and behaviour therapy. Adding meal replacements to a low-fat diet (with and without exercise and behaviour therapy) produced significant improvement in weight. Head-to-head interventions failed to show significant effect on weight with the exception of a Mediterranean diet with behaviour therapy compared with low-fat diet. Diet with exercise and/or behaviour therapy demonstrated significant reduction in hypertension and improvement in risk of metabolic syndrome and diabetes compared with no treatment control. Lifestyle interventions demonstrated significant improvement in weight, reduction in hypertension and reduction in risk of type 2 diabetes and the metabolic syndrome.
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Affiliation(s)
- T Brown
- School of Health and Social Care, University of Teesside, Middlesbrough, UK.
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Abstract
InterRett, International Rett Syndrome Association (IRSA) Rett Phenotype Database, is a unique international project funded by the IRSA, which brings together child neurologists, geneticists, paediatricians, epidemiologists, researchers and families of affected children. The principal aim of InterRett is to increase the clinical understanding of Rett syndrome throughout the world and with the statistical power of large case numbers, determine any correlations between genotype and the phenotypic characteristics. Since establishment of the database in January 2003, InterRett has registered 286 cases from 24 countries, with family questionnaire data submitted on 242 cases and clinician data on 116 cases. Collated de-identified data gathered from families and clinicians have been incorporated into a searchable online database allowing simple and complex interrogation of the clinical phenotype information. InterRett will also serve as a clearing house for data to encourage inter-country collaboration between researchers and negotiations are in place with several countries for data contributions in excess of 1000 cases. The resulting online database will be an invaluable resource for understanding the nature and management of Rett syndrome, as well as providing a model for other rare childhood disorders.
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Affiliation(s)
- H Moore
- Telethon Institute for Child Health Research, Perth, Australia.
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Touquet R, Csipke E, Holloway P, Brown A, Patel T, Seddon AJ, Gulati P, Moore H, Batrick N, Crawford MJ. Resuscitation room blood alcohol concentrations: one-year cohort study. Emerg Med J 2009; 25:752-6. [PMID: 18955613 PMCID: PMC2602738 DOI: 10.1136/emj.2008.062711] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [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] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To clarify the relationship between presenting clinical condition and blood alcohol concentration (BAC) among adult patients admitted to a resuscitation room (RR) of an emergency department (ED) in order to help guide clinical practice. METHOD Single-site prospective cohort study of all patients admitted to the RR of an inner-city hospital over a one-year period. The study sample comprised all those aged 16 years and over from whom a blood sample was taken, with BAC (results not known to ED staff), pathology by International Classification of Diseases (ICD) version 10 coding, injury severity score for trauma, return visit to hospital and mortality during the subsequent 6-month period, being recorded. RESULTS 291 (15%) of 1908 presentations had a positive BAC (ie, BAC >10 mg/100 ml) ranging from 11 to 574 mg/100 ml, of which almost 40% were over 240 mg/100 ml (ICD-10 code Y90.8). In addition to collapse from alcohol/drugs, almost half of those presenting following self-harm or assault had a positive BAC. Those with a positive BAC had a higher rate of ED re-attendance in the following 6 months. 10% of all presentations were due to trauma. CONCLUSION The following five presentations to the RR are associated with a positive BAC: collapse from alcohol/drugs, self-harm, trauma, gastrointestinal bleeding (ICD-10 code K92.2) and non-cardiac chest pain (ICD-10 code R07). Patients with a positive BAC demonstrate a very wide range of pathology, some with severe levels of misuse. This highlights the opportunity for prompt feedback when sober, to ensure all is done to encourage patients to contemplate change in order to reduce re-attendance.
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Affiliation(s)
- R Touquet
- Imperial College Healthcare NHS Trust, London, UK.
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Paradis F, Moore H, Novak S, Dyck MK, Dixon WT, Foxcroft GR. Global protein profiling of porcine cumulus cells in response to native oocyte secreted factors in vitro. Soc Reprod Fertil Suppl 2009; 66:119-120. [PMID: 19848275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- F Paradis
- Swine Reproduction-Development Program, Dept. AFNS, University of Alberta, Edmonton, AB, T6G 2P5, Canada.
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Cherry N, Moore H, McNamee R, Pacey A, Burgess G, Clyma JA, Dippnall M, Baillie H, Povey A. Occupation and male infertility: glycol ethers and other exposures. Occup Environ Med 2008; 65:708-14. [PMID: 18417551 DOI: 10.1136/oem.2007.035824] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the relation between male infertility and occupational exposures, particularly glycol ethers. METHODS A case-referent study was designed in which men attending 14 fertility clinics in 11 centres across the UK in 1999-2002 were recruited following 12 months of unprotected intercourse and without a previous semen analysis. Cases were those with low motile sperm concentration (MSC) relative to the time since their last ejaculation (MSC <12 x 10(6) for 3 days of abstinence). Referents were other men attending these clinics and meeting the inclusion criteria. A single semen sample was collected at the clinic and analysed at the andrology laboratory serving each hospital. Concentration was determined manually with motility assessed centrally from video recordings. Exposures and confounding factors were assessed from self-completed and nurse-interviewer questionnaires, completed prior to the results of the semen analysis. The occupational histories were assessed for exposures relative to UK norms by a team of occupational hygienists blind to case status. RESULTS Of 2118 men in employment at the time of the interview, 874 (41.3%) were cases. Work with organic solvents, particularly glycol ethers, in the 3 months before the first clinic visit was associated with the likelihood of low motile sperm count. Unadjusted odds ratios (OR) for moderate and high glycol ether exposure (compared with none) were 1.70 (95% CI: 1.11 to 2.61) and 2.54 (95% CI: 1.24 to 5.21). Adjustment for potential confounders (surgery to the testes, previous conception, wearing boxer shorts, drinking alcohol, employed in manual work) reduced the risk associated with glycol ether exposure: moderate OR = 1.46 (95% CI: 0.93 to 2.28), high OR = 2.25 (95% CI: 1.08 to 4.69). No other occupational risk factor was identified. CONCLUSIONS Glycol ether exposure was related to low motile sperm count in men attending fertility clinics. This suggests that, at the time of the study, glycol ethers continued to be a hazard for male fertility.
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Affiliation(s)
- N Cherry
- Community and Occupational Medicine Program, 13-103 Clinical Sciences Building, University of Alberta, Edmonton Alberta, Canada T6G2G3.
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Belknap SM, Moore H, Lanzotti SA, Yarnold PR, Getz M, Deitrick DL, Peterson A, Akeson J, Maurer T, Soltysik RC, Storm GA, Brooks I. Application of Software Design Principles and Debugging Methods to an Analgesia Prescription Reduces Risk of Severe Injury From Medical Use of Opioids. Clin Pharmacol Ther 2008; 84:385-92. [DOI: 10.1038/clpt.2008.24] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Wesolowski R, Choueiri TK, Rybicki L, Shealy AG, Casey G, Weng D, Moore H. BRCA mutation status and risk of secondary malignancy following chemotherapy for breast cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11017] [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: 11/20/2022] Open
Abstract
11017 Background: Since the BRCA gene is responsible for excisional DNA repair, we hypothesized that breast cancer patients with BRCA mutation would be more susceptible to the induction of second malignancies following chemotherapy treatment than breast cancer patients who tested negative for BRCA mutations. Methods: Breast cancer patients tested for BRCA1 and BRCA2 mutations at the Cleveland Clinic were identified and evaluated for history of neoadjuvant or adjuvant chemotherapy and for the occurrence of subsequent non-breast primary invasive cancer. Patients with inadequate follow-up and those with inoperable disease at diagnosis were excluded from the analysis. Fisher’s exact test was used to compare different cohorts. The IRB at Cleveland Clinic approved the study. Results: Of 115 identified breast cancer patients tested for BRCA mutations, 77 met the inclusion criteria. Twenty-seven of these patients carried BRCA1 or BRCA2 mutations and 50 tested negative for these mutations. Twelve patients (44%) in the BRCA positive group and 8 patients (16%) in the BRCA negative group underwent prophylactic oophorectomy. Median follow-up for the two groups was 53.5 months (75 months in the BRCA positive group and 48.5 months in the BRCA negative group). Median age at diagnosis was 42 years (40.5 years in the BRCA positive group and 44.5 in the BRCA negative group). In the BRCA positive group 3 of 25 patients (12%) treated with chemotherapy developed second malignancies (ovarian cancer, transitional cell cancer in urinary tract and renal cell carcinoma) compared with none of the 2 patients who did not get chemotherapy (p= 1.0). In the BRCA negative group, 2/34 patients (6%), treated with chemotherapy developed second cancers compared with 2/16 patients (12%), who were not treated with chemotherapy (p=0.58). Cancers in the BRCA negative group included two bladder carcinomas in the chemotherapy treated patients and in the non-chemotherapy group, non-small cell lung cancer, uterine, ovarian, endometrial and peritoneal cancers. Conclusions: At more than 4-years of follow up, chemotherapy in operable breast cancer patients was not associated with an increase in the risk of secondary malignancy or with a differential effect on this endpoint by BRCA mutation status in this retrospective study. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | | | - G. Casey
- The Cleveland Clinic, Cleveland, OH
| | - D. Weng
- The Cleveland Clinic, Cleveland, OH
| | - H. Moore
- The Cleveland Clinic, Cleveland, OH
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Fanning SR, Short S, Coleman K, Andresen S, Budd GT, Moore H, Rim A, Crowe J, Weng DE. Correlation of dynamic infrared imaging with radiologic and pathologic response for patients treated with primary systemic therapy for locally advanced breast cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10696 Background: Assessment of response to therapy for locally advanced breast cancer includes serial assessments of physical exam, radiologic imaging, or repeated biopsies. Expense, subjective assessment, and patient risk make these methods impractical. Dynamic infrared imaging (DIRI) utilizes a quantum well infrared photon (QWIP) sensor with software to analyze the emission patterns over time. DIRI can detect biological temperature gradients with sensitivity of 0.009ºC. Tumor-induced local tissue nitric oxide production can increase local capillary blood flow. Anti-tumor therapies have been shown to result in decreased peri-tumoral capillary blood flow. These changes in temperature, detected by serial DIRI imaging, may provide a low cost, non-invasive, easily reproducible objective tool for real-time clinical assessment. Methods: In this prospective pilot study, we are evaluating patients with locally advanced breast cancer using serial DIRI. Primary endpoints include: sensitivity, specificity, PPV, and NPV of DIRI in comparison to pathologic response, concordance of DIRI to physical exam, and concordance of DIRI to standard radiographic evaluation at initial diagnosis and prior to surgery. DIRI results are reported as quantification of changes in the 0.2Hz modulation of temperature over the breast during the course of treatment and measurement of area of average temperature in a region of interest compared between breasts. One hundred patients will be enrolled in this trial. Results: Sixteen patients have been enrolled. Six have proceeded to surgery. All but one patient exhibited evidence of tumor response by physical exam. These findings correlated with response when comparing initial to pre-surgical MRI. In all responding patients, DIRI results revealed a decrease in the number of regions over the breast in which the 0.2Hz frequency dominated. Similarly, DIRI evaluation according to area of average temperature in the region of interest compared between breasts was concordant in patients with response to therapy. Conclusions: Assessment of response by physical exam, MRI, and DIRI were consistent. Preliminary data reveals that serial DIRI imaging can be an effective adjunctive tool. No significant financial relationships to disclose.
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Affiliation(s)
| | - S. Short
- Cleveland Clinic Foundation, Cleveland, OH
| | - K. Coleman
- Cleveland Clinic Foundation, Cleveland, OH
| | | | - G. T. Budd
- Cleveland Clinic Foundation, Cleveland, OH
| | - H. Moore
- Cleveland Clinic Foundation, Cleveland, OH
| | - A. Rim
- Cleveland Clinic Foundation, Cleveland, OH
| | - J. Crowe
- Cleveland Clinic Foundation, Cleveland, OH
| | - D. E. Weng
- Cleveland Clinic Foundation, Cleveland, OH
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