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Brierley CK, Yip BH, Orlando G, Goyal H, Wen S, Wen J, Levine MF, Jakobsdottir GM, Rodriguez-Meira A, Adamo A, Bashton M, Hamblin A, Clark SA, O'Sullivan J, Murphy L, Olijnik AA, Cotton A, Narina S, Pruett-Miller SM, Enshaei A, Harrison C, Drummond M, Knapper S, Tefferi A, Antony-Debré I, Thongjuea S, Wedge DC, Constantinescu S, Papaemmanuil E, Psaila B, Crispino JD, Mead AJ. Chromothripsis orchestrates leukemic transformation in blast phase MPN through targetable amplification of DYRK1A. bioRxiv 2023:2023.12.08.570880. [PMID: 38106192 PMCID: PMC10723394 DOI: 10.1101/2023.12.08.570880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Chromothripsis, the process of catastrophic shattering and haphazard repair of chromosomes, is a common event in cancer. Whether chromothripsis might constitute an actionable molecular event amenable to therapeutic targeting remains an open question. We describe recurrent chromothripsis of chromosome 21 in a subset of patients in blast phase of a myeloproliferative neoplasm (BP-MPN), which alongside other structural variants leads to amplification of a region of chromosome 21 in ∼25% of patients ('chr21amp'). We report that chr21amp BP-MPN has a particularly aggressive and treatment-resistant phenotype. The chr21amp event is highly clonal and present throughout the hematopoietic hierarchy. DYRK1A , a serine threonine kinase and transcription factor, is the only gene in the 2.7Mb minimally amplified region which showed both increased expression and chromatin accessibility compared to non-chr21amp BP-MPN controls. We demonstrate that DYRK1A is a central node at the nexus of multiple cellular functions critical for BP-MPN development, including DNA repair, STAT signalling and BCL2 overexpression. DYRK1A is essential for BP-MPN cell proliferation in vitro and in vivo , and DYRK1A inhibition synergises with BCL2 targeting to induce BP-MPN cell apoptosis. Collectively, these findings define the chr21amp event as a prognostic biomarker in BP-MPN and link chromothripsis to a druggable target.
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Shaw SC, Carravallah L, Johnson M, O'Sullivan J, Chown N, Neilson S, Doherty M. Barriers to healthcare and a 'triple empathy problem' may lead to adverse outcomes for autistic adults: A qualitative study. Autism 2023:13623613231205629. [PMID: 37846479 DOI: 10.1177/13623613231205629] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
LAY ABSTRACT Autistic people live with more mental and physical health conditions and, on average, die younger than non-autistic people. Despite widespread commitments to tackling these issues, autistic people still report various barriers to accessing healthcare. This article aims to explore the area in depth, from the perspective of autistic people. This research benefits from being led by autistic people, for autistic people - all of the researchers are autistic, and most of us are also medical doctors. Data, in the form of written comments and stories, were collected as part of a large survey. Here, we explored these for common themes and possible deeper meaning within the experiences. People who took part reported a variety of barriers. Here, our article gives voice to their stories, in their own words. Themes included: early barriers; communication mismatch; doubt - in oneself and from doctors; helplessness and fear; and healthcare avoidance and adverse health outcomes. Our findings allowed us to create a model that aimed to understand and explain the reported barriers in the context of the previously known consequences. We also built on wider autism theories to explain our findings in more depth.
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MacMahon T, O'Sullivan J. A Quantitative Analysis of Clinical Handovers Between Emergency Medicine Physicians. Ir Med J 2022; 115:704. [PMID: 36920472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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O'Sullivan J, Heinrich D, Castro Marcos E, George S, Song D, Dizdarevic S, Baldari S, Essler M, de Jong I, Lastoria S, Hammerer P, Tombal B, James N, Verholen F, Meltzer J, Sandström P, Sartor O. 1394P Alkaline phosphatase (ALP) decline and pain response as markers for overall survival (OS) in patients (Pts) with metastatic castration-resistant prostate cancer (mCRPC) treated with radium-223 (223Ra) in the REASSURE study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1526] [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: 11/16/2022] Open
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O'Sullivan J, Gonzalez B, Gudenkauf L, Lehmann R, Allen S, Ernst-Guenther C, Wolinsky H, Poschenrieder A, Mirante O, Morgans A. 1401P Quality of life across three countries using a large-scale, fully digital survey of patients with prostate cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Horesh E, Chéret J, O'Sullivan J, Paus R. LB1017 A novel link between human hair follicle neuroimmunology and mitochondrial biology: Substance P increases intrafollicular oxidative stress and mitochondrial biogenesis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.1045] [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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7
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Suzuki T, Chéret J, Scala F, Gherardini J, O'Sullivan J, Epstein-Kuka G, Bauman A, Demetriades C, Paus R. 650 Controlling mTORC1 activity as a novel therapeutic strategy for managing human hair growth and pigmentation. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.661] [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]
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Murphy R, Payan N, Osman S, Prise K, Hounsell A, O'Sullivan J, McGarry C, Jain S. PO-1769 Prostate cancer radiogenomics machine learning classification for predicting disease progression. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03733-1] [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: 10/18/2022]
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Abstract
OBJECTIVES Autistic people experience poor physical and mental health along with reduced life expectancy compared with non-autistic people. Our aim was to identify self-reported barriers to primary care access by autistic adults compared with non-autistic adults and to link these barriers to self-reported adverse health consequences. DESIGN Following consultation with the autistic community at an autistic conference, Autscape, we developed a self-report survey, which we administered online through social media platforms. SETTING A 52-item, international, online survey. PARTICIPANTS 507 autistic adults and 157 non-autistic adults. PRIMARY AND SECONDARY OUTCOME MEASURES Self-reported barriers to accessing healthcare and associated adverse health outcomes. RESULTS Eighty per cent of autistic adults and 37% of non-autistic respondents reported difficulty visiting a general practitioner (GP). The highest-rated barriers by autistic adults were deciding if symptoms warrant a GP visit (72%), difficulty making appointments by telephone (62%), not feeling understood (56%), difficulty communicating with their doctor (53%) and the waiting room environment (51%). Autistic adults reported a preference for online or text-based appointment booking, facility to email in advance the reason for consultation, the first or last clinic appointment and a quiet place to wait. Self-reported adverse health outcomes experienced by autistic adults were associated with barriers to accessing healthcare. Adverse outcomes included untreated physical and mental health conditions, not attending specialist referral or screening programmes, requiring more extensive treatment or surgery due to late presentations and untreated potentially life-threatening conditions. There were no significant differences in difficulty attending, barriers experienced or adverse outcomes between formally diagnosed and self-identified autistic respondents. CONCLUSIONS Reduction of healthcare inequalities for autistic people requires that healthcare providers understand autistic perspectives, communication needs and sensory sensitivities. Adjustments for autism-specific needs are as necessary as ramps for wheelchair users.
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Affiliation(s)
- Mary Doherty
- Department of Anaesthesia, Our Lady's Hospital, Navan, Meath, Ireland
| | | | - Jane O'Sullivan
- Department of Anaesthesia, Mater Private Hospital, Dublin, Leinster, Ireland
| | - Laura Carravallah
- Pediatrics and Human Development, and Medicine, Michigan State University-College of Human Medicine, East Lansing, Michigan, USA
| | | | - Walter Cullen
- Department of General Practice, School of Medicine, UCD, Dublin, Ireland
| | - Sebastian C K Shaw
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, Brighton and Hove, UK
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O'Sullivan J, Linnane C, Baraks V, Miller C. Is individualised care more effective than pre-determined exercises, in a group environment for shoulder conditions? A service evaluation. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.161] [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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O'Sullivan J, Miller C, Jeffrey J, Power D. Brachial plexus neuropathies during the COVID-19 pandemic: A retrospective case series of 15 patients in critical care. Physiotherapy 2022. [PMCID: PMC8848150 DOI: 10.1016/j.physio.2021.12.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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12
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Goff A, O'Sullivan J, Nguyen C, Wilcox I. Menstrual Cycle Variability in Symptoms of Postural Orthostatic Tachycardia Syndrome (POTS). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chand S, Wilcox I, McGrady M, Lal S, Hunyor I, O'Sullivan J, Fulthorp E, Price M, Mccoll A. Clinical and Echocardiographic Parameters in Community-Based Individuals Symptomatic Post Pfizer and AstraZeneca COVID-19 Vaccination. Heart Lung Circ 2022. [PMCID: PMC9345547 DOI: 10.1016/j.hlc.2022.06.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Generali T, Jansen K, Steedman R, De Rita F, Viganò G, McParlin D, Hermuzi A, Crossland D, O'Sullivan J, Coats L, Hasan A, Nassar MS. Contemporary Ross procedure outcomes: medium- to long-term results in 214 patients. Eur J Cardiothorac Surg 2021; 60:1112-1121. [PMID: 33969415 DOI: 10.1093/ejcts/ezab193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 10/03/2020] [Revised: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Our goal was to present 2 decades of our experience with the Ross procedure and its sequential modifications, adopted since 2010, to improve the reoperation rate. METHODS We performed a single-centre, retrospective review of database information and medical notes about the implantation technique: the freestanding root. We compared era 1 (1997-2009) and era 2 (2010-2019). RESULTS Between 1997 and 2019, a total of 214 Ross procedures were performed (71% men, median age 24 years) [interquartile range (IQR) 15-38]. Of these, 87% had various forms of congenital-dysplastic aortic valves. The median cross-clamping and bypass times were 173 (IQR 148-202) and 202 (IQR 182-244) min. The median postoperative stay was 6 days (2-77). Thirty-day mortality was 0.5%. The median follow-up time was 8.2 years (IQR 3.9-13.2). Survival at 10 and 20 years was 97% and 95%; freedom from greater than moderate aortic regurgitation or aortic valve intervention was 91% and 80%; and 93% of the patients were in New York Heart Association functional class I. Twenty (21%) patients operated on during era 1 and 6 (9%) during era 2 underwent autograft reoperations. The median follow-up time was 14.3 (IQR 11.5-17.4) and 4.8 (IQR 2.5-7) years. Freedom from autograft reoperation was 87% and 69% at 10 and 20 years, with no significant difference between eras. Freedom from homograft reoperation was 96% and 76% at 10 and 20 years. The presence of aortic regurgitation, infective endocarditis and era 1 were predictors of autograft reoperation. Male gender and era 1 were predictors of neoaortic root dilatation. CONCLUSIONS The contemporary modified Ross procedure continues to deliver excellent results and should remain part of the strategy to treat children and young adults requiring aortic valve replacement.
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Affiliation(s)
- T Generali
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - K Jansen
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - R Steedman
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - F De Rita
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - G Viganò
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - D McParlin
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - A Hermuzi
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - D Crossland
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - J O'Sullivan
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - L Coats
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - A Hasan
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - M S Nassar
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Congenital Heart Disease Research Group, Population Health Science Institute, Newcastle University, Newcastle Upon Tyne, UK
- Cardiothoracic Unit, Alexandria University, Alexandria, Egypt
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Cheret J, Suzuki T, Scala F, O'Sullivan J, Nicu C, Gherardini J, Epstein-Kuka G, Bauman A, Demetriades C, Paus R. 602 mTORC1 activity controls human scalp hair follicle pigmentation and growth. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.630] [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: 10/21/2022]
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Patmore S, Singh S, O'Sullivan J. PO-73 Coagulation-cancer crosstalk: defining the role of von Willebrand factor in breast cancer progression. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00246-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hitka T, O'Sullivan J, Szucs S, Iohom G. Determination of the initial minimum effective dose of 0.5% bupivacaine with 20 μg of fentanyl for an operative fixation of fractured neck of femur: a prospective, observational trial. Minerva Anestesiol 2021; 87:766-773. [PMID: 33591143 DOI: 10.23736/s0375-9393.21.15012-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Fractured neck of femur (FNF) is a common cause of morbidity and mortality in elderly. Spinal catheter allows fractionation of local anesthetic dose which combined with intrathecal opioid leads to a dose reduction and better hemodynamic stability. The primary objective of this paper was to investigate the initial minimum local anesthetic dose (iMLAD) of 0.5% isobaric bupivacaine with 20 μg of fentanyl administered via spinal catheter in order to commence the operative fixation of FNF. METHODS A prospective, single-blinded, adaptive clinical trial with patients undergoing dynamic hip screw implantation (DHS) or hemiarthroplasty (HEMI) due to FNF. The Dixon and Massey's up and down method was used to determine the ED50 of intrathecal bupivacaine. This figure was confirmed with Probit analysis, in addition to the ED95. RESULTS Using the Dixon and Massey's approach, the iMLADED50 for DHS was 0.29 mL (1.45 mg) and the iMLADED50 for HEMI was 0.33 mL (1.65 mg) of 0.5% isobaric bupivacaine. The Probit analyses demonstrated that the iMLADED95 for DHS and HEMI were 0.32 mL (1.6 mg) and 0.34 mL (1.7 mg) respectively. The mean cumulative dose of 0.5% bupivacaine for the whole surgery was 0.67 mL (3.35 mg) and 0.87 mL (4.35 mg) in the DHS and HEMI groups, respectively. CONCLUSIONS This study demonstrates that the placement of a spinal catheter allows for careful titration of local anesthetic, enabling a reduction of the initial intrathecal dose of 0.5% isobaric bupivacaine below 0.4 mL (2 mg) and leading to a significant reduction of a dose required for the whole surgery when combined with an intrathecal opioid.
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Affiliation(s)
- Tomas Hitka
- Department of Anesthesia and Intensive Care, Cork University Hospital, Cork, Ireland -
| | - Jane O'Sullivan
- Department of Anesthesia and Intensive Care, Tallaght University Hospital, Dublin, Ireland
| | - Szilard Szucs
- Department of Anesthesia and Intensive Care, Cork University Hospital, Cork, Ireland
| | - Gabriella Iohom
- Cork University Hospital, Cork, Ireland.,University College of Cork, Cork, Ireland
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Morris P, Dennis M, Hunyor I, Puranik R, O'Sullivan J, Lal S. Myocardial Fibrosis and Left Ventricular Hypertrophy Elevates Cardiovascular Risk in Patients with Diabetes Mellitus. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ranjan V, O'Sullivan J, Albertinale E, Albanese B, Chanelière T, Schenkel T, Vion D, Esteve D, Flurin E, Morton JJL, Bertet P. Multimode Storage of Quantum Microwave Fields in Electron Spins over 100 ms. Phys Rev Lett 2020; 125:210505. [PMID: 33274991 DOI: 10.1103/physrevlett.125.210505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
We report long coherence times (up to 300 ms) for near-surface bismuth donor electron spins in silicon coupled to a superconducting microresonator, biased at a clock transition. This enables us to demonstrate the partial absorption of a train of weak microwave fields in the spin ensemble, their storage for 100 ms, and their retrieval, using a Hahn-echo-like protocol. Phase coherence and quantum statistics are preserved in the storage.
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Affiliation(s)
- V Ranjan
- Université Paris-Saclay, CEA, CNRS, SPEC, 91191 Gif-sur-Yvette Cedex, France
| | - J O'Sullivan
- London Centre for Nanotechnology, University College London, London WC1H 0AH, United Kingdom
| | - E Albertinale
- Université Paris-Saclay, CEA, CNRS, SPEC, 91191 Gif-sur-Yvette Cedex, France
| | - B Albanese
- Université Paris-Saclay, CEA, CNRS, SPEC, 91191 Gif-sur-Yvette Cedex, France
| | - T Chanelière
- Université Grenoble Alpes, CNRS, Grenoble INP, Institut Néel, 38000 Grenoble, France
| | - T Schenkel
- Accelerator Technology and Applied Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - D Vion
- Université Paris-Saclay, CEA, CNRS, SPEC, 91191 Gif-sur-Yvette Cedex, France
| | - D Esteve
- Université Paris-Saclay, CEA, CNRS, SPEC, 91191 Gif-sur-Yvette Cedex, France
| | - E Flurin
- Université Paris-Saclay, CEA, CNRS, SPEC, 91191 Gif-sur-Yvette Cedex, France
| | - J J L Morton
- London Centre for Nanotechnology, University College London, London WC1H 0AH, United Kingdom
| | - P Bertet
- Université Paris-Saclay, CEA, CNRS, SPEC, 91191 Gif-sur-Yvette Cedex, France
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O'Sullivan J, McCarrick C, Tierney P, O'Connor DB, Collins J, Franklin R. Correction: Identification of Informed Consent in Patient Videos on Social Media: Prospective Study. JMIR Med Educ 2020; 6:e25045. [PMID: 33125336 PMCID: PMC7665947 DOI: 10.2196/25045] [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] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/15/2020] [Indexed: 06/11/2023]
Abstract
[This corrects the article DOI: 10.2196/14081.].
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Affiliation(s)
- Jane O'Sullivan
- Department of AnaesthesiaLetterkenny University HospitalDonegalIreland
| | | | - Paul Tierney
- Department of AnatomyTrinity College DublinDublinIreland
| | - Donal B O'Connor
- Professorial Surgical UnitTallaght University Hospital & Trinity College DublinDublinIreland
| | - Jack Collins
- Department of AnaesthesiaLetterkenny University HospitalDonegalIreland
| | - Robert Franklin
- Department of AnaesthesiaLetterkenny University HospitalDonegalIreland
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Hay JL, O'Sullivan J, Kerwash E, Ilie AR, Cole SM. A review of clinical pharmacology deficiencies of European centralised drug marketing authorisation applications. Regul Toxicol Pharmacol 2020; 118:104804. [PMID: 33049309 DOI: 10.1016/j.yrtph.2020.104804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/22/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022]
Abstract
The aim of this observational review was to review trends in deficiencies in clinical pharmacology dossiers by analysing the frequency and characteristics of major objections (MOs) related to clinical pharmacokinetics and dose-exposure-response (DER) relationships in assessment reports for medicinal products submitted in centralised procedures to the European Medicines Agency (EMA). Initial Assessor (Day 120) assessment reports between 2013 and 2018 were reviewed MOs and characterised with regards to ATC code, orphan status, legal basis and type of molecule, major objection topic and if scientific advice had been sought during development. 23% of the 551 identified Day 120 assessments contained at least one major objection related to clinical pharmacology. Most common topics identified were related to the pharmacokinetics in the target populations, analytical methods, dose-exposure-response relationships, absorption, distribution, metabolism, excretion, comparative bioavailability, and bioequivalence issues. The importance of a robust clinical PK dossier in the assessment of marketing authorisation applications was highlighted by the high frequency of major objections. This review should provide valuable insights to ensure that aspects of bioanalytical methods, comparative bioavailability, PK in the target population and DER relationships are thoroughly addressed in future marketing authorisation applications.
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Affiliation(s)
- Justin L Hay
- Medicines & Healthcare Products Regulatory Agency, London, UK; EMA Modelling and Simulation Working Group, UK.
| | | | - Essam Kerwash
- Medicines & Healthcare Products Regulatory Agency, London, UK; EMA Modelling and Simulation Working Group, UK
| | | | - Susan M Cole
- Medicines & Healthcare Products Regulatory Agency, London, UK; EMA Modelling and Simulation Working Group, UK; EMA Pharmacokinetics Working Party, UK
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O'Sullivan J, McCarrick C, Tierney P, O'Connor DB, Collins J, Franklin R. Identification of Informed Consent in Patient Videos on Social Media: Prospective Study. JMIR Med Educ 2020; 6:e14081. [PMID: 33048058 PMCID: PMC7592068 DOI: 10.2196/14081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 02/26/2020] [Accepted: 03/19/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The American Medical Association Code of Medical Ethics states that any clinical image taken for public education forms part of the patient's records. Hence, a patient's informed consent is required to collect, share, and distribute their image. Patients must be informed of the intended use of the clinical image and the intended audience as part of the informed consent. OBJECTIVE This paper aimed to determine whether a random selection of instructional videos containing footage of central venous catheter insertion on real patients on YouTube (Google LLC) would mention the presence of informed consent to post the video on social media. METHODS We performed a prospective evaluation by 2 separate researchers of the first 125 videos on YouTube with the search term "central line insertion." After duplicates were deleted and exclusion criteria applied, 41 videos of patients undergoing central line insertion were searched for reference to patient consent. In the case of videos of indeterminate consent status, the posters were contacted privately through YouTube to clarify the status of consent to both film and disseminate the video on social media. A period of 2 months was provided to respond to initial contact. Furthermore, YouTube was contacted to clarify company policy. The primary outcome was to determine if videos on YouTube were amended to include details of consent at 2 months postcontact. The secondary outcome was a response to the initial email at 2 months. RESULTS The researchers compiled 143 videos. Of 41 videos that contained footage of patient procedures, 41 were of indeterminate consent status and 23 contained identifiable patient footage. From the 41 posters that were contacted, 3 responded to initial contact and none amended the video to document consent status. Response from YouTube is pending. CONCLUSIONS There are instructional videos for clinicians on social media that contain footage of patients undergoing medical procedures and do not have any verification of informed consent. While this study investigated a small sample of available videos, the problem appears ubiquitous and should be studied more extensively.
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Affiliation(s)
- Jane O'Sullivan
- Department of Anaesthesia, Letterkenny University Hospital, Donegal, Ireland
| | | | - Paul Tierney
- Department of Anatomy, Trinity College Dublin, Dublin, Ireland
| | - Donal B O'Connor
- Professorial Surgical Unit, Tallaght University Hospital & Trinity College Dublin, Dublin, Ireland
| | - Jack Collins
- Department of Anaesthesia, Letterkenny University Hospital, Donegal, Ireland
| | - Robert Franklin
- Department of Anaesthesia, Letterkenny University Hospital, Donegal, Ireland
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Brennan K, Martin K, FitzGerald SP, O'Sullivan J, Wu Y, Blanco A, Richardson C, Mc Gee MM. A comparison of methods for the isolation and separation of extracellular vesicles from protein and lipid particles in human serum. Sci Rep 2020; 10:1039. [PMID: 31974468 PMCID: PMC6978318 DOI: 10.1038/s41598-020-57497-7] [Citation(s) in RCA: 406] [Impact Index Per Article: 101.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/16/2019] [Indexed: 12/31/2022] Open
Abstract
Extracellular vesicles (EVs) are nano-sized vesicles containing nucleic acid and protein cargo that are released from a multitude of cell types and have gained significant interest as potential diagnostic biomarkers. Human serum is a rich source of readily accessible EVs; however, the separation of EVs from serum proteins and non-EV lipid particles represents a considerable challenge. In this study, we compared the most commonly used isolation techniques, either alone or in combination, for the isolation of EVs from 200 µl of human serum and their separation from non-EV protein and lipid particles present in serum. The size and yield of particles isolated by each method was determined by nanoparticle tracking analysis, with the variation in particle size distribution being used to determine the relative impact of lipoproteins and protein aggregates on the isolated EV population. Purification of EVs from soluble protein was determined by calculating the ratio of EV particle count to protein concentration. Finally, lipoprotein particles co-isolated with EVs was determined by Western blot analysis of lipoprotein markers APOB and APOE. Overall, this study reveals that the choice of EV isolation procedure significantly impacts EV yield from human serum, together with the presence of lipoprotein and protein contaminants.
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Affiliation(s)
- K Brennan
- UCD School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin (UCD), Belfield, Dublin, 4, Ireland.
| | - K Martin
- Randox Teoranta, Meenmore, Dungloe, Donegal, Ireland
| | - S P FitzGerald
- Randox Laboratories Ltd., Crumlin, Antrim, United Kingdom
| | - J O'Sullivan
- Trinity Translational Medicine Institute (TTMI), Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin, Ireland
| | - Y Wu
- UCD School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin (UCD), Belfield, Dublin, 4, Ireland
| | - A Blanco
- UCD Conway Flow Cytometry Core, Conway Institute, University College Dublin (UCD), Dublin, Ireland
| | - C Richardson
- Randox Teoranta, Meenmore, Dungloe, Donegal, Ireland
| | - M M Mc Gee
- UCD School of Biomolecular & Biomedical Science, Conway Institute, University College Dublin (UCD), Belfield, Dublin, 4, Ireland
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Morris P, Lal S, Dennis M, O'Sullivan J, Hunyor I, Grieve S, Bao S, Puranik R. 027 Unexplained Left Ventricular Late Gadolinium Enhancement (LGE) on Cardiac Magnetic Resonance (CMR) Confers an Adverse Prognosis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.034] [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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25
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Toxopeus E, Lynam-Lennon N, Biermann K, Dickens G, de Ruiter PE, van Lanschot J, Reynolds JV, Wijnhoven B, O'Sullivan J, van der Laan L. Tumor microRNA-126 controls cell viability and associates with poor survival in patients with esophageal adenocarcinoma. Exp Biol Med (Maywood) 2019; 244:1210-1219. [PMID: 31390899 DOI: 10.1177/1535370219868671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Esophageal adenocarcinoma displays a poor prognosis and current treatments are often not curative. Pathological TNM-stage is a prognostic parameter, but a better understanding of the pathophysiology of esophageal adenocarcinoma is needed to better predict survival. Recent work in other malignancies indicated an important role for the regulator microRNA-126 (miR-126) in tumors. The aim of this study was to investigate the function of miR-126 in esophageal adenocarcinoma and to correlate expression of miR-126 with tumor cell behavior and patient survival. Functional assays were performed in esophageal adenocarcinoma cell lines (OE33) in vitro by overexpressing or antagonizing miR-126 and assessing cellular processes linked to the hallmarks of cancer. In vivo pre-treatment biopsies of 58 patients with esophageal adenocarcinoma who underwent neoadjuvant chemoradiotherapy and surgery were analyzed for miR-126 expression in tumor cells by qRT-PCR and patient survival was analyzed by Kaplan–Meier and Cox regression. In OE33 cancer cells, stable overexpression of miR-126 modest though significantly altered expression of genes related to cell death (MEK1) and DNA repair (POLB and TERF1) was observed. Also the secretion of the angiogenic and pro-inflammatory factors, VEGF, IL-1β, and IL-6 were regulated by miR-126 ( P < 0.029). Importantly, miR-126 was found to be a regulator of cell viability in OE33 cells. Overexpressing ( P = 0.043) and antagonizing ( P = 0.035) miR-126 showed reciprocal effects on tumor cell viability and significantly regulated expression of pro- and anti-apoptotic genes, TP53, and GATA6 ( P < 0.031). In patients, high levels of miR-126 expression in pre-treatment tumors were significantly associated with poor survival ( P = 0.031). In multivariable analysis, high miR-126 ( P = 0.038) together with ypN-stage ( P = 0.048) were shown to be independent risk factors for poor survival. In conclusion, high expression of miR-126 in esophageal adenocarcinoma prevents tumor-cell death and is associated with poor patient survival. This study warrants further analysis of miR-126 as biomarker or potential therapeutic target for OAC. Impact statement Esophageal adenocarcinoma is a common form of cancer of the esophagus. It has an increasing health impact as it is associated with very poor patient survival. A better understanding of the pathophysiology of this cancer is needed to identify better treatment strategies and to provide a better prognosis for these patients. MicroRNAs have emerged as important molecular regulators of cancer cell viability and proliferation. The aim of our study was to investigate the role of one very well established microRNA, miR-126, in esophageal adenocarcinoma. Our research shows clear experimental evidence that miR-126 controls cell viability of esophageal adenocarcinoma cells. High (over)expression of miR-126 increased the viability of these cells. Our preclinical data were shown to be clinically relevant for this field of oncology. In an independent validation study of esophageal adenocarcinoma biopsies, we confirmed that high miR-126 expression in tumor cells was an independent risk factor for poor patient survival.
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Affiliation(s)
- Ela Toxopeus
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, GD Rotterdam 3015, the Netherlands
| | - N Lynam-Lennon
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin St. James's Hospital, Dublin 8, Dublin, Ireland
| | - K Biermann
- Department of Pathology, Erasmus MC, University Medical Centre Rotterdam, GD Rotterdam 3015, the Netherlands
| | - G Dickens
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, GD Rotterdam 3015, the Netherlands
| | - P E de Ruiter
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, GD Rotterdam 3015, the Netherlands
| | - Jjb van Lanschot
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, GD Rotterdam 3015, the Netherlands
| | - J V Reynolds
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin St. James's Hospital, Dublin 8, Dublin, Ireland
| | - Bpl Wijnhoven
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, GD Rotterdam 3015, the Netherlands
| | - J O'Sullivan
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin St. James's Hospital, Dublin 8, Dublin, Ireland
| | - Ljw van der Laan
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, GD Rotterdam 3015, the Netherlands
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Guinan EM, Bennett AE, Doyle SL, O'Neill L, Gannon J, Foley G, Elliott JA, O'Sullivan J, Reynolds JV, Hussey J. Measuring the impact of oesophagectomy on physical functioning and physical activity participation: a prospective study. BMC Cancer 2019; 19:682. [PMID: 31299920 PMCID: PMC6624943 DOI: 10.1186/s12885-019-5888-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 06/26/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Oesophagectomy remains the only curative intervention for oesophageal cancer, with defined nutritional and health-related quality of life (HR-QOL) consequences. It follows therefore that there is a significant risk of decline in physical wellbeing with oesophagectomy however this has been inadequately quantified. This study prospectively examines change in physical functioning and habitual physical activity participation, from pre-surgery through 6-months post-oesophagectomy. METHODS Patients scheduled for oesophagectomy with curative intent were recruited. Key domains of physical functioning including exercise tolerance (six-minute walk test (6MWT)) and muscle strength (hand-grip strength), and habitual physical activity participation, including sedentary behaviour (accelerometry) were measured pre-surgery (T0) and repeated at 1-month (T1) and 6-months (T2) post-surgery. HR-QOL was measured using the EORTC-QOL C30. RESULTS Thirty-six participants were studied (mean age 62.4 (8.8) years, n = 26 male, n = 26 transthoracic oesophagectomy). Mean 6MWT distance decreased significantly from T0 to T1 (p = 0.006) and returned to T0 levels between T1 and T2 (p < 0.001). Percentage time spent sedentary increased throughout recovery (p < 0.001) and remained significantly higher at T2 in comparison to T0 (p = 0.003). In contrast, percentage time spent engaged in either light or moderate-to-vigorous intensity activity, all reduced significantly (p < 0.001 for both) and remained significantly lower at T2 in comparison to T0 (p = 0.009 and p = 0.01 respectively). Patients reported deficits in multiple domains of HR-QOL during recovery including global health status (p = 0.04), physical functioning (p < 0.001) and role functioning (p < 0.001). Role functioning remained a clinically important 33-points lower than pre-operative values at T2. CONCLUSION Habitual physical activity participation remains significantly impaired at 6-months post-oesophagectomy. Physical activity is a measurable and modifiable target for physical rehabilitation, which is closely aligned with patient-reported deficits in role functioning. Rehabilitation aimed at optimising physical health in oesophageal cancer survivorship is warranted.
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Affiliation(s)
- E M Guinan
- School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - A E Bennett
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - S L Doyle
- School of Biological Sciences, Dublin Institute of Technology, Dublin, Ireland
| | - L O'Neill
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - J Gannon
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - G Foley
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - J A Elliott
- Department of Surgery, St. James' Hospital, Dublin, Ireland
| | - J O'Sullivan
- Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, Dublin, Ireland
| | - J V Reynolds
- Department of Surgery, St. James' Hospital, Dublin, Ireland.,Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, Dublin, Ireland
| | - J Hussey
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Vittery E, O'Sullivan J, Polyviou S, Coats L, Chaudhry B. Anatomical Details Should Accompany Studies of Hypoplastic Left Heart Syndrome. Pediatr Cardiol 2019; 40:1101-1102. [PMID: 31089756 DOI: 10.1007/s00246-019-02121-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 05/02/2019] [Indexed: 11/28/2022]
Affiliation(s)
- E Vittery
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
| | - J O'Sullivan
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.,Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
| | - S Polyviou
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK
| | - L Coats
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.,Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
| | - B Chaudhry
- Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
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28
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Alshehri A, O'Sullivan J, Prise K, Jain S, Turner P, Campfield C, Biggart S, Chatzigiannis C, Cole A. EP-2032 Automated Bone Scan Index (aBSI) as an Imaging Biomarker in Castration Sensitive Prostate Cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32452-1] [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: 10/26/2022]
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29
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Koay Y, Stanton K, Kienzle V, Celermajer D, O'Sullivan J. Of Mice and Men: Metabolic Effects of Chronic Exercise. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.550] [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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30
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O'Sullivan J, Collins J, Cooper D, Magdalina A, Meehan F, Kumar L, Quinlan J, O'Connor D, Fitzpatrick G. Optimisation of perioperative investigations among elective orthopaedic patients in a Dublin-based teaching hospital. J Perioper Pract 2018; 29:291-299. [PMID: 30565523 DOI: 10.1177/1750458918813254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The current National Institute for Health and Care Excellence guidelines, in accordance with the Association of Anaesthetists of Great Britain and Ireland guidelines, recommend the following haematological investigations for all patients undergoing major elective surgery: full blood count, renal profile and coagulation screen if clinically indicated. However, the guidelines fail to specify a time-interval for which normal blood results remain valid. Currently all patients in Ireland undergoing substantial elective surgery requiring general or regional anaesthetic have a preoperative assessment prior to the surgery. Patients have phlebotomy performed as part of this assessment. Patients admitted for elective surgery often have these bloods repeated on the morning of surgery. Objectives To determine if blood investigations taken over a one-year period prior to surgery can be used as a baseline for clinically stable patients undergoing elective surgery. Study design and methods All consecutive day of surgery admission patients >18 years of age undergoing elective orthopaedic surgery in Tallaght Hospital between 1 December 2014 and 1 December 2015 were identified using hospital records. Their blood results in the one-year period prior to surgery were compared to the blood results on the morning of surgery, using a McNemar’s test. A further clinical analysis was performed. Results There was no statistically significant change between blood results from three months prior to the surgery and the morning of surgery (P < 0.05). Furthermore, the blood results remained largely unchanged in the one year prior to surgery. No patient had the operation deferred due to aberrant blood results, following previously normal results prior to surgery. The potential cost-saving of omitting bloods is enormous. Conclusions There appears to be neither a statistical nor clinical benefit to repeating blood tests on the morning of surgery, following normal bloods <3 months in a clinically stable individual.
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Affiliation(s)
- Jane O'Sullivan
- 1 Department of Anaesthetics, Letterkenny University Hospital, Letterkenny, Ireland.,2 Tallaght University Hospital, Dublin, Ireland
| | - Jack Collins
- 1 Department of Anaesthetics, Letterkenny University Hospital, Letterkenny, Ireland.,2 Tallaght University Hospital, Dublin, Ireland
| | - David Cooper
- 3 Department of Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Ana Magdalina
- 4 Department of Statistics, University of Limerick, Limerick, Ireland
| | - Frances Meehan
- 5 Department of Anaesthetics, Tallaght University Hospital, Dublin, Ireland
| | - Lachmann Kumar
- 6 Department of Medicine, Tallaght University Hospital, Dublin, Ireland
| | - John Quinlan
- 7 Department of Orthopaedics, Tallaght University Hospital, Dublin, Ireland
| | - Donal O'Connor
- 3 Department of Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Gerry Fitzpatrick
- 5 Department of Anaesthetics, Tallaght University Hospital, Dublin, Ireland
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31
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Ryan SF, Adamson NL, Aktipis A, Andersen LK, Austin R, Barnes L, Beasley MR, Bedell KD, Briggs S, Chapman B, Cooper CB, Corn JO, Creamer NG, Delborne JA, Domenico P, Driscoll E, Goodwin J, Hjarding A, Hulbert JM, Isard S, Just MG, Kar Gupta K, López-Uribe MM, O'Sullivan J, Landis EA, Madden AA, McKenney EA, Nichols LM, Reading BJ, Russell S, Sengupta N, Shapiro LR, Shell LK, Sheard JK, Shoemaker DD, Sorger DM, Starling C, Thakur S, Vatsavai RR, Weinstein M, Winfrey P, Dunn RR. The role of citizen science in addressing grand challenges in food and agriculture research. Proc Biol Sci 2018; 285:20181977. [PMID: 30464064 PMCID: PMC6253361 DOI: 10.1098/rspb.2018.1977] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 10/30/2018] [Indexed: 11/12/2022] Open
Abstract
The power of citizen science to contribute to both science and society is gaining increased recognition, particularly in physics and biology. Although there is a long history of public engagement in agriculture and food science, the term 'citizen science' has rarely been applied to these efforts. Similarly, in the emerging field of citizen science, most new citizen science projects do not focus on food or agriculture. Here, we convened thought leaders from a broad range of fields related to citizen science, agriculture, and food science to highlight key opportunities for bridging these overlapping yet disconnected communities/fields and identify ways to leverage their respective strengths. Specifically, we show that (i) citizen science projects are addressing many grand challenges facing our food systems, as outlined by the United States National Institute of Food and Agriculture, as well as broader Sustainable Development Goals set by the United Nations Development Programme, (ii) there exist emerging opportunities and unique challenges for citizen science in agriculture/food research, and (iii) the greatest opportunities for the development of citizen science projects in agriculture and food science will be gained by using the existing infrastructure and tools of Extension programmes and through the engagement of urban communities. Further, we argue there is no better time to foster greater collaboration between these fields given the trend of shrinking Extension programmes, the increasing need to apply innovative solutions to address rising demands on agricultural systems, and the exponential growth of the field of citizen science.
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Affiliation(s)
- S F Ryan
- Department of Applied Ecology, NC State Extension, Raleigh, NC, USA
- Department of Entomology and Plant Pathology, University of Tennessee, Knoxville, TN, USA
| | - N L Adamson
- Xerces Society for Invertebrate Conservation/USDA NRCS ENTSC, Greensboro, NC, USA
| | - A Aktipis
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - L K Andersen
- Department of Applied Ecology, NC State Extension, Raleigh, NC, USA
| | - R Austin
- Department of Crop and Soil Sciences, NC State Extension, Raleigh, NC, USA
| | - L Barnes
- Lincoln Heights Environmental Connections Magnet Elementary School, Fuquay-Varina, NC, USA
| | - M R Beasley
- Knightdale High School of Collaborative Design, Knightdale, NC, USA
| | - K D Bedell
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S Briggs
- NC Plant Sciences Initiative, College of Agriculture and Life Sciences, NC State Extension, Raleigh, NC, USA
| | - B Chapman
- Department of Agricultural and Human Sciences, NC State Extension, Raleigh, NC, USA
| | - C B Cooper
- Department of Forestry and Environmental Resources, NC State Extension, Raleigh, NC, USA
| | - J O Corn
- William and Ida Friday Institute for Educational Innovation, NC State Extension, Raleigh, NC, USA
| | - N G Creamer
- Department of Horticultural Science, NC State Extension, Raleigh, NC, USA
| | - J A Delborne
- Department of Forestry and Environmental Resources, NC State Extension, Raleigh, NC, USA
| | - P Domenico
- Curriculum Enhancement Programs at Wake County Public School System, Cary, NC, USA
| | - E Driscoll
- Department of Horticultural Science, NC State Extension, Raleigh, NC, USA
| | - J Goodwin
- Department of Communication, NC State Extension, Raleigh, NC, USA
| | - A Hjarding
- North Carolina Wildlife Federation, Charlotte, NC, USA
- The University of North Carolina at Charlotte, Charlotte, NC, USA
| | - J M Hulbert
- Forestry and Agricultural Biotechnology Institute, University of Pretoria, Pretoria, South Africa
| | - S Isard
- Department of Plant Pathology and Environmental Microbiology, Pennsylvania State University, State College, PA, USA
- Department of Meteorology and Atmospheric Sciences, Pennsylvania State University, State College, PA, USA
| | - M G Just
- Department of Entomology and Plant Pathology, NC State Extension, Raleigh, NC, USA
| | - K Kar Gupta
- Biodiversity Lab, North Carolina Museum of Natural Sciences, Raleigh, NC, USA
| | - M M López-Uribe
- Department of Entomology, Center for Pollinator Research, Pennsylvania State University, State College, PA, USA
| | - J O'Sullivan
- Center for Environmental Farming Systems, North Carolina A&T State University, Greensboro, NC, USA
| | - E A Landis
- Department of Biology, Tufts University, Medford, MA, USA
| | - A A Madden
- Department of Applied Ecology, NC State Extension, Raleigh, NC, USA
| | - E A McKenney
- Department of Applied Ecology, NC State Extension, Raleigh, NC, USA
- Research and Collections, North Carolina Museum of Natural Sciences, Raleigh, NC, USA
| | - L M Nichols
- Department of Applied Ecology, NC State Extension, Raleigh, NC, USA
| | - B J Reading
- Department of Applied Ecology, NC State Extension, Raleigh, NC, USA
| | - S Russell
- Millbrook Environmental Connections Magnet Elementary School, Raleigh, NC, USA
| | - N Sengupta
- Consultant - Biodiversity Conservation & Sustainable Development, Auroville, Tamil Nadu, India
| | - L R Shapiro
- Department of Applied Ecology, NC State Extension, Raleigh, NC, USA
| | - L K Shell
- Research and Collections, North Carolina Museum of Natural Sciences, Raleigh, NC, USA
| | - J K Sheard
- Center for Macroecology, Evolution and Climate, Natural History Museum of Denmark, Copenhagen University, Copenhagen, Denmark
| | - D D Shoemaker
- Department of Entomology and Plant Pathology, University of Tennessee, Knoxville, TN, USA
| | - D M Sorger
- Department of Applied Ecology, NC State Extension, Raleigh, NC, USA
- Research and Collections, North Carolina Museum of Natural Sciences, Raleigh, NC, USA
| | - C Starling
- Heritage High School, Wake Forest, NC, USA
| | - S Thakur
- College of Veterinary Medicine, NC State Extension, Raleigh, NC, USA
| | - R R Vatsavai
- Department of Computer Science, NC State Extension, Raleigh, NC, USA
| | - M Weinstein
- Evaluation and Accountability Coordinator Extension Administration, NC State Extension, Raleigh, NC, USA
| | - P Winfrey
- Arizona State University Biodesign Institute, Tempe, AZ, USA
| | - R R Dunn
- Department of Applied Ecology, NC State Extension, Raleigh, NC, USA
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Gonzalez-Fernandez O, Jansen K, MacGowan G, Woods A, Robinson-Smith N, Tovey S, Hasan A, Coats L, Crossland D, O'Sullivan J, Schueler S. P711Ventricular assist devices for failing systemic right ventricle in adults with prior atrial switch procedure and congenitally corrected transposition of the great arteries:responders vs non responders. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - K Jansen
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
| | - G MacGowan
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
| | - A Woods
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
| | - N Robinson-Smith
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
| | - S Tovey
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
| | - A Hasan
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
| | - L Coats
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
| | - D Crossland
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
| | - J O'Sullivan
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
| | - S Schueler
- Freeman Hospital, Cardiothoracic, Newcastle upon Tyne, United Kingdom
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Abstract
Haemorrhage remains a leading cause of maternal death. We conducted an audit to identify strategies to improve the management at our local NHS Trust. A data collection form was based on our local guideline. A coded database search was conducted for all deliveries where the estimated blood loss was ≥2000 ml (from June 1 2015 to December 31 2015), returning 68 search results (13.7/1000 births). Fifty-six records were included. Poor compliance (<75%) was seen in some key areas including the major obstetric haemorrhage (MOH) call activation (52%), the presence of an anaesthetic consultant (63%) and tranexamic acid administration (46%). Thirty out of 56 cases (54%) were acutely transfused. Women, who were not transfused acutely, appeared to be more likely to need a secondary transfusion if no MOH call had been activated (9/27 (33%) versus 3/29 (10%), p = .052). A key area for improvement was the activation of MOH calls. Following this audit, we adjusted our guideline to make it more clinically useful and staff training sessions were held, including simulation training. Impact statement What is already known on this subject? A postpartum haemorrhage (PPH) is an obstetric emergency. A structured approach is important to optimise the care of the mothers during this dangerous time, and has been shown to reduce the transfusion requirements. However, clinical practice may not adhere to the guideline recommendations. What the results of this study add? With the objective evidence of increased rates of PPH ≥2000 ml at our institution, our work identifying the flaws in management was a critical component of the work to improve the outcomes. This study gives impetus to find innovative ways to improve adherence to guidelines, and inspired an update of our local guideline to improve the applicability and utility. This project suggests a new marker for the adequacy of an acute management (a requirement for secondary blood transfusion without having received an acute transfusion), and raises questions about what constitutes optimum PPH management. What the implications are of these findings for clinical practice and/or further research? The primary and secondary transfusion data raised new questions to investigate in the future: does the involvement of consultants and the escalation of care via the instigation of major haemorrhage protocols improve decision-making and patient outcomes? Does the necessity for a secondary transfusion indicate a suboptimal acute care?
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Affiliation(s)
- J O'Sullivan
- a Merton College, University of Oxford , Oxford , UK
| | - R Mansfield
- b Magdalen College, University of Oxford , Oxford , UK
| | - R Talbot
- c Department of Obstetrics and Gynaecology , Oxford University Hospitals NHS Foundation Trust, Women's Centre , Oxford , UK
| | - A E Cairns
- d Nuffield Department of Primary Care Health Sciences , University of Oxford, Radcliffe Primary Care, Radcliffe Observatory Quarter , Oxford , UK
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Sydes MR, Spears MR, Mason MD, Clarke NW, Dearnaley DP, de Bono JS, Attard G, Chowdhury S, Cross W, Gillessen S, Malik ZI, Jones R, Parker CC, Ritchie AWS, Russell JM, Millman R, Matheson D, Amos C, Gilson C, Birtle A, Brock S, Capaldi L, Chakraborti P, Choudhury A, Evans L, Ford D, Gale J, Gibbs S, Gilbert DC, Hughes R, McLaren D, Lester JF, Nikapota A, O'Sullivan J, Parikh O, Peedell C, Protheroe A, Rudman SM, Shaffer R, Sheehan D, Simms M, Srihari N, Strebel R, Sundar S, Tolan S, Tsang D, Varughese M, Wagstaff J, Parmar MKB, James ND. Adding abiraterone or docetaxel to long-term hormone therapy for prostate cancer: directly randomised data from the STAMPEDE multi-arm, multi-stage platform protocol. Ann Oncol 2018; 29:1235-1248. [PMID: 29529169 PMCID: PMC5961425 DOI: 10.1093/annonc/mdy072] [Citation(s) in RCA: 175] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Adding abiraterone acetate with prednisolone (AAP) or docetaxel with prednisolone (DocP) to standard-of-care (SOC) each improved survival in systemic therapy for advanced or metastatic prostate cancer: evaluation of drug efficacy: a multi-arm multi-stage platform randomised controlled protocol recruiting patients with high-risk locally advanced or metastatic PCa starting long-term androgen deprivation therapy (ADT). The protocol provides the only direct, randomised comparative data of SOC + AAP versus SOC + DocP. Method Recruitment to SOC + DocP and SOC + AAP overlapped November 2011 to March 2013. SOC was long-term ADT or, for most non-metastatic cases, ADT for ≥2 years and RT to the primary tumour. Stratified randomisation allocated pts 2 : 1 : 2 to SOC; SOC + docetaxel 75 mg/m2 3-weekly×6 + prednisolone 10 mg daily; or SOC + abiraterone acetate 1000 mg + prednisolone 5 mg daily. AAP duration depended on stage and intent to give radical RT. The primary outcome measure was death from any cause. Analyses used Cox proportional hazards and flexible parametric models, adjusted for stratification factors. This was not a formally powered comparison. A hazard ratio (HR) <1 favours SOC + AAP, and HR > 1 favours SOC + DocP. Results A total of 566 consenting patients were contemporaneously randomised: 189 SOC + DocP and 377 SOC + AAP. The patients, balanced by allocated treatment were: 342 (60%) M1; 429 (76%) Gleason 8-10; 449 (79%) WHO performance status 0; median age 66 years and median PSA 56 ng/ml. With median follow-up 4 years, 149 deaths were reported. For overall survival, HR = 1.16 (95% CI 0.82-1.65); failure-free survival HR = 0.51 (95% CI 0.39-0.67); progression-free survival HR = 0.65 (95% CI 0.48-0.88); metastasis-free survival HR = 0.77 (95% CI 0.57-1.03); prostate cancer-specific survival HR = 1.02 (0.70-1.49); and symptomatic skeletal events HR = 0.83 (95% CI 0.55-1.25). In the safety population, the proportion reporting ≥1 grade 3, 4 or 5 adverse events ever was 36%, 13% and 1% SOC + DocP, and 40%, 7% and 1% SOC + AAP; prevalence 11% at 1 and 2 years on both arms. Relapse treatment patterns varied by arm. Conclusions This direct, randomised comparative analysis of two new treatment standards for hormone-naïve prostate cancer showed no evidence of a difference in overall or prostate cancer-specific survival, nor in other important outcomes such as symptomatic skeletal events. Worst toxicity grade over entire time on trial was similar but comprised different toxicities in line with the known properties of the drugs. Trial registration Clinicaltrials.gov: NCT00268476.
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Affiliation(s)
- M R Sydes
- MRC Clinical Trials Unit at UCL, London.
| | | | | | - N W Clarke
- Christie and Royal Salford Hospital, Manchester
| | | | | | - G Attard
- UCL Cancer Institute, University College London, London
| | - S Chowdhury
- Guy's & St Thomas NHS, Foundation Trust, London
| | - W Cross
- St James University Hospital, Leeds, UK
| | - S Gillessen
- Division of Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen; University of Bern, Bern; Swiss Group for Cancer Clinical Research (SAKK), Bern, Switzerland
| | - Z I Malik
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - R Jones
- Institute of Cancer Sciences, University of Glasgow, Glasgow; Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow
| | - C C Parker
- Institute of Cancer Research, Sutton; Royal Marsden Hospital, Sutton
| | | | - J M Russell
- Institute of Cancer Sciences, University of Glasgow, Glasgow; Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow
| | - R Millman
- MRC Clinical Trials Unit at UCL, London
| | - D Matheson
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton
| | - C Amos
- MRC Clinical Trials Unit at UCL, London
| | - C Gilson
- MRC Clinical Trials Unit at UCL, London
| | - A Birtle
- Rosemere Cancer Centre, Royal Preston Hospital, Preston
| | - S Brock
- Dorset Cancer Centre, Poole Hospital, Poole
| | - L Capaldi
- Worcestershire Acute Hospitals NHS Trust, Worcester
| | | | - A Choudhury
- Division of Cancer Sciences, University of Manchester, Manchester; Manchester Academic Health Science Centre, Manchester; Christie Hospital NHS Foundation Trust, Manchester
| | - L Evans
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - D Ford
- City Hospital, Cancer Centre at Queen Elizabeth Hospital, Birmingham
| | - J Gale
- Portsmouth Oncology Centre, Queen Alexandra Hospital, Portsmouth
| | | | - D C Gilbert
- Sussex Cancer Centre, Royal Sussex County Hospital, Brighton
| | - R Hughes
- Mount Vernon Group, Mount Vernon Hospital, Middlesex
| | | | | | | | - J O'Sullivan
- Centre for Cancer Research and Cell Biology, Queens University Belfast, Belfast; Belfast City Hospital, Belfast
| | - O Parikh
- Lancashire Teaching Hospitals NHS Trust, Preston
| | - C Peedell
- Department of Oncology & Radiotherapy, South Tees NHS Trust, Middlesbrough
| | - A Protheroe
- Oxford University Hospitals NHS Foundation Trust
| | - S M Rudman
- Guy's & St Thomas NHS, Foundation Trust, London
| | - R Shaffer
- Department of Oncology, Royal Surrey County Hospital, Guildford
| | - D Sheehan
- Royal Devon and Exeter Hospital, Exeter
| | - M Simms
- Hull & East Yorkshire Hospitals NHS Trust, Hull
| | - N Srihari
- Shrewsbury and Telford Hospitals NHS Trust, Shrewsbury, UK
| | - R Strebel
- Kantonsspital Graubünden, Chur; Swiss Group for Cancer Clinical Research (SAKK), Bern, Switzerland
| | - S Sundar
- Department of Oncology, Nottingham, University Hospitals NHS Trust, Nottingham
| | - S Tolan
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool
| | - D Tsang
- Southend Hospital, Southend-on-Sea
| | - M Varughese
- Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust
| | - J Wagstaff
- Swansea University College of Medicine, Swansea
| | | | - N D James
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, UK
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Demain LAM, Antunes D, O'Sullivan J, Bhaskhar SS, O'Keefe RT, Newman WG. A known pathogenic variant in the essential mitochondrial translation gene RMND1 causes a Perrault-like syndrome with renal defects. Clin Genet 2018; 94:276-277. [PMID: 29671881 DOI: 10.1111/cge.13255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 12/01/2022]
Affiliation(s)
- L A M Demain
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Manchester, UK.,Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - D Antunes
- Medical Genetics Department, Hospital de Dona Estefânia, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - J O'Sullivan
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Manchester, UK.,Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - S S Bhaskhar
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Manchester, UK.,Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - R T O'Keefe
- Division of Cellular and Molecular Function, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - W G Newman
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Manchester, UK.,Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
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Hetherington S, Crowther K, Jain S, Mitchell D, O'Sullivan J, Shum L, Gilleece T. EP-2397: Therapeutic Radiographer follow up for prostate cancer patients. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32705-1] [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: 10/14/2022]
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Ladha C, Belshaw Z, O'Sullivan J, Asher L. A step in the right direction: an open-design pedometer algorithm for dogs. BMC Vet Res 2018; 14:107. [PMID: 29558919 PMCID: PMC5861607 DOI: 10.1186/s12917-018-1422-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accelerometer-based technologies could be useful in providing objective measures of canine ambulation, but most are either not tailored to the idiosyncrasies of canine gait, or, use un-validated or closed source approaches. The aim of this paper was to validate algorithms which could be applied to accelerometer data for i) counting the number of steps and ii) distance travelled by a dog. To count steps, an approach based on partitioning acceleration was used. This was applied to accelerometer data from 13 dogs which were walked a set distance and filmed. Each footfall captured on video was annotated. In a second experiment, an approach based on signal features was used to estimate distance travelled. This was applied to accelerometer data from 10 dogs with osteoarthritis during normal walks with their owners where GPS (Global Positioning System) was also captured. Pearson's correlations and Bland Altman statistics were used to compare i) the number of steps measured on video footage and predicted by the algorithm and ii) the distance travelled estimated by GPS and predicted by the algorithm. RESULTS Both step count and distance travelled could be estimated accurately by the algorithms presented in this paper: 4695 steps were annotated from the video and the pedometer was able to detect 91%. GPS logged a total of 20,184 m meters across all dogs; the mean difference between the predicted and GPS estimated walk length was 211 m and the mean similarity was 79%. CONCLUSIONS The algorithms described show promise in detecting number of steps and distance travelled from an accelerometer. The approach for detecting steps might be advantageous to methods which estimate gross activity because these include energy output from stationary activities. The approach for estimating distance might be suited to replacing GPS in indoor environments or others with limited satellite signal. The algorithms also allow for temporal and spatial components of ambulation to be calculated. Temporal and spatial aspects of dog ambulation are clinical indicators which could be used for diagnosis or monitoring of certain diseases, or used to provide information in support of canine weight-loss programmes.
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Affiliation(s)
- C Ladha
- Centre for Behaviour and Evolution, Henry Wellcome Building, Newcastle University, Newcastle, NE2 4HH, UK. .,, VetSens. 53 Wellburn Park, Jesmond, Newcastle, NE2 2JY, UK.
| | - Z Belshaw
- School of Veterinary Medicine and Science, University of Nottingham, Sutton, Bonington Campus, Leicestershire, LE12 5RD, UK
| | - J O'Sullivan
- Centre for Behaviour and Evolution, Henry Wellcome Building, Newcastle University, Newcastle, NE2 4HH, UK
| | - L Asher
- Centre for Behaviour and Evolution, Henry Wellcome Building, Newcastle University, Newcastle, NE2 4HH, UK
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Jain S, Lyons C, Walker S, McQuaid S, Hynes S, Mitchell D, Pang B, Logan G, McCavigan A, O'Rourke D, Davidson C, Knight L, Berge V, Neal D, Pandha H, Harkin P, James J, Kennedy R, O'Sullivan J, Waugh D. A Metastatic Biology Gene Expression Assay to Predict the Risk of Distant Metastases in Patients With Localized Prostate Cancer Treated With Primary Radical Treatment. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Holmes O, Gratton J, Szanto J, Vandervoort E, Doody J, Henderson E, Morgan S, O'Sullivan J, Malone S. Reducing Errors in Prostate Tracking with an Improved Fiducial Implantation Protocol for Stereotactic Body Radiotherapy (SBRT). Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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40
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James N, de Bono J, Spears M, Clarke N, Mason M, Dearnaley D, Ritchie A, Russell M, Gilson C, Jones R, Gillessen S, Matheson D, Aung S, Birtle A, Chowdhury S, Gale J, Malik Z, O'Sullivan J, Parmar M, Sydes M. Adding abiraterone for patients (pts) with high-risk prostate cancer (PCa) starting long-term androgen deprivation therapy (ADT): Outcomes in non-metastatic (M0) patients from STAMPEDE (NCT00268476). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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41
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Crucean A, Alqahtani A, Barron DJ, Brawn WJ, Richardson RV, O'Sullivan J, Anderson RH, Henderson DJ, Chaudhry B. Re-evaluation of hypoplastic left heart syndrome from a developmental and morphological perspective. Orphanet J Rare Dis 2017; 12:138. [PMID: 28793912 PMCID: PMC5551014 DOI: 10.1186/s13023-017-0683-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/07/2017] [Indexed: 12/27/2022] Open
Abstract
Background Hypoplastic left heart syndrome (HLHS) covers a spectrum of rare congenital anomalies characterised by a non-apex forming left ventricle and stenosis/atresia of the mitral and aortic valves. Despite many studies, the causes of HLHS remain unclear and there are conflicting views regarding the role of flow, valvar or myocardial abnormalities in its pathogenesis, all of which were proposed prior to the description of the second heart field. Our aim was to re-evaluate the patterns of malformation in HLHS in relation to recognised cardiac progenitor populations, with a view to providing aetiologically useful sub-groupings for genomic studies. Results We examined 78 hearts previously classified as HLHS, with subtypes based on valve patency, and re-categorised them based on their objective ventricular phenotype. Three distinct subgroups could be identified: slit-like left ventricle (24%); miniaturised left ventricle (6%); and thickened left ventricle with endocardial fibroelastosis (EFE; 70%). Slit-like ventricles were always found in combination with aortic atresia and mitral atresia. Miniaturised left ventricles all had normally formed, though smaller aortic and mitral valves. The remaining group were found to have a range of aortic valve malformations associated with thickened left ventricular walls despite being described as either atresia or stenosis. The degree of myocardial thickening was not correlated to the degree of valvar stenosis. Lineage tracing in mice to investigate the progenitor populations that form the parts of the heart disrupted by HLHS showed that whereas Nkx2–5-Cre labelled myocardial and endothelial cells within the left and right ventricles, Mef2c-AHF-Cre, which labels second heart field-derived cells only, was largely restricted to the endocardium and myocardium of the right ventricle. However, like Nkx2–5-Cre, Mef2c-AHF-Cre lineage cells made a significant contribution to the aortic and mitral valves. In contrast, Wnt1-Cre made a major contribution only to the aortic valve. This suggests that discrete cardiac progenitors might be responsible for the patterns of defects observed in the distinct ventricular sub-groups. Conclusions Only the slit-like ventricle grouping was found to map to the current nomenclature: the combination of mitral atresia with aortic atresia. It appears that slit-like and miniature ventricles also form discrete sub-groups. Thus, reclassification of HLHS into subgroups based on ventricular phenotype, might be useful in genetic and developmental studies in investigating the aetiology of this severe malformation syndrome.
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Affiliation(s)
- A Crucean
- Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, B4 6NH, UK
| | - A Alqahtani
- Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK
| | - D J Barron
- Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, B4 6NH, UK
| | - W J Brawn
- Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, B4 6NH, UK
| | - R V Richardson
- Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK
| | - J O'Sullivan
- Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.,Department of Congenital Cardiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, UK
| | - R H Anderson
- Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK
| | - D J Henderson
- Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK
| | - B Chaudhry
- Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.
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Schultz R, Kochmann K, O'Sullivan J. Response to Editorial: Children, poverty and health promotion in Australia. Health Promot J Austr 2017; 28:174. [PMID: 28614693 DOI: 10.1071/he17032] [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] [Received: 03/29/2017] [Accepted: 04/28/2017] [Indexed: 11/23/2022] Open
Affiliation(s)
- Rosalie Schultz
- Centre for Remote Health, Flinders University, PO Box 4066, Alice Springs, NT 0871, Australia
| | | | - Jane O'Sullivan
- School of Agriculture and Food Sciences, Faculty of Science, University of Queensland, St Lucia, Qld 4072, Australia
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Jain S, Lyons C, Walker S, McQuaid S, Hynes S, Mitchell D, Pang B, Logan G, McCavigan A, O'Rourke D, Davidson C, Knight L, Sheriff A, Berge V, Neal D, Pandha H, Watson R, Mason M, Kay E, Harkin D, James J, Salto-Tellez M, Kennedy R, O'Sullivan J, Waugh D. OC-0126: A gene expression assay to predict the risk of distant metastases in localized prostate cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30569-8] [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: 10/19/2022]
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O'Sullivan J, Hintze JM, Molony P, O'Connor DB, Conlan KC. A tenebrous tale: malignant melanoma of the oesophagus. BMJ Case Rep 2017; 2017:bcr-2016-217908. [PMID: 28438755 DOI: 10.1136/bcr-2016-217908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 57-year-old man presented with a 4-month history of worsening symptoms of oesophageal obstruction. The physical examination was unremarkable. An oesophagogastroduodenoscopy revealed an exophytic tumour in the distal oesophagus. A biopsy demonstrated malignant melanoma. Staging of the melanoma showed disseminated lymph node and bony-spine metastases. He had no prior history of cutaneous or ocular melanoma. Following full multidisciplinary team input, he was palliated with a metal mesh stent and immunotherapy. He died 3 months later following community management.
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Affiliation(s)
- Jane O'Sullivan
- Department of Surgery, Tallaght Hospital, Tallaght D24, Ireland
| | - Justin Matthias Hintze
- Department of Surgery, Tallaght Hospital, Tallaght D24, Ireland.,Center for Regenerative Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Peter Molony
- Department of Pathology, Tallaght Hospital, Tallaght D24, Ireland
| | - Donal B O'Connor
- University of Dublin Trinity College, Dublin, Ireland.,Professorial Surgical Unit, Tallaght Hospital, Tallaght D24, Ireland
| | - Kevin C Conlan
- University of Dublin Trinity College, Dublin, Ireland.,Professorial Surgical Unit, Tallaght Hospital, Tallaght D24, Ireland
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Garza-Cuartero L, O'Sullivan J, Blanco A, McNair J, Welsh M, Flynn RJ, Williams D, Diggle P, Cassidy J, Mulcahy G. Fasciola hepatica infection reduces Mycobacterium bovis burden and mycobacterial uptake and suppresses the pro-inflammatory response. Parasite Immunol 2017; 38:387-402. [PMID: 27108767 PMCID: PMC6680181 DOI: 10.1111/pim.12326] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 04/18/2016] [Indexed: 01/06/2023]
Abstract
Bovine tuberculosis (BTB), caused by Mycobacterium bovis, has an annual incidence in cattle of 0.5% in the Republic of Ireland and 4.7% in the UK, despite long‐standing eradication programmes being in place. Failure to achieve complete eradication is multifactorial, but the limitations of diagnostic tests are significant complicating factors. Previously, we have demonstrated that Fasciola hepatica infection, highly prevalent in these areas, induced reduced sensitivity of the standard diagnostic tests for BTB in animals co‐infected with F. hepatica and M. bovis. This was accompanied by a reduced M. bovis‐specific Th1 immune response. We hypothesized that these changes in co‐infected animals would be accompanied by enhanced growth of M. bovis. However, we show here that mycobacterial burden in cattle is reduced in animals co‐infected with F. hepatica. Furthermore, we demonstrate a lower mycobacterial recovery and uptake in blood monocyte‐derived macrophages (MDM) from F. hepatica‐infected cattle which is associated with suppression of pro‐inflammatory cytokines and a switch to alternative activation of macrophages. However, the cell surface expression of TLR2 and CD14 in MDM from F. hepatica‐infected cattle is increased. These findings reflecting the bystander effect of helminth‐induced downregulation of pro‐inflammatory responses provide insights to understand host‐pathogen interactions in co‐infection.
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Affiliation(s)
- L Garza-Cuartero
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - J O'Sullivan
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - A Blanco
- Conway Institute, University College Dublin, Dublin, Ireland
| | - J McNair
- Veterinary Sciences Division, Agri-Food and Biosciences Institute, Belfast, UK
| | - M Welsh
- CSO, SISAF, The Innovation Centre, Belfast, UK
| | - R J Flynn
- School of Veterinary Science, University of Nottingham, Nottingham, UK
| | - D Williams
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - P Diggle
- Division of Medicine, Lancaster University, Lancaster, UK
| | - J Cassidy
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - G Mulcahy
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland.,Conway Institute, University College Dublin, Dublin, Ireland
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McGarrigle SA, Guinan EM, Hussey J, O'Sullivan J, Boyle T, Hanhauser Y, Al-azawi D, Kennedy MJ, Gallagher DJ, Connolly EM. Abstract P3-09-02: Unhealthy lifestyle patterns are prevalent in unaffected BRCA mutation carriers & are associated with increased oxidative stress and telomere length alterations. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-09-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The lifetime-risk of breast-cancer is greatly increased in women carrying a deleterious mutation in the BRCA1 or BRCA2 genes. Recently, there has been increased penetrance of BRCA1 and BRCA2 mutations which may be due to lifestyle influences.
There is a need to identify approaches to reduce the penetrance of BRCA 1/2 mutations. Understanding how modifiable lifestyle-factors affect cancer-risk in BRCA-mutation carriers may have implications for risk-reduction in this group. At the molecular level, oxidative-stress and telomere dysfunction are early events in cancer development and these processes may be considered surrogate markers of cancer-risk. It has been reported that BRCA-mutation carriers are more susceptible to these pro-carcinogenic processes that non-carriers.
The aim of this pilot study was to objectively measure lifestyle factors in unaffected BRCA-mutation carriers and to assess the impact of these lifestyle-factors on oxidative-stress profiles and telomere length.
Participants (n=75) were recruited from breast-cancer family-risk clinics and cancer-genetics clinics. Body-composition (BMI, waist-circumference), metabolic profiles and physical-activity (triaxial accelerometry) were measured for each participant. Serum levels of the oxidative-stress markers 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxo-DG) and 4-hydroxynonenal (4-HNE) were measured in a subset of participants (n=30) by ELISA. Telomere length was measured in a subset of participants (n=30) by quantitative PCR (qPCR).
Participants demonstrated poor adherence to physical-activity guidelines with 94% not reaching physical-activity levels recommended by the American College of Sports Medicine. The majority of participants were overweight (39%) or obese (32%) with 73% exhibiting abdominal obesity. 21% of participants had the metabolic syndrome (MetS) at the time of study enrolment with the majority of participants (80%) presenting with at least one feature of the MetS. Circulating levels of 8-oxo-DG did not appear to be affected by body composition or MetS status, however, serum levels of the lipid peroxidation marker 4-HNE were significantly higher in participants with the MetS (p < 0.0001). Correlation of serum 4-HNE levels with individual features of the MetS and related parameters revealed significant direct correlations with waist circumference (p = 0.02), number of features of MetS (p = 0.0007), insulin (p = 0.02) insulin resistance score (HOMA-IR) (p = 0.01), HBA1c (p = 0.006), glucose (p = 0.048) and triglycerides (p <0.0001). Age-adjusted telomere length was not influenced by anthropometric measurements or MetS status in this group. Moderate physical activity levels were inversely associated with age-adjusted telomere length; particularly, among post-menopausal participants (p =0.009).
This work has provided compelling evidence that in this cohort of BRCA-mutation carriers, unhealthy lifestyle-patterns are prevalent. In addition, these results suggest that the potential may exist to modify pro-carcinogenic processes in this cohort by modifying physical activity levels and targeting the metabolic syndrome and its component features lifestyle interventions and/or medication.The lifetime-risk of breast-cancer is greatly increased in women carrying a deleterious mutation in the BRCA1 or BRCA2 genes. Recently, there has been increased penetrance of BRCA1 and BRCA2 mutations which may be due to lifestyle influences.
There is a need to identify approaches to reduce the penetrance of BRCA 1/2 mutations. Understanding how modifiable lifestyle-factors affect cancer-risk in BRCA-mutation carriers may have implications for risk-reduction in this group. At the molecular level, oxidative-stress and telomere dysfunction are early events in cancer development and these processes may be considered surrogate markers of cancer-risk. It has been reported that BRCA-mutation carriers are more susceptible to these pro-carcinogenic processes that non-carriers.
The aim of this pilot study was to objectively measure lifestyle factors in unaffected BRCA-mutation carriers and to assess the impact of these lifestyle-factors on oxidative-stress profiles and telomere length.
Participants (n=75) were recruited from breast-cancer family-risk clinics and cancer-genetics clinics. Body-composition (BMI, waist-circumference), metabolic profiles and physical-activity (triaxial accelerometry) were measured for each participant. Serum levels of the oxidative-stress markers 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxo-DG) and 4-hydroxynonenal (4-HNE) were measured in a subset of participants (n=30) by ELISA. Telomere length was measured in a subset of participants (n=30) by quantitative PCR (qPCR).
Participants demonstrated poor adherence to physical-activity guidelines with 94% not reaching physical-activity levels recommended by the American College of Sports Medicine. The majority of participants were overweight (39%) or obese (32%) with 73% exhibiting abdominal obesity. 21% of participants had the metabolic syndrome (MetS) at the time of study enrolment with the majority of participants (80%) presenting with at least one feature of the MetS. Circulating levels of 8-oxo-DG did not appear to be affected by body composition or MetS status, however, serum levels of the lipid peroxidation marker 4-HNE were significantly higher in participants with the MetS (p < 0.0001). Correlation of serum 4-HNE levels with individual features of the MetS and related parameters revealed significant direct correlations with waist circumference (p = 0.02), number of features of MetS (p = 0.0007), insulin (p = 0.02) insulin resistance score (HOMA-IR) (p = 0.01), HBA1c (p = 0.006), glucose (p = 0.048) and triglycerides (p <0.0001). Age-adjusted telomere length was not influenced by anthropometric measurements or MetS status in this group. Moderate physical activity levels were inversely associated with age-adjusted telomere length; particularly, among post-menopausal participants (p =0.009).
This work has provided compelling evidence that in this cohort of BRCA-mutation carriers, unhealthy lifestyle-patterns are prevalent. In addition, these results suggest that the potential may exist to modify pro-carcinogenic processes in this cohort by modifying physical activity levels and targeting the metabolic syndrome and its component features lifestyle interventions and/or medication.
Citation Format: McGarrigle SA, Guinan EM, Hussey J, O'Sullivan J, Boyle T, Hanhauser Y, Al-azawi D, Kennedy MJ, Gallagher DJ, Connolly EM. Unhealthy lifestyle patterns are prevalent in unaffected BRCA mutation carriers & are associated with increased oxidative stress and telomere length alterations [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 P3-09-02.
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Affiliation(s)
- SA McGarrigle
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
| | - EM Guinan
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
| | - J Hussey
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
| | - J O'Sullivan
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
| | - T Boyle
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
| | - Y Hanhauser
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
| | - D Al-azawi
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
| | - MJ Kennedy
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
| | - DJ Gallagher
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
| | - EM Connolly
- Trinity College Dublin, Dublin, Ireland; St. James's Hospital, Dublin, Ireland
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Wolsztynski E, O'Sullivan F, O'Sullivan J, Eary JF. Statistical assessment of treatment response in a cancer patient based on pre-therapy and post-therapy FDG-PET scans. Stat Med 2016; 36:1172-1200. [PMID: 27990685 DOI: 10.1002/sim.7198] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 07/28/2016] [Accepted: 11/20/2016] [Indexed: 12/12/2022]
Abstract
This work arises from consideration of sarcoma patients in which fluorodeoxyglucose positron emission tomography (FDG-PET) imaging pre-therapy and post-chemotherapy is used to assess treatment response. Our focus is on methods for evaluation of the statistical uncertainty in the measured response for an individual patient. The gamma distribution is often used to describe data with constant coefficient of variation, but it can be adapted to describe the pseudo-Poisson character of PET measurements. We propose co-registering the pre-therapy and post- therapy images and modeling the approximately paired voxel-level data using the gamma statistics. Expressions for the estimation of the treatment effect and its variability are provided. Simulation studies explore the performance in the context of testing for a treatment effect. The impact of misregistration errors and how test power is affected by estimation of variability using simplified sampling assumptions, as might be produced by direct bootstrapping, is also clarified. The results illustrate a marked benefit in using a properly constructed paired approach. Remarkably, the power of the paired analysis is maintained even if the pre-image and post- image data are poorly registered. A theoretical explanation for this is indicated. The methodology is further illustrated in the context of a series of fluorodeoxyglucose-PET sarcoma patient studies. These data demonstrate the additional prognostic value of the proposed treatment effect test statistic. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- E Wolsztynski
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | - F O'Sullivan
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | - J O'Sullivan
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | - J F Eary
- Department of Radiology, University of Alabama, Birmingham, U.S.A
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Heneghan C, Spencer EA, Bobrovitz N, Collins DRJ, Nunan D, Plüddemann A, Gbinigie OA, Onakpoya I, O'Sullivan J, Rollinson A, Tompson A, Goldacre B, Mahtani KR. Lack of evidence for interventions offered in UK fertility centres. BMJ 2016; 355:i6295. [PMID: 27890864 DOI: 10.1136/bmj.i6295] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Carl Heneghan
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - E A Spencer
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - N Bobrovitz
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - D R J Collins
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - D Nunan
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - A Plüddemann
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - O A Gbinigie
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - I Onakpoya
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - J O'Sullivan
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - A Rollinson
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - A Tompson
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - B Goldacre
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - K R Mahtani
- Centre for Evidence-Based Medicine, Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK
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O'Sullivan J, Cooper D, Kumar L, Collins J, O'Connor D, Fitzpatrick G. Optimizing preoperative investigations for elective surgical patients. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sultan S, Manecksha R, O'Sullivan J, Hynes N, Quill D, Courtney D. Survival of Ruptured Abdominal Aortic Aneurysms in the West of Ireland: Do Prognostic Indicators of Outcome Exist? Vasc Endovascular Surg 2016; 38:43-9. [PMID: 14760476 DOI: 10.1177/153857440403800105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ruptured abdominal aortic aneurysm (RAAA) is a demanding vascular surgical problem and the cause of significant morbidity and mortality. The aim of this study was to identify prognostic factors that influence outcome. Over 6 years, 42 ruptured abdominal aortic aneurysms were operated on with a mean diameter of 7.2 cm. RAAA was defined as free intraperitoneal rupture. Data were collected retrospectively from hospital medical records. The male:female ratio was 8:1 and the mean age was 74 years (range 55–89). Fifteen were in hypovolemic shock and 27 patients were clinically stable. The perioperative mortality rate for the 15 shocked patients was 60% (9 patients) and the 1-year cumulative survival rate was 33%. The perioperative mortality rate for the 27 clinically stable patients was 40% (11 patients) and the 1-year cumulative survival rate was 56%. Survival curves were constructed for these groups to compare male versus female, age =70 versus age <70, shocked versus stable, and preoperative hemoglobin (Hb) =10 vs >10. No patient with preoperative cardiac arrest survived more than 24 hours. With VassarStats, the confidence interval for age, gender, hemodynamic status, and preoperative Hb were calculated. The standard weighted mean analysis by ANOVA gave a p value of <0.001. The overall 30-day mortality rate was 47% (20 of 42) and the 1-year mortality rate was 52% (22 of 42). Male patients over 70 years with RAAA in hypovolemic shock with low Hb have a higher 30-day mortality rate and few survive more than 1 year. The study suggests that each of these 4 parameters separately was not a strong prognostic indicator. Collectively, however, they strongly influence the prognosis of patients with RAAA. These findings strengthen the case for selective treatment for RAAA.
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Affiliation(s)
- S Sultan
- Western Vascular Institute, Department of Vascular and Endovascular Surgery, University College Hospital, Galway, Republic of Ireland.
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