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Rana D, Westrop S, Jaiswal N, Germeni E, McGarty A, Ells L, Lally P, McEwan M, Melville C, Harris L, Wu O. Lifestyle modification interventions for adults with intellectual disabilities: systematic review and meta-analysis at intervention and component levels. J Intellect Disabil Res 2024; 68:387-445. [PMID: 38414293 DOI: 10.1111/jir.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Adults with intellectual disabilities (IDs) are susceptible to multiple health risk behaviours such as alcohol consumption, smoking, low physical activity, sedentary behaviour and poor diet. Lifestyle modification interventions can prevent or reduce negative health consequences caused by these behaviours. We aim to determine the effectiveness of lifestyle modification interventions and their components in targeting health risk behaviours in adults with IDs. METHODS A systematic review and meta-analysis were conducted. Electronic databases, clinical trial registries, grey literature and citations of systematic reviews and included studies were searched in January 2021 (updated February 2022). Randomised controlled trials and non-randomised controlled trials targeting alcohol consumption, smoking, low physical activity, sedentary behaviours and poor diet in adults (aged ≥ 18 years) with ID were included. Meta-analysis was conducted at the intervention level (pairwise and network meta-analysis) and the component-level (component network meta-analysis). Studies were coded using Michie's 19-item theory coding scheme and 94-item behaviour change taxonomies. Risk of bias was assessed using the Cochrane Risk of Bias (ROB) Version 2 and Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I). The study involved a patient and public involvement (PPI) group, including people with lived experience, who contributed extensively by shaping the methodology, providing valuable insights in interpreting results and organising of dissemination events. RESULTS Our literature search identified 12 180 articles, of which 80 studies with 4805 participants were included in the review. The complexity of lifestyle modification intervention was dismantled by identifying six core components that influenced outcomes. Interventions targeting single or multiple health risk behaviours could have a single or combination of multiple core-components. Interventions (2 RCTS; 4 non-RCTs; 228 participants) targeting alcohol consumption and smoking behaviour were effective but based on limited evidence. Similarly, interventions targeting low physical activity only (16 RCTs; 17 non-RCTs; 1413 participants) or multiple behaviours (low physical activity only, sedentary behaviours and poor diet) (17 RCTs; 24 non-RCTs; 3164 participants) yielded mixed effectiveness in outcomes. Most interventions targeting low physical activity only or multiple behaviours generated positive effects on various outcomes while some interventions led to no change or worsened outcomes, which could be attributed to the presence of a single core-component or a combination of similar core components in interventions. The intervention-level meta-analysis for weight management outcomes showed that none of the interventions were associated with a statistically significant change in outcomes when compared with treatment-as-usual and each other. Interventions with core-components combination of energy deficit diet, aerobic exercise and behaviour change techniques showed the highest weight loss [mean difference (MD) = -3.61, 95% credible interval (CrI) -9.68 to 1.95] and those with core-components combination dietary advice and aerobic exercise showed a weight gain (MD 0.94, 95% CrI -3.93 to 4.91). Similar findings were found with the component network meta-analysis for which additional components were identified. Most studies had a high and moderate risk of bias. Various theories and behaviour change techniques were used in intervention development and adaptation. CONCLUSION Our systematic review is the first to comprehensively explore lifestyle modification interventions targeting a range of single and multiple health risk behaviours in adults with ID, co-produced with people with lived experience. It has practical implications for future research as it highlights the importance of mixed-methods research in understanding lifestyle modification interventions and the need for population-specific improvements in the field (e.g., tailored interventions, development of evaluation instruments or tools, use of rigorous research methodologies and comprehensive reporting frameworks). Wide dissemination of related knowledge and the involvement of PPI groups, including people with lived experience, will help future researchers design interventions that consider the unique needs, desires and abilities of people with ID.
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Affiliation(s)
- D Rana
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - S Westrop
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Mental Health and Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Jaiswal
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - E Germeni
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A McGarty
- Mental Health and Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Ells
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
| | - P Lally
- UCL Institute of Epidemiology and Health Care, University College London, London, UK
- Department of Psychology, University of Surrey, Guildford, UK
| | - M McEwan
- People First (Scotland), Edinburgh, UK
| | - C Melville
- Mental Health and Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Harris
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - O Wu
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Westrop SC, Rana D, Jaiswal N, Wu O, McGarty AM, Melville C, Ells L, Lally P, McEwan M, Harris L, Germeni E. Supporting active engagement of adults with intellectual disabilities in lifestyle modification interventions: a realist evidence synthesis of what works, for whom, in what context and why. J Intellect Disabil Res 2024; 68:293-316. [PMID: 38379511 DOI: 10.1111/jir.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 11/10/2023] [Accepted: 12/19/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Lifestyle modification interventions for adults with intellectual disabilities have had, to date, mixed effectiveness. This study aimed to understand how lifestyle modification interventions for adults with intellectual disabilities work, for whom they work and in what circumstances. METHODS A realist evidence synthesis was conducted that incorporated input from adults with intellectual disabilities and expert researchers. Following the development of an initial programme theory based on key literature and input from people with lived experience and academics working in this field, five major databases (MEDLINE, EMBASE, CINAHL, PsycINFO and ASSIA) and clinical trial repositories were systematically searched. Data from 79 studies were synthesised to develop context, mechanism and outcome configurations (CMOCs). RESULTS The contexts and mechanisms identified related to the ability of adults with intellectual disabilities to actively take part in the intervention, which in turn contributes to what works, for whom and in what circumstances. The included CMOCs related to support involvement, negotiating the balance between autonomy and behaviour change, fostering social connectedness and fun, accessibility and suitability of intervention strategies and delivery and broader behavioural pathways to lifestyle change. It is also essential to work with people with lived experiences when developing and evaluating interventions. CONCLUSIONS Future lifestyle interventions research should be participatory in nature, and accessible data collection methods should also be explored as a way of including people with severe and profound intellectual disabilities in research. More emphasis should be given to the broader benefits of lifestyle change, such as opportunities for social interaction and connectedness.
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Affiliation(s)
- S C Westrop
- Mental Health and Wellbeing, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - D Rana
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Jaiswal
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - O Wu
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A M McGarty
- Mental Health and Wellbeing, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - C Melville
- Mental Health and Wellbeing, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - L Ells
- Obesity Institute, School of Health, Leeds Beckett University, City Campus, Leeds, UK
| | - P Lally
- UCL Institute of Epidemiology and Health Care, University College London, London, UK
- Department of Psychology, University of Surrey, Guildford, UK
| | - M McEwan
- People First (Scotland), Edinburgh, UK
| | - L Harris
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - E Germeni
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Saha K, Subramenium Ganapathy A, Wang A, Arumugam P, Michael Morris N, Harris L, Yochum G, Koltun W, Perdew GH, Nighot M, Ma T, Nighot P. Alpha-tocopherylquinone-mediated activation of the Aryl Hydrocarbon Receptor regulates the production of inflammation-inducing cytokines and ameliorates intestinal inflammation. Mucosal Immunol 2023; 16:826-842. [PMID: 37716509 PMCID: PMC10809159 DOI: 10.1016/j.mucimm.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/18/2023]
Abstract
This study investigated the role of Alpha-tocopherylquinone (TQ) in regulating the intestinal immune system and the underlying mechanisms. In the experimental dextran sodium sulfate and T cell-mediated colitis models, TQ significantly reduced the mRNA levels of interleukin (IL)-6, IL-1β, IL-17A, IL-23, and tumor necrosis factor (TNF)-α and the abundance of proinflammatory macrophages, T helper (Th)17 cells, and ILC3s in the colons of wild-type mice. TQ also prevented lipopolysaccharide (LPS)-induced activation of NFκB and signal transducer and activator of transcription (Stat)-3 pathways in the human macrophage U937 cells. Pharmacological inhibition or CRISPR-Cas-9-mediated knockout of Aryl hydrocarbon Receptor (AhR) prevented the anti-inflammatory effects of TQ in the LPS-treated U937 cells. Furthermore, TQ reduced the mRNA levels of the LPS-induced pro-inflammatory cytokines in the WT but not Ahr-/- mice splenocytes. TQ also reduced IL-6R protein levels and IL-6-induced Stat-3 activation in Jurkat cells and in vitro differentiation of Th17 cells from wild-type but not Ahr-/- mice naive T cells. Additionally, TQ prevented the pro-inflammatory effects of LPS on macrophages and stimulation of T cells in human PBMCs and significantly reduced the abundance of tumor necrosis factor-α, IL-1β, and IL-6hi inflammatory macrophages and Th17 cells in surgically resected Crohn's disease (CD) tissue. Our study shows that TQ is a naturally occurring, non-toxic, and effective immune modulator that activates AhR and suppresses the Stat-3-NFκB signaling.
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Affiliation(s)
- Kushal Saha
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | - Alexandra Wang
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Priya Arumugam
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Nathan Michael Morris
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Leonard Harris
- Division of Colon and Rectal Surgery, Department of Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Gregory Yochum
- Division of Colon and Rectal Surgery, Department of Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Walter Koltun
- Division of Colon and Rectal Surgery, Department of Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Gary H Perdew
- Department of Veterinary and Biomedical Sciences and the Center for Molecular Toxicology and Carcinogenesis, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Meghali Nighot
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Thomas Ma
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Prashant Nighot
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA.
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Abana CO, Palmiero AN, Liu K, Green MM, Li Z, Harris L, Mayor S, Samuel KQ, Younkin RA, Moore EJ, Norton W, Swain J, Fowlkes NW, Koong AC, Woodward WA, Taniguchi CM, Beddar S, Mitra D, Schueler E, Lin SH. Subacute Cutaneous Toxicity with Single-Fraction Electron FLASH RT in Yorkshire Swine. Int J Radiat Oncol Biol Phys 2023; 117:S10-S11. [PMID: 37784265 DOI: 10.1016/j.ijrobp.2023.06.223] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Information regarding acute/subacute skin toxicity of electron FLASH radiation therapy (RT) is limited. We evaluated short-term safety of electron FLASH for human trials by investigating subacute toxicity compared to conventional dose-rate RT (CONV) in the Yorkshire pig, an animal model known to closely approximate human skin and routinely used for toxicity studies. MATERIALS/METHODS Two healthy 50 kg pigs underwent CT imaging for RT treatment planning with field visualization via BBs and tattoos on each dorsolateral flank. Each target received a single fraction of 20, 25 or 30 Gy with FLASH and CONV on opposing sides delivered using a dedicated mobile linear accelerator. FLASH dose rates ranged from 164-245 Gy/sec (12 pulses delivered over 0.122 sec) while the CONV dose rate was set at 0.18 Gy/sec. Doses were verified using thermo- and optically stimulated luminescent dosimeters, and Gafchromic films. We obtained baseline and weekly images up to 98 days post-RT (D98) for blinded toxicity grading by 3 expert radiation oncologists using the modified RTOG radiation dermatitis (RD) scale. We measured erythema and pigmentation indices on those timepoints using a handheld spectrophotometer. We also obtained punch biopsies of targets and non-irradiated controls on D10 and D30 for RNA sequencing and two 6-marker multiplex immunofluorescence analyses of inflammation, immune response, and fibrosis. FLASH and CONV data were compared using repeated measures ANOVA and transcriptomic analyses using DESeq2. RESULTS All RT targets developed peak median grade 4 (ulceration, hemorrhage, or necrosis) RD by D84 regardless of FLASH or CONV delivery. However, FLASH targets developed peak RD later than CONV targets after 20 Gy (D84 vs D63), 25 Gy (D84 vs D49) and 30 Gy (D63 vs D42). FLASH induced qualitatively lower mean pigmentation and erythema indices than CONV for all 3 doses. Similarly, peak mean pigmentation indices occurred later with FLASH vs CONV for 20 Gy (D84 vs D63), 25 Gy (D84 vs D49) and 30 Gy (D77 vs D63). However, peak mean erythema indices occurred on the same day for FLASH and CONV (D63 for 20 Gy and D42 for 25 and 30 Gy). Transcriptomic analyses revealed significantly upregulated signals for wound healing (including TGF-beta, cell adhesion and extracellular matrix receptor interaction) and leukocyte infiltration with 20 Gy CONV mostly by D10, while FLASH upregulated those pathways only after 25 or 30 Gy, or by D30, or never at all. Preliminary immunofluorescence data showed FLASH may induce less T cell infiltrate and TGF-beta-expressing macrophages than CONV. CONCLUSION Single-fraction electron FLASH resulted in delayed onsets of both subacute cutaneous toxicity and wound healing with leukocytic infiltration signaling than dose-matched CONV based on both subjective and objective metrics of skin injury. Our findings suggest further investigations of optimal dose of electron FLASH for safe clinical translation is warranted, and we have a dose-finding study currently underway.
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Affiliation(s)
- C O Abana
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A N Palmiero
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K Liu
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M M Green
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Li
- Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - L Harris
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Mayor
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K Q Samuel
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R A Younkin
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E J Moore
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - W Norton
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Swain
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N W Fowlkes
- Department of Veterinary Medicine & Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A C Koong
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - W A Woodward
- Department of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C M Taniguchi
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Beddar
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - D Mitra
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E Schueler
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Mankarious MM, Connelly TM, Harris L, Deiling S, Yochum GS, Koltun WA. Creating a Surgical Biobank: The Hershey Medical Center Experience. Dis Colon Rectum 2023; 66:1174-1184. [PMID: 37378558 DOI: 10.1097/dcr.0000000000002944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
BACKGROUND Tissue harvesting at the time of surgery offers surgeons and scientists a unique opportunity to discover and better understand disease pathophysiology. Tissue biobanking presents challenges in patient consents, specimen collection, preparation, and storage, but the potential for scientific discovery justifies the effort. Although the number of tissue biobanks is increasing worldwide, information regarding necessary infrastructure, process flow, and management of expected obstacles is lacking. OBJECTIVE To provide a framework and motivation for clinician scientists intending to start an intestinal tissue biobank under their direction. DATA SOURCES The Carlino Family Inflammatory Bowel and Colorectal Diseases Biobank is housed at the Milton S. Hershey Medical Center. STUDY SELECTION Review. INTERVENTION Implementation of a surgical tissue biobank at a large tertiary care institution. MAIN OUTCOME MEASURES Assess critical challenges and obstacles over the years as well as keys to the success of the program. RESULTS Over 2 decades, the institutional biobank grew from an IBD biobank to one which now incorporates thousands of surgical specimens representing numerous colorectal diseases. This was done through a process of refinement focusing on patient recruitment and an efficient consenting and specimen management process. The biobank's success is further insured by institutional, external, and philanthropic support; scientific collaborations; and sharing of biological specimens with other groups of dedicated researchers. LIMITATIONS This is a single-center experience in collecting surgically resected colorectal specimens. CONCLUSIONS Surgical specimen biobanks are essential in studying disease cause using genomics, transcriptomics, and proteomic technologies. Therefore, surgeons, clinicians, and scientists should build biobanks at their institutions to promote further scientific discovery and improve specimen diversity.
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Affiliation(s)
- Marc M Mankarious
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Tara M Connelly
- Department of Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Leonard Harris
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Sue Deiling
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Gregory S Yochum
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Walter A Koltun
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
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Kline BP, Weaver T, Brinton DL, Harris L, Yochum GS, Berg AS, Koltun WA. Clinical and Genetic Factors Impact Time to Surgical Recurrence After Ileocolectomy for Crohn's Disease. Ann Surg 2021; 274:346-351. [PMID: 31714311 DOI: 10.1097/sla.0000000000003660] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate factors associated with time to surgical recurrence after Crohn's ileocolectomy. SUMMARY BACKGROUND DATA The most common surgery performed for Crohn's disease is ileocolectomy. Identifying patients at high risk for surgical recurrence may assist with medical and surgical decision-making. METHODS Data were obtained from 409 patients with Crohn's disease (CD) who had undergone ≥1 ileocolectomies at Penn State Hershey Medical Center. Six single-nucleotide polymorphisms (SNPs) associated with CD were evaluated in these patients: rs2076756, rs2066844, and rs2066845 in NOD2, rs4958847 and rs13361189 in IRGM, and rs2241880 in ATG16L1. Genotype and clinical factors were analyzed to determine associations with time to recurrent ileocolectomy. A subgroup analysis was performed on 241 patients naïve to biologics before initial ileocolectomy to assess the effect of biologic therapy on time to recurrent surgery. RESULTS There were 286 patients who underwent a single ileocolectomy, whereas 123 required multiple ileocolectomies. Ileocolonic involvement [hazard ratio (HR) 1.90, 95% confidence interval (CI) 1.21-3.00, P = 0.006] and rs2066844 in NOD2 (HR 1.8, 95% CI 1.17-2.77, P = 0.007) were associated with decreased time to surgical recurrence by multivariate analysis. In patients naïve to preoperative biologics, the initiation of postoperative biologics was associated with a 40% decreased incidence of surgical recurrence (HR 0.60, CI 0.39-0.93, P = 0.02) over time. CONCLUSIONS Ileocolonic distribution of disease and the rs2066844 SNP in NOD2 are associated with shorter time to recurrent ileocolectomy. The initiation of postoperative biologics in naïve patients was associated with a reduced incidence of recurrence over time.
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Affiliation(s)
- Bryan P Kline
- Department of Surgery, Division of Colon and Rectal Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA
| | - Taelor Weaver
- Department of Surgery, Division of Colon and Rectal Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA
| | - David L Brinton
- Department of Surgery, Division of Colon and Rectal Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA
| | - Leonard Harris
- Department of Surgery, Division of Colon and Rectal Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA
| | - Gregory S Yochum
- Department of Surgery, Division of Colon and Rectal Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, College of Medicine, Hershey, PA
| | - Arthur S Berg
- Department of Surgery, Division of Colon and Rectal Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA
- Department of Public Health Sciences, Division of Biostatistics and Bioinformatics, The Pennsylvania State University, College of Medicine, Hershey, PA USA
| | - Walter A Koltun
- Department of Surgery, Division of Colon and Rectal Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA
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Cruikshank N, Harris L, Richards S, Metcalfe J, Page B, Watson A, Wijesinghe L. 497 Targeting Improvements in The Elective Aneurysm Pathway in The Dorset and Wiltshire Vascular Network (DWVN). Br J Surg 2021. [DOI: 10.1093/bjs/znab134.438] [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: 11/14/2022]
Abstract
Abstract
Introduction
Two consecutive NVR reports identified the DWVN as the 7th slowest network to treat patients with AAAs. We aimed to detect if there were any significant delays in our pathway.
Method
We performed a retrospective audit of patients having elective open and endovascular repair. 144 patients who had AAA repair between 30/06/2016-01/08/2018 were included. Data were collected on the following stages: the date the AAA reached ≥55mm, referral date, date clinician reviewed, CT scan date, CPET testing date, MDT date and operation date. The time in days between each stage was recorded and any delays documented.
Results
At RBH the longest delay was between MDT and surgery (median 73 days, IQR 32 days-130 days). At DCH the major delay was between CPET and MDT (median 28.5 days, IQR 10 days-31 days). At SDH the longest stage was between MDT and operation (median of 88 days, IQR 37 days-154 days).
Examples of reasons for delays across the three hospitals included awaiting specialist opinions, patient being unwell and no ITU beds available.
Conclusions
The pathway for elective AAA treatment in the DWVN is slow across all three hospitals. The greatest delay is often between MDT and surgery. Targeting this stage could significantly shorten the pathway.
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Affiliation(s)
- N Cruikshank
- The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, United Kingdom
| | - L Harris
- Salisbury NHS Foundation Trust, Salisbury, United Kingdom
| | - S Richards
- Salisbury NHS Foundation Trust, Salisbury, United Kingdom
| | - J Metcalfe
- Dorset County Hospital NHS Foundation Trust, Dorchester, United Kingdom
- The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, United Kingdom
| | - B Page
- Dorset County Hospital NHS Foundation Trust, Dorchester, United Kingdom
| | - A Watson
- Dorset County Hospital NHS Foundation Trust, Dorchester, United Kingdom
- The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, United Kingdom
| | - L Wijesinghe
- The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, United Kingdom
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Flaum S, Seewald M, Echols A, Minadeo L, Dalton V, Harris L. P81 Family planning and the Flint water crisis. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Seewald M, Martin L, Simon A, Harris L. P5 Public perceptions of physicians who provide abortion care. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.027] [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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Eshelman MA, Harris L, Deiling S, Koltun WA, Jeganathan NA, Yochum GS. Transcriptomic analysis of ileal tissue from Crohn's disease patients identifies extracellular matrix genes that distinguish individuals by age at diagnosis. Physiol Genomics 2020; 52:478-484. [PMID: 32866088 DOI: 10.1152/physiolgenomics.00062.2020] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Crohn's disease (CD) is a debilitating gastrointestinal (GI) disorder that can impact the entirety of the GI tract. While substantial progress has been made in the medical management of CD, it remains incurable, frequently relapses, and is a significant financial and medical burden. The pathophysiology of CD is not well understood, but it is thought to arise in genetically susceptible individuals upon an environmental insult. Further elucidation of the disease etiology promises to expose additional therapeutic avenues, with the hope of reducing the burden of CD. One approach to understanding disease pathophysiology is to identify clinically relevant molecular disease subsets by using transcriptomics. In this report, we use hierarchical clustering of the ileal transcriptomes of 34 patients and identify two CD subsets. Clinically, these clusters differed in the age of the patients at CD diagnosis, suggesting that age of onset affects disease pathophysiology. The clusters were segregated by three major gene ontology categories: developmental processes, ion homeostasis, and the immune response. Of the genes constituting the immune system category, expression of extracellular matrix-associated genes, COL4A1, S100A9, ADAMTS2, SERPINE1, and FCN1, exhibits the strongest correlation with an individual's age at CD diagnosis. Together these findings demonstrate that transcriptional profiling is a powerful approach to subclassify CD patients.
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Affiliation(s)
- Melanie A Eshelman
- Department of Surgery, Division of Colon & Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Leonard Harris
- Department of Surgery, Division of Colon & Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Sue Deiling
- Department of Surgery, Division of Colon & Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Walter A Koltun
- Department of Surgery, Division of Colon & Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - N Arjun Jeganathan
- Department of Surgery, Division of Colon & Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Gregory S Yochum
- Department of Surgery, Division of Colon & Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Department of Biochemistry & Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
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Connolly R, Wang V, Hyman D, Grivas P, Mitchell E, Wright J, Sharon E, Gray R, Li S, McShane L, Rubinstein L, Patton D, Williams P, Hamilton S, Conley B, Arteaga C, Harris L, O'Dwyer P, Chen A, Flaherty K. 553P Activity of trastuzumab and pertuzumab (HP) in patients with non-breast/gastroesophgeal HER2-amplified tumours: Results of the NCI-MATCH trial (EAY131) subprotocol J. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng 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Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, Fawole A, Gohil J, Green B, Hussain A, McMenamin L, McMenamin L, Tang M, Azmi F, Benchetrit S, Cope T, Haque A, Harlinska A, Holdsworth R, Ivo T, Martin J, Nisar T, Patel A, Sasapu K, Trevett J, Vernet G, Aamir A, Bird C, Durham-Hall A, Gibson W, Hartley J, May N, Maynard V, Johnson S, Wood CM, O'Brien M, Orbell J, Stringfellow TD, Tenters F, Tresidder S, Cheung W, Grant A, Tod N, Bews-Hair M, Lim ZH, Lim SW, Vella-Baldacchino M, Auckburally S, Chopada A, Easdon S, Goodson R, McCurdie F, Narouz M, Radford A, Rea E, Taylor O, Yu T, Alfa-Wali M, Amani L, Auluck I, Bruce P, Emberton J, Kumar R, Lagzouli N, Mehta A, Murtaza A, Raja M, Dennahy IS, Frew K, Given A, He YY, Karim MA, MacDonald E, McDonald E, McVinnie D, Ng SK, Pettit A, Sim DPY, Berthaume-Hawkins SD, Charnley R, Fenton K, Jones D, Murphy C, Ng JQ, Reehal R, Robinson H, Seraj SS, Shang E, Tonks A, White P, Yeo A, Chong P, Gabriel R, Patel N, Richardson E, Symons L, Aubrey-Jones D, Dawood S, Dobrzynska M, Faulkner S, Griffiths H, Mahmood F, Patel P, Perry M, Power A, Simpson R, Ali A, Brobbey P, Burrows A, Elder P, Ganyani R, Horseman C, Hurst P, Mann H, Marimuthu K, McBride S, Pilsworth E, Powers N, Stanier P, Innes R, Kersey T, Kopczynska M, Langasco N, Patel N, Rajagopal R, Atkins B, Beasley W, Lim ZC, Gill A, Ang HL, Williams H, Yogeswara T, Carter R, Fam M, Fong J, Latter J, Long M, Mackinnon S, McKenzie C, Osmanska J, Raghuvir V, Shafi A, Tsang K, Walker L, Bountra K, Coldicutt O, Fletcher D, Hudson S, Iqbal S, Bernal TL, Martin JWB, Moss-Lawton F, Smallwood J, Vipond M, Cardwell A, Edgerton K, Laws J, Rai A, Robinson K, Waite K, Ward J, Youssef H, Knight C, Koo PY, Lazarou A, Stanger S, Thorn C, Triniman MC, Botha A, Boyles L, Cumming S, Deepak S, Ezzat A, Fowler AJ, Gwozdz AM, Hussain SF, Khan S, Li H, Morrell BL, Neville J, Nitiahpapand R, Pickering O, Sagoo H, Sharma E, Welsh K, Denley S, Khan S, Agarwal M, Al-Saadi N, Bhambra R, Gupta A, Jawad ZAR, Jiao LR, Khan K, Mahir G, Singagireson S, Thoms BL, Tseu B, Wei R, Yang N, Britton N, Leinhardt D, Mahfooz M, Palkhi A, Price M, Sheikh S, Barker M, Bowley D, Cant M, Datta U, Farooqi M, Lee A, Morley G, Amin MN, Parry A, Patel S, Strang S, Yoganayagam N, Adlan A, Chandramoorthy S, Choudhary Y, Das K, Feldman M, France B, Grace R, Puddy H, Soor P, Ali M, Dhillon P, Faraj A, Gerard L, Glover M, Imran H, Kim S, Patrick Y, Peto J, Prabhudesai A, Smith R, Tang A, Vadgama N, Dhaliwal R, Ecclestone T, Harris A, Ong D, Patel D, Philp C, Stewart E, Wang L, Wong E, Xu Y, Ashaye T, Fozard T, Galloway F, Kaptanis S, Mistry P, Nguyen T, Olagbaiye F, Osman M, Philip Z, Rembacken R, Tayeh S, Theodoropoulou K, Herman A, Lau J, Saha A, Trotter M, Adeleye O, Cave D, Gunwa T, Magalhães J, Makwana S, Mason R, Parish M, Regan H, Renwick P, Roberts G, Salekin D, Sivakumar C, Tariq A, Liew I, McDade A, Stewart D, Hague M, Hudson-Peacock N, Jackson CES, James F, Pitt J, Walker EY, Aftab R, Ang JJ, Anwar S, Battle J, Budd E, Chui J, Crook H, Davies P, Easby S, Hackney E, Ho B, Imam SZ, Rammell J, Andrews H, Perry C, Schinle P, Ahmed P, Aquilina T, Balai E, Church M, Cumber E, Curtis A, Davies G, Dennis Y, Dumann E, Greenhalgh S, Kim P, King S, Metcalfe KHM, Passby L, Redgrave N, Soonawalla Z, Waters S, Zornoza A, Gulzar I, Hole J, Hull K, Ishaq H, Karaj J, Kelkar A, Love E, Patel S, Thakrar D, Vine M, Waterman A, Dib NP, Francis N, Hanson M, Ingleton R, Sadanand KS, Sukirthan N, Arnell S, Ball M, Bassam N, Beghal G, Chang A, Dawe V, George A, Huq T, Hussain A, Ikram B, Kanapeckaite L, Khan M, Ramjas D, Rushd A, Sait S, Serry M, Yardimci E, Capella S, Chenciner L, Episkopos C, Karam E, McCarthy C, Moore-Kelly W, Watson N, Ahluwalia V, Barnfield J, Ben-Gal O, Bloom I, Gharatya A, Khodatars K, Merchant N, Moonan A, Moore M, Patel K, Spiers H, Sundaram K, Turner J, Bath MF, Black J, Chadwick H, Huisman L, Ingram H, Khan S, Martin L, Metcalfe M, Sangal P, Seehra J, Thatcher A, Venturini S, Whitcroft I, Afzal Z, Brown S, Gani A, Gomaa A, Hussein N, Oh SY, Pazhaniappan N, Sharkey E, Sivagnanasithiyar T, Williams C, Yeung J, Cruddas L, Gurjar S, Pau A, Prakash R, Randhawa R, Chen L, Eiben I, Naylor M, Osei-Bordom D, Trenear R, Bannard-Smith J, Griffiths N, Patel BY, Saeed F, Abdikadir H, Bennett M, Church R, Clements SE, Court J, Delvi A, Hubert J, Macdonald B, Mansour F, Patel RR, Perris R, Small S, Betts A, Brown N, Chong A, Croitoru C, Grey A, Hickland P, Ho C, Hollington D, McKie L, Nelson AR, Stewart H, Eiben P, Nedham M, Ali I, Brown T, Cumming S, Hunt C, Joyner C, McAlinden C, Roberts J, Rogers D, Thachettu A, Tyson N, Vaughan R, Verma N, Yasin T, Andrew K, Bhamra N, Leong S, Mistry R, Noble H, Rashed F, Walker NR, Watson L, Worsfold M, Yarham E, Abdikadir H, Arshad A, Barmayehvar B, Cato L, Chan-lam N, Do V, Leong A, Sheikh Z, Zheleniakova T, Coppel J, Hussain ST, Mahmood R, Nourzaie R, Prowle J, Sheik-Ali S, Thomas A, Alagappan A, Ashour R, Bains H, Diamond J, Gordon J, Ibrahim B, Khalil M, Mittapalli D, Neo YN, Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, Tilliridou V, Wright R, Ye W, Alturki N, Helliwell R, Jones E, Kelly D, Lambotharan S, Scott K, Sivakumar R, Victor L, Boraluwe-Rallage H, Froggatt P, Haynes S, Hung YMA, Keyte A, Matthews L, Evans E, Haray P, John I, Mathivanan A, Morgan L, Oji O, Okorocha C, Rutherford A, Spiers H, Stageman N, Tsui A, Whitham R, Amoah-Arko A, Cecil E, Dietrich A, Fitzpatrick H, Guy C, Hair J, Hilton J, Jawad L, McAleer E, Taylor Z, Yap J, Akhbari M, Debnath D, Dhir T, Elbuzidi M, Elsaddig M, Glace S, Khawaja H, Koshy R, Lal K, Lobo L, McDermott A, Meredith J, Qamar MA, Vaidya A, Acquaah F, Barfi L, Carter N, Gnanappiragasam D, Ji C, Kaminski F, Lawday S, Mackay K, Sulaiman SK, Webb R, Ananthavarathan P, Dalal F, Farrar E, Hashemi R, Hossain M, Jiang J, Kiandee M, Lex J, Mason L, Matthews JH, McGeorge E, Modhwadia S, Pinkney T, Radotra A, Rickard L, Rodman L, Sales A, Tan KL, Bachi A, Bajwa DS, Battle J, Brown LR, Butler A, Calciu A, Davies E, Gardner I, Girdlestone T, Ikogho O, Keelan G, O'Loughlin P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar 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Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Harris L, Humphrey GK, Muir DM, Dodwell PC, Humphrey GK. Use of the Canterbury Child's Aid in Infancy and Early Childhood: A Case Study. Journal of Visual Impairment & Blindness 2020. [DOI: 10.1177/0145482x8507900102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study reports on auditory-motor and sonar aid training in a child from age 6 months to 4 years. As an infant, the child used the aid for a variety of purposes, including reaching, feeding, and walking, after she had received auditory-motor training. As a preschooler, she used the aid to explore novel environments and avoid objects in her path. The relation between the child's use of the aid as an infant and as a preschooler is discussed, and the importance of training in the use of such a device is stressed.
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Affiliation(s)
- Leonard Harris
- Beechgrove Regional Children's Centre, Kingston, Ontario
| | - G. Keith Humphrey
- Department of Psychology, University of Lethbridge, Lethbridge, Alberta
| | - Darwin M. Muir
- Department of Psychology, Queen's University, Kingston, Ontario
| | | | - G. K. Humphrey
- Department of Psychology, University of Lethbridge, Lethbridge, Alberta T1K 3M4, Canada
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Mackie JT, Blyde D, Harris L, Roe WD, Keyburn AL. Brucellosis associated with stillbirth in a bottlenose dolphin in Australia. Aust Vet J 2020; 98:92-95. [PMID: 32030727 DOI: 10.1111/avj.12903] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 10/10/2019] [Accepted: 11/15/2019] [Indexed: 01/31/2023]
Abstract
A captive adult female bottlenose dolphin presented with stillbirth. The placenta appeared oedematous. No other gross lesions were evident in the placenta or the stillborn calf. Histopathology revealed mild multifocal placentitis and foetal encephalitis. Brucella sp. was isolated from lung, liver, spleen and kidney. Sequence and phylogenetic analysis demonstrated this organism to be most similar to Brucella ceti sequence type (ST) 27. Brucella sp. DNA was detected in formalin-fixed paraffin-embedded placenta and brain by real-time PCR using primers targeting the IS711 gene. Immunohistochemical staining revealed Brucella sp. antigen in placental inflammation. This is the first report of isolation of Brucella sp. from a marine mammal in the Southern Hemisphere and the first report of marine Brucella-associated disease in Australia.
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Affiliation(s)
- J T Mackie
- QML Vetnostics, Murarrie, Queensland, Australia
| | - D Blyde
- Sea World, Main Beach, Queensland, Australia
| | - L Harris
- QML Vetnostics, Murarrie, Queensland, Australia
| | - W D Roe
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - A L Keyburn
- CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia
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Curiale MS, Gangar V, Gravens C, Agin JR, Bound A, Bowles L, Brockman R, Brusatti L, Bulawka CE, Cohen A, Deeks C, Eklund CA, Fukuoka J, Gangar V, Hammer C, Harris L, Hoffman C, Jost-Keating K, Keng JG, Kerdahi K, Krzyanowski W, Manley D, Miller C, Mondon D, Neufang K, Niroomand F, Plante R, Post L, Roman M, Rude D, Raghubeer EV, Ryder J, Smith C, Stoltzner L, Thomas L, Vanderbilt B, Wright T. VIDAS Enzyme-Linked Fluorescent Immunoassay for Detection of Salmonella in Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.3.491] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
The VIDAS SLM method for detection of Salmonella was compared with the Bacteriological Analytical Manual (BAM)/AOAC culture method in a collaborative study. Twenty laboratories participated in the evaluation. Each laboratory tested one or more of 6 test products: milk chocolate, nonfat dry milk, dried whole egg, soy flour, ground black pepper, and ground raw turkey. No significant differences (P< 0.05) were observed between the 2 methods. The 2 methods were in agreement for 99% of 1544 samples analyzed. Of the 20 samples out of agreement, 8 were VIDAS SLM positive and BAM/AOAC negative, and 12 were VIDAS SLM negative and BAM/AOAC positive. The VIDAS SLM method for detection of Salmonella in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
- Michael S Curiale
- Silliker Laboratories Group, Inc., Corporate Research Center, 160 Armory Dr, South Holland, IL 60473
| | - Vidhya Gangar
- Silliker Laboratories Group, Inc., Corporate Research Center, 160 Armory Dr, South Holland, IL 60473
| | - Carol Gravens
- bioMérieux Vitek, Inc., 595 Anglum Rd, Hazelwood, MO 63042-2320
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Foley N, O'Connor M, Harris L. A050 Defibrillator Therapy in Patients Receiving a Primary Prevention CRT-D Device: The Wellington Experience. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.05.055] [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: 11/24/2022]
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Eshelman MA, Jeganathan NA, Schieffer KM, Kline BP, Mendenhall M, Deiling S, Harris L, Koltun WA, Yochum GS. Elevated Colonic Mucin Expression Correlates with Extended Time to Surgery for Ulcerative Colitis Patients. J Gastrointestin Liver Dis 2019; 28:405-413. [PMID: 31826065 DOI: 10.15403/jgld-250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/09/2019] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Both genetic and environmental factors contribute to the development and persistence of ulcerative colitis (UC). As supported by differential responses to therapy, multiple subclasses of disease likely comprise UC. We reasoned that profiling the colonic transcriptomes may offer one approach to molecular subtype UC. METHODS We conducted RNA-sequencing (RNA-seq) on full-thickness colonic tissues from 26 UC patients undergoing colectomy. Hierarchal clustering from transcriptomic data identified disease subsets. Subsets were characterized using differential gene expression analysis, cell type deconvolution, and network analysis. RESULTS We identified two UC subsets that were distinguished by 957 differentially expressed genes. Cluster 1 was enriched in genes associated with intestinal epithelial cell (IEC) differentiation, while cluster 2 was enriched in genes associated with epithelial-to-mesenchymal transition (EMT) and inflammatory responses. Cluster 1 was associated with an extended time from diagnosis to colectomy [hazard ratio = 0.45 (95% CI: 0.14-0.88); p=0.03]. Of cluster 1 genes, elevated MUC5B, MUC4, and MUC2 expression displayed the strongest correlation with increased time to surgery [hazard ratio = 0.37 (95% CI: 0.11-0.61); p=0.0044]. CONCLUSIONS Our transcriptome analysis indicates that UC can be sub-classified into at least two molecular signatures. We found that elevated mucin gene expression correlated with prolonged time to colectomy following diagnosis. This work identified MUC5B, MUC4, and MUC2 as potential prognostic indicators of disease severity, as reflected in time to surgery after diagnosis.
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Affiliation(s)
- Melanie A Eshelman
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, PA, USA; Department of Surgery, Division of Colon and Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, PA, USA. .
| | - N Arjun Jeganathan
- Department of Surgery, Division of Colon and Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Kathleen M Schieffer
- The Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
| | - Bryan P Kline
- Department of Surgery, Division of Colon and Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Megan Mendenhall
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, PA, USA; Department of Surgery, Division of Colon and Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Sue Deiling
- Department of Surgery, Division of Colon and Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Leonard Harris
- Department of Surgery, Division of Colon and Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Walter A Koltun
- Department of Surgery, Division of Colon and Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Gregory S Yochum
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, PA, USA; Department of Surgery, Division of Colon and Rectal Surgery, Pennsylvania State University College of Medicine, Hershey, PA, USA.
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Abstract
Abstract
Current methods of analysis for ethylene oxide (EO) in medical devices include headspace and simulated-use extractions followed by gas chromatography with either a packed or a capillary column. The quantitation limits are about 0.5–1.0 μg/g for a packed column and about 0.1–0.2 μg/g for a capillary column. The current allowable levels of EO on medical devices sterilized with EO gas as outlined in International Organization for Standardization (ISO) 10993-7 may be significantly reduced from current levels by applying the ISO Draft International Standard 10993-17 method for establishing allowable limits. This may require EO test methods with detection and quantitation limits that are much lower than those of the currently available methods. This paper describes a new method that was developed for the determination of low-level EO by solid-phase microextraction using the direct-immersion method. Factors such as temperature and stirring were found to affect absorption efficiency and absorption time. A low extraction temperature (about 6°C) was found to be more efficient than room-temperature extraction. Stirring was found to reduce absorption time by about 50%. Under these conditions, detection and quantitation limits of 0.002 and 0.009 μg/g, respectively, were obtained by using a capillary column. As a result, this method makes compliance with lower EO limits feasible.
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Affiliation(s)
- Kamal Ayoub
- Tyco/Healthcare-Kendall, 2010 E. International Speedway Blvd, DeLand, FL 32724
| | - Leonard Harris
- Tyco/Healthcare-Kendall, 2010 E. International Speedway Blvd, DeLand, FL 32724
| | - Bill Thompson
- Tyco/Healthcare-Kendall, 2010 E. International Speedway Blvd, DeLand, FL 32724
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Vehmeijer JT, Koyak Z, Zwinderman AH, Harris L, Peinado R, Oechslin EN, Silversides CK, Bouma BJ, Budts W, van Gelder IC, Oliver JM, Mulder BJM, de Groot JR. PREVENTION-ACHD: PRospEctiVE study on implaNTable cardioverter-defibrillator therapy and suddeN cardiac death in Adults with Congenital Heart Disease; Rationale and Design. Neth Heart J 2019; 27:474-479. [PMID: 31270738 PMCID: PMC6773785 DOI: 10.1007/s12471-019-1297-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Many adult congenital heart disease (ACHD) patients are at risk of sudden cardiac death (SCD). An implantable cardioverter-defibrillator (ICD) may prevent SCD, but the evidence for primary prevention indications is still unsatisfactory. STUDY DESIGN PREVENTION-ACHD is a prospective study with which we aim to prospectively validate a new risk score model for primary prevention of SCD in ACHD patients, as well as the currently existing guideline recommendations. Patients are screened using a novel risk score to predict SCD as well as current ICD indications according to an international Consensus Statement. Patients are followed up for two years. The primary endpoint is the occurrence of SCD and sustained ventricular arrhythmias. The Study was registered at ClinicalTrials.gov (NCT03957824). CONCLUSION PREVENTION-ACHD is the first prospective study on SCD in ACHD patients. In the light of a growing and aging population of patients with more severe congenital heart defects, more robust clinical evidence on primary prevention of SCD is urgently needed.
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Affiliation(s)
- J T Vehmeijer
- Heart Center, Department of Cardiology, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands.
| | - Z Koyak
- Heart Center, Department of Cardiology, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands
| | - A H Zwinderman
- Department of Clinical Epidemiology and Biostatistics, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands
| | - L Harris
- Division of Cardiology, Peter Munk Cardiac Center, Toronto Congenital Cardiac Center of Adults, University of Toronto, Toronto, Canada
| | - R Peinado
- Department of Cardiology, La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | - E N Oechslin
- Division of Cardiology, Peter Munk Cardiac Center, Toronto Congenital Cardiac Center of Adults, University of Toronto, Toronto, Canada
| | - C K Silversides
- Division of Cardiology, Peter Munk Cardiac Center, Toronto Congenital Cardiac Center of Adults, University of Toronto, Toronto, Canada
| | - B J Bouma
- Heart Center, Department of Cardiology, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands
| | - W Budts
- Department of Cardiology, Universitair Ziekenhuis Leuven, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - I C van Gelder
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J M Oliver
- Department of Cardiology, Gregorio Marañon University Hospital and CIBERCV, Madrid, Spain
| | - B J M Mulder
- Heart Center, Department of Cardiology, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands.,Netherlands Heart Institute, Utrecht, The Netherlands
| | - J R de Groot
- Heart Center, Department of Cardiology, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands
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Harris L, Hateley S, Seemungal B. P22 Phenytoin versus levetiracetam for post traumatic brain injury seizure prophylaxis; a retrospective study at a UK major trauma centre. J Neurol Neurosurg Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.98] [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: 11/03/2022]
Abstract
Objectives12% of patients with severe Traumatic brain injury (TBI) suffer from seizures. Evidence suggests that the use of an antiepileptic drug (AED) is beneficial in preventing early post TBI seizures. To date, no specific NICE guidelines exist on the choice of post TBI seizure prophylaxis. This study aims to identify the trend in AED usage, the impact on length of stay and to compare the tolerability of phenytoin and levetiracetam.DesignRetrospective observational study.Subjects201 patients.MethodsAll patients admitted to a Major Trauma Unit following a head injury treated with levetiracetam or phenytoin for seizure prophylaxis were included in the study. Data was collected between October 2013 – September 2014 and November 2016 – October 2017. Patient demographics, Glasgow Coma Score (GCS) on admission, length of treatment, AED toxicity, length of stay, complications, surgical input and length of ITU stay were recorded.Results85.6% of patients were treated with phenytoin in 2013–2014% and 82.5% were treated with levetiracetam in 2016–2017. The average length of stay for phenytoin was 23.2 days and 13.9 days for levetiracetam. Subgroup analysis was performed on patients with an admission GCS of 14–15. Length of stay for phenytoin was 14.9 days (SD −11.87) and levetiracetam 9.4 days (SD 10.588) (p=0.07). 24% of patients on phenytoin and 14% on levetiracetam suffered from dizziness.ConclusionsThis suggests that levetiracetam is tolerated better with fewer side effects. We recommend its use in clinical practice.
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Tanioka M, Parker JS, Henry LN, Tolaney S, Dang C, Krop IE, Harris L, Polley M, Berry DA, Winer EP, Carey LA, Perou CM. Abstract P3-08-04: Transient state change, but not permanent subtype change, after HER2-targeted therapy for HER2-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In CALGB 40601 (Alliance, NCT00770809), a neoadjuvant phase III trial of paclitaxel and trastuzumab with or without lapatinib for 12 weeks for patients with HER2-positive breast cancer, 33% of pretreatment tumors were Luminal A subtype, however, 69% of post-treatment samples with residual disease were Luminal A subtype. In addition, 71% of Luminal B (12/17) and 67% of HER2-Enriched (6/9) tumors changed into Luminal A, while 80% of Luminal A (20/24) remained Luminal A (Carey et al. J Clin Oncol. 2016). It is not known whether this shift to Luminal A was transient or permanent.
Methods: We selected matched pairs of pre- and post-treatment 40601 samples with tumor purity >10% based upon DNA analyses to ensure all samples contained tumor. PAM50 intrinsic subtyping was applied to the 40601 samples gene expression data using a two-step normalization process based on The Genome Cancer Atlas, and PAM50 training set. In addition, a HER2-enriched expression subtype patient-derived xenograft (PDX) tumor called WHIM35, was studied and was either untreated (n=10), or treated with lapatinib at 220 mg/kg for 1 week (wk) (n=5), for 2 wks (n=8), or for 3 wks (n=4). We also treated WHIM35 tumors with lapatinib for 2 wks (on) and then removed laptinib for 1 wk (off) (n=6), or for 2 wks on and 2-4 wk off (n=6), and finally for 3 wks on, and 1 wk off (n=3). PAM50 intrinsic subtyping was applied to the PDX gene expression data and subtype assessed as well as a genomic-based proliferation score. ANOVA p-values were calculated by comparing median values across all gene signature or correlation scores.
Results: We found 10 pairs of 40601 samples that kept their tumor purity values, however, their subtype changed to Luminal A after treatment (i.e., in the residual disease), and in these cases no minor tumor subclone became a dominant clone in the post treatment sample. Pretreatment subtypes were 6 Luminal B, 3 Luminal A, and 1 HER2-enriched. The tumor purity values did not change after the treatments, but correlation to Luminal A was significantly higher (p=0.01), while correlation to HER2-enriched (p=0.004) and proliferation signature scores (p=0.003) were significantly lower in the post-treatment samples. Among the WHIM35 PDX tumors, one sample changed its subtype from HER2-enriched to Luminal A after the lapatinib treatment and the rest remained HER2-enriched, suggesting environmental differences between patient samples and the PDX model. However, correlation to Luminal A was significantly higher in all lapatinib treated WHIM35 samples (p=8.3e-12), and notably went back to the initial low levels just one week after removing lapatinib. Likewise, correlation to HER2-enriched (p=1.2e-10) and proliferation signature scores (p=6.2e-12) also got lower while treated with lapatinib, but went back to the initial levels after cessation of treatment.
Conclusions: Our findings suggest that the apparent subtype change during HER2-targeting therapy is not permanent, but is more likely a transient state change from a HER2-enriched subtype into a more Luminal A-like state. When we plan additional treatment strategies using residual disease phenotypes, it may not be clear what is the true subtype of the sample due to this inherent plasticity.
Citation Format: Tanioka M, Parker JS, Henry LN, Tolaney S, Dang C, Krop IE, Harris L, Polley M, Berry DA, Winer EP, Carey LA, Perou CM. Transient state change, but not permanent subtype change, after HER2-targeted therapy for HER2-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-04.
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Affiliation(s)
- M Tanioka
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - JS Parker
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - LN Henry
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - S Tolaney
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - C Dang
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - IE Krop
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - L Harris
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - M Polley
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - DA Berry
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - EP Winer
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - LA Carey
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
| | - CM Perou
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; University of North Carolina, Chapel Hill; University of Utah, Salt Lake City; Dana-Farber/Partners CancerCare, Boston; Memorial Sloan Kettering Cancer Center, New York; National Cancer Institute, Washington; Alliance Statistics and Data Center, Mayo Clinic, Rochester; Alliance Statistics and Data Center, M.D. Anderson, Houston
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Abstract
ObjectivesType 2 peg fractures are known to have low fusion rates but most are elderly with comorbidities and not fit for surgery. Increasingly, clinicians want to stop using hard collars due to its complications, but with little supporting evidence. We aim to provide data to add to this debate.DesignSingle centre cohort study.Subjects145 consecutive patients referred to a Major Trauma Centre as type 2 peg fracture.MethodsAll patients referred with a suspected peg fracture between March 2015 and December 2017 were included. All imaging were assessed and case notes reviewed for patient demographics, fracture management, complications and outcomes.Results102 cases were peg fractures (mean age=80 years). 92 (90.2%) were managed conservatively with a hard collar (mean of 87 days). 37% developed symptoms from the collar, namely pain, stiffness and non-tolerance. Bony union was achieved in only 39.1% of patients with increasing age being an independent risk factor (p<0.001). Of the 56 patients who did not have bony union, there were no reported symptoms and 90% were discharged without a collar. 2 patients were offered but declined fixation and neither reported any on-going symptoms.ConclusionsThis study adds to the body of evidence that fusion rates are low, and collar complications are not insignificant when type 2 peg fractures are treated in a hard collar. However, outcomes are good regardless of union, potentially rendering the collar unnecessary. We aim to conduct a randomised prospective study to further investigate.
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Harris L, Hankey C, Jones N, Murray H, Pert C, Tobin J, Boyle S, Shearer R, Melville CA. Process evaluation of a cluster-randomised controlled trial of multi-component weight management programme in adults with intellectual disabilities and obesity. J Intellect Disabil Res 2019; 63:49-63. [PMID: 30417575 DOI: 10.1111/jir.12563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/10/2018] [Accepted: 09/27/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Providing effective weight management to adults with intellectual disabilities is necessary to challenge the high rates of obesity. The aim of this process evaluation was to explore the feasibility of conducting a full-scale clinical trial of the TAKE 5 multi-component weight management programme. METHODS The study was a 12-month pilot cluster-randomised controlled trial. Adults with intellectual disabilities and obesity were randomised to either TAKE 5, which included an energy deficit diet (EDD) or Waist Winners Too, based on health education principles. A mixed-methods process evaluation was conducted focussing on the reach, recruitment, fidelity, implementation, dose (delivered/received) and context. RESULTS The study successfully recruited adults with intellectual disabilities. Both weight management programmes were delivered with high fidelity and implemented as intended. Only one weight management programme, TAKE 5, demonstrated potential efficacy in reducing body weight and body composition. The effectiveness was largely attributed to the EDD and social support from carers. CONCLUSIONS The extensive process evaluation illustrated that a full-scale trial of a multi-component programme including an EDD is feasible and an acceptable approach to weight management for adults with intellectual disabilities and obesity.
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Affiliation(s)
- L Harris
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C Hankey
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Jones
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - H Murray
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C Pert
- Learning Disability Psychology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - J Tobin
- Glasgow City CHP North East Sector, Eastbank Conference Training Centre, Glasgow, UK
| | - S Boyle
- Consultant Clinical Psychologist NHS Greater, Glasgow, UK
| | - R Shearer
- Glasgow and Clyde Specialist Weight Management Service, Glasgow, UK
| | - C A Melville
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
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Street LM, Harris L, Curry RS, Eisenach JC. Capsaicin-induced pain and sensitisation in the postpartum period. Br J Anaesth 2018; 122:103-110. [PMID: 30579387 DOI: 10.1016/j.bja.2018.09.026] [Citation(s) in RCA: 3] [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: 04/20/2018] [Revised: 09/12/2018] [Accepted: 09/28/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Recovery from Caesarean delivery in women and surgical nerve injury in animals after delivery is more rapid than expected, an effect reversed in animals by spinal injection of an oxytocin receptor antagonist. We hypothesised that endogenous modulation of acute pain is altered postpartum. METHODS Endogenous inhibition of acute pain in a conditioned pain modulation paradigm or endogenous sensitisation by topical capsaicin was tested in women who were breastfeeding 10-14 days after Caesarean delivery and age-matched controls (n=80 total: 20 per group and 20 per test). The study was powered to detect a difference in area of hyperalgesia after capsaicin of 33%. Capsaicin-evoked pain was recorded in women, and capsaicin-evoked mechanical hypersensitivity was measured in rats 48 h after delivery and in age-matched female and male animals. RESULTS There was no effect of the postpartum period in the endogenous sensitisation assay in women, and the conditioned pain modulation assay failed to produce analgesia in either group. Postpartum women, however, reported less intense pain than controls at the end of topical capsaicin exposure (1.3 [1.4] vs 2.0 [2.0] on 0-10 verbal scale), and acute hypersensitivity after capsaicin was less in postpartum than control rats (withdrawal threshold 25 [15] vs 3.6 [1] g). CONCLUSIONS These results agree with a recent report that oxytocin may desensitise the transient receptor potential for vanilloid-1 channel, although other explanations, including hormone effects, are possible. These results do not, however, support the inhibition of capsaicin-evoked spinal sensitisation in the postpartum period. CLINICAL TRIAL REGISTRATION NCT01843517.
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Affiliation(s)
- L M Street
- Department of Obstetrics and Gynecology, Augusta University, Augusta, GA, USA
| | - L Harris
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - R S Curry
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - J C Eisenach
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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Parker C, Emlet C, Furlotte C, Harris L. SEXUALITY AND INTIMACY AMONG OLDER ADULTS LIVING WITH HIV IN ONTARIO: CHANGES, CHALLENGES, AND CONCERNS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - C Emlet
- University of Washington, Tacoma
| | | | - L Harris
- Kent School of Social Work, University of Louisville
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Harris L, Rocca C, Upadhyay U, Dworkin S, Ndunyu L, Gitome S, Bukusi E, Newmann S. Reproductive autonomy and covert contraceptive use in Nyanza, Kenya. Contraception 2018. [DOI: 10.1016/j.contraception.2018.07.088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Axinte L, Harris L. CT head scans for head injury; Are we NICE enough... Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.524] [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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McGarty AM, Downs SJ, Melville CA, Harris L. A systematic review and meta-analysis of interventions to increase physical activity in children and adolescents with intellectual disabilities. J Intellect Disabil Res 2018; 62:312-329. [PMID: 29277930 DOI: 10.1111/jir.12467] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 10/26/2017] [Accepted: 11/29/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Increasing physical activity (PA) through intervention can promote physical and mental health benefits in children and adolescents. However, children and adolescents with intellectual disabilities (ID) have consistently been shown to engage in low levels of PA, which are insufficient for long-term health. Despite this, little is known about the effectiveness of interventions to increase PA in children and adolescents with ID. The aims of this study were therefore to systematically review how effective interventions are at increasing PA levels in children and adolescents with ID and to further examine what components have been used in these interventions. METHOD A systematic search of MEDLINE, EMBASE, Education Resources Information Center, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, Cochrane Central Register for Controlled Trials and International Standard Randomised Controlled Trial Number trials registry was conducted (up to July 2016). Articles were included if they met the following eligibility criteria: children and adolescents (<18 years) with ID, measurement of PA at baseline and post-intervention and intervention studies. Effect sizes were calculated as standardised mean difference (d) and meta-analysis calculated between intervention and no treatment control intervention. RESULTS Five studies met the eligibility criteria and were included in the review. Study design, methodological quality and intervention components were varied. Interventions did not support sufficient changes in PA to improve health. The meta-analysis demonstrated that intervention groups were not more effective at increasing PA levels post-intervention (d: 2.20; 95% CI -0.57 to 0.97) compared with control. However, due to a decrease in PA in the control intervention, a moderate significant effect was demonstrated at follow-up (d: 0.49; 95% CI 0.14 to 0.84). CONCLUSIONS There is a lack of studies which aim to increase PA levels in children and adolescents with ID, with current interventions ineffective. Future studies are required before accurate recommendations for appropriate intervention design and components can be made.
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Affiliation(s)
- A M McGarty
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - S J Downs
- Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - C A Melville
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - L Harris
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Abstract
c-erbB-2 is an oncoprotein which is overexpressed in up to 40% of primary breast cancers. c-erbB-2 overexpression is a bad prognostic factor in patients with lymph node-positive disease. Unfortunately, there has been no agreement to date on whether c-erbB-2 overexpression is of prognostic significance in patients with lymph node-negative disease. c-erbB-2 overexpression is correlated with the absence of estrogen receptor expression in a number of publications. Correlation between c-erbB-2 overexpression and hormone sensitivity in the clinical setting is less well established and is the focus of ongoing studies. Both preclinical and clinical studies support an association between c-erbB-2 receptor overexpression and resistance to alkylating agents. In contrast, the data for c-erbB-2 and anthracyclines should be viewed in a slightly different manner. Anthracyclines appear to have a greater therapeutic effect in c-erbB-2-positive disease which may be dose sensitive. In c-erbB-2-negative disease not only is the therapeutic effect reduced but there does not appear to be any improved response to higher doses of anthracyclines. The data for c-erbB-2 and the taxanes is still not clear enough to provide any definite conclusions. If there is a correlation it would at present appear to be between paclitaxel and response rates, but this needs to be confirmed in larger studies. Few studies have looked at changes in c-erbB-2 on therapy. Those that have seem to show no significant change on either tamoxifen or chemotherapy.
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Affiliation(s)
- E Tagliabue
- Division of Experimental Oncology E, Istituto Nazionale Tumori, Milan, Italy.
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Abstract
c-erbB-2 is an oncoprotein which is overexpressed in some breast cancers. Recently it has been established that the extracellular domain of c-erbB-2 is shed into the serum of patients with breast cancer. There appears to be no association between tumor stage and extracellular domain of c-erbB-2 (c-erbB-2/ECD): c-erbB-2/ECD seems to correlate with patient prognosis whatever the stage of disease. The data also suggest that c-erbB-2/ECD may be useful in monitoring for tumor recurrence and in predicting resistance to hormonal therapy, but not as useful in predicting response to chemotherapy. This may relate to the power of this marker to reflect disease burden, which has an overwhelmingly negative impact on outcome.
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Affiliation(s)
- L Harris
- Department of Hematology/Oncology, Duke University, Durham, North Carolina, USA
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Lacy B, Harris L, Chang L, Lucak S, Gutman C, Dove L, Covington P, Lembo A. A169 EFFICACY AND SAFETY OF ELUXADOLINE IN ELDERLY PATIENTS WITH IRRITABLE BOWEL SYNDROME WITH DIARRHEA. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- B Lacy
- Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | | | - L Chang
- University of California, Los Angeles, CA
| | - S Lucak
- Weill Cornell Medical Center, New York, NY
| | | | - L Dove
- Former employee of Furiex Pharmaceuticals, Inc., an affiliate of Allergan plc, Parsippany, NJ
| | - P Covington
- Former employee of Furiex Pharmaceuticals, Inc., an affiliate of Allergan plc, Parsippany, NJ
| | - A Lembo
- Beth Israel Deaconess Medical Center, Boston, MA
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Krop IE, Hillman D, Polley MY, Tanioka M, Parker J, Huebner L, Henry NL, Tolaney SM, Dang C, Harris L, Berry DA, Perou CM, Partridge A, Winer EP, Carey LA. Abstract GS3-02: Invasive disease-free survival and gene expression signatures in CALGB (Alliance) 40601, a randomized phase III neoadjuvant trial of dual HER2-targeting with lapatinib added to chemotherapy plus trastuzumab. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-gs3-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose
Dual HER2 targeting increases pathologic complete response (pCR) rate to neoadjuvant therapy and improves outcomes in both early and metastatic HER2-positive disease. CALGB 40601 is a randomized phase III trial examining the impact of dual HER2 blockade consisting of trastuzumab (H) and lapatinib (L) added to paclitaxel (T) on pCR, considering tumor and microenvironment molecular features. We previously found that pCR was numerically but not significantly increased with dual therapy, and that tumor molecular subtype and evidence of immune activation significantly and independently affected pCR (Carey et al, JCO 2016). In this secondary analysis, we sought to evaluate the effects of treatment arm and gene expression-defined subgroups on invasive disease free survival (IDFS).
Patients and Methods
Patients (Pts) with stage II to III HER2-positive breast cancer underwent tumor biopsy followed by random assignment with equal probabilityto paclitaxel plus trastuzumab alone (TH) or with the addition of lapatinib (THL) for 16 weeks before surgery. A paclitaxel plus lapatinib (TL) arm was closed early based on reports of futility from other trials. A secondary endpoint was IDFS, defined as the time from surgery until local or distant recurrence, new primary, or death from any cause, whichever was first. Gene expression signatures were identified by RNA sequencing.
Results
Between 12/2008 and 2/2012, 305 pts were enrolled. 261 pts had IDFS and gene expression information available (THL, n = 103; TH, n =101; TL, n = 57); there were no significant differences in clinical characteristics between this subset and the entire population. The median IDFS follow-up was 4.6 years with 40 IDFS events having occurred (THL, n=7; TH, n=19; TL, n=14). IDFS was significantly longer in the THL arm compared to standard TH (HR=0.34; 95% CI: 0.14-0.82; p=0.02). IDFS was also significantly longer among pCR than non-pCR pts (HR=0.40; 95% CI: 0.19-0.81; p=0.01), and did not differ by hormone receptor (HR) status, clinical stage, tumor size, race, menopausal status or age. Among gene expression signatures, only immune activation measured by an IgG signature was associated with longer IDFS (HR=0.71; 95% CI: 0.51-0.98; p=0.04); this signature was previously also associated with pCR. Multivariate analysis showed dual therapy (HR=0.35; p=0.02), pCR (HR=0.36; p=0.01), IgG (HR=0.69; p=0.05), and molecular subtype (LumA vs HER2E, HR=0.24, p=0.005) were associated with longer IDFS. A subgroup analysis by hormone receptor status revealed that among pts with HR+ disease, pts with luminal A experienced longer IDFS (HR=0.23; p=0.02) compared to those with luminal B or HER2-enriched molecular subtypes.
Conclusion
Dual HER2-targeting with lapatinib added to 16 weeks of TH produced significantly longer IDFS than TH alone, despite modest effects on pCR. Similar to pts with HER2-negative disease, pts with luminal A had better IDFS than those with other molecular subtypes. Immune activation as measured by RNA-based signature independently predicted both pCR and IDFS.
Support: U10CA180882, U10CA180821, U24CA196171, P50-CA58823, Susan G Komen, BCRF
Citation Format: Krop IE, Hillman D, Polley M-Y, Tanioka M, Parker J, Huebner L, Henry NL, Tolaney SM, Dang C, Harris L, Berry DA, Perou CM, Partridge A, Winer EP, Carey LA. Invasive disease-free survival and gene expression signatures in CALGB (Alliance) 40601, a randomized phase III neoadjuvant trial of dual HER2-targeting with lapatinib added to chemotherapy plus trastuzumab [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr GS3-02.
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Affiliation(s)
- IE Krop
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - D Hillman
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - M-Y Polley
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - M Tanioka
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - J Parker
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - L Huebner
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - NL Henry
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - SM Tolaney
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - C Dang
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - L Harris
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - DA Berry
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - CM Perou
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - A Partridge
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - EP Winer
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - LA Carey
- Dana-Farber Cancer Institute, Boston, MA; Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN; University of North Carolina, Chapel Hill, NC; University of Michigan, Ann Arbor, MI; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
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Braman N, Prasanna P, Singh S, Beig N, Gilmore H, Etesami M, Bates D, Gallagher K, Bloch BN, Somlo G, Sikov W, Harris L, Plecha D, Varadan V, Madabhushi A. Abstract P4-02-06: Intratumoral and peritumoral MRI signatures of HER2-enriched subtype also predict pathological response to neoadjuvant chemotherapy in HER2+ breast cancers. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-02-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Applying the PAM50 classifier to targeted RNA-Sequencing data allows HER2+ tumors to be sub-categorized into intrinsic breast cancer subtypes. HER2+ breast cancers belonging to the HER2-enriched [HER2-E] subtype exhibit the highest rate of response to neoadjuvant therapy with combination of HER2-blockade and chemotherapy, as well as dual-HER2 blockade alone. A non-invasive predictor of PAM50 subtype from clinical dynamic contrast-enhanced MRI [DCE-MRI] could provide valuable clinical guidance in the treatment of HER2+ breast cancer. In this work, we identify a set of computer-extracted heterogeneity features computed within the lesion and its surrounding peritumoral region capable of distinguishing HER2-E from other HER2+ breast cancers [Non-HER2-E]. We then demonstrate that this imaging signature of HER2-E is also predictive of pathological complete response [pCR] in an independent HER2+ testing set, consistent with the HER2-E subtype's elevated response to HER2-targeted therapy.
Methods: The training set consisted of 42 HER2+ patients with both 1.5 or 3 T DCE-MRI and targeted RNA sequencing collected prior to neoadjuvant treatment from a multicenter trial [BrUOG 211B, n=35] and The Cancer Genome Atlas-Breast Cancer project [TCGA-BRCA, n=7]. Intrinsic subtypes were assigned by unsupervised hierarchical clustering of the PAM50 gene set. 19 patients were determined to belong to the HER2-E subtype, while the remaining 23 represented non-HER2-E subtypes [19 HER2-Luminal, 4 HER2-basal]. Lesion boundaries were annotated by an expertly trained radiologist and expanded to 5 annular peritumoral regions in 3 mm increments out to a maximum radius of 15 mm. Computer-extracted heterogeneity features were computed voxelwise within intratumoral and peritumoral regions by first order statistics. A top HER2-E-associated feature from each region was identified by Wilcoxon feature selection and used to train a diagonal linear discriminant analysis [DLDA] classifier to predict HER2-E in a 3-fold cross-validation setting. This classifier was then applied to pCR prediction from DCE-MRI in a testing set of 28 HER2+ patients with available post neoadjuvant chemotherapy surgical specimens at one institution. 16 patients achieved pCR (ypT0/is), while the remainder had partial or no response (non-pCR).
Results: A combination of heterogeneity features within the intratumoral region and annular peritumoral regions out to 12 mm from the tumor yielded optimal results within the training set, with an average HER2-E prediction AUC of .77 +/- .03. When applied to response prediction in an independent testing set, this HER2-E classifier was predictive of pCR (AUC = .72).
Conclusions: Computer-extracted heterogeneity features calculated within the tumor and the surrounding peritumoral environment on DCE-MRI were able to distinguish the HER2-E PAM50 intrinsic subtype from other HER2+ breast cancers. HER2-E was characterized by elevated expression of intratumoral and peritumoral heterogeneity features, indicating a more disordered imaging phenotype within and around the tumor. Additional independent validation of these findings is needed.
Citation Format: Braman N, Prasanna P, Singh S, Beig N, Gilmore H, Etesami M, Bates D, Gallagher K, Bloch BN, Somlo G, Sikov W, Harris L, Plecha D, Varadan V, Madabhushi A. Intratumoral and peritumoral MRI signatures of HER2-enriched subtype also predict pathological response to neoadjuvant chemotherapy in HER2+ breast cancers [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-02-06.
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Affiliation(s)
- N Braman
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - P Prasanna
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - S Singh
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - N Beig
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - H Gilmore
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - M Etesami
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - D Bates
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - K Gallagher
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - BN Bloch
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - G Somlo
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - W Sikov
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - L Harris
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - D Plecha
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - V Varadan
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
| | - A Madabhushi
- Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Cleveland, OH; National Institutes of Health; Boston Medical Center, Boston, MA; City of Hope Beckman Research Institute and Medical Center, Duarte, CA; Brown University, Providence, RI
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Agrawal V, Cheung YH, Keswarpu P, Somlo G, Abu-Khalaf M, Sikov W, Varadan V, Harris L, Dimitrova N. Abstract P2-05-06: Not presented. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-05-06] [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
This abstract was not presented at the symposium.
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Affiliation(s)
- V Agrawal
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - YH Cheung
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - P Keswarpu
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - G Somlo
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - M Abu-Khalaf
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - W Sikov
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - V Varadan
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - L Harris
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - N Dimitrova
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
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Harris L, McGarty A, Hutchison L, Ells L, Hankey C. Short-term intermittent energy restriction interventions for weight management: a systematic review and meta-analysis. Obes Rev 2018; 19:1-13. [PMID: 28975722 DOI: 10.1111/obr.12593] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/22/2017] [Accepted: 07/03/2017] [Indexed: 11/30/2022]
Abstract
This systematic review synthesized the available evidence on the effect of short-term periods of intermittent energy restriction (weekly intermittent energy restriction; ≥7-d energy restriction) in comparison with usual care (daily continuous energy restriction), in the treatment of overweight and obesity in adults. Six electronic databases were searched from inception to October 2016. Only randomized controlled trials of interventions (≥12 weeks) in adults with overweight and obesity were included. Five studies were included in this review. Weekly intermittent energy restriction periods ranged from an energy intake between 1757 and 6276 kJ/d-1 . The mean duration of the interventions was 26 (range 14 to 48) weeks. Meta-analysis demonstrated no significant difference in weight loss between weekly intermittent energy restriction and continuous energy restriction post-intervention (weighted mean difference: -1.36 [-3.23, 0.51], p = 0.15) and at follow-up (weighted mean difference: -0.82 [-3.76, 2.11], p = 0.58). Both interventions achieved comparable weight loss of >5 kg and therefore were associated with clinical benefits to health. The findings support the use of weekly intermittent energy restriction as an alternative option for the treatment of obesity. Currently, there is insufficient evidence to support the long-term sustainable effects of weekly intermittent energy restriction on weight management.
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Affiliation(s)
- L Harris
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A McGarty
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Hutchison
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Ells
- Health and Social Care Institute, Teesside University, United Kingdom Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, Middlesbrough, UK
| | - C Hankey
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Melville CA, McGarty A, Harris L, Hughes-McCormack L, Baltzer M, McArthur LA, Morrison J, Allan L, Cooper SA. A population-based, cross-sectional study of the prevalence and correlates of sedentary behaviour of adults with intellectual disabilities. J Intellect Disabil Res 2018; 62:60-71. [PMID: 29214701 DOI: 10.1111/jir.12454] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/29/2017] [Accepted: 10/24/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND High levels of sedentary behaviour have a negative impact on health and well-being. There is limited evidence on the prevalence and correlates of sedentary behaviour of adults with intellectual disabilities (ID). METHODS A population-based sample of adults with ID were invited to take part in a comprehensive health check programme. Demographic and health data were collected during a structured interview and physical examination. Screen time was used as a proxy measure of sedentary behaviour. Bivariate and multivariate statistical modelling examined correlates of screen time. RESULTS Fifty per cent of the 725 participants reported four or more hours of screen time per day. Male gender, higher levels of intellectual ability, mobility problems, obesity, not having hearing impairment and not having epilepsy were all significantly associated with higher screen time in the final multivariate model (R2 = 0.16; Hosmer-Lemeshow goodness of fit statistic P = 0.36). CONCLUSIONS This is the first study to publish population-based data on the prevalence and correlates of sedentary behaviour in adults with ID. Compared with adults who do not have ID, adults with ID have higher levels, and different correlates, of sedentary behaviour. A better understanding of the social context of sedentary behaviour will inform the design of effective behaviour change programmes for adults with ID.
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Affiliation(s)
- C A Melville
- Institute of Health and Wellbeing, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - A McGarty
- Institute of Health and Wellbeing, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - L Harris
- Institute of Health and Wellbeing, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - L Hughes-McCormack
- Institute of Health and Wellbeing, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - M Baltzer
- School of Social and Political Sciences, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - L A McArthur
- Institute of Health and Wellbeing, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - J Morrison
- Institute of Health and Wellbeing, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - L Allan
- Care, Support & Rights Division, Population Health Improvement Directorate, Scottish Government, Edinburgh, UK
| | - S-A Cooper
- Institute of Health and Wellbeing, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Weinberg L, Harris L, Bellomo R, Ierino F, Story D, Eastwood G, Collins M, Churilov L, Mount P. Effects of intraoperative and early postoperative normal saline or Plasma-Lyte 148® on hyperkalaemia in deceased donor renal transplantation: a double-blind randomized trial. Br J Anaesth 2017; 119:606-615. [DOI: 10.1093/bja/aex163] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2017] [Indexed: 11/12/2022] Open
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Schieffer KM, Choi CS, Emrich S, Harris L, Deiling S, Karamchandani DM, Salzberg A, Kawasawa YI, Yochum GS, Koltun WA. RNA-seq implicates deregulation of the immune system in the pathogenesis of diverticulitis. Am J Physiol Gastrointest Liver Physiol 2017; 313:G277-G284. [PMID: 28619727 PMCID: PMC6146301 DOI: 10.1152/ajpgi.00136.2017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/06/2017] [Accepted: 06/06/2017] [Indexed: 01/31/2023]
Abstract
Individuals with diverticula or outpouchings of the colonic mucosa and submucosa through the colonic wall have diverticulosis, which is usually asymptomatic. In 10-25% of individuals, the diverticula become inflamed, resulting in diverticulitis. Very little is known about the pathophysiology or gene regulatory pathways involved in the development of diverticulitis. To identify these pathways, we deep sequenced RNAs isolated from full-thickness sections of sigmoid colon from diverticulitis patients and control individuals. Specifically for diverticulitis cases, we analyzed tissue adjacent to areas affected by chronic disease. Since the tissue was collected during elective sigmoid resection, the disease was in a quiescent state. A comparison of differentially expressed genes found that gene ontology (GO) pathways associated with the immune response were upregulated in diverticulitis patients compared with nondiverticulosis controls. Next, weighted gene coexpression network analysis was performed to identify the interaction among coexpressed genes. This analysis revealed RASAL3, SASH3, PTPRC, and INPP5D as hub genes within the brown module eigengene, which highly correlated (r = 0.67, P = 0.0004) with diverticulitis. Additionally, we identified elevated expression of downstream interacting genes. In summary, transcripts associated with the immune response were upregulated in adjacent tissue from the sigmoid colons of chronic, recurrent diverticulitis patients. Further elucidating the genetic or epigenetic mechanisms associated with these alterations can help identify those at risk for chronic disease and may assist in clinical decision management.NEW & NOTEWORTHY By using an unbiased approach to analyze transcripts expressed in unaffected colonic tissues adjacent to those affected by chronic diverticulitis, our study implicates that a defect in the immune response may be involved in the development of the disease. This finding expands on the current data that suggest the pathophysiology of diverticulitis is mediated by dietary, age, and obesity-related factors. Further characterizing the immunologic differences in diverticulitis may better inform clinical decision-making.
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Affiliation(s)
- Kathleen M Schieffer
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Christine S Choi
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Scott Emrich
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Leonard Harris
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Sue Deiling
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Dipti M Karamchandani
- Division of Anatomic Pathology, Department of Pathology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Anna Salzberg
- Institute for Personalized Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Yuka I Kawasawa
- Institute for Personalized Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
- Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania; and
| | - Gregory S Yochum
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Walter A Koltun
- Division of Colon and Rectal Surgery, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania;
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Gillespie H, Kwok A, Raves V, Bari A, Mestrov F, Rees T, Harris L, Payne B. A RETROSPECTIVE AUDIT OF PAIN MANAGEMENT IN PATIENTS PRESENTING WITH HIP FRACTURE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H. Gillespie
- Northern Sydney Local Health District, Mona Vale, New South Wales, Australia
| | - A.C. Kwok
- Northern Sydney Local Health District, Mona Vale, New South Wales, Australia
| | - V. Raves
- Northern Sydney Local Health District, Mona Vale, New South Wales, Australia
| | - A. Bari
- Northern Sydney Local Health District, Mona Vale, New South Wales, Australia
| | - F. Mestrov
- Northern Sydney Local Health District, Mona Vale, New South Wales, Australia
| | - T. Rees
- Northern Sydney Local Health District, Mona Vale, New South Wales, Australia
| | - L. Harris
- Northern Sydney Local Health District, Mona Vale, New South Wales, Australia
| | - B. Payne
- Northern Sydney Local Health District, Mona Vale, New South Wales, Australia
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Harris L. Is Vein Bypass Truly Superior to Endovascular Intervention for Tibial Disease With "Severe" Limb Ischaemia? Eur J Vasc Endovasc Surg 2017; 54:202. [PMID: 28587798 DOI: 10.1016/j.ejvs.2017.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 05/03/2017] [Indexed: 11/24/2022]
Affiliation(s)
- L Harris
- Buffalo General Medical Center, Kaleida Health, 100 High St, Buffalo, NY 14203, USA.
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Affiliation(s)
- L. Harris
- Department of Nuclear Engineering The University of Michigan Ann Arbor, Michigan
| | - G. Sherwood
- Department of Nuclear Engineering The University of Michigan Ann Arbor, Michigan
| | - J. S. King
- Department of Nuclear Engineering The University of Michigan Ann Arbor, Michigan
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Leslie WS, Taylor R, Harris L, Lean MEJ. Weight losses with low-energy formula diets in obese patients with and without type 2 diabetes: systematic review and meta-analysis. Int J Obes (Lond) 2017; 41:997. [PMID: 28290463 PMCID: PMC5467239 DOI: 10.1038/ijo.2017.46] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Singh S, Gilmore H, Somlo G, Abu-Khalaf M, Sikov W, Harris L, Varadan V. Abstract P1-05-09: Association of co-amplicons with immune infiltration in subtypes of HER2-Positive breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-05-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: HER2+ breast cancers are heterogeneous at both clinical and molecular levels. We and others have determined that the HER2-Enriched subtype exhibits the highest rate of pathologic complete response (pCR) to neoadjuvant chemotherapy and trastuzumab (T), while the HER2-Basal subtype is resistant to anti-HER2 therapy (Carey et al, JCO 2015;Varadan et al, CCR 2016). Additionally, we reported that signatures of immune cell infiltration and immune cell subsets evaluated after one dose of T can predict pCR to preoperative T and chemotherapy (Varadan et al, CCR 2016). Given recent evidence for improved immune response with increasing mutational load, we chose to characterize the association of somatic mutations and copy-number alterations with subtypes of HER2+ breast cancer and immune modulation after one dose of T.
Methods: Fresh tumor core biopsies were taken at baseline and 2 weeks after one dose of either T or nab-paclitaxel (N) from 60 patients with stage II-III HER2+ cancers enrolled on a multicenter trial (BrUOG 211B). All patients then received 18 weeks of T+N+carboplatin. PAM50 subtyping was performed using gene expression data from patient tumor biopsies and tumors were classified into HER2-Enriched, HER2-Luminal and HER2-Basal subtypes. Whole-exome sequencing (WES) was performed on a total of 86 samples (49 baseline, 37 brief-exposure), sequenced at an average depth of 90X. Somatic mutations were detected by applying multiple mutation-detection algorithms on the WES data, followed by stringent quality control using public and in-house variant databases, and mutation data curated from 11,000 tumors sequenced by the TCGA. Somatic copy-number alterations were estimated using a published algorithm, ENVE (Varadan et al, Genome Med 2015) that robustly detects somatic copy-number alterations in WES tumor profiles. We employed previously defined gene-expression signatures (Varadan et al, CCR 2016) of total immune infiltration and immune cell subsets, to assess for association with genomic aberrations.
Results: HER2-Basal tumors exhibited lower average copy number for HER2 and were less likely to have high-level amplifications of co-amplicons (e.g. 11q13, 20q13) with the exception of the MYC amplicon (8q24). They also exhibited a non-significant (P=0.33) trend towards higher mutational burden (Avg=85) compared to HER2-Luminals (Avg=79). A majority of somatic mutations (62%, 2282/3666) persisted after a single-dose of either T or N, while 17% (624/3666) were not detectable after brief-exposure. There was no association between immune infiltration and mutational burden in any HER2 subtype. Tumors harboring FGFR1 (8p11) amplifications exhibited higher gene-signature levels for macrophages (P=0.0073) and T-cells (P=0.0493) but not B-cells (P=0.213).
Conclusions: The HER2-Basal subtype is less likely to respond to trastuzumab-based neoadjuvant therapy and exhibits lower numbers of common amplicons. The disappearance of mutations after brief-exposure to therapy may be due to either tumor heterogeneity/sampling or clonal selection. The association of 8p11 amplifications with increased T-cell infiltration suggests that this amplicon may play an immunogenic role in HER2+ breast cancer. These results warrant further investigation in larger cohorts.
Citation Format: Singh S, Gilmore H, Somlo G, Abu-Khalaf M, Sikov W, Harris L, Varadan V. Association of co-amplicons with immune infiltration in subtypes of HER2-Positive breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-05-09.
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Affiliation(s)
- S Singh
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT; Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Cancer Diagnosis Program, National Cancer Institute, Rockville, MD
| | - H Gilmore
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT; Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Cancer Diagnosis Program, National Cancer Institute, Rockville, MD
| | - G Somlo
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT; Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Cancer Diagnosis Program, National Cancer Institute, Rockville, MD
| | - M Abu-Khalaf
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT; Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Cancer Diagnosis Program, National Cancer Institute, Rockville, MD
| | - W Sikov
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT; Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Cancer Diagnosis Program, National Cancer Institute, Rockville, MD
| | - L Harris
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT; Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Cancer Diagnosis Program, National Cancer Institute, Rockville, MD
| | - V Varadan
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT; Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Cancer Diagnosis Program, National Cancer Institute, Rockville, MD
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Tanioka M, Fan C, Carey LA, Hyslop T, Pitcher BN, Parker JA, Hoadley KA, Henry NL, Tolaney S, Dang C, Krop IE, Harris L, Berry DA, Mardis E, Perou CM, Winer EP, Hudis CA. Abstract S3-05: Integrated analysis of multidimensional genomic data on CALGB 40601 (Alliance), a randomized neoadjuvant phase III trial of weekly paclitaxel (T) and trastuzumab (H) with or without lapatinib (L) for HER2-positive breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-s3-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: RNA profiling and mutational analyses in CALGB 40601 (NCT00770809) found significant impact on pathologic complete response (pCR) rates from tumor (intrinsic subtype, p53 mutation) and microenvironmental (immune cell) features. Integrated analysis across platforms is needed to better understand the roles of these different factors with respect to response to HER2-targeted therapies.
Methods: We performed a comprehensive genomic analyses on pCR, defined as no invasive tumor in the breast, by integrating clinicopathological information with somatic mutation status, 422 segment-level DNA Copy Number Alterations (CNAs), and 510 gene expression signatures using mRNAseq and DNA exome sequencing from 213 pre-treatment tumors. Excluding 48 samples in the TL arm that was closed early due to futility, and 4 Normal-like tumors, the dataset consisted of 161 patients from TH and THL arms including 47 HER2-enriched (HER2E), 8 Basal-like, 54 Luminal A, and 52 Luminal B, all of whom received H. The main analysis was performed using the Elastic Net on multivariate logistic regression models for predicting pCR. The samples were divided into a training and a test set, then models were built to predict pCR by 10-fold cross-validation in the training set, then applying the best model onto the test set to construct ROC curves and evaluate prediction accuracy by calculating area under ROC (AUC). We also used the DawnRank, a network-based bioinformatics tool that integrates DNA and RNA data to identify driver genes, to find predictors of resistance to H-containing therapies.
Results: Among clinicopathological factors, clinical estrogen/progesterone receptor (ER/PgR) status and intrinsic subtype by PAM50 were statistically associated with pCR, but treatment arm (TH vs THL) and stage were not. In the Elastic Net analysis, the models incorporating either gene signatures (AUC: 0.724) or CNAs (AUC: 0.777) were more predictive of response than mutation status model (AUC: 0.635). Gene signatures and CNAs were further combined with either mutation status (AUC: 0.773), clinical ER/PgR status (AUC: 0.787) or ER/PgR status plus intrinsic subtype (AUC: 0.784). The combination with the highest AUC comprised gene signatures, CNAs, and ER/PgR status, and demonstrated that CNAs at Chromosome (Chr.) 6p, 10q22, or 11q23, the signature of Correlation to HER2E, and a T-cell signature, positively predicted pCR and that Luminal and PgR gene signatures were negative predictors. The CN gain of Chr.6p, which contains the HLA genes, predicted for pCR and was associated with higher expression of HLA genes and B cell / IgG signatures. The CN loss of Chr.11q23 including CD3D, CD3E, and CD3G was also identified by DawnRank as a region associated with resistance.
Conclusions: Tumor genetics (CNAs), tumor RNA subtype (HER2E, Luminal), and the microenvironment (immune cells) were independently predictive of response to H-containing therapies and biologically and clinically important for HER2-positive breast cancer, supporting integrated RNA- and DNA-based tumor assessments to clarify response to HER2-targeting.
Support: U10CA031946/033601/180821/180882/180888.
Citation Format: Tanioka M, Fan C, Carey LA, Hyslop T, Pitcher BN, Parker JA, Hoadley KA, Henry NL, Tolaney S, Dang C, Krop IE, Harris L, Berry DA, Mardis E, Perou CM, Winer EP, Hudis CA. Integrated analysis of multidimensional genomic data on CALGB 40601 (Alliance), a randomized neoadjuvant phase III trial of weekly paclitaxel (T) and trastuzumab (H) with or without lapatinib (L) for HER2-positive breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr S3-05.
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Affiliation(s)
- M Tanioka
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - C Fan
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - LA Carey
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - T Hyslop
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - BN Pitcher
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - JA Parker
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - KA Hoadley
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - NL Henry
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - S Tolaney
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - C Dang
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - IE Krop
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - L Harris
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - DA Berry
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - E Mardis
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - CM Perou
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - EP Winer
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
| | - CA Hudis
- University of North Carolina, Chapel Hill, NC; Alliance Statistics and Data Center, Duke University, Durham, NC; University of Michigan, Ann Arbor, MI; Dana Farber Cancer Institute, Boston, MA; Memorial Sloan Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; Alliance Statistics and Data Center, M.D. Anderson, Houston, TX; Washington University, St. Louis, MO
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Kantharia S, Cornish N, Portnow L, Brichkov I, Shaw J, Harris L, Honig S, Sobolevsky S. Radiofrequency ablation for primary lung carcinomas: a retrospective review at a community hospital. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1094] [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] Open
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Leslie WS, Taylor R, Harris L, Lean MEJ. Weight losses with low-energy formula diets in obese patients with and without type 2 diabetes: systematic review and meta-analysis. Int J Obes (Lond) 2017; 41:96-101. [PMID: 27698345 PMCID: PMC5368342 DOI: 10.1038/ijo.2016.175] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 12/16/2022]
Abstract
AIM To provide a systematic review, of published data, to compare weight losses following very low calorie (<800 kcal per day VLCD) or low-energy liquid-formula (>800 kcal per day LELD) diets, in people with and without type 2 diabetes mellitus (T2DM). METHODS Systematic electronic searches of Medline (1946-2015) and Embase (1947-2015) to identify published studies using formula total diet replacement diets (VLCD/LELD). Random effects meta-analysis using weighted mean difference (WMD) in body weight between groups (with and without diabetes) as the summary estimate. RESULTS Final weight loss, in the five included studies, weighted for study sizes, (n=569, mean BMI=35.5-42.6 kg/m2), was not significantly different between participants with and without T2DM: -1.2 kg; 95% CI: -4.1 to 1.6 kg). Rates of weight loss were also similar in the two groups -0.6 kg per week (T2DM) and 0.5 kg per week (no diabetes), and for VLCD (<800 kcal per day) and LELD (>800 kcal per day). CONCLUSIONS Weight losses with liquid-formula diets are very similar for VLCD and LELD and for obese subjects with or without T2DM. They can potentially achieve new weight loss/ maintenance targets of >15-20% for people with severe and medically complicated obesity.
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Affiliation(s)
- W S Leslie
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - R Taylor
- Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - L Harris
- Institute of Mental Health & Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - M E J Lean
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
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Loll D, Bauermeister J, Ela E, Manu A, Morhe E, Dozier J, Harris L, Dalton V, Hall K. Reproductive autonomy and contraceptive use among adolescent and young adult women in Ghana. Contraception 2016. [DOI: 10.1016/j.contraception.2016.07.124] [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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Pan JC, Booth J, Ross V, Harris L, Pan P. Abstract PR213. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492611.92153.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kohut SA, Stinson J, Forgeron P, Luca S, Harris L. (490) Being a peer mentor to youth with painful chronic conditions: perceived benefits and challenges. The Journal of Pain 2016. [DOI: 10.1016/j.jpain.2016.01.297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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