1
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Patel J, Aittaleb R, Doherty R, Gera A, Lau B, Messinger D, Wadden J, Franson A, Saratsis A, Koschmann C. Liquid biopsy in H3K27M diffuse midline glioma. Neuro Oncol 2024; 26:S101-S109. [PMID: 38096156 PMCID: PMC11066927 DOI: 10.1093/neuonc/noad229] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Indexed: 02/15/2024] Open
Abstract
Diffuse midline glioma (DMG) with H3K27M mutation is an aggressive and difficult to treat pediatric brain tumor. Recurrent gain of function mutations in H3.3 (H3.3A) and H3.1 (H3C2) at the 27th lysine to methionine (H3K27M) are seen in over 2/3 of DMGs, and are associated with a worse prognosis. Due to the anatomical location of DMG, traditional biopsy carries risk for neurologic injury as it requires penetration of vital midline structures. Further, radiographic (MRI) monitoring of DMG often shows nonspecific changes, which makes therapeutic monitoring difficult. This indicates a critical need for more minimally invasive methods, such as liquid biopsy, to understand, diagnose, and monitor H3K27M DMG. Here, we review the use of all modalities to date to detect biomarkers of H3K27M in cerebrospinal fluid (CSF), blood, and urine, and compare their effectiveness in detection, diagnosis, and monitoring treatment response. We provide specific detail of recent efforts to monitor CSF and plasma H3K27M cell-free DNA in patients undergoing therapy with the imipridone ONC201. Lastly, we discuss the future of therapeutic monitoring of H3K27M-DMG, including biomarkers such as mitochondrial DNA, mutant and modified histones, and novel sequencing-based approaches for improved detection methods.
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Affiliation(s)
- Jina Patel
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Rayan Aittaleb
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Robert Doherty
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Ananya Gera
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Benison Lau
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Dana Messinger
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jack Wadden
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Andrea Franson
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
| | | | - Carl Koschmann
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
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2
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Mullineaux ST, McKinley JM, Marks NJ, Doherty R, Scantlebury DM. A nose for trouble: ecotoxicological implications for climate change and disease in Saiga antelope (S. t. tatarica). Environ Geochem Health 2024; 46:93. [PMID: 38367154 PMCID: PMC10874336 DOI: 10.1007/s10653-024-01874-y] [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: 07/11/2023] [Accepted: 01/12/2024] [Indexed: 02/19/2024]
Abstract
In recent decades, Saiga antelope (Saiga t. tatarica) mass die-offs have become more common. The mass die-off of 2015 in central Kazakhstan, recorded 140,000 individual deaths across multiple herds. Previously, research has shown atmospheric humidity, the bacterium Pasteurella multocida serotype B, and resultant haemorrhagic septicaemia, were the primary cause. However, other synergistic factors may have impacted this process. Here we use a multivariate compositional data analysis (CoDA) approach to assess what other factors may have been involved. We show a pollutant linkage mechanism where relative humidity and dewpoint temperature combine with environmental pollutants, potentially toxic elements (e.g., Hg, As), complex carbon compounds (e.g., Acetone, Toluene), and inorganic compounds (e.g., CHx, SO2) which affected the Saiga during the calving season (start and peak) and at the onset of the mass die-off. We suggest a mechanism for this process. Upon arrival at their carving grounds, the Saiga experienced a sudden precipitation event, a spike in temperatures, and resultant high humidity occurs. The infectious bacterium P. multocida serotype B then spreads. Further, environmental pollutants contained within steppe soils are released to the air, forming localised smog events, these synergistically combine, and mass die-off occurs.
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Affiliation(s)
- S T Mullineaux
- School of Natural and Built Environment, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - J M McKinley
- School of Natural and Built Environment, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - N J Marks
- School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - R Doherty
- School of Natural and Built Environment, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - D M Scantlebury
- School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
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3
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Koschmann C, Al-Holou WN, Alonso MM, Anastas J, Bandopadhayay P, Barron T, Becher O, Cartaxo R, Castro MG, Chung C, Clausen M, Dang D, Doherty R, Duchatel R, Dun M, Filbin M, Franson A, Galban S, Garcia Moure M, Garton H, Gowda P, Marques JG, Hawkins C, Heath A, Hulleman E, Ji S, Jones C, Kilburn L, Kline C, Koldobskiy MA, Lim D, Lowenstein PR, Lu QR, Lum J, Mack S, Magge S, Marini B, Martin D, Marupudi N, Messinger D, Mody R, Morgan M, Mota M, Muraszko K, Mueller S, Natarajan SK, Nazarian J, Niculcea M, Nuechterlein N, Okada H, Opipari V, Pai MP, Pal S, Peterson E, Phoenix T, Prensner JR, Pun M, Raju GP, Reitman ZJ, Resnick A, Rogawski D, Saratsis A, Sbergio SG, Souweidane M, Stafford JM, Tzaridis T, Venkataraman S, Vittorio O, Wadden J, Wahl D, Wechsler-Reya RJ, Yadav VN, Zhang X, Zhang Q, Venneti S. A road map for the treatment of pediatric diffuse midline glioma. Cancer Cell 2024; 42:1-5. [PMID: 38039965 PMCID: PMC11067690 DOI: 10.1016/j.ccell.2023.11.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/04/2023] [Accepted: 11/04/2023] [Indexed: 12/03/2023]
Abstract
Recent clinical trials for H3K27-altered diffuse midline gliomas (DMGs) have shown much promise. We present a consensus roadmap and identify three major barriers: (1) refinement of experimental models to include immune and brain-specific components; (2) collaboration among researchers, clinicians, and industry to integrate patient-derived data through sharing, transparency, and regulatory considerations; and (3) streamlining clinical efforts including biopsy, CNS-drug delivery, endpoint determination, and response monitoring. We highlight the importance of comprehensive collaboration to advance the understanding, diagnostics, and therapeutics for DMGs.
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Affiliation(s)
| | | | | | | | | | - Tara Barron
- Stanford University, Stanford, CA 94305, USA
| | - Oren Becher
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | | | - Chan Chung
- Daegu Gyeongbuk Institute of Science & Technology, Daegu, South Korea
| | | | - Derek Dang
- University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Ryan Duchatel
- University of Newcastle, Callaghan, NSW 2308, Australia
| | - Matthew Dun
- University of Newcastle, Callaghan, NSW 2308, Australia
| | | | | | | | | | - Hugh Garton
- University of Michigan, Ann Arbor, MI 48109, USA
| | | | | | | | - Allison Heath
- Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | | | - Sunjong Ji
- University of Michigan, Ann Arbor, MI 48109, USA
| | - Chris Jones
- Division of Molecular Pathology, Institute for Cancer Research, London SM2 5NG, UK
| | | | - Cassie Kline
- Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | | | - Daniel Lim
- University of California, San Francisco, San Francisco, CA 94143, USA
| | | | - Q Richard Lu
- Cincinnati Children's Hospital Medical Center, and University of Cincinnati, Cincinnati, OH 45229, USA
| | - Joanna Lum
- University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Suresh Magge
- University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Donna Martin
- University of Michigan, Ann Arbor, MI 48109, USA
| | | | | | - Rajen Mody
- University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Mateus Mota
- University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Sabine Mueller
- University of California, San Francisco, San Francisco, CA 94143, USA; Parker Institute for Cancer Immunotherapy, University of Zurich, Zurich, Switzerland
| | | | - Javad Nazarian
- Children's National, Washington, DC 20010, USA; University of Zurich, Zurich, Switzerland
| | | | - Nicholas Nuechterlein
- University of Michigan, Ann Arbor, MI 48109, USA; National Institutes of Health, Bethesda, MD, USA
| | - Hideho Okada
- University of California, San Francisco, San Francisco, CA 94143, USA
| | | | | | | | | | - Timothy Phoenix
- Cincinnati Children's Hospital Medical Center, and University of Cincinnati, Cincinnati, OH 45229, USA
| | | | - Matthew Pun
- University of Michigan, Ann Arbor, MI 48109, USA
| | - G Praveen Raju
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | - Adam Resnick
- Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | | | | | | | - Mark Souweidane
- Weill Cornell Medicine, New York Presbyterian and Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - James M Stafford
- Weill Cornell Medicine, New York Presbyterian and Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Theophilos Tzaridis
- Herbert Irving Comprehensive Cancer Center and Department of Neurology, Columbia University Medical Center, New York, NY 10032, USA
| | | | - Orazio Vittorio
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Jack Wadden
- University of Michigan, Ann Arbor, MI 48109, USA
| | - Daniel Wahl
- University of Michigan, Ann Arbor, MI 48109, USA
| | | | | | - Xu Zhang
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Qiang Zhang
- University of Michigan, Ann Arbor, MI 48109, USA
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4
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Doherty R, Madigan S, Nevill A, Warrington G, Ellis J. The impact of long haul travel on the sleep of elite athletes. Neurobiol Sleep Circadian Rhythms 2023; 15:100102. [PMID: 37766939 PMCID: PMC10520441 DOI: 10.1016/j.nbscr.2023.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
In order to manage and implement strategies to alleviate the symptoms of jet lag it is essential to assess the impact of jet lag in athletes. The aim of this study was to assess the impact of long haul eastward travel on elite athletes' (n = 7 elite national track cyclists; male n = 3, and female n = 4) sleep. The athletes' sleep was monitored before, during and after travel using both actigraphy and self-report measures. Participants wore an activity monitor for 5 days prior to travel, during the long haul travel and 5 days upon arrival at their destination and completed a daily online sleep diary Actigraphy highlighted significant reductions in time in bed, total sleep time and sleep efficiency (%) due to long haul eastward travel, particularly in the 48 h after travel. Sleep diary data exhibited significant reductions in time in bed, total sleep time, sleep efficiency, sleep quality and a significant increase in fatigue going to bed as a result of long haul eastward travel. In order to facilitate the development of interventions to reduce the symptoms and severity of jet lag objective and subjective assessments of sleep should be coupled with assessments of chronotype and perceived sleep need.
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Affiliation(s)
- R. Doherty
- Sports Lab North West, Atlantic Technological University, Letterkenny Campus, F92 FC93 Donegal, Ireland
- Sport Ireland Institute, National Sports Campus, Abbotstown, D15 PNON, Ireland
| | - S.M. Madigan
- Sport Ireland Institute, National Sports Campus, Abbotstown, D15 PNON, Ireland
| | - A. Nevill
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall Campus, Walsall, WV1 1LY, UK
| | - G. Warrington
- Sport and Human Performance Research Centre, Schuman Building, University of Limerick, V94 T9PX, Ireland
- Department of Physical Education and Sport Sciences, University of Limerick, V94 T9PX, Ireland
| | - J.G. Ellis
- Northumbria Centre for Sleep Research, Northumbria University, Newcastle, NE7 7XA, UK
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5
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Parkinson M, Doherty R, Curtis F, Dani M, Fertleman M, Kolanko M, Soreq E, Barnaghi P, Sharp D, Li LM. 1415 NOVEL APPROACHES TO POST DISCHARGE CARE. REMOTE HEALTHCARE MONITORING SYSTEMS FOLLOWING TRAUMATIC BRAIN INJURY IN OLDER ADULTS. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.040] [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: 01/19/2023] Open
Abstract
Abstract
Introduction
Major trauma including Traumatic Brain Injury (TBI) is an increasingly common cause of hospitalisation in older adults (OAs). We studied post-discharge recovery from TBI using a remote healthcare monitoring system that captures data on activity and sleep. We aim to assess the feasibility and acceptability of this technology to monitor recovery at home following a significant acute health event in OAs.
Methods
We installed Minder, a remote healthcare monitoring system, in recently discharged patients >60 years with moderate-severe TBI. We present descriptive analyses of post-discharge recovery for two males, corroborating data from Minder against verified activities and events. We recorded semi-structured interviews assessing acceptability. Both participants have similar household set-up, multimorbidity profiles and clinical frailty scores; however, one participant has prior cognitive impairment (PAT1), and one does not (PAT2).
Results
We present 10 weeks of sleep and activity data from Minder and feedback from interviews. Data observed from PAT1 revealed habitual patterns of activity and sleep. These remained stable, despite discrete clinical events. Conversely, PAT2's data revealed irregular sleep patterns that became increasingly fragmented. Activity was detected in multiple rooms throughout the house at night, consistent with carer reports of night-time wandering. Increased overnight activity coincided with multiple falls, prompting increased care provision. Initial feedback from interviews was the technology helped participants and those involved in their care feel supported.
Conclusions
As pressure on services mounts, novel approaches to post-discharge care are of increasing importance. Remote healthcare monitoring can provide high temporal resolution data offering ‘real world’ insights into the effects of significant health events in OAs. Our provisional results support our hypothesis that use of this technology is feasible and acceptable for frail, multimorbid participants and highlights the substantial potential of this technology to help clinicians improve community-based care and more effectively monitor interventions and chronic conditions.
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Affiliation(s)
| | - R Doherty
- Imperial College London Brain sciences,
| | - F Curtis
- Imperial College London and the University of Surrey UK DRI Care Research and Technology Centre,
| | - M Dani
- Imperial College London Bioengineering,
| | | | - M Kolanko
- Imperial College London Brain sciences,
- Imperial College London and the University of Surrey UK DRI Care Research and Technology Centre,
| | - E Soreq
- Imperial College London Brain sciences,
- Imperial College London and the University of Surrey UK DRI Care Research and Technology Centre,
| | - P Barnaghi
- Imperial College London Brain sciences,
- Imperial College London and the University of Surrey UK DRI Care Research and Technology Centre,
| | - D Sharp
- Imperial College London Brain sciences,
- Imperial College London and the University of Surrey UK DRI Care Research and Technology Centre,
| | - L M Li
- Imperial College London Brain sciences,
- Imperial College London and the University of Surrey UK DRI Care Research and Technology Centre,
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6
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Outland BE, Erickson S, Doherty R, Fox W, Ward L. Reforming Physician Payments to Achieve Greater Equity and Value in Health Care: A Position Paper of the American College of Physicians. Ann Intern Med 2022; 175:1019-1021. [PMID: 35724380 DOI: 10.7326/m21-4484] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Socioeconomic factors remain one of the most clinically significant contributors to health outcomes in this country, yet the current fee-for-service payment structure incentivizes volume and does not address such factors. The American College of Physicians proposes specific policy recommendations on reforming payment programs, including those designed to treat underserved patient populations, to better address value in health care and achieve greater equity. The proposal advocates that population-based prospective payment models, including hybrid models that combine fee-for-service with prospective payments, not only have the potential to achieve high-value care but can also be designed in such a way as to adjust for the social drivers that impact health outcomes. The need to recognize health care disparities and inequities in the implementation of the Quality Payment Program in particular and risk scoring in general and the need for social policies to improve access to health information technology are further examples of policy prescriptions that can advance equity. Evidence-based services and programs in Medicare Part B that are shown to preserve the Medicare trust fund through savings in Part A should be able to be scored as offsets for the cost of those new programs. The approach of building a health care system that is smarter about how dollars are spent to make people healthier must shift to one with a clear intention of decreasing health inequities and addressing social drivers of health.
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Affiliation(s)
- Brian E Outland
- American College of Physicians, Washington, DC (B.E.O., S.E., R.D.)
| | - Shari Erickson
- American College of Physicians, Washington, DC (B.E.O., S.E., R.D.)
| | - Robert Doherty
- American College of Physicians, Washington, DC (B.E.O., S.E., R.D.)
| | - William Fox
- Fox and Brantley Internal Medicine, Charlottesville, Virginia (W.F.)
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7
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Pearson-Farr J, Doherty R, Chatelet D, Goggin P, Ng B, Lucas J, Cleal J, Lewis R, Cheong Y. P-414 Ultrastructural and functional defects in cilia of endometrial glands from women with reproductive failure. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.391] [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] Open
Abstract
Abstract
Study question
Do endometrial gland factors influence pregnancy success?
Summary answer
Increased proportion of cilia defects during the window of implantation in endometrial glands from women with reproductive failure compared to controls
What is known already
Endometrial glands are important for embryo implantation and successful pregnancy. There is an unmet clinical need to relate endometrial gland structure to function, identify markers for reproductive failure and targets for therapeutic interventions. Ciliated epithelial cells in the endometrium are a distinct cell type with a particular cell transcriptomic signature. Cilia defects have been reported in endometrial glands from women with reproductive failure however, a quantitative study of cilia defects in endometrial glands is yet to be established.
Study design, size, duration
An observational study comparing women with subfertility, recurrent pregnancy loss and controls
Participants/materials, setting, methods
Endometrial samples were collected during the implantation period from fertile controls (n = 10), women with subfertility (n = 11) and women with recurrent pregnancy loss (n = 15). Ciliated cells in endometrial glands were imaged by transmission electron microscopy and the proportion of cilia defects were quantified and compared between study groups. Endometrial glands were isolated from endometrial biopsies and the cilia beat frequency of ciliated cells was quantified by high-speed video analysis.
Main results and the role of chance
Our study reports a significant increase in the proportion of cilia ultrastructural defects in endometrial glands from women with subfertility versus fertile controls (P < 0.05). Cilia defects included microtubule disarrangement, transposition and loss of cilia inner dynein arm motor proteins. Ciliated cells in endometrial glands from women with recurrent pregnancy loss demonstrated a higher proportion of defects compared to fertile controls but this did not reach statistical significance (P = 0.07). A significant decrease in cilia beat frequency was reported in ciliated cells of endometrial glands from women with subfertility compared to fertile controls (P < 0.05).
Limitations, reasons for caution
This is an observational study with a relatively small sample size however, the participants in the study and control groups were matched for age, BMI and menstrual cycle characteristics.
Wider implications of the findings
This study quantified ultrastructural and functional differences of ciliated cells in endometrial glands from women with reproductive failure. Endometrial glands with perturbed cilia structure and function may be non-conductive to successful pregnancy. Differences in endometrial gland cilia could be used to identify a perturbed endometrium and develop targeted therapies.
Trial registration number
not applicable
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Affiliation(s)
- J Pearson-Farr
- University of Southampton, Human Development and Health , Southampton, United Kingdom
| | - R Doherty
- University of Southampton, Biomedical Imaging Unit , Southampton, United Kingdom
| | - D Chatelet
- University of Southampton, Biomedical Imaging Unit , Southampton, United Kingdom
| | - P Goggin
- University of Southampton, Biomedical Imaging Unit , Southampton, United Kingdom
| | - B Ng
- University of Southampton, School of Clinical and Experimental Sciences , Southampton, United Kingdom
| | - J Lucas
- University of Southampton, School of Clinical and Experimental Sciences , Southampton, United Kingdom
| | - J Cleal
- University of Southampton, Human Development and Health , Southampton, United Kingdom
| | - R Lewis
- University of Southampton, Human Development and Health , Southampton, United Kingdom
| | - Y Cheong
- University of Southampton, Human Development and Health , Southampton, United Kingdom
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8
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Killeen E, Doherty R, Higgins M, O'Reilly A, Brewer L. 254 OPTIMISING COMMUNICATION WITH FAMILIES OF PATIENTS ON ACUTE STROKE AND GERIATRIC MEDICINE WARDS IN A LARGE TERTIARY HOSPITAL. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.254] [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: 02/25/2023] Open
Abstract
Abstract
Background
Good communication with patients and families is important for older adults admitted to acute stroke or geriatric medicine wards, particularly with COVID19-related restricted visiting. These patients often have communication difficulties including aphasia, delirium, cognitive or hearing impairment, limiting their own communication with relatives. Using the Plan, Do, Study, Act (PDSA) approach we undertook a quality improvement project to optimise communication with families of patients on above wards in a large tertiary hospital.
Methods
PDSA cycle 1: Staff were surveyed to identify satisfaction level with communication and ways to optimise communication. Inpatients on study wards were identified, we recorded demographic and clinical details and prevalence of communication difficulties. We created a designated folder with individual ‘communication sheets’ in conjunction with ward doctors and the nurse manager. PDSA cycle 2: We performed a rapid interval audit of the communication folder use. ‘Outlier’ patients were excluded as their teams did not receive education about folder use.
Results
PDSA cycle 1: A total of 90 inpatients on three wards were included, mean age 78y (SD ±14.4y), 47% were male. Three-quarters (73%) had a communication difficulty noted, reported by nursing staff. Two patients were intubated and six had stroke-related aphasia. Half of surveyed staff reported communication with families was suboptimal. Most (86%) suggested a centrally-located communication logbook would be helpful. PDSA cycle 2: Over two weeks, communication sheets were reviewed for all included patients. Median frequency of calls to families was 4 days (range 0–14). Most (79%) had the name of the primary contact clearly documented. Many (52%) included no contact number. Only 9% had secondary contact information documented.
Conclusion
Communication with families of patients on acute stroke and geriatric medicine wards was suboptimal. Over a short interval this improved with regular phone calls using specific centrally-located communication folders. Further optimisation of their use is needed.
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Affiliation(s)
| | | | | | | | - L Brewer
- Beaumont Hospital , Dublin, Ireland
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9
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Shah D, Comba A, Faisal SM, Kadiyala P, Baker GJ, Alghamri MS, Doherty R, Zamler D, Nuñez G, Castro MG, Lowenstein PR. A novel miR1983-TLR7-IFNβ circuit licenses NK cells to kill glioma cells, and is under the control of galectin-1. Oncoimmunology 2021; 10:1939601. [PMID: 34249474 PMCID: PMC8244780 DOI: 10.1080/2162402x.2021.1939601] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/31/2021] [Indexed: 02/08/2023] Open
Abstract
Although pharmacological stimulation of TLRs has anti-tumor effects, it has not been determined whether endogenous stimulation of TLRs can lead to tumor rejection. Herein, we demonstrate the existence of an innate anti-glioma NK-mediated circuit initiated by glioma-released miR-1983 within exosomes, and which is under the regulation of galectin-1 (Gal-1). We demonstrate that miR-1983 is an endogenous TLR7 ligand that activates TLR7 in pDCs and cDCs through a 5'-UGUUU-3' motif at its 3' end. TLR7 activation and downstream signaling through MyD88-IRF5/IRF7 stimulates secretion of IFN-β. IFN-β then stimulates NK cells resulting in the eradication of gliomas. We propose that successful immunotherapy for glioma could exploit this endogenous innate immune circuit to activate TLR7 signaling and stimulate powerful anti-glioma NK activity, at least 10-14 days before the activation of anti-tumor adaptive immunity.
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Affiliation(s)
- Diana Shah
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Andrea Comba
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Syed M. Faisal
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Padma Kadiyala
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Gregory J. Baker
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mahmoud S. Alghamri
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Robert Doherty
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel Zamler
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Gabriel Nuñez
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Maria G. Castro
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Pedro R. Lowenstein
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MIUSA
- Cancer Biology Training Program, University of Michigan Medical School, Ann Arbor, MI, USA
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10
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Mullineaux ST, McKinley JM, Marks NJ, Scantlebury DM, Doherty R. Heavy metal (PTE) ecotoxicology, data review: Traditional vs. a compositional approach. Sci Total Environ 2021; 769:145246. [PMID: 33736251 DOI: 10.1016/j.scitotenv.2021.145246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/19/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
Potentially Toxic Elements (PTEs) otherwise known as heavy metals are ubiquitous in soils and can have a range of negative health and environmental impacts. In terrestrial systems understanding how PTEs move in the environment is made challenging by the complex interactions within soil and the wider environment and the compositional nature of PTEs. PTEs are compositional because data of individual PTEs within in a sample are ratios which may be under a sum constraint, where individual components sum up to a whole. In this study three different scenarios were considered, one using the centred log ratio transformation (clr) a compositional transformation, the more "traditional" log10 transformation (log10) and untransformed data acting as a comparison (unt) were applied to four different datasets. Three were the Liver, Muscle and Kidney tissue of Eurasian Badgers (Meles meles) and the fourth was soil and data were extracted from a regional geospatial survey. Cluster analysis demonstrated that the clr and log10 transformation were able to resolve compositional trends at the point of the individual sample, whilst unt could not and did not meet the preconditions for the next phase of analysis. At the level of compositional trends between PTEs complex heatmaps demonstrated that clr was able to isolate PTE relationships and highlight commonalities between different datasets, whilst log10 could not. In the final phase, principal component analysis (PCA) of the clr transformation showed similarities between the signals in the soft tissues and the disparities they had with soil, whilst the log10 transformation was unable to achieve this. Overall, the clr transformation was shown to perform more consistently under a variety of analytical scenarios and the compositional approach will provide more realistic interpretations about PTEs in both soil and animal soft tissue than the log10 or unt conditions.
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Affiliation(s)
- S T Mullineaux
- School of Biological Sciences, 1-33 Chlorine Gardens, Belfast BT9 5AJ, United Kingdom of Great Britain and Northern Ireland.
| | - J M McKinley
- School of Natural and Built Environment, Elmwood Avenue, Belfast BT7 1NN, United Kingdom of Great Britain and Northern Ireland
| | - N J Marks
- School of Biological Sciences, 1-33 Chlorine Gardens, Belfast BT9 5AJ, United Kingdom of Great Britain and Northern Ireland
| | - D M Scantlebury
- School of Biological Sciences, 1-33 Chlorine Gardens, Belfast BT9 5AJ, United Kingdom of Great Britain and Northern Ireland
| | - R Doherty
- School of Natural and Built Environment, David Keir Building, Stranmillis Road, Belfast BT9 5AG, United Kingdom of Great Britain and Northern Ireland
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11
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Serchen J, Doherty R, Atiq O, Hilden D. A Comprehensive Policy Framework to Understand and Address Disparities and Discrimination in Health and Health Care: A Policy Paper From the American College of Physicians. Ann Intern Med 2021; 174:529-532. [PMID: 33428444 DOI: 10.7326/m20-7219] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Racial and ethnic minority populations in the United States experience disparities in their health and health care that arise from a combination of interacting factors, including racism and discrimination, social drivers of health, health care access and quality, individual behavior, and biology. To ameliorate these disparities, the American College of Physicians (ACP) proposes a comprehensive policy framework that recognizes and confronts the many elements of U.S. society, some of which are intertwined and compounding, that contribute to poorer health outcomes. In addition to this framework, which includes high-level principles and discusses how disparities are interconnected, ACP offers specific policy recommendations on disparities and discrimination in education and the workforce, those affecting specific populations, and those in criminal justice practices and policies in its 3 companion policy papers. ACP believes that a cross-cutting approach that identifies and offers solutions to the various aspects of society contributing to poor health is essential to achieving its goal of good health care for all, poor health care for none.
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Affiliation(s)
- Josh Serchen
- American College of Physicians, Washington, DC (J.S., R.D.)
| | - Robert Doherty
- American College of Physicians, Washington, DC (J.S., R.D.)
| | - Omar Atiq
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (O.A.)
| | - David Hilden
- Hennepin Healthcare, Minneapolis, Minnesota (D.H.)
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12
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Mullineaux ST, Redpath SHA, Ogle N, McKinley JM, Marks NJ, Scantlebury DM, Doherty R. Potentially toxic element accumulation in badgers (Meles meles): a compositional approach. Sci Total Environ 2021; 762:143087. [PMID: 33131870 DOI: 10.1016/j.scitotenv.2020.143087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 06/11/2023]
Abstract
Potentially Toxic Elements (PTEs) in Badgers (Meles meles), otherwise known as heavy metals, are unique amongst environmental pollutants occurring, both naturally and anthropogenically. PTEs have a broad range of negative health and environmental effects, therefore identifying their sources and pathways through the environment is imperative for public health policy. This is difficult in terrestrial systems due to the compositional nature of soil geochemistry. In this study, a compositional statistical approach was used to identify how PTEs accumulate in a terrestrial carnivorous mammal, Eurasian Badgers (Meles meles). Compositional principal component analysis (PCA) was used on geochemical data from the Tellus survey, the soil baseline and badger tissue data to map geo-spatial patterns of PTEs and show accumulative trends measured in time. Mapping PCs identified distinct regions of PTE presence in soil and PTE accumulation in badger tissues in Northern Ireland. PTEs were most elevated in liver, kidney and then muscle tissues. Liver and kidney showed the most distinct geo-spatial patterns of accumulation and muscle was the most depleted. PC1 and 2 for each type were modelled using generalised additive mixed models (GAMM) to identify trends through time. PC1 for the liver and muscle were associated with rainfall and ∂N15 in the liver, showing a link to diet and a bioaccumulation pathway, whilst PC2 for both tissues was associated with mean temperature, showing a link to seasonal activity and a bioaccessibility pathway. However, in kidney tissue these trends are reversed and PC1 was associated with bioaccessibility and PC2 with bioaccumulation. Combined these techniques can elucidate both geo-spatial trends in PTEs and the mechanisms by which they move in environment and in future may be an effective tool for assessing PTE bioavailability in environmental health surveys.
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Affiliation(s)
- S T Mullineaux
- School of Biological Sciences, 1-33 Chlorine Gardens, Belfast BT9 5AJ, United Kingdom of Great Britain and Northern Ireland.
| | - S H A Redpath
- School of Biological Sciences, 1-33 Chlorine Gardens, Belfast BT9 5AJ, United Kingdom of Great Britain and Northern Ireland
| | - N Ogle
- School of Natural and Built Environment, David Keir Building, Stranmillis Road, Belfast BT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - J M McKinley
- School of Natural and Built Environment, Elmwood Avenue, Belfast BT7 1NN, United Kingdom of Great Britain and Northern Ireland
| | - N J Marks
- School of Biological Sciences, 1-33 Chlorine Gardens, Belfast BT9 5AJ, United Kingdom of Great Britain and Northern Ireland
| | - D M Scantlebury
- School of Biological Sciences, 1-33 Chlorine Gardens, Belfast BT9 5AJ, United Kingdom of Great Britain and Northern Ireland
| | - R Doherty
- School of Natural and Built Environment, David Keir Building, Stranmillis Road, Belfast BT9 5AG, United Kingdom of Great Britain and Northern Ireland
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13
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Gregory JV, Kadiyala P, Doherty R, Cadena M, Habeel S, Ruoslahti E, Lowenstein PR, Castro MG, Lahann J. Systemic brain tumor delivery of synthetic protein nanoparticles for glioblastoma therapy. Nat Commun 2020; 11:5687. [PMID: 33173024 PMCID: PMC7655867 DOI: 10.1038/s41467-020-19225-7] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 09/16/2020] [Indexed: 01/10/2023] Open
Abstract
Glioblastoma (GBM), the most aggressive form of brain cancer, has witnessed very little clinical progress over the last decades, in part, due to the absence of effective drug delivery strategies. Intravenous injection is the least invasive drug delivery route to the brain, but has been severely limited by the blood-brain barrier (BBB). Inspired by the capacity of natural proteins and viral particulates to cross the BBB, we engineered a synthetic protein nanoparticle (SPNP) based on polymerized human serum albumin (HSA) equipped with the cell-penetrating peptide iRGD. SPNPs containing siRNA against Signal Transducer and Activation of Transcription 3 factor (STAT3i) result in in vitro and in vivo downregulation of STAT3, a central hub associated with GBM progression. When combined with the standard of care, ionized radiation, STAT3i SPNPs result in tumor regression and long-term survival in 87.5% of GBM-bearing mice and prime the immune system to develop anti-GBM immunological memory.
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Affiliation(s)
- Jason V Gregory
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA
- Chemical Engineering, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA
| | - Padma Kadiyala
- Department of Neurosurgery, University of Michigan Medical School, 1500 E. Medical Center Drive SPC 5338, Ann Arbor, MI, 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, 109 Zina Pitcher Place, Ann Arbor, MI, 48109, USA
| | - Robert Doherty
- Department of Neurosurgery, University of Michigan Medical School, 1500 E. Medical Center Drive SPC 5338, Ann Arbor, MI, 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, 109 Zina Pitcher Place, Ann Arbor, MI, 48109, USA
| | - Melissa Cadena
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA
- Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd, Ann Arbor, MI, 48109, USA
| | - Samer Habeel
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA
- Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd, Ann Arbor, MI, 48109, USA
| | - Erkki Ruoslahti
- Cancer Research Center, Sanford Burnham Prebys Medical Discovery Institute, 10901 North Torrey Pines Road, La Jolla, CA, 92037, USA
- Center for Nanomedicine and Department of Cell, Molecular and Developmental Biology, Building 235, University of California, Santa Barbara, Santa Barbara, CA, 93106, USA
| | - Pedro R Lowenstein
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA
- Department of Neurosurgery, University of Michigan Medical School, 1500 E. Medical Center Drive SPC 5338, Ann Arbor, MI, 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, 109 Zina Pitcher Place, Ann Arbor, MI, 48109, USA
| | - Maria G Castro
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
- Department of Neurosurgery, University of Michigan Medical School, 1500 E. Medical Center Drive SPC 5338, Ann Arbor, MI, 48109, USA.
- Department of Cell and Developmental Biology, University of Michigan Medical School, 109 Zina Pitcher Place, Ann Arbor, MI, 48109, USA.
| | - Joerg Lahann
- Biointerfaces Institute, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
- Chemical Engineering, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
- Biomedical Engineering, University of Michigan, 2200 Bonisteel Blvd, Ann Arbor, MI, 48109, USA.
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14
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Serchen J, Doherty R, Atiq O, Hilden D. Racism and Health in the United States: A Policy Statement From the American College of Physicians. Ann Intern Med 2020; 173:556-557. [PMID: 32559145 DOI: 10.7326/m20-4195] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Racial minorities in the United States have reported experiencing widespread racism throughout all aspects of life, from housing to education to employment. Existing research has examined the role of racism, discrimination, and violence in one's interaction with the health care system and their association with poorer mental and physical health. Systemic racism that underlies the fabric of society often manifests itself in prominent institutions, such as law enforcement agencies, regardless of individual intent. Overt and covert racist laws and policies, personal implicit biases, and other factors result in Black individuals and other people of color being the subject of law enforcement violence and criminal justice system interactions at disproportionately high rates. The demonstrated association between discriminatory law enforcement practices and violence and personal and community health necessitates treating these issues as public health issues worthy of a public policy intervention. Addressing some of the sources of institutional racism and harm through transparency and accountability measures is the first of many steps required to begin correcting historical racial injustices.
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Affiliation(s)
- Josh Serchen
- American College of Physicians, Washington, DC (J.S., R.D.)
| | - Robert Doherty
- American College of Physicians, Washington, DC (J.S., R.D.)
| | - Omar Atiq
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (O.A.)
| | - David Hilden
- University of Minnesota Medical School, Minneapolis, Minnesota (D.H.)
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15
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Doherty R, Cooney TG, Mire RD, Engel LS, Goldman JM. Envisioning a Better U.S. Health Care System for All: A Call to Action by the American College of Physicians. Ann Intern Med 2020; 172:S3-S6. [PMID: 31958804 DOI: 10.7326/m19-2411] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 11/22/2022] Open
Affiliation(s)
| | - Thomas G Cooney
- Oregon Health & Science University and Portland Veterans Affairs Medical Center, Portland, Oregon (T.G.C.)
| | - Ryan D Mire
- Heritage Medical Associates, Nashville, Tennessee (R.D.M.)
| | - Lee S Engel
- Louisiana State University Health Sciences Center, New Orleans, Louisiana (L.S.E.)
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16
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Palaiologou E, Etter O, Goggin P, Chatelet DS, Johnston DA, Lofthouse EM, Doherty R, Pearson-Farr J, Sengers BG, Torrens C, Cleal JK, Page AM, Lewis RM. Human placental villi contain stromal macrovesicles associated with networks of stellate cells. J Anat 2019; 236:132-141. [PMID: 31512233 PMCID: PMC6904625 DOI: 10.1111/joa.13082] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2019] [Indexed: 12/26/2022] Open
Abstract
Placental function is essential for fetal development and establishing the foundations for lifelong health. The placental villous stroma is a connective tissue layer that supports the fetal capillaries and villous trophoblast. All the nutrients that cross the placenta must also cross the stroma, and yet little is known about this region. This study uses high‐resolution three‐dimensional imaging to explore the structural complexity of this region within the placental villi. Serial block‐face scanning electron microscopy and confocal microscopy were used to image the placental villous stroma in three‐dimensions. Transmission electron microscopy (TEM) was used to generate high resolution two‐dimensional images. Stereological approaches were used to quantify volumes of stromal constituents. Three‐dimensional imaging identified stromal extracellular vesicles, which constituted 3.9% of the villous stromal volume. These stromal extracellular vesicles were ovoid in shape, had a median length of 2750 nm (range 350–7730 nm) and TEM imaging confirmed that they were bounded by a lipid bilayer. Fifty‐nine per cent of extracellular vesicles were in contact with a fibroblast‐like stellate cell and these vesicles were significantly larger than those where no contact was observed. These stellate cells formed local networks with adherent junctions observed at contact points. This study demonstrates that the villous stroma contains extracellular macrovesicles which are considerably larger than any previously described in tissue or plasma. The size and abundance of these macrovesicles in the villous stroma highlight the diversity of extracellular vesicle biology and their roles within connective tissues.
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Affiliation(s)
- E Palaiologou
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - O Etter
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Goggin
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - D S Chatelet
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - D A Johnston
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - E M Lofthouse
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - R Doherty
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Pearson-Farr
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - B G Sengers
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK
| | - C Torrens
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK
| | - J K Cleal
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK
| | - A M Page
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - R M Lewis
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK
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17
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Young M, Kailavasan M, Taylor J, Cornford P, Colquhoun A, Rochester M, Hanchanale V, Somani B, Nabi G, Garthwaite M, Gowda R, Reeves F, Rai B, Doherty R, Gkentzis A, Athanasiadis G, Patterson J, Wilkinson B, Myatt A, Biyani CS, Jain S. The Success and Evolution of a Urological "Boot Camp" for Newly Appointed UK Urology Registrars: Incorporating Simulation, Nontechnical Skills and Assessment. J Surg Educ 2019; 76:1425-1432. [PMID: 31036524 DOI: 10.1016/j.jsurg.2019.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/02/2019] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Urological training has dramatically changed in recent years. Training durations are shorter and a drive toward consultant led care has reduced trainees experience. Within the UK, approximately 50 registrars annually embark on a 5-year Urology training programme, with variable levels of basic urological experience. OBJECTIVE To describe a simulation programme aimed at delivering the knowledge and skills necessary to safely and effectively start working as a registrar in Urology by intensive training with a 1:1 faculty to delegate ratio. DESIGN, SETTING, AND PARTICIPANTS Our course content mirrors the UK training syllabus for junior Urology registrars. We delivered 8 modules over a 4-day programme with a fifth day of assessments. Delegates level of urological knowledge, operative competency and confidence pre-, immediately post-training and at 3-months postcourse were assessed. Objective delegate and faculty feedback was also collected. Technical skills modules include; inguinoscrotal surgery, ureteroscopy, transurethral resection, urodynamics, and Botox administration as well as basic reconstructive and laparoscopic operative skills. "Nontechnical" skills included simulated ward round, out-patient, and emergency scenarios. RESULTS Feedback from delegates and faculty members has been overwhelmingly positive. We have used this feedback to tailor the content of the course for following years. An increased knowledge level (based on mean examination scores [precourse 55.5%, postcourse 70.1%]) and operative competency was observed in all skills assessed (transurethral resection of the prostate, transurethral resection of bladder tumor, Ureteroscopy, laparoscopic skills, and instrument assembly). Operative confidence was increased immediately and at 3-months postcourse. CONCLUSIONS Our "boot camp" course provides a realistic introduction and foundation to begin Urological practice. Being delivered at the beginning of the training scheme, prior to intensive patient exposure, registrars are in an optimum position to develop their newly acquired knowledge and skills to enhance training and intends to improve patient safety and satisfaction.
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Affiliation(s)
- M Young
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - M Kailavasan
- Royal Birmingham Heartlands Hospital, Birmingham, United Kingdom
| | - J Taylor
- Forth Valley Royal Hospital, Scotland, United Kingdom
| | - P Cornford
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - A Colquhoun
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - M Rochester
- Norfolk & Norwich University Hospitals NHS Foundation Trust, United Kingdom
| | - V Hanchanale
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - B Somani
- University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - G Nabi
- Ninewells Hospital, Dundee, United Kingdom
| | - M Garthwaite
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - R Gowda
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - F Reeves
- University of East Anglia, Norwich, United Kingdom
| | - B Rai
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - R Doherty
- Norfolk & Norwich University Hospitals NHS Foundation Trust, United Kingdom
| | - A Gkentzis
- Royal Bolton Hospital, Bolton, United Kingdom
| | | | - J Patterson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - B Wilkinson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - A Myatt
- Hull and East Yorkshire NHS Trust, Hull, United Kingdom
| | - C S Biyani
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, United Kingdom.
| | - S Jain
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, United Kingdom
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18
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Affiliation(s)
- Renee Butkus
- American College of Physicians, Washington, DC (R.B., R.D.)
| | - Robert Doherty
- American College of Physicians, Washington, DC (R.B., R.D.)
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19
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Seyedpour SM, Kirmizakis P, Brennan P, Doherty R, Ricken T. Optimal remediation design and simulation of groundwater flow coupled to contaminant transport using genetic algorithm and radial point collocation method (RPCM). Sci Total Environ 2019; 669:389-399. [PMID: 30884263 DOI: 10.1016/j.scitotenv.2019.01.409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
The simulation-optimisation models of groundwater and contaminant transport can be a powerful tool in the management of groundwater resources and remediation design. In this study, using Multiquadratic Radial Basis Function (MRBF) a coupled groundwater flow and reactive transport of contaminant and oxidant was developed in the framework of the Meshfree method. The parameter analysis has determined the optimum shape parameter (0.97), and the results of the model were compared with a physical sandbox model which were in good agreement. The genetic algorithm approach was used to find the optimum design of the remediation using permanganate as an oxidant. To find the optimum design we considered two objectives and two constraints. The results revealed that the breakthrough of contaminant to the downstream area of interest and the concentration of the contaminant in this area is reduced significantly with optimisation.
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Affiliation(s)
- S M Seyedpour
- Institute of Mechanics, Structural Analysis, and Dynamics, TU Dortmund University, Dortmund 44227, Germany; Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Stuttgart 70569, Germany.
| | - P Kirmizakis
- School of Natural and Built Environment, Queen's University Belfast, BT9 5AG, United Kingdom.
| | - P Brennan
- School of Chemical Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland.
| | - R Doherty
- School of Natural and Built Environment, Queen's University Belfast, BT9 5AG, United Kingdom.
| | - T Ricken
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Stuttgart 70569, Germany.
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20
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Kadiyala P, Li D, Nuñez FM, Altshuler D, Doherty R, Kuai R, Yu M, Kamran N, Edwards M, Moon JJ, Lowenstein PR, Castro MG, Schwendeman A. High-Density Lipoprotein-Mimicking Nanodiscs for Chemo-immunotherapy against Glioblastoma Multiforme. ACS Nano 2019; 13:1365-1384. [PMID: 30721028 PMCID: PMC6484828 DOI: 10.1021/acsnano.8b06842] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Glioblastoma multiforme (GBM) is an aggressive primary brain tumor, for which there is no cure. Treatment effectiveness for GBM has been limited due to tumor heterogeneity, an immunosuppressive tumor microenvironment (TME), and the presence of the blood-brain barrier, which hampers the transport of chemotherapeutic compounds to the central nervous system (CNS). High-density lipoprotein (HDL)-mimicking nanodiscs hold considerable promise to achieve delivery of bioactive compounds into tumors. Herein, we tested the ability of synthetic HDL nanodiscs to deliver chemotherapeutic agents to the GBM microenvironment and elicit tumor regression. To this end, we developed chemo-immunotherapy delivery vehicles based on sHDL nanodiscs loaded with CpG, a Toll-like receptor 9 (TLR9) agonist, together with docetaxel (DTX), a chemotherapeutic agent, for targeting GBM. Our data show that delivery of DTX-sHDL-CpG nanodiscs into the tumor mass elicited tumor regression and antitumor CD8+ T cell responses in the brain TME. We did not observe any overt off-target side effects. Furthermore, the combination of DTX-sHDL-CpG treatment with radiation (IR), which is the standard of care for GBM, resulted in tumor regression and long-term survival in 80% of GBM-bearing animals. Mice remained tumor-free upon tumor cell rechallenge in the contralateral hemisphere, indicating the development of anti-GBM immunological memory. Collectively, these data indicate that sHDL nanodiscs constitute an effective drug delivery platform for the treatment of GBM, resulting in tumor regression, long-term survival, and immunological memory when used in combination with IR. The proposed delivery platform has significant potential for clinical translation.
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Affiliation(s)
- Padma Kadiyala
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Dan Li
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI 48109, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI 48109, USA
| | - Fernando M. Nuñez
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - David Altshuler
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Robert Doherty
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Rui Kuai
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI 48109, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI 48109, USA
| | - Minzhi Yu
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI 48109, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI 48109, USA
| | - Neha Kamran
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Marta Edwards
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - James J. Moon
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI 48109, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Pedro R. Lowenstein
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Maria G. Castro
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- Lead Contacts
| | - Anna Schwendeman
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI 48109, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI 48109, USA
- Lead Contacts
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21
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Butkus R, Doherty R, Bornstein SS, Carney JK, Cooney T, Engel L, Gantzer HE, Henry TL, Lenchus JD, McCandless BM, Quinton J, Southworth M, Valdrighi A, Wallace MA. Reducing Firearm Injuries and Deaths in the United States: A Position Paper From the American College of Physicians. Ann Intern Med 2018; 169:704-707. [PMID: 30383132 DOI: 10.7326/m18-1530] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
For more than 20 years, the American College of Physicians (ACP) has advocated for the need to address firearm-related injuries and deaths in the United States. Yet, firearm violence continues to be a public health crisis that requires the nation's immediate attention. The policy recommendations in this paper build on, strengthen, and expand current ACP policies approved by the Board of Regents in April 2014, based on analysis of approaches that the evidence suggests will be effective in reducing deaths and injuries from firearm-related violence.
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Affiliation(s)
- Renee Butkus
- American College of Physicians, Washington, DC (R.B., R.D.)
| | - Robert Doherty
- American College of Physicians, Washington, DC (R.B., R.D.)
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22
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Wilson TJ, Zamler DB, Doherty R, Castro MG, Lowenstein PR. Reversibility of glioma stem cells' phenotypes explains their complex in vitro and in vivo behavior: Discovery of a novel neurosphere-specific enzyme, cGMP-dependent protein kinase 1, using the genomic landscape of human glioma stem cells as a discovery tool. Oncotarget 2018; 7:63020-63041. [PMID: 27564115 PMCID: PMC5325344 DOI: 10.18632/oncotarget.11589] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/13/2016] [Indexed: 11/25/2022] Open
Abstract
Glioma cells grow in two phenotypic forms, as adherent monolayers and as free floating “neurospheres/tumorspheres”, using specific media supplements. Whether each phenotype is irreversible remains unknown. Herein we show that both states are reversible using patient derived glioblastoma cell cultures (i.e., HF2303, IN859, MGG8, IN2045). Both phenotypic states differ in proliferation rate, invasion, migration, chemotaxis and chemosensitivity. We used microarrays to characterize gene expression across the patient derived glioblastoma cell cultures, to find specific inhibitors of the sphere population. Traditional chemotherapeutics (i.e., doxorubicin or paclitaxel) inhibit rapidly dividing adherent cells; it has been more challenging to inhibit the growth of the sphere phenotype. PRKG1, known to induce apoptosis when activated, is increased in all patient derived glioblastoma spheres. Stimulation of PRKG1 activity preferentially reduced cell viability in the sphere phenotype. Computational network and gene ontology analysis identified novel potential target genes linked to the PRKG1 expression node.
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Affiliation(s)
- Thomas J Wilson
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Daniel B Zamler
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Robert Doherty
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Maria G Castro
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, MI, USA.,Department of Cell and Developmental Biology, Training Programs in Cancer Biology, Immunology & Neurosciences, The University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Pedro R Lowenstein
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, MI, USA.,Department of Cell and Developmental Biology, Training Programs in Cancer Biology, Immunology & Neurosciences, The University of Michigan School of Medicine, Ann Arbor, MI, USA
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23
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Koschmann C, Zamler D, MacKay A, Robinson D, Wu YM, Doherty R, Marini B, Tran D, Garton H, Muraszko K, Robertson P, Leonard M, Zhao L, Bixby D, Peterson L, Camelo-Piragua S, Jones C, Mody R, Lowenstein PR, Castro MG. Characterizing and targeting PDGFRA alterations in pediatric high-grade glioma. Oncotarget 2018; 7:65696-65706. [PMID: 27582545 PMCID: PMC5323185 DOI: 10.18632/oncotarget.11602] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 08/13/2016] [Indexed: 12/20/2022] Open
Abstract
Pediatric high-grade glioma (HGG, WHO Grade III and IV) is a devastating brain tumor with a median survival of less than two years. PDGFRA is frequently mutated/amplified in pediatric HGG, but the significance of this finding has not been fully characterized. We hypothesize that alterations of PDGFRA will promote distinct prognostic and treatment implications in pediatric HGG. In order to characterize the impact of PDGFR pathway alterations, we integrated genomic data from pediatric HGG patients (n=290) from multiple pediatric datasets and sequencing platforms. Integration of multiple human datasets showed that PDGFRA mutation, but not amplification, was associated with older age in pediatric HGG (P= <0.0001). In multivariate analysis, PDGFRA mutation was correlated with worse prognosis (P = 0.026), while PDGFRA amplification was not (P = 0.11). By Kaplan-Meier analysis, non-brainstem HGG with PDGFRA amplification carried a worse prognosis than non-brainstem HGG without PDGFRA amplification (P = 0.021). There were no pediatric patients with PDGFRA-amplified HGG that survived longer than two years. Additionally, we performed paired molecular profiling (germline / tumor / primary cell culture) and targeting of an infant thalamic HGG with amplification and outlier increased expression of PDGFRA. Dasatinib inhibited proliferation most effectively. In summary, integration of the largest genomic dataset of pediatric HGG to date, allowed us to highlight that PDGFRA mutation is found in older pediatric patients and that PDGFRA amplification is prognostic in non-brainstem HGG. Future precision-medicine based clinical trials for pediatric patients with PDGFRA-altered HGG should consider the optimized delivery of dasatinib.
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Affiliation(s)
- Carl Koschmann
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA.,Department of Neurosurgery, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Daniel Zamler
- Department of Neurosurgery, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Alan MacKay
- Divisions of Molecular Pathology and Cancer Therapeutics, Institute of Cancer Research, London, SM2 5NG, UK
| | - Dan Robinson
- Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Yi-Mi Wu
- Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Robert Doherty
- Department of Neurosurgery, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Bernard Marini
- Department of Pharmacology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Dustin Tran
- Department of Neurosurgery, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Hugh Garton
- Department of Neurosurgery, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Karin Muraszko
- Department of Neurosurgery, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Patricia Robertson
- Department of Pediatrics, Division of Neurology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Marcia Leonard
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Lili Zhao
- Department of Biostatistics, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Dale Bixby
- Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Luke Peterson
- Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Sandra Camelo-Piragua
- Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Chris Jones
- Divisions of Molecular Pathology and Cancer Therapeutics, Institute of Cancer Research, London, SM2 5NG, UK
| | - Rajen Mody
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Pedro R Lowenstein
- Department of Neurosurgery, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA.,Department of Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Maria G Castro
- Department of Neurosurgery, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA.,Department of Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
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24
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Shah D, Kadiyala P, Kamran N, Baker GJ, Doherty R, Zamler D, Nuñez G, Castro MG, Lowenstein PR. IMMU-26. TLR7 ACTIVATION IS ESSENTIAL FOR NK CELLS TO ELIMINATE GLIOMA TUMORS. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.484] [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: 11/14/2022] Open
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25
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Doherty R, Manley K, Gordon S, Irving S, Kumar S, Masood J, Philip J, Bultitude M, Wiseman OJ. Current ESWL practice and outcomes in the UK: A multicentre snapshot. Journal of Clinical Urology 2017. [DOI: 10.1177/2051415817696438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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
Objectives: The objective of this article is to investigate the current clinical practice and outcomes of extracorporeal shock wave lithotripsy (SWL) in the United Kingdom. Patients and methods: Patient demographics, stone characteristics and SWL protocols were collected prospectively for 30 consecutive new patient referrals at each of seven contributing UK institutions performing SWL. Final outcomes in terms of stone-free rates (SFRs), and complications were recorded. Results: Completed demographic data were available for 204 patients. Treatment protocols varied between centres. Mean patient age was 51 years. Over 70% of stones treated measured between 5 and 10 mm, and one-third were in the ureter, with two-thirds in the kidney, where the majority (31% overall) were in the lower pole. The overall cumulative SFR was 50.3% (range 33–70% between centres). SWL was notably more effective for ureteric stones (SFR 59.3% overall) than for renal calculi (SFR 45.6% overall). Complications were noted in six patients. Conclusion: This study provides a valuable snapshot of real-life clinical practice and demonstrates considerable variability in the application of SWL in the UK. The results support existing data which suggest that SWL is a safe and well tolerated treatment modality; however, overall SFRs were low.
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Affiliation(s)
- R Doherty
- Norfolk and Norwich University Hospital NHS Foundation Trust, UK
| | - K Manley
- Norfolk and Norwich University Hospital NHS Foundation Trust, UK
| | - S Gordon
- Epsom and St Helier University Hospitals NHS Trust, UK
| | - S Irving
- Norfolk and Norwich University Hospital NHS Foundation Trust, UK
| | - S Kumar
- Royal Berkshire NHS Foundation Trust, UK
| | - J Masood
- Homerton University Hospital NHS Foundation Trust, UK
| | - J Philip
- Bristol Urological Institute, UK
| | | | - OJ Wiseman
- Cambridge University Teaching Hospitals NHS Trust, UK
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27
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Koschmann C, Calinescu AA, Nunez FJ, Mackay A, Fazal-Salom J, Thomas D, Mendez F, Kamran N, Dzaman M, Mulpuri L, Krasinkiewicz J, Doherty R, Lemons R, Brosnan-Cashman JA, Li Y, Roh S, Zhao L, Appelman H, Ferguson D, Gorbunova V, Meeker A, Jones C, Lowenstein PR, Castro MG. ATRX loss promotes tumor growth and impairs nonhomologous end joining DNA repair in glioma. Sci Transl Med 2016; 8:328ra28. [PMID: 26936505 DOI: 10.1126/scitranslmed.aac8228] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Recent work in human glioblastoma (GBM) has documented recurrent mutations in the histone chaperone protein ATRX. We developed an animal model of ATRX-deficient GBM and showed that loss of ATRX reduces median survival and increases genetic instability. Further, analysis of genome-wide data for human gliomas showed that ATRX mutation is associated with increased mutation rate at the single-nucleotide variant (SNV) level. In mouse tumors, ATRX deficiency impairs nonhomologous end joining and increases sensitivity to DNA-damaging agents that induce double-stranded DNA breaks. We propose that ATRX loss results in a genetically unstable tumor, which is more aggressive when left untreated but is more responsive to double-stranded DNA-damaging agents, resulting in improved overall survival.
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Affiliation(s)
- Carl Koschmann
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA. Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Anda-Alexandra Calinescu
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Felipe J Nunez
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Alan Mackay
- Divisions of Molecular Pathology and Cancer Therapeutics, Institute of Cancer Research, London SM2 5NG, UK
| | - Janet Fazal-Salom
- Divisions of Molecular Pathology and Cancer Therapeutics, Institute of Cancer Research, London SM2 5NG, UK
| | - Daniel Thomas
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Flor Mendez
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Neha Kamran
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Marta Dzaman
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Lakshman Mulpuri
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Johnathon Krasinkiewicz
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Robert Doherty
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Rosemary Lemons
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | | | - Youping Li
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Soyeon Roh
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Lili Zhao
- Department of Biostatistics, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Henry Appelman
- Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - David Ferguson
- Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Vera Gorbunova
- Department of Biology, University of Rochester, Rochester, NY 14627, USA
| | - Alan Meeker
- Departments of Pathology and Urology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Chris Jones
- Divisions of Molecular Pathology and Cancer Therapeutics, Institute of Cancer Research, London SM2 5NG, UK
| | - Pedro R Lowenstein
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Maria G Castro
- Departments of Neurosurgery and Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA.
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28
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Koschmann C, Zamler D, MacKay A, Robinson D, Wu YM, Doherty R, Marini B, Tran D, Garton H, Muraszko K, Robertson P, Leonard M, Zhao L, Bixby D, Peterson L, Camelo-Piragua S, Jones C, Mody R, Lowenstein PR, Castro MG. GENT-10. CHARACTERIZING AND TARGETING PDGFRA ALTERATIONS IN PEDIATRIC HIGH-GRADE GLIOMA. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now212.316] [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: 11/13/2022] Open
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29
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Wilson T, Zamler D, Doherty R, Mikkelsen T, deCarvalho A, Castro M, Lowenstein P. CBIO-10. REVERSIBILITY OF GLIOMA STEM CELLS’ SPHERE FORMATION EXPLAINS THEIR IN VITRO BEHAVIOR AND IN VIVO TUMORIGENESIS POTENTIAL. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now212.148] [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: 11/14/2022] Open
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30
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Doherty R. Academic Medicine and Concierge Practice. Ann Intern Med 2016; 165:375-6. [PMID: 27595217 DOI: 10.7326/l16-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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31
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Calinescu AA, Yadav VN, Carballo E, Kadiyala P, Tran D, Zamler DB, Doherty R, Srikanth M, Lowenstein PR, Castro MG. Survival and Proliferation of Neural Progenitor-Derived Glioblastomas Under Hypoxic Stress is Controlled by a CXCL12/CXCR4 Autocrine-Positive Feedback Mechanism. Clin Cancer Res 2016; 23:1250-1262. [PMID: 27542769 DOI: 10.1158/1078-0432.ccr-15-2888] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 07/15/2016] [Accepted: 08/01/2016] [Indexed: 12/31/2022]
Abstract
Purpose: One likely cause of treatment failure in glioblastoma is the persistence of glioma stem-like cells (GSLCs) which are highly resistant to therapies currently employed. We found that CXCL12 has highest expression in glioma cells derived from neural progenitor cells (NPC). The development and molecular signature of NPC-derived glioblastomas were analyzed and the therapeutic effect of blocking CXCL12 was tested.Experimental Design: Tumors were induced by injecting DNA into the lateral ventricle of neonatal mice, using the Sleeping Beauty transposase method. Histology and expression of GSLC markers were analyzed during disease progression. Survival upon treatment with pharmacologic (plerixafor) or genetic inhibition of CXCR4 was analyzed. Primary neurospheres were generated and analyzed for proliferation, apoptosis, and expression of proteins regulating survival and cell-cycle progression.Results: Tumors induced from NPCs display histologic features of human glioblastoma and express markers of GSLC. In vivo, inhibiting the CXCL12/CXCR4 signaling axis results in increased survival of tumor-bearing animals. In vitro, CXCR4 blockade induces apoptosis and inhibits cell-cycle progression, downregulates molecules regulating survival and proliferation, and also blocks the hypoxic induction of HIF-1α and CXCL12. Exogenous administration of CXCL12 rescues the drug-induced decrease in proliferation.Conclusions: This study demonstrates that the CXCL12/CXCR4 axis operates in glioblastoma cells under hypoxic stress via an autocrine-positive feedback mechanism, which promotes survival and cell-cycle progression. Our study brings new mechanistic insight and encourages further exploration of the use of drugs blocking CXCL12 as adjuvant agents to target hypoxia-induced glioblastoma progression, prevent resistance to treatment, and recurrence of the disease. Clin Cancer Res; 23(5); 1250-62. ©2016 AACR.
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Affiliation(s)
| | - Viveka Nand Yadav
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Erica Carballo
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Padma Kadiyala
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Dustin Tran
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Daniel B Zamler
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Robert Doherty
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Maithreyi Srikanth
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Pedro Ricardo Lowenstein
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan.,Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Maria Graciela Castro
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan. .,Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
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32
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Ardill JES, Armstrong L, Smye M, Doherty R, McCance DR, Johnston BT. Neuroendocrine tumours of the small bowel: interpretation of raised circulating chromogranin A, urinary 5 hydroxy indole acetic acid and circulating neurokinin A. QJM 2016; 109:111-5. [PMID: 25979268 DOI: 10.1093/qjmed/hcv095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Neuroendocrine tumours (NETs) of the small bowel are difficult to diagnose as symptoms are non-specific and more often found in common gastrointestinal diseases. Chromogranin A (CGA), urinary 5 hydroxy indole acetic acid (U-5HIAA) and Neurokinin A (NKA) are used as laboratory diagnostic tests but results may be misleading or confusing. AIM To clarify the relevance of NET biomarkers for diagnosis of small bowel NETs. DESIGN A review of laboratory test results. METHODS We reviewed 500 consecutive raised plasma CGA, U-5HIAA and plasma NKA, results from patients in N Ireland. The diagnosis of NET was confirmed by the Northern Ireland Cancer Registry. RESULTS In 500 specimens recording raised CGA, 52.2% were from patients with NETs, 13.6% being small bowel tumours, 5.4% of specimens from patients with auto-immune atrophic gastritis and 15.4% from patients taking proton pump inhibitors. In 500 specimens with raised U-5HIAA, 87.8% were from patients with NETs, 68.2% being small bowel tumours. Lung NETs contributed 12.2% and NETs from other sites, 7.4%. Of 500 specimens with raised NKA (reference range (RR) > 20 ng/L), 72.6% were from patients with small bowel NETs and 6% specimens from patients with other NETs. In 20% of specimens NKA concentrations were 21-23 ng/L, within limits of assay precision. CONCLUSION CGA remains the best general circulating marker for NETs although only half of raised test results are due to an NET. U-5HIAA is an excellent marker for small bowel and lung NETs with 80% of high test results confirming these diagnoses. NKA is the most specific biomarker for small bowel NETs.
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Affiliation(s)
- J E S Ardill
- From the Regional Regulatory Peptide Laboratory, Kelvin Building, NET Specialist Group, Royal Victoria Hospital Belfast NHS Trust, Belfast BT12 6BA, Northern Ireland, UK, Queen's University Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, UK and
| | - L Armstrong
- From the Regional Regulatory Peptide Laboratory, Kelvin Building
| | - M Smye
- Clinical Biochemistry, Kelvin Building, Royal Victoria Hospital Belfast NHS Trust, Belfast BT12 6BA, Northern Ireland, UK
| | - R Doherty
- Clinical Biochemistry, Kelvin Building, Royal Victoria Hospital Belfast NHS Trust, Belfast BT12 6BA, Northern Ireland, UK
| | - D R McCance
- NET Specialist Group, Royal Victoria Hospital Belfast NHS Trust, Belfast BT12 6BA, Northern Ireland, UK, Queen's University Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, UK and
| | - B T Johnston
- NET Specialist Group, Royal Victoria Hospital Belfast NHS Trust, Belfast BT12 6BA, Northern Ireland, UK, Queen's University Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, UK and
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33
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Doherty R. Assessing the Patient Care Implications of "Concierge" and Other Direct Patient Contracting Practices: A Policy Position Paper From the American College of Physicians. Ann Intern Med 2015; 163:949-52. [PMID: 26551655 DOI: 10.7326/m15-0366] [Citation(s) in RCA: 18] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As physicians seek innovative practice models, one that is gaining ground is for practices to contract with patients to pay directly for some or all services-often called cash-only, retainer, boutique, concierge, or direct primary care or specialty care practices. Such descriptions do not reflect the variability found in practices. For the purposes of this paper, the American College of Physicians (ACP) defines a direct patient contracting practice (DPCP) as any practice that directly contracts with patients to pay out-of-pocket for some or all of the services provided by the practice, in lieu of or in addition to traditional insurance arrangements, and/or charges an administrative fee to patients, sometimes called a retainer or concierge fee, often in return for a promise of more personalized and accessible care. This definition encompasses the practice types previously described. The move to DPCPs is based on the premise that access and quality of care will be improved without third-party payers imposing themselves between the patient and the physician. Yet concerns have been raised that DPCPs may cause access issues for patients who cannot afford to pay directly for care. This ACP position paper, initiated and written by its Medical Practice and Quality Committee and approved by the Board of Regents on 25 July 2015, assesses the impact of DPCPs on access, cost, and quality; discusses principles from the ACP Ethics Manual, Sixth Edition, that should apply to all practice types; and makes recommendations to mitigate any adverse effect on underserved patients.
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Calinescu A, Carballo E, Tran D, Zamler D, Doherty R, Lowenstein P, Castro M. TMOD-02BLOCKING CXCR4 INCREASES SURVIVAL IN A MOUSE MODEL OF NEURAL STEM CELLS-DERIVED GLIOBLASTOMA BY BLOCKING AN AUTOCRINE POSITIVE FEEDBACK LOOP REGULATING APOPTOSIS AND CELL CYCLE PROGRESSION VIA Rb1 AND cdk4/cdk6/CyclinD1. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov237.02] [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: 11/13/2022] Open
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Baker GJ, Yadav VN, Chockley P, Doherty R, Ritt M, Sivaramakrishnan S, Castro MG, Lowenstein PR. Abstract 3651: Natural killer cells eradicate galectin-1 deficient glioma in the absence of adaptive immunity. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-3651] [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
Natural killer (NK) cells safeguard against early tumor formation by seeking out and destroying transformed target cells in a process referred to as NK immunosurveillance. While it is clear that malignant brain tumors such as glioblastoma (GBM) evade NK-mediated tumor suppression, the precise mechanisms by which this occurs remain unknown. We now show that shRNA-mediated knockdown of the β-galactoside-binding lectin, galectin-1 (gal-1), in malignant glioma cells leads to the failure to form lethal intracranial tumors in RAG1-/- mice, a mouse strain devoid of adaptive immunity. However, gal-1 deficient glioma growth is fully restored on implantation into the brain of severely immunocompromised NOD-scid IL2Rg null mice, which lack both adaptive and innate immune function, thus implicating the innate immune response in the early rejection of gal-1 deficient glioma. Immunodepletion of NK cells in RAG1-/- or C57BL/6J mice using anti-asialo GM1 or anti-NK1.1 antibodies permit the growth of large gal-1 deficient gliomas, while macrophage depletion with clodronate liposomes only permits limited tumor growth. This combined result suggests that NK cells and macrophages may work together to achieve gal-1 deficient glioma rejection. Antigen-specific IFN-γ ELISpot assays using splenocytes from immunocompetent C57BL/6J mice indicate that gal-1 deficient glioma is cleared prior to the onset of an adaptive anti-tumor immune response. Flow cytometric analysis of brain tumor-infiltrating immune cells reveal that gal-1 deficient gliomas contain significantly more macrophages and granzyme B+ NK cells compared to gal-1 expressing gliomas. In-vitro experiments further show that gal-1 deficient glioma cells are inherently over 3-times more sensitive to NK-mediated tumor lysis, fail to suppress pro-inflammatory (M1) microglial activation, and secrete pro-inflammatory cytokines IL-1β, IL-12p70, and CXCL2. We conclude that glioma-derived gal-1 is a powerful inhibitor of NK-mediated cytotoxicity in-vivo, and predict that its suppression will be of therapeutic value in the treatment of human malignant brain tumors by dramatically heightening anti-tumor NK immunosurveillance.
Citation Format: Gregory J. Baker, Viveka Nand Yadav, Peter Chockley, Robert Doherty, Michael Ritt, Sivaraj Sivaramakrishnan, Maria G. Castro, Pedro R. Lowenstein. Natural killer cells eradicate galectin-1 deficient glioma in the absence of adaptive immunity. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3651. doi:10.1158/1538-7445.AM2014-3651
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Doherty R, Rosato M, Wright DM, O’Reilly D. PP36 Is the risk of teenage motherhood influenced by area of residence? Br J Soc Med 2014. [DOI: 10.1136/jech-2014-204726.132] [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: 11/04/2022]
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Baker GJ, Chockley P, Yadav VN, Doherty R, Ritt M, Sivaramakrishnan S, Castro MG, Lowenstein PR. Natural killer cells eradicate galectin-1-deficient glioma in the absence of adaptive immunity. Cancer Res 2014; 74:5079-90. [PMID: 25038230 DOI: 10.1158/0008-5472.can-14-1203] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Natural killer (NK) cells safeguard against early tumor formation by destroying transformed target cells in a process referred to as NK immune surveillance. However, the immune escape mechanisms used by malignant brain tumors to subvert this innate type of immune surveillance remain unclear. Here we show that malignant glioma cells suppress NK immune surveillance by overexpressing the β-galactoside-binding lectin galectin-1. Conversely, galectin-1-deficient glioma cells could be eradicated by host NK cells before the initiation of an antitumor T-cell response. In vitro experiments demonstrated that galectin-1-deficient GL26-Cit glioma cells are ∼3-fold more sensitive to NK-mediated tumor lysis than galectin-1-expressing cells. Our findings suggest that galectin-1 suppression in human glioma could improve patient survival by restoring NK immune surveillance that can eradicate glioma cells. Cancer Res; 74(18); 5079-90. ©2014 AACR.
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Affiliation(s)
- Gregory J Baker
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan. Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Peter Chockley
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan. Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Viveka Nand Yadav
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan. Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Robert Doherty
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan. Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Michael Ritt
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Sivaraj Sivaramakrishnan
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan. Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
| | - Maria G Castro
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan. Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Pedro R Lowenstein
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan. Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan.
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Butkus R, Doherty R, Daniel H. Reducing firearm-related injuries and deaths in the United States: executive summary of a policy position paper from the American College of Physicians. Ann Intern Med 2014; 160:858-60. [PMID: 24722815 DOI: 10.7326/m14-0216] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Assi HH, Paran C, VanderVeen N, Savakus J, Doherty R, Petruzzella E, Hoeschele JD, Appelman H, Raptis L, Mikkelsen T, Lowenstein PR, Castro MG. Preclinical characterization of signal transducer and activator of transcription 3 small molecule inhibitors for primary and metastatic brain cancer therapy. J Pharmacol Exp Ther 2014; 349:458-69. [PMID: 24696041 PMCID: PMC4019317 DOI: 10.1124/jpet.114.214619] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [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: 03/13/2014] [Accepted: 03/31/2014] [Indexed: 12/28/2022] Open
Abstract
Signal transducer and activator of transcription 3 (STAT3) has been implicated as a hub for multiple oncogenic pathways. The constitutive activation of STAT3 is present in several cancers, including gliomas (GBMs), and is associated with poor therapeutic responses. Phosphorylation of STAT3 triggers its dimerization and nuclear transport, where it promotes the transcription of genes that stimulate tumor growth. In light of this role, inhibitors of the STAT3 pathway are attractive therapeutic targets for cancer. To this end, we evaluated the STAT3-inhibitory activities of three compounds (CPA-7 [trichloronitritodiammineplatinum(IV)], WP1066 [(S,E)-3-(6-bromopyridin-2-yl)-2-cyano-N-(1-phenylethyl)acrylamide, C17H14BrN3O], and ML116 [4-benzyl-1-{thieno[2,3-d]pyrimidin-4-yl}piperidine, C18H19N3S]) in cultured rodent and human glioma cells, including GBM cancer stem cells. Our results demonstrate a potent induction of growth arrest in GBM cells after drug treatment with a concomitant induction of cell death. Although these compounds were effective at inhibiting STAT3 phosphorylation, they also displayed variable dose-dependent inhibition of STAT1, STAT5, and nuclear factor κ light-chain enhancer of activated B cells. The therapeutic efficacy of these compounds was further evaluated in peripheral and intracranial mouse tumor models. Whereas CPA-7 elicited regression of peripheral tumors, both melanoma and GBM, its efficacy was not evident when the tumors were implanted within the brain. Our data suggest poor permeability of this compound to tumors located within the central nervous system. WP1066 and ML116 exhibited poor in vivo efficacy. In summary, CPA-7 constitutes a powerful anticancer agent in models of peripheral solid cancers. Our data strongly support further development of CPA-7-derived compounds with increased permeability to enhance their efficacy in primary and metastatic brain tumors.
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Affiliation(s)
- Hikmat H Assi
- Department of Neurosurgery and Department of Cell and Developmental Biology, University of Michigan School of Medicine, Ann Arbor, Michigan (H.H.A., C.P., N.V., J.S., R.D., P.R.L., M.G.C.); Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California (H.H.A.); Department of Chemistry, Eastern Michigan University, Ypsilanti, Michigan (E.P., J.D.H.); Department of Pathology, University of Michigan School of Medicine, University Hospital, Ann Arbor, Michigan (H.A.); Department of Biomedical and Molecular Sciences, Queen's University School of Medicine, Kingston, Ontario, Canada (L.R.); and Department of Neurology, Henry Ford Hospital, Detroit, Michigan (T.M.)
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VanderVeen N, Paran C, Appelhans A, Krasinkiewicz J, Lemons R, Appelman H, Doherty R, Palmer D, Ng P, Lowenstein PR, Castro MG. Marmosets as a preclinical model for testing "off-label" use of doxycycline to turn on Flt3L expression from high-capacity adenovirus vectors. Mol Ther Methods Clin Dev 2014; 1:10. [PMID: 25068145 PMCID: PMC4111110 DOI: 10.1038/mtm.2013.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 11/24/2013] [Indexed: 12/17/2022]
Abstract
We developed a combined conditional cytotoxic, i.e., herpes simplex type 1-thymidine kinase (TK), plus immune-stimulatory, i.e., fms-like tyrosine kinase ligand-3-mediated gene therapy for glioblastoma multiforme (GBM). Therapeutic transgenes were encoded within high-capacity adenoviral vectors (HC-Ad); TK was expressed constitutively, while Flt3L was under the control of the TetOn regulatable promoter. We previously assessed efficacy and safety in intracranial GBM rodent models. But, since this approach involves expression of a cytokine within the brain, we chose the nonhuman primate, i.e., Callithrix jaccus (marmoset) as it has been established that its immune response shares similarities with man. We characterized the safety, cell-type specific expression, and doxycycline (DOX)-inducibility of HC-Ad-TetOn-Flt3L delivered within the striatum. We used allometrically scaled DOX doses delivered orally, twice daily for one month, mimicking the route and duration of DOX administration planned for the GBM trial. Flt3L was effectively expressed within astrocytes, microglia, oligodendrocytes, and neurons. No evidence of brain or systemic toxicities due to the treatment was encountered. Our data indicate that DOX doses equivalent to those used in humans to treat infections can be safely used "off-label" to turn "on" therapeutic gene expression from HC-Ad-TetOn-Flt3L; providing evidence for the safety of this approach in the clinic.
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Affiliation(s)
- Nathan VanderVeen
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Christopher Paran
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Ashley Appelhans
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Johnny Krasinkiewicz
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Rosemary Lemons
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Henry Appelman
- Department of Pathology, The University of Michigan School of Medicine, University Hospital, Ann Arbor, Michigan, USA
| | - Robert Doherty
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Donna Palmer
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Philip Ng
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Pedro R Lowenstein
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Maria G Castro
- Department of Neurosurgery, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, The University of Michigan School of Medicine, Ann Arbor, Michigan, USA
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Spence MS, Lyons K, McVerry F, Smith B, Manoharan GB, Maguire C, Doherty R, Anderson L, Morton A, Hughes S, Hoeritzauer I, Manoharan G. New St. Jude Medical Portico™ transcatheter aortic valve: features and early results. Minerva Cardioangiol 2013; 61:263-269. [PMID: 23681129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Patients with symptomatic aortic valve disease who are inoperable or have high surgery-related risks may be treated with transcatheter aortic valve implantation devices. With this method increasingly applied, device innovations are aimed at achieving improved procedural results and therapeutic outcome. This paper describes the innovations implemented in the St. Jude Medical Portico™ system for transcatheter aortic valve implantation, the application of this system and initial clinical experience.
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Affiliation(s)
- M S Spence
- Belfast Heart Centre, Royal Victoria Hospital, Belfast Trust, Belfast, UK.
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Doherty R, O'Farrelly C, Meade KG. Epigenetic regulation of the innate immune response to LPS in bovine peripheral blood mononuclear cells (PBMC). Vet Immunol Immunopathol 2013; 154:102-10. [PMID: 23764468 DOI: 10.1016/j.vetimm.2013.05.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 05/03/2013] [Accepted: 05/05/2013] [Indexed: 12/30/2022]
Abstract
Epigenetic regulation of gene expression could help explain variation in responses to infection and differences in disease susceptibility in cattle. The aim of this study was to examine epigenetic mechanisms in the regulation of LPS-induced innate immune gene expression in peripheral blood mononuclear cells (PBMCs) from five healthy calves. Firstly, epigenetic enzyme gene expression (histone deacetylase (HDAC) and DNA methyltransferase (DNMT)) was measured after LPS stimulation. Secondly, the effect of the histone deacetylase inhibitor Trichostatin A (TSA) on histone H3 acetylation and on innate immune gene expression was also measured. Results showed differential expression of HDAC6, HDAC7 and DNMT3A genes in response to LPS in cells from all animals, while TSA significantly inhibited pro-inflammatory cytokine (TNF, IL2 and IFNG) expression (P<0.05), presumably by histone acetylation. These results suggest an important role for the HDAC family of enzymes in the regulation of bovine innate immune gene expression.
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Affiliation(s)
- R Doherty
- Animal & Bioscience Research Department, Animal & Grassland Research and Innovation Centre, Teagasc, Grange, Co, Meath, Ireland
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Sawyer S, Boyle S, Young MA, Kovalenko S, Doherty R, McKinley J, Alsop K, Rehfisch M, Macaskill S, Ha A, Beshay V, Lindeman G, Harris M, Fox S, Mitchell G, James P. The contribution of LARGE genomic rearrangements of BRCA1 and BRCA2 gene mutations in breast and ovarian cancer families in a clinical cohort. Hered Cancer Clin Pract 2012. [PMCID: PMC3327262 DOI: 10.1186/1897-4287-10-s2-a89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mora B, Base E, Schmid W, Andreas M, Weber U, Junreitmaier M, Foerster F, Hiesmayr M, Tschernich HD, Guldbrand D, Goetzsche O, Eika B, Fumagalli S, Francini S, Gabbai D, Pedri S, Casalone Rinaldi M, Makhanian Y, Sollami R, Tarantini F, Marchionni N, Azcarate PM, Castano S, Rodriguez-Manero M, Arraiza M, Levy B, Barba J, Rabago G, Bastarrika G, Rus H, Radoi M, Ciurea C, Boda D, Erdei T, Denes M, Mihalcz A, Kardos A, Foldesi CS, Temesvari A, Lengyel M, Cameli M, Lisi M, Righini F, Ballo P, Henein M, Mondillo S, Nistri S, Galderisi M, Ballo PC, Pagliani L, Olivotto I, Santoro A, Papesso B, Innelli P, Cecchi F, Mondillo S, Hristova K, Katova TZ, Kostova V, Simova Y, Nesheva N, Ivanovic B, Tadic MT, Simic DS, Rao CM, Aguglia D, Casciola G, Imbesi C, Marvelli A, Sgro M, Benedetto D, Tripepi G, Zoccali C, Benedetto FA, Mantziari L, Kamperidis V, Damvopoulou E, Ventoulis I, Giannakoulas G, Paraskevaidis S, Vassilikos V, Karvounis H, Styliadis IH, Sonder TK, Loegstrup BB, Lambrechtsen J, Van Bortel LM, Segers P, Egstrup K, Tho A, Moceri P, Bertora D, Gibelin P, Cho EJ, Choi KY, Kim BJ, Kim DB, Jang SW, Park CS, Jung HO, Jeon HK, Youn HJ, Kim JH, Donal E, Coquerel N, Bodi S, Thebault C, Kervio G, Carre F, Daly MJ, Fairley SL, Doherty R, Ashfield K, Kirkpatrick R, Smith B, Buchanan J, Hill L, Dixon LJ, Rosca M, O' Connor K, Magne J, Romano G, Calin A, Popescu BA, Beladan CC, Pierard L, Ginghina C, Lancellotti P, Bochenek T, Wita K, Tabor Z, Grabka M, Elzbieciak M, Trusz-Gluza M, Moreau O, Thebault C, Kervio G, Leclercq C, Donal E, Sahlen A, Shahgaldi K, Aminoff A, Aagaard P, Manouras A, Winter R, Ehrenborg E, Braunschweig F, Bedetti G, Gargani L, Pizzi C, Sicari R, Picano E, Ballo P, Nistri S, Innelli P, Galderisi M, Mondillo S, Zhang J, Zhang HB, Duan YY, Chen LL, Li J, Liu LW, Zhu T, Li HL, Su HL, Zhou XD, Ruiz Ortiz M, Mesa Rubio D, Delgado Ortega M, Romo Penas E, Toledano Degado F, Leon Del Pino C, Lopez Aguilera J, Villanueva Fernandez E, Cejudo Diaz Del Campo L, Suarez De Lezo J, Abergel E, Simon M, Dehant P, Bogino E, Jimenez M, Verdier JC, Chauvel C, Albertsen AE, Nielsen JC, Mortensen PT, Egeblad H, Nasr GM, Tawfik S, Omar A, Olofsson M, Boman K, Sonder TK, Loegstrup BB, Lambrechtsen J, Segers P, Van Bortel LM, Egstrup K, Rezzoug N, Vaes B, Degryse J, Vanoverschelde JL, Pasquet AA, Poggio D, Bonadies M, Pacher V, Mazzetti S, Grillo M, D'elia E, Khouri T, Specchia G, Mornos C, Rusinaru D, Cozma D, Ionac A, Petrescu L, Rotzak R, Rosenman Y, Patterson RD, Ratnatheepan S, Bogle RG, Goebel B, Gjesdal O, Kottke D, Otto S, Jung C, Edvardsen T, Figulla HR, Poerner TC, Otsuka T, Suzuki M, Yoshikawa H, Hashimoto G, Itou N, Ono T, Yamamoto M, Osaki T, Tsuchida T, Sugi K, Wolber T, Haegeli L, Huerlimann D, Brunckhorst C, Duru F, Wu ZM, Shu XH, Dong LL, Fan B, Ge JB, Greutmann M, Tobler D, Biaggi P, Mah M, Crean A, Oechslin EN, Silversides CK, Ivanovic B, Tadic MT, Simic DS, Giusca S, Jurcut R, Ghiorghiu I, Coman IM, Popescu BA, Amzulescu M, Ionescu R, Delcroix M, Voigt JU, Ginghina C, Piatkowski R, Kochanowski J, Scislo P, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Maceira Gonzalez AM, Cosin-Sales J, Dalli E, Igual B, Monmeneu JV, Lopez-Lereu P, Estornell J, Ruvira J, Sotillo J, Stevanovic A, Toncev A, Dimkovic S, Dekleva M, Paunovic N, Toncev D, Sekularac N, Yildirimturk O, Helvacioglu FF, Tayyareci Y, Yurdakul S, Demiroglu ICC, Aytekin S, Pinedo Gago M, Amat Santos I, Revilla Orodea A, Lopez Diaz J, Arnold R, De La Fuente Galan L, Recio Platero A, Gomez Salvador I, Puerto Sanz A, San Roman Calvar JA, Yotti R, Bermejo J, Mombiela T, Benito Y, Sanchez PL, Solis J, Prieto R, Fernandez-Aviles F, Zilberszac R, Gabriel H, Graf S, Mundigler G, Maurer G, Rosenhek R, Zito C, Salvia J, Longordo C, Donato D, Alati E, Miceli M, Pardeo A, Arcidiaco S, Oreto G, Carerj S, Kamperidis V, Hadjimiltiades S, Sianos G, Anastasiadis K, Grosomanidis V, Efthimiadis G, Karvounis H, Parcharidis G, Styliadis IH, Yousry M, Rickenlund A, Petrini J, Gustafsson T, Liska J, Hamsten A, Eriksson P, Franco-Cereceda A, Eriksson MJ, Caidahl K, Mizia-Stec K, Pysz P, Jasinski M, Drzewiecka-Gerber A, Krejca M, Bochenek A, Wos S, Gasior Z, Trusz-Gluza M, Tendera M, Yildirimturk O, Helvacioglu FF, Tayyareci Y, Yurdakul S, Demiroglu ICC, Aytekin S, Niki K, Sugawara M, Takamisawa I, Watanabe H, Sumiyoshi T, Hosoda S, Ida T, Takanashi S, Olsen NT, Sogaard P, Jons C, Mogelvang R, Larsson HBW, Goetze JP, Nielsen OW, Fritz-Hansen T, Sayar N, Orhan AL, Erer HB, Eren M, Atmaca H, Yilmaz HY, Cakmak N, Altay S, Terzi S, Yesilcimen K, Garcia Orta R, Moreno E, Lopez M, Uribe I, Vidal M, Ruiz-Lopez MF, Gonzalez-Molina M, Oyonarte JM, Lopez S, Azpitarte J, Szymanski C, Levine RA, Zheng H, Handschumacher MD, Tawakol A, Hung J, Le Ven F, Etienne Y, Jobic Y, Frachon I, Castellant P, Fatemi M, Blanc JJ, Rusinaru D, Tribouilloy C, Grigioni F, Avierinos JF, Barbieri A, Buiciuc O, Enriquez-Sarano M, Said K, Farag AK, El-Ramly M, Rizk H, Iorio A, Pinamonti B, Bobbo M, Merlo M, Massa L, Faganello G, Di Lenarda A, Sinagra G, Margato R, Ribeiro H, Ferreira C, Matias A, Fontes P, Moreira JI, Milan A, Puglisi E, Magnino C, Fabbri A, Leone D, Vairo A, Crudo V, Iannaccone A, Milazzo V, Veglio F, Maroz-Vadalazhskaya N, Ostrovskiy I, Zito C, Imbalzano E, Saitta A, Oreto G, Cusma-Piccione M, Di Bella G, Nava R, Ferro M, Falanga G, Carerj S, Frigy A, Buzogany J, Szabados CS, Dan L, Carasca E, Ikonomidis I, Lekakis J, Tzortzis S, Kremastinos DT, Papadopoulos C, Paraskevaidis I, Triantafyllidi H, Trivilou P, Venetsanou K, Anastasiou-Nana M, Wierzbowska-Drabik K, Kurpesa M, Trzos E, Rechcinski T, Mozdzan M, Kasprzak JD, Kosmala W, Kotwica T, Przewlocka-Kosmala M, Mysiak A, Skultetyova D, Filipova S, Chnupa P, Mantziari L, Pechlivanidis G, Giannakoulas G, Dimitroula H, Karvounis H, Styliadis IH, Milan A, Puglisi E, Magnino C, Fabbri A, Leone D, Vairo A, Iannaccone A, Crudo V, Milazzo V, Veglio F, Tsai WC, Liu YW, Lin CC, Huang YY, Tsai LM, Park SM, Kim YH, Shin SM, Shim WJ, Gonzalez Mansilla A, Torres Macho J, Sanchez Sanchez V, Diez P, Delgado J, Borruel S, Saenz De La Calzada C, Pyxaras S, Valentincic M, Barbati G, Lo Giudice F, Perkan A, Magnani S, Merlo M, Pinamonti B, Sinagra G, Palecek T, Ambroz D, Jansa P, Lindner J, Vitovec M, Polacek P, Jiratova K, Linhart A, Baskurt M, Dogan GM, Abaci O, Kaya A, Kucukoglu S, Duszanska A, Kukulski T, Skoczylas I, Majsnerowska A, Nowowiejska-Wiewiora A, Streb W, Szulik M, Polonski L, Kalarus Z, Yerly PO, Prella M, Joly A, Nicod L, Aubert JD, Aebischer N, Dores H, Leal S, Rosario I, Correia MJ, Monge J, Grilo AM, Arroja I, Fonseca C, Aleixo A, Silva A, Perez-David E, Sanchez-Alegre M, Yotti R, Gomez Anta I, De La Torre J, Alarcon J, Garcia Robles JA, Lafuente J, Bermejo J, Fernandez-Aviles F, Garcia Alonso CJ, Vallejo Camazon N, Gonzalez Guardia A, Nunez R, Bosch Carabante C, Mateu L, Gual Capllonch F, Ferrer Sistach E, Lopez Ayerbe J, Bayes Genis A, Tomaszewski A, Kutarski A, Tomaszewski M, Bramos D, Kalantaridou A, Takos D, Skaltsiotis E, Trika C, Tsirikos N, Pamboukas C, Kottis G, Toumanidis S, Aggeli C, Felekos I, Roussakis G, Kazazaki C, Lampropoulos K, Lagoudakou S, Stergiou C, Pitsavos C, Stefanadis C, Kihara C, Murata K, Wada Y, Tanaka T, Uchida K, Okuda S, Susa T, Matsuzaki M, Shahgaldi K, Manouras A, Abrahamsson A, Gudmundsson P, Brodin L, Winter R, Knebel F, Schattke S, Sanad W, Schimke I, Schroeckh S, Brechtel L, Lock J, Makauskiene R, Baumann G, Borges AC, Moelmen-Hansen HE, Wisloff U, Aamot IL, Stoylen A, Ingul CB, Estensen ME, Beitnes JO, Grindheim G, Henriksen T, Aaberge L, Smiseth OA, Gullestad L, Aakhus S, Gargani L, Agoston G, Moggi Pignone A, Capati E, Badano L, Moreo A, Bombardieri S, Varga A, Sicari R, Picano E, Carrideo M, Faricelli S, Corazzini A, Ippedico R, Ruggieri B, Di Blasio A, D'angelo E, Di Baldassarre A, Ripari P, Gallina S, Kentrschynskyj A, Rickenlund A, Caidahl K, Hylander B, Jacobson S, Pagels A, Eriksson MJ, Dumitrescu SI, Tintoiu I, Greere V, Cristian G, Chiriac L, Pinte F, Droc I, Neagoe G, Stanciu S, Voicu VA, Kuch-Wocial A, Pruszczyk P, Szmigielski CA, Szulc M, Styczynski G, Sinski M, Kaczynska A, Ryabikov A, Malyutina S, Halcox J, Bobak M, Nikitin YU, Marmot M, Barbosa D, Kiss G, Orderud F, Amundsen B, Jasaityte R, Loeckx D, Claus P, Torp H, D'hooge J, Kuhl JT, Lonborg J, Fuchs A, Andersen M, Vejlstrup N, Engstrom T, Moller JE, Kofoed KF, Smith LA, Bhan A, Paul M, Monaghan MJ, Zaborska B, Stec S, Sikora-Frac M, Krynski T, Kulakowski P, Pushparajah K, Dashwood D, Barlow A, Nugent K, Miller O, Simpson J, Valeur N, Ersboll MK, Kjaergaard J, Greibe R, Risum N, Hassager C, Sogaard P, Kober L, Sahlen A, Manouras A, Shahgaldi K, Winter R, Brodin L, Popovic D, Nedeljkovic I, Petrovic M, Vujisic-Tesic B, Arandjelovic A, Stojiljkovic S, Stojiljkovic S, Jakovljevic B, Damjanovic S, Ostojic M, Agrios IA, Bramos DB, Skaltsiotis HS, Takos DT, Kaladaridis A, Vasiladiotis NV, Kottis GK, Antoniou AA, Pamboucas CP, Toumanidis STT, Locorotondo G, Porto I, Paraggio L, Fedele E, Barchetta S, De Caterina AR, Rebuzzi AG, Crea F, Galiuto L, Lipiec P, Szymczyk E, Michalski B, Wozniakowski B, Stefanczyk L, Rotkiewicz A, Shim A, Kasprzak JD, Vainer J, Habets J, Lousberg A, Pont De C, Waltenberger J, Farouk H, Heshmat H, Adel A, El Chilali K, Baghdady Y, Sorour K, Gustafsson U, Larsson M, Bjallmark A, Lindqvist P, A'roch R, Haney M, Waldenstrom A, Mladenovic Z, Tavciovski D, Mijailovic Z, Djordjevic - Dikic A, Obradovic S, Matunovic R, Jovic Z, Djuric P, Torp H, Aase S, Dalen H, Sarkola T, Redington AN, Keeley F, Bradley T, Jaeggi E, Sahlen H, Winter R, Brodin L, Sahlen A, Olsen NT, Risum N, Jons C, Mogelvang R, Valeur N, Fritz-Hansen T, Sogaard P. Poster session IV * Friday 10 December 2010, 14:00-18:00. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Mitra AV, Bancroft EK, Barbachano Y, Page EC, Foster CS, Jameson C, Mitchell G, Lindeman GJ, Stapleton A, Suthers G, Evans DG, Cruger D, Blanco I, Mercer C, Kirk J, Maehle L, Hodgson S, Walker L, Izatt L, Douglas F, Tucker K, Dorkins H, Clowes V, Male A, Donaldson A, Brewer C, Doherty R, Bulman B, Osther PJ, Salinas M, Eccles D, Axcrona K, Jobson I, Newcombe B, Cybulski C, Rubinstein WS, Buys S, Townshend S, Friedman E, Domchek S, Ramon Y Cajal T, Spigelman A, Teo SH, Nicolai N, Aaronson N, Ardern-Jones A, Bangma C, Dearnaley D, Eyfjord J, Falconer A, Grönberg H, Hamdy F, Johannsson O, Khoo V, Kote-Jarai Z, Lilja H, Lubinski J, Melia J, Moynihan C, Peock S, Rennert G, Schröder F, Sibley P, Suri M, Wilson P, Bignon YJ, Strom S, Tischkowitz M, Liljegren A, Ilencikova D, Abele A, Kyriacou K, van Asperen C, Kiemeney L, Easton DF, Eeles RA. Targeted prostate cancer screening in men with mutations in BRCA1 and BRCA2 detects aggressive prostate cancer: preliminary analysis of the results of the IMPACT study. BJU Int 2010; 107:28-39. [PMID: 20840664 DOI: 10.1111/j.1464-410x.2010.09648.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the role of targeted prostate cancer screening in men with BRCA1 or BRCA2 mutations, an international study, IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in BRCA1/2 mutation carriers and controls), was established. This is the first multicentre screening study targeted at men with a known genetic predisposition to prostate cancer. A preliminary analysis of the data is reported. PATIENTS AND METHODS Men aged 40-69 years from families with BRCA1 or BRCA2 mutations were offered annual prostate specific antigen (PSA) testing, and those with PSA > 3 ng/mL, were offered a prostate biopsy. Controls were men age-matched (± 5 years) who were negative for the familial mutation. RESULTS In total, 300 men were recruited (205 mutation carriers; 89 BRCA1, 116 BRCA2 and 95 controls) over 33 months. At the baseline screen (year 1), 7.0% (21/300) underwent a prostate biopsy. Prostate cancer was diagnosed in ten individuals, a prevalence of 3.3%. The positive predictive value of PSA screening in this cohort was 47·6% (10/21). One prostate cancer was diagnosed at year 2. Of the 11 prostate cancers diagnosed, nine were in mutation carriers, two in controls, and eight were clinically significant. CONCLUSIONS The present study shows that the positive predictive value of PSA screening in BRCA mutation carriers is high and that screening detects clinically significant prostate cancer. These results support the rationale for continued screening in such men.
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Affiliation(s)
- Anita V Mitra
- The Institute of Cancer Research, Sutton, Surrey, UK
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Ardern-Jones A, Kenen R, Lynch E, Doherty R, Eeles R. The impact of ‘uninformative’ BRCA1/2 genetic test results on health professionals, caring for affected and unaffected women with a significant breast cancer family history. Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Mitra A, Fisher C, Foster CS, Jameson C, Barbachanno Y, Bartlett J, Bancroft E, Doherty R, Kote-Jarai Z, Peock S, Easton D, Eeles R. Prostate cancer in male BRCA1 and BRCA2 mutation carriers has a more aggressive phenotype. Br J Cancer 2008; 98:502-7. [PMID: 18182994 PMCID: PMC2361443 DOI: 10.1038/sj.bjc.6604132] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
There is a high and rising prevalence of prostate cancer (PRCA) within the male population of the United Kingdom. Although the relative risk of PRCA is higher in male BRCA2 and BRCA1 mutation carriers, the histological characteristics of this malignancy in these groups have not been clearly defined. We present the histopathological findings in the first UK series of BRCA1 and BRCA2 mutation carriers with PRCA. The archived histopathological tissue sections of 20 BRCA1/2 mutation carriers with PRCA were collected from histopathology laboratories in England, Ireland and Scotland. The cases were matched to a control group by age, stage and serum PSA level of PRCA cases diagnosed in the general population. Following histopathological evaluation and re-grading according to current conventional criteria, Gleason scores of PRCA developed by BRCA1/2 mutation carriers were identified to be significantly higher (Gleason scores 8, 9 or 10, P=0.012) than those in the control group. Since BRCA1/2 mutation carrier status is associated with more aggressive disease, it is a prognostic factor for PRCA outcome. Targeting screening to this population may detect disease at an earlier clinical stage which may therefore be beneficial.
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Affiliation(s)
- A Mitra
- Translational Cancer Genetics Team, Institute of Cancer Research, Surrey, UK
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Shanley S, Myhill K, Doherty R, Ardern-Jones A, Hall S, Vince C, Thomas S, Aspinall P, Eeles R. Delivery of cancer genetics services: The Royal Marsden telephone clinic model. Fam Cancer 2007; 6:213-9. [PMID: 17508269 DOI: 10.1007/s10689-007-9131-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Accepted: 04/04/2007] [Indexed: 10/23/2022]
Abstract
We have conducted a telelink telephone-led cancer genetic counselling model at The Royal Marsden NHS Foundation Trust. The study commenced in March 2004 and evaluation of the clinic was conducted over 17 months from March 2005 to the end of July 2006. A total of 612 patients had telephone consultations during this time, 228 of whom were referred from primary care with a median of 30 patients counselled per month (range of 19-63, depending on staff availability with average of two staff per clinic). Waiting times were measured for General Practitioner referrals and all 228 were counselled within the national target-stipulated 13 weeks (median 6 weeks, range 1-12). An additional 132 patients who were sent appointment letters after receipt of their family history questionnaires did not attend their appointments (18% of all potential referrals) and required recontacting by letter. After telephone counselling, 42% of patients were able to be discharged from the telephone clinic without a subsequent face-to-face appointment, thereby saving resources. The telephone clinic also had a short set-up time with flexibility on timing and day of administration, which would be an advantage in centres where outreach clinic facilities are scarce. The telelink telephone counselling model is highly efficient in triaging high risk individuals for face-to-face counselling as per the Kenilworth model, in effecting concentration of resources and in providing a flexible individual-centred approach to cancer genetic counselling delivery.
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Affiliation(s)
- S Shanley
- Cancer Genetics Unit, Orchard House, Royal Marsden NHS Foundation Trust, Downs Rd, Sutton, SM2 5PT, UK.
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Ferguson AS, Huang WE, Lawson KA, Doherty R, Gibert O, Dickson KW, Whiteley AS, Kulakov LA, Thompson IP, Kalin RM, Larkin MJ. Microbial analysis of soil and groundwater from a gasworks site and comparison with a sequenced biological reactive barrier remediation process. J Appl Microbiol 2007; 102:1227-38. [PMID: 17448158 DOI: 10.1111/j.1365-2672.2007.03398.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To investigate the distribution of a polymicrobial community of biodegradative bacteria in (i) soil and groundwater at a former manufactured gas plant (FMGP) site and (ii) in a novel SEquential REactive BARrier (SEREBAR) bioremediation process designed to bioremediate the contaminated groundwater. METHODS AND RESULTS Culture-dependent and culture-independent analyses using denaturing gradient gel electrophoresis (DGGE) and polymerase chain reaction (PCR) for the detection of 16S ribosomal RNA gene and naphthalene dioxygenase (NDO) genes of free-living (planktonic groundwater) and attached (soil biofilm) samples from across the site and from the SEREBAR process was applied. Naphthalene arising from groundwater was effectively degraded early in the process and the microbiological analysis indicated a dominant role for Pseudomonas and Comamonas in its degradation. The microbial communities appeared highly complex and diverse across both the sites and in the SEREBAR process. An increased population of naphthalene degraders was associated with naphthalene removal. CONCLUSION The distribution of micro-organisms in general and naphthalene degraders across the site was highly heterogeneous. Comparisons made between areas contaminated with polycyclic aromatic hydrocarbons (PAH) and those not contaminated, revealed differences in the microbial community profile. The likelihood of noncultured bacteria being dominant in mediating naphthalene removal was evident. SIGNIFICANCE AND IMPACT OF THE STUDY This work further emphasizes the importance of both traditional and molecular-based tools in determining the microbial ecology of contaminated sites and highlights the role of noncultured bacteria in the process.
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Affiliation(s)
- A S Ferguson
- QUESTOR Centre and EERC School of Planning Architechture and Civil Engineering, David Keir Building, The Queen's University of Belfast, Belfast, UK
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Doherty R, Lubinski J, Manguoglu E, Luleci G, Christie M, Craven P, Bancroft E, Mitra A, Morgan S, Eeles R. Short report. The AIDIT and IMPACT conference 2006: Outcomes and future directions. Hered Cancer Clin Pract 2007; 5:53-5. [PMID: 19723350 PMCID: PMC2736762 DOI: 10.1186/1897-4287-5-1-53] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Accepted: 02/01/2007] [Indexed: 12/24/2022] Open
Affiliation(s)
- R Doherty
- Translational Cancer Genetics Team, The Institute of Cancer Research, London, UK
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