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Allen I, Hassan H, Joko-Fru WY, Huntley C, Loong L, Rahman T, Torr B, Bacon A, Knott C, Jose S, Vernon S, Lüchtenborg M, Pethick J, Lavelle K, McRonald F, Eccles D, Morris EJ, Hardy S, Turnbull C, Tischkowitz M, Pharoah P, Antoniou AC. Risks of second primary cancers among 584,965 female and male breast cancer survivors in England: a 25-year retrospective cohort study. Lancet Reg Health Eur 2024; 40:100903. [PMID: 38745989 PMCID: PMC11092881 DOI: 10.1016/j.lanepe.2024.100903] [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] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 05/16/2024]
Abstract
Background Second primary cancers (SPCs) after breast cancer (BC) present an increasing public health burden, with little existing research on socio-demographic, tumour, and treatment effects. We addressed this in the largest BC survivor cohort to date, using a novel linkage of National Disease Registration Service datasets. Methods The cohort included 581,403 female and 3562 male BC survivors diagnosed between 1995 and 2019. We estimated standardized incidence ratios (SIRs) for combined and site-specific SPCs using incidences for England, overall and by age at BC and socioeconomic status. We estimated incidences and Kaplan-Meier cumulative risks stratified by age at BC, and assessed risk variation by socio-demographic, tumour, and treatment characteristics using Cox regression. Findings Both genders were at elevated contralateral breast (SIR: 2.02 (95% CI: 1.99-2.06) females; 55.4 (35.5-82.4) males) and non-breast (1.10 (1.09-1.11) females, 1.10 (1.00-1.20) males) SPC risks. Non-breast SPC risks were higher for females younger at BC diagnosis (SIR: 1.34 (1.31-1.38) <50 y, 1.07 (1.06-1.09) ≥50 y) and more socioeconomically deprived (SIR: 1.00 (0.98-1.02) least deprived quintile, 1.34 (1.30-1.37) most). Interpretation Enhanced SPC surveillance may benefit BC survivors, although specific recommendations require more detailed multifactorial risk and cost-benefit analyses. The associations between deprivation and SPC risks could provide clinical management insights. Funding CRUK Catalyst Award CanGene-CanVar (C61296/A27223). Cancer Research UK grant: PPRPGM-Nov 20∖100,002. This work was supported by core funding from the NIHR Cambridge Biomedical Research Centre (NIHR203312)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
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Affiliation(s)
- Isaac Allen
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Hend Hassan
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Walburga Yvonne Joko-Fru
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Catherine Huntley
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Lucy Loong
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Tameera Rahman
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Health Data Insight CIC, Cambridge, United Kingdom
| | - Bethany Torr
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Andrew Bacon
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Craig Knott
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Health Data Insight CIC, Cambridge, United Kingdom
| | - Sophie Jose
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Health Data Insight CIC, Cambridge, United Kingdom
| | - Sally Vernon
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Margreet Lüchtenborg
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer, Society and Public Health, Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Joanna Pethick
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Katrina Lavelle
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Fiona McRonald
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Diana Eccles
- Department of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Eva J.A Morris
- Applied Health Research Unit, Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Steven Hardy
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Marc Tischkowitz
- Department of Medical Genetics, Cambridge Biomedical Research Centre, National Institute for Health Research, University of Cambridge, Cambridge, United Kingdom
| | - Paul Pharoah
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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McRonald FE, Pethick J, Santaniello F, Shand B, Tyson A, Tulloch O, Goel S, Lüchtenborg M, Borthwick GM, Turnbull C, Shaw AC, Monahan KJ, Frayling IM, Hardy S, Burn J. Identification of people with Lynch syndrome from those presenting with colorectal cancer in England: baseline analysis of the diagnostic pathway. Eur J Hum Genet 2024; 32:529-538. [PMID: 38355963 PMCID: PMC11061113 DOI: 10.1038/s41431-024-01550-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 01/08/2024] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
It is believed that >95% of people with Lynch syndrome (LS) remain undiagnosed. Within the National Health Service (NHS) in England, formal guidelines issued in 2017 state that all colorectal cancers (CRC) should be tested for DNA Mismatch Repair deficiency (dMMR). We used a comprehensive population-level national dataset to analyse implementation of the agreed diagnostic pathway at a baseline point 2 years post-publication of official guidelines. Using real-world data collected and curated by the National Cancer Registration and Analysis Service (NCRAS), we retrospectively followed up all people diagnosed with CRC in England in 2019. Nationwide laboratory diagnostic data incorporated somatic (tumour) testing for dMMR (via immunohistochemistry or microsatellite instability), somatic testing for MLH1 promoter methylation and BRAF status, and constitutional (germline) testing of MMR genes. Only 44% of CRCs were screened for dMMR; these figures varied over four-fold with respect to geography. Of those CRCs identified as dMMR, only 51% underwent subsequent diagnostic testing. Overall, only 1.3% of patients with colorectal cancer had a germline MMR genetic test performed; up to 37% of these tests occurred outside of NICE guidelines. The low rates of molecular diagnostic testing in CRC support the premise that Lynch syndrome is underdiagnosed, with significant attrition at all stages of the testing pathway. Applying our methodology to subsequent years' data will allow ongoing monitoring and analysis of the impact of recent investment. If the diagnostic guidelines were fully implemented, we estimate that up to 700 additional people with LS could be identified each year.
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Affiliation(s)
| | - Joanna Pethick
- National Disease Registration Service, NHS England, London, UK
| | - Francesco Santaniello
- National Disease Registration Service, NHS England, London, UK
- Health Data Insight, Cambridge, UK
| | - Brian Shand
- National Disease Registration Service, NHS England, London, UK
- Health Data Insight, Cambridge, UK
| | - Adele Tyson
- National Disease Registration Service, NHS England, London, UK
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Oliver Tulloch
- National Disease Registration Service, NHS England, London, UK
- Health Data Insight, Cambridge, UK
| | - Shilpi Goel
- National Disease Registration Service, NHS England, London, UK
- Health Data Insight, Cambridge, UK
| | - Margreet Lüchtenborg
- National Disease Registration Service, NHS England, London, UK
- Cancer Epidemiology and Cancer Services Research, King's College London, London, UK
| | - Gillian M Borthwick
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Adam C Shaw
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Kevin J Monahan
- St Mark's Hospital Centre for Familial Intestinal Cancer, Imperial College, London, UK
| | - Ian M Frayling
- St Mark's Hospital Centre for Familial Intestinal Cancer, Imperial College, London, UK
- St Vincent's University Hospital, Dublin, Ireland
| | - Steven Hardy
- National Disease Registration Service, NHS England, London, UK
| | - John Burn
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
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Allen S, Loong L, Garrett A, Torr B, Durkie M, Drummond J, Callaway A, Robinson R, Burghel GJ, Hanson H, Field J, McDevitt T, McVeigh TP, Bedenham T, Bowles C, Bradshaw K, Brooks C, Butler S, Del Rey Jimenez JC, Hawkes L, Stinton V, MacMahon S, Owens M, Palmer-Smith S, Smith K, Tellez J, Valganon-Petrizan M, Waskiewicz E, Yau M, Eccles DM, Tischkowitz M, Goel S, McRonald F, Antoniou AC, Morris E, Hardy S, Turnbull C. Recommendations for laboratory workflow that better support centralised amalgamation of genomic variant data: findings from CanVIG-UK national molecular laboratory survey. J Med Genet 2024; 61:305-312. [PMID: 38154813 PMCID: PMC10982625 DOI: 10.1136/jmg-2023-109645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/28/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND National and international amalgamation of genomic data offers opportunity for research and audit, including analyses enabling improved classification of variants of uncertain significance. Review of individual-level data from National Health Service (NHS) testing of cancer susceptibility genes (2002-2023) submitted to the National Disease Registration Service revealed heterogeneity across participating laboratories regarding (1) the structure, quality and completeness of submitted data, and (2) the ease with which that data could be assembled locally for submission. METHODS In May 2023, we undertook a closed online survey of 51 clinical scientists who provided consensus responses representing all 17 of 17 NHS molecular genetic laboratories in England and Wales which undertake NHS diagnostic analyses of cancer susceptibility genes. The survey included 18 questions relating to 'next-generation sequencing workflow' (11), 'variant classification' (3) and 'phenotypical context' (4). RESULTS Widely differing processes were reported for transfer of variant data into their local LIMS (Laboratory Information Management System), for the formatting in which the variants are stored in the LIMS and which classes of variants are retained in the local LIMS. Differing local provisions and workflow for variant classifications were also reported, including the resources provided and the mechanisms by which classifications are stored. CONCLUSION The survey responses illustrate heterogeneous laboratory workflow for preparation of genomic variant data from local LIMS for centralised submission. Workflow is often labour-intensive and inefficient, involving multiple manual steps which introduce opportunities for error. These survey findings and adoption of the concomitant recommendations may support improvement in laboratory dataflows, better facilitating submission of data for central amalgamation.
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Affiliation(s)
- Sophie Allen
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Lucy Loong
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Alice Garrett
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Department of Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Bethany Torr
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, NEY Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - James Drummond
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Alison Callaway
- Wessex Regional Genetics Laboratory, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rachel Robinson
- Yorkshire Regional Genetics Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - George J Burghel
- Manchester Centre for Genomic Medicine and NW Laboratory Genetics Hub, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Helen Hanson
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Department of Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Joanne Field
- Genomics and Molecular Medicine Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Trudi McDevitt
- Department of Clinical Genetics, CHI at Crumlin, Dublin, Ireland
| | - Terri P McVeigh
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Tina Bedenham
- West Midlands, Oxford and Wessex Genomic Laboratory Hub, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Christopher Bowles
- Department of Molecular Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Kirsty Bradshaw
- East Midlands and East of England Genomics Laboratory, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claire Brooks
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Samantha Butler
- Central and South Genomic Laboratory Hub, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Lorraine Hawkes
- South East Genomics Laboratory Hub, Guy's Hospital, London, UK
| | - Victoria Stinton
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Suzanne MacMahon
- Centre for Molecular Pathology, Institute of Cancer Research Sutton, Sutton, UK
- Department of Molecular Diagnostics, The Royal Marsden NHS Foundation Trust, London, UK
| | - Martina Owens
- Department of Molecular Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Sheila Palmer-Smith
- Institute of Medical Genetics, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Kenneth Smith
- South West Genomic Laboratory Hub, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - James Tellez
- North East and Yorkshire Genomic Laboratory Hub, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Mikel Valganon-Petrizan
- Centre for Molecular Pathology, Institute of Cancer Research Sutton, Sutton, UK
- Department of Molecular Diagnostics, The Royal Marsden NHS Foundation Trust, London, UK
| | - Erik Waskiewicz
- Institute of Medical Genetics, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Michael Yau
- South East Genomics Laboratory Hub, Guy's Hospital, London, UK
| | - Diana M Eccles
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Shilpi Goel
- NHS England, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Fiona McRonald
- NHS England, National Disease Registration Service, London, UK
| | - Antonis C Antoniou
- Department of Public Health and Primary Care, University of Cambridge Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Eva Morris
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Steven Hardy
- NHS England, National Disease Registration Service, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
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4
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Huntley C, Loong L, Mallinson C, Bethell R, Rahman T, Alhaddad N, Tulloch O, Zhou X, Lee J, Eves P, McRonald F, Torr B, Burn J, Shaw A, Morris EJ, Monahan K, Hardy S, Turnbull C. The comprehensive English National Lynch Syndrome Registry: development and description of a new genomics data resource. EClinicalMedicine 2024; 69:102465. [PMID: 38356732 PMCID: PMC10864212 DOI: 10.1016/j.eclinm.2024.102465] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
Background Lynch Syndrome (LS) is a cancer predisposition syndrome caused by constitutional pathogenic variants in the mismatch repair (MMR) genes. To date, fragmentation of clinical and genomic data has restricted understanding of national LS ascertainment and outcomes, and precluded evaluation of NICE guidance on testing and management. To address this, via collaboration between researchers, the National Disease Registration Service (NDRS), NHS Genomic Medicine Service Alliances (GMSAs), and NHS Regional Clinical Genetics Services, a comprehensive registry of LS carriers in England has been established. Methods For comprehensive ascertainment of retrospectively identified MMR pathogenic variant (PV) carriers (diagnosed prior to January 1, 2023), information was retrieved from all clinical genetics services across England, then restructured, amalgamated, and validated via a team of trained experts in NDRS. An online submission portal was established for prospective ascertainment from January 1, 2023. The resulting data, stored in a secure database in NDRS, were used to investigate the demographic and genetic characteristics of the cohort, censored at July 25, 2023. Cancer outcomes were investigated via linkage to the National Cancer Registration Dataset (NCRD). Findings A total of 11,722 retrospective and 570 prospective data submissions were received, resulting in a comprehensive English National Lynch Syndrome Registry (ENLSR) comprising 9030 unique individuals. The most frequently identified pathogenic MMR genes were MSH2 and MLH1 at 37.2% (n = 3362) and 29.1% (n = 2624), respectively. 35.9% (n = 3239) of the ENLSR cohort received their LS diagnosis before their first cancer diagnosis (presumptive predictive germline test). Of these, 6.3% (n = 204) developed colorectal cancer, at a median age of initial diagnosis of 51 (IQR 40-62), compared to 73 years (IQR 64-80) in the general population (p < 0.0001). Interpretation The ENLSR represents the first comprehensive national registry of PV carriers in England and one of the largest cohorts of MMR PV carriers worldwide. The establishment of a secure, centralised infrastructure and mechanism for routine registration of newly identified carriers ensures sustainability of the data resource. Funding This work was funded by the Wellcome Trust, Cancer Research UK and Bowel Cancer UK. The funder of this study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
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Affiliation(s)
- Catherine Huntley
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- National Disease Registration Service, NHS England, London, UK
| | - Lucy Loong
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- National Disease Registration Service, NHS England, London, UK
| | | | - Rachel Bethell
- National Disease Registration Service, NHS England, London, UK
| | - Tameera Rahman
- National Disease Registration Service, NHS England, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Neelam Alhaddad
- National Disease Registration Service, NHS England, London, UK
| | - Oliver Tulloch
- National Disease Registration Service, NHS England, London, UK
| | - Xue Zhou
- National Disease Registration Service, NHS England, London, UK
| | - Jason Lee
- National Disease Registration Service, NHS England, London, UK
| | - Paul Eves
- National Disease Registration Service, NHS England, London, UK
| | - Fiona McRonald
- National Disease Registration Service, NHS England, London, UK
| | - Bethany Torr
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - John Burn
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Adam Shaw
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Eva J.A. Morris
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kevin Monahan
- The Lynch Syndrome and Family Cancer Clinic, St Mark's Hospital and Academic Institute, Harrow, London, UK
- Imperial College London, London, UK
| | - Steven Hardy
- National Disease Registration Service, NHS England, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- National Disease Registration Service, NHS England, London, UK
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Cook S, Pethick J, Kibbi N, Hollestein L, Lavelle K, de Vere Hunt I, Turnbull C, Rous B, Husain A, Burn J, Lüchtenborg M, Santaniello F, McRonald F, Hardy S, Linos E, Venables Z, Rajan N. Sebaceous carcinoma epidemiology, associated malignancies and Lynch/Muir-Torre syndrome screening in England from 2008 to 2018. J Am Acad Dermatol 2023; 89:1129-1135. [PMID: 37031776 DOI: 10.1016/j.jaad.2023.03.046] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/02/2023] [Accepted: 03/19/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Sebaceous carcinomas (SC) may be associated with the cancer predisposition syndrome Muir-Torre/Lynch syndrome (MTS/LS), identifiable by SC mismatch repair (MMR) screening; however, there is limited data on MMR status of SC. OBJECTIVE To describe the epidemiology of SC, copresentation of other cancers, and population level frequency of MMR screening in SC. METHODS A population-based retrospective cohort study of SC patients in the National Cancer Registration and Analysis Service in England. RESULTS This study included 1077 SC cases (739 extraocular, 338 periocular). Age-standardized incidence rates (ASIR) were higher in men compared with women, 2.74 (95% CI, 2.52-9.69) per 1,000,000 person-years for men versus 1.47 person-years (95% CI, 1.4-1.62) for women. Of the patients, 19% (210/1077) developed at least one MTS/LS-associated malignancy. MMR immunohistochemical screening was performed in only 20% (220/1077) of SC tumors; of these, 32% (70/219) of tumors were MMR deficient. LIMITATIONS Retrospective design. CONCLUSIONS Incorporation of MMR screening into clinical practice guidelines for the management of SC will increase the opportunity for MTS/LS diagnoses, with implications for cancer surveillance, chemoprevention with aspirin, and immunotherapy treatment targeted to MTS/LS cancers.
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Affiliation(s)
- Sam Cook
- Department of Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Joanna Pethick
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Loes Hollestein
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands; Department of Research, Netherlands Comprehensive Cancer Center (IKNL), Utrecht, The Netherlands
| | - Katrina Lavelle
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Isabella de Vere Hunt
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Clare Turnbull
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Brian Rous
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Akhtar Husain
- Department of Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - John Burn
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Margreet Lüchtenborg
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom; Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King's College London, London, United Kingdom
| | - Francesco Santaniello
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom; Health Data Insight, Cambridge, United Kingdom
| | - Fiona McRonald
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Steven Hardy
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Eleni Linos
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Zoe Venables
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom; Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Neil Rajan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
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Embry L, Bingen K, Conklin HM, Hardy S, Jacola LM, Marchak JG, Paltin I, Pelletier W, Devine KA. Children's Oncology Group's 2023 blueprint for research: Behavioral science. Pediatr Blood Cancer 2023; 70 Suppl 6:e30557. [PMID: 37430416 PMCID: PMC10528542 DOI: 10.1002/pbc.30557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/12/2023]
Abstract
As survival rates for childhood cancer have improved, there has been increasing focus on identifying and addressing adverse impacts of cancer and its treatment on children and their families during treatment and into survivorship. The Behavioral Science Committee (BSC) of the Children's Oncology Group (COG), comprised of psychologists, neuropsychologists, social workers, nurses, physicians, and clinical research associates, aims to improve the lives of children with cancer and their families through research and dissemination of empirically supported knowledge. Key achievements of the BSC include enhanced interprofessional collaboration through integration of liaisons into other key committees within COG, successful measurement of critical neurocognitive outcomes through standardized neurocognitive assessment strategies, contributions to evidence-based guidelines, and optimization of patient-reported outcome measurement. The collection of neurocognitive and behavioral data continues to be an essential function of the BSC, in the context of therapeutic trials that are modifying treatments to maximize event-free survival, minimize adverse outcomes, and optimize quality of life. In addition, through hypothesis-driven research and multidisciplinary collaborations, the BSC will also begin to prioritize initiatives to expand the systematic collection of predictive factors (e.g., social determinants of health) and psychosocial outcomes, with overarching goals of addressing health inequities in cancer care and outcomes, and promoting evidence-based interventions to improve outcomes for all children, adolescents, and young adults with cancer.
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Affiliation(s)
- Leanne Embry
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Kristin Bingen
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Heather M Conklin
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Steven Hardy
- Division of Oncology, Children's National Hospital and Departments of Pediatrics and Psychiatry & Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Lisa M Jacola
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jordan Gilleland Marchak
- Emory University School of Medicine and Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Iris Paltin
- Division of Oncology, The Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Wendy Pelletier
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Katie A Devine
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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7
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Loong L, Huntley C, McRonald F, Santaniello F, Pethick J, Torr B, Allen S, Tulloch O, Goel S, Shand B, Rahman T, Luchtenborg M, Garrett A, Barber R, Bedenham T, Bourn D, Bradshaw K, Brooks C, Bruty J, Burghel GJ, Butler S, Buxton C, Callaway A, Callaway J, Drummond J, Durkie M, Field J, Jenkins L, McVeigh TP, Mountford R, Nyanhete R, Petrides E, Robinson R, Scott T, Stinton V, Tellez J, Wallace AJ, Yarram-Smith L, Sahan K, Hallowell N, Eccles DM, Pharoah P, Tischkowitz M, Antoniou AC, Evans DG, Lalloo F, Norbury G, Morris E, Burn J, Hardy S, Turnbull C. Germline mismatch repair (MMR) gene analyses from English NHS regional molecular genomics laboratories 1996-2020: development of a national resource of patient-level genomics laboratory records. J Med Genet 2023; 60:669-678. [PMID: 36572524 PMCID: PMC10359571 DOI: 10.1136/jmg-2022-108800] [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: 07/01/2022] [Accepted: 11/18/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To describe national patterns of National Health Service (NHS) analysis of mismatch repair (MMR) genes in England using individual-level data submitted to the National Disease Registration Service (NDRS) by the NHS regional molecular genetics laboratories. DESIGN Laboratories submitted individual-level patient data to NDRS against a prescribed data model, including (1) patient identifiers, (2) test episode data, (3) per-gene results and (4) detected sequence variants. Individualised per-laboratory algorithms were designed and applied in NDRS to extract and map the data to the common data model. Laboratory-level MMR activity audit data from the Clinical Molecular Genetics Society/Association of Clinical Genomic Science were used to assess early years' missing data. RESULTS Individual-level data from patients undergoing NHS MMR germline genetic testing were submitted from all 13 English laboratories performing MMR analyses, comprising in total 16 722 patients (9649 full-gene, 7073 targeted), with the earliest submission from 2000. The NDRS dataset is estimated to comprise >60% of NHS MMR analyses performed since inception of NHS MMR analysis, with complete national data for full-gene analyses for 2016 onwards. Out of 9649 full-gene tests, 2724 had an abnormal result, approximately 70% of which were (likely) pathogenic. Data linkage to the National Cancer Registry demonstrated colorectal cancer was the most frequent cancer type in which full-gene analysis was performed. CONCLUSION The NDRS MMR dataset is a unique national pan-laboratory amalgamation of individual-level clinical and genomic patient data with pseudonymised identifiers enabling linkage to other national datasets. This growing resource will enable longitudinal research and can form the basis of a live national genomic disease registry.
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Affiliation(s)
- Lucy Loong
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Catherine Huntley
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Fiona McRonald
- NHS Digital, National Disease Registration Service, London, UK
| | - Francesco Santaniello
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Joanna Pethick
- NHS Digital, National Disease Registration Service, London, UK
| | - Bethany Torr
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Sophie Allen
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Oliver Tulloch
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Shilpi Goel
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Brian Shand
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Tameera Rahman
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Margreet Luchtenborg
- NHS Digital, National Disease Registration Service, London, UK
- Centre for Cancer, Society & Public Health, King's College London, London, UK
| | - Alice Garrett
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Richard Barber
- Central and South Genomic Laboratory Hub, West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - Tina Bedenham
- West Midlands, Oxford and Wessex Genomic Laboratory Hub, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - David Bourn
- North East and Yorkshire Genomic Laboratory Hub, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Kirsty Bradshaw
- East Midlands and East of England Genomics Laboratory, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claire Brooks
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jonathan Bruty
- East Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - George J Burghel
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Samantha Butler
- Central and South Genomic Laboratory Hub, West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - Chris Buxton
- Bristol Genetics Laboratory, Southmead Hospital, Bristol, UK
| | - Alison Callaway
- Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury, UK
| | - Jonathan Callaway
- Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury, UK
| | - James Drummond
- East Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Joanne Field
- East Midlands and East of England Genomics Laboratory, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lucy Jenkins
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Terri P McVeigh
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Cancer Genetics Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Roger Mountford
- North West Genomic Laboratory Hub (Liverpool), Manchester Centre for Genomic Medicine, Liverpool, UK
| | - Rodney Nyanhete
- Sheffield Diagnostic Genetics Service, North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Evgenia Petrides
- West Midlands, Oxford and Wessex Genomic Laboratory Hub, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Rachel Robinson
- Yorkshire and North East Genomic Laboratory Hub, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Tracy Scott
- Yorkshire and North East Genomic Laboratory Hub, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Victoria Stinton
- North West Genomic Laboratory Hub (Liverpool), Manchester Centre for Genomic Medicine, Liverpool, UK
| | - James Tellez
- North East and Yorkshire Genomic Laboratory Hub, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Andrew J Wallace
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Kate Sahan
- The Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford Ethox Centre, Oxford, UK
| | - Nina Hallowell
- The Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford Ethox Centre, Oxford, UK
| | - Diana M Eccles
- Cancer Sciences, University of Southampton Faculty of Medicine, Southampton, UK
- Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Paul Pharoah
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Antonis C Antoniou
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - D Gareth Evans
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Evolution & Genomic Sciences, The University of Manchester, Manchester, UK
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Gail Norbury
- South East Genomic Laboratory Hub, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Eva Morris
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - John Burn
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Steven Hardy
- NHS Digital, National Disease Registration Service, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Cancer Genetics Unit, Royal Marsden Hospital NHS Trust, London, UK
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8
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Hassan H, Rahman T, Bacon A, Knott C, Allen I, Huntley C, Loong L, Walburga Y, Lavelle K, Morris E, Hardy S, Torr B, Eccles DM, Turnbull C, Tischkowitz M, Pharoah P, Antoniou AC. Abstract 988: Long-term health outcomes of bilateral salpingo-oophorectomy in women with personal history of breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-988] [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: 04/07/2023]
Abstract
Abstract
Introduction: Breast cancer is the most common cancer in women. Women with personal history of breast cancer are at increased risk of second primary cancers including ovarian cancer. Bilateral salpingo-oophorectomy (BSO) is a well-established option for ovarian cancer risk reduction. However, the benefit of ovarian cancer risk reduction should be balanced against the health sequelae caused by the premature estrogen loss. We examined the associations between BSO after breast cancer diagnosis and long-term health outcomes, using large-scale linked electronic health records.
Methods: We selected women diagnosed with invasive breast cancer before the age of 75 between 1995 and 2019 using data from the National Cancer Registration Dataset (NCRD), which describes all cancers registered in England. These women were linked to the Hospital Episode Statistics (HES) Admitted Patient Care (APC) dataset to identify the delivery of BSO, while the use of hormonal replacement therapy (HRT) was identified from the community dispensed prescriptions dataset. Long-term outcomes (e.g., ischemic heart disease) were selected from HES, and the NCRD provided data on second cancer diagnosis and all-cause mortality. Multiple imputation was used to impute missing data on stage, grade, hormonal receptor status and ethnicity. Women were followed from the date of breast cancer diagnosis to development of an outcome of interest or censoring or end of data collection. Multivariable Cox regression was used to examine the associations, with BSO modeled as a time-dependent covariate. The analysis was stratified by patient age at BSO (<55 and ≥55 years).
Results: The study included 566,731 women, with median follow up time 8.40 (IQR: 4.4-14.5) years. Of those, 23,881 women had BSO after their breast cancer diagnosis. BSO before the age of 55 was not associated with all-cause mortality (hazard ratio (HR):1.03, 95%CI:0.98-1.08), while BSO after the age of 55 was associated with a small reduction in the risk of all-cause mortality (HR:0.93, 95%CI:0.89-0.99). BSO before and after the age of 55 was associated with increased risk of ischemic heart disease with HRs of 1.23(95%CI:1.07-1.41) and 1.13(95%CI:1.02-1.25), respectively. There was no association between BSO and cerebrovascular events (HR:0.97, 95%CI:0.82-1.15, for BSO under age 55, HR:0.96, 95%CI:0.87-1.07, for BSO after age 55). Ongoing analyses are investigating the associations stratified by the severity of cardiovascular outcome (fatal/non-fatal) and the use of HRT, and the associations with second cancers and neuropsychiatric outcomes.
Conclusion: BSO after 55 does not appear to be associated with detrimental health effects in women diagnosed with breast cancer. Further examination of the associations between BSO and other long-term health outcomes and the influence of HRT in younger women is needed.
Citation Format: Hend Hassan, Tameera Rahman, Andrew Bacon, Craig Knott, Isaac Allen, Catherine Huntley, Lucy Loong, Yvonne Walburga, Katrina Lavelle, Eva Morris, Steven Hardy, Bethany Torr, Diana M Eccles, Clare Turnbull, Marc Tischkowitz, Paul Pharoah, Antonis C. Antoniou. Long-term health outcomes of bilateral salpingo-oophorectomy in women with personal history of breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 988.
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Affiliation(s)
- Hend Hassan
- 1University of Cambridge, Cambridge, United Kingdom
| | - Tameera Rahman
- 2National Disease Registration Service, NHS Digital, Leeds, United Kingdom
| | - Andrew Bacon
- 3National Cancer Registration and Analysis Service (NCRAS), Cambridge, United Kingdom
| | - Craig Knott
- 4Health Data Insight CIC, Cambridge, United Kingdom
| | - Isaac Allen
- 1University of Cambridge, Cambridge, United Kingdom
| | | | - Lucy Loong
- 6Institute of Cancer Research, Oxford, United Kingdom
| | | | - Katrina Lavelle
- 2National Disease Registration Service, NHS Digital, Leeds, United Kingdom
| | - Eva Morris
- 7University of Oxford, Oxford, United Kingdom
| | - Steven Hardy
- 2National Disease Registration Service, NHS Digital, Leeds, United Kingdom
| | - Bethany Torr
- 8The Institute of Cancer Research, Surrey, United Kingdom
| | | | - Clare Turnbull
- 5The Institute of Cancer Research, London, United Kingdom
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9
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Allen I, Rahman T, Bacon A, Knott C, Jose S, Vernon S, Hassan H, Huntley C, Loong L, Walburga Y, Lavelle K, Morris E, Hardy S, Torr B, Eccles D, Turnbull C, Tischkowitz M, Pharoah P, Antoniou AC. Abstract 3057: Second primary cancer risks for female and male breast cancer survivors. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3057] [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: 04/07/2023]
Abstract
Abstract
Background: Second primary cancer (SPC) incidence is rising among breast cancer (BC) survivors, but these risks remain unclear. We estimated SPC risks for male and female BC survivors using large-scale electronic health record data from a linkage of National Cancer Registration and Analysis Service data and Hospital Episode Statistics surgical records in England.
Material and Methods: We used a retrospective cohort study design comprising 763,578 female and 4,795 male BC survivors first diagnosed with BC between 1995-2018. We calculated overall and site-specific SPC standardized incidence ratios (SIRs) by comparing observed and expected SPC counts for 19 cancer sites. Study participants were followed from one year after the first BC diagnosis until either a SPC diagnosis (excluding ipsilateral breast and non-melanoma skin cancers), death, migration, relevant surgical procedures, or the end of 2019. Expected SPC counts were calculated using year-, age- and sex-specific cancer incidence rates in the general English population. We stratified the SIRs by age group, sex, and cancer site. We estimated Kaplan-Meier absolute risks of site-specific SPCs and assessed the influence of age at first BC diagnosis using Cox proportional hazards models.
Results: There were 68,550 and 720 incident SPCs among female and male BC survivors, respectively. There was a significant increased risk of all SPCs combined for female BC survivors (SIR: 1.19, 95%CI: 1.18-1.20). There were significant increased risks for SPC at all sites combined, all non-breast sites combined, and at 12 further specific sites for females and at 2 specific sites for males. Among females, the increase was greatest for contralateral breast (SIR: 1.82, 95%CI: 1.79-1.85) and uterine cancers (SIR: 1.80, 95%CI: 1.76-1.85). The risk at all sites combined was higher for women first diagnosed with BC before age 50 (SIR: 1.89, 95%CI: 1.85-1.92) compared to women diagnosed with BC at age 50 or over (SIR: 1.11, 95%CI: 1.10-1.12). The largest associations were observed for contralateral breast (SIR: 3.19, 95%CI: 3.11-3.29) and uterine (SIR: 1.77, 95%CI: 1.73-1.82) SPCs in the younger and older age groups, respectively. Increasing age at first female BC diagnosis was associated with decreasing CBC absolute risks, but significantly increased absolute risks of all other SPCs. Male BC survivors were at increased risk of contralateral breast (SIR: 42.39, 95%CI: 28.39-60.89) and prostate (SIR: 1.29, 95%CI: 1.13-1.46) SPCs.
Conclusions: This is the largest study to date to assess SPC risks following BC in either men or women. SPC risks were significantly increased, both in combination and at specific sites. These findings could help guide clinical management, such as screening recommendations, for BC survivors. Further analysis is underway to investigate the effects of chemotherapy, radiotherapy, hormonal therapy, comorbidities, or germline BC susceptibility.
Citation Format: Isaac Allen, Tameera Rahman, Andrew Bacon, Craig Knott, Sophie Jose, Sally Vernon, Hend Hassan, Catherine Huntley, Lucy Loong, Yvonne Walburga, Katrina Lavelle, Eva Morris, Steven Hardy, Beth Torr, Diana Eccles, Clare Turnbull, Marc Tischkowitz, Paul Pharoah, Antonis C. Antoniou. Second primary cancer risks for female and male breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3057.
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Affiliation(s)
- Isaac Allen
- 1University of Cambridge, Cambridge, United Kingdom
| | | | | | - Craig Knott
- 2Health Data Insight, Cambridge, United Kingdom
| | - Sophie Jose
- 2Health Data Insight, Cambridge, United Kingdom
| | | | - Hend Hassan
- 1University of Cambridge, Cambridge, United Kingdom
| | | | - Lucy Loong
- 4Institute of Cancer Research, London, United Kingdom
| | | | | | - Eva Morris
- 5University of Oxford, Oxford, United Kingdom
| | | | - Beth Torr
- 4Institute of Cancer Research, London, United Kingdom
| | - Diana Eccles
- 6University of Southampton, Southampton, United Kingdom
| | | | | | - Paul Pharoah
- 1University of Cambridge, Cambridge, United Kingdom
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10
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Hill W, Lim EL, Weeden CE, Lee C, Augustine M, Chen K, Kuan FC, Marongiu F, Evans EJ, Moore DA, Rodrigues FS, Pich O, Bakker B, Cha H, Myers R, van Maldegem F, Boumelha J, Veeriah S, Rowan A, Naceur-Lombardelli C, Karasaki T, Sivakumar M, De S, Caswell DR, Nagano A, Black JRM, Martínez-Ruiz C, Ryu MH, Huff RD, Li S, Favé MJ, Magness A, Suárez-Bonnet A, Priestnall SL, Lüchtenborg M, Lavelle K, Pethick J, Hardy S, McRonald FE, Lin MH, Troccoli CI, Ghosh M, Miller YE, Merrick DT, Keith RL, Al Bakir M, Bailey C, Hill MS, Saal LH, Chen Y, George AM, Abbosh C, Kanu N, Lee SH, McGranahan N, Berg CD, Sasieni P, Houlston R, Turnbull C, Lam S, Awadalla P, Grönroos E, Downward J, Jacks T, Carlsten C, Malanchi I, Hackshaw A, Litchfield K, DeGregori J, Jamal-Hanjani M, Swanton C. Lung adenocarcinoma promotion by air pollutants. Nature 2023; 616:159-167. [PMID: 37020004 PMCID: PMC7614604 DOI: 10.1038/s41586-023-05874-3] [Citation(s) in RCA: 112] [Impact Index Per Article: 112.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 02/21/2023] [Indexed: 04/07/2023]
Abstract
A complete understanding of how exposure to environmental substances promotes cancer formation is lacking. More than 70 years ago, tumorigenesis was proposed to occur in a two-step process: an initiating step that induces mutations in healthy cells, followed by a promoter step that triggers cancer development1. Here we propose that environmental particulate matter measuring ≤2.5 μm (PM2.5), known to be associated with lung cancer risk, promotes lung cancer by acting on cells that harbour pre-existing oncogenic mutations in healthy lung tissue. Focusing on EGFR-driven lung cancer, which is more common in never-smokers or light smokers, we found a significant association between PM2.5 levels and the incidence of lung cancer for 32,957 EGFR-driven lung cancer cases in four within-country cohorts. Functional mouse models revealed that air pollutants cause an influx of macrophages into the lung and release of interleukin-1β. This process results in a progenitor-like cell state within EGFR mutant lung alveolar type II epithelial cells that fuels tumorigenesis. Ultradeep mutational profiling of histologically normal lung tissue from 295 individuals across 3 clinical cohorts revealed oncogenic EGFR and KRAS driver mutations in 18% and 53% of healthy tissue samples, respectively. These findings collectively support a tumour-promoting role for PM2.5 air pollutants and provide impetus for public health policy initiatives to address air pollution to reduce disease burden.
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Affiliation(s)
- William Hill
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Emilia L Lim
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Clare E Weeden
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Claudia Lee
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Division of Medicine, University College London, London, UK
| | - Marcellus Augustine
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Division of Medicine, University College London, London, UK
- Tumour Immunogenomics and Immunosurveillance Laboratory, University College London Cancer Institute, London, UK
| | - Kezhong Chen
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Department of Thoracic Surgery and Thoracic Oncology Institute, Peking University People's Hospital, Beijing, China
| | - Feng-Che Kuan
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang-Gung University, Taoyuan, Taiwan
| | - Fabio Marongiu
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Edward J Evans
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David A Moore
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Department of Cellular Pathology, University College London Hospitals, London, UK
| | - Felipe S Rodrigues
- Tumour-Host Interaction Laboratory, The Francis Crick Institute, London, UK
| | - Oriol Pich
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Bjorn Bakker
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Hongui Cha
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Renelle Myers
- BC Cancer Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Febe van Maldegem
- Oncogene Biology Laboratory, The Francis Crick Institute, London, UK
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jesse Boumelha
- Oncogene Biology Laboratory, The Francis Crick Institute, London, UK
| | - Selvaraju Veeriah
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Andrew Rowan
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | | | - Takahiro Karasaki
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Metastasis Laboratory, University College London Cancer Institute, London, UK
| | - Monica Sivakumar
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Swapnanil De
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Deborah R Caswell
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Ai Nagano
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - James R M Black
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Genome Evolution Research Group, Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Carlos Martínez-Ruiz
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Genome Evolution Research Group, Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Min Hyung Ryu
- Department of Medicine, Division of Respiratory Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease, Vancouver Coastal Health Research Institute, UBC, Vancouver, British Columbia, Canada
| | - Ryan D Huff
- Department of Medicine, Division of Respiratory Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease, Vancouver Coastal Health Research Institute, UBC, Vancouver, British Columbia, Canada
| | - Shijia Li
- Department of Medicine, Division of Respiratory Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease, Vancouver Coastal Health Research Institute, UBC, Vancouver, British Columbia, Canada
| | | | - Alastair Magness
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Alejandro Suárez-Bonnet
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, UK
- Experimental Histopathology, The Francis Crick Institute, London, UK
| | - Simon L Priestnall
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, UK
- Experimental Histopathology, The Francis Crick Institute, London, UK
| | - Margreet Lüchtenborg
- National Disease Registration Service (NDRS), NHS England, Leeds, UK
- Centre for Cancer, Society and Public Health, Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Katrina Lavelle
- National Disease Registration Service (NDRS), NHS England, Leeds, UK
| | - Joanna Pethick
- National Disease Registration Service (NDRS), NHS England, Leeds, UK
| | - Steven Hardy
- National Disease Registration Service (NDRS), NHS England, Leeds, UK
| | - Fiona E McRonald
- National Disease Registration Service (NDRS), NHS England, Leeds, UK
| | - Meng-Hung Lin
- Health Information and Epidemiology Laboratory, Chang-Gung Memorial Hospital, Chiayi, Taiwan
| | - Clara I Troccoli
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Flagship Biosciences, Boulder, CO, USA
| | - Moumita Ghosh
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - York E Miller
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Veterans Affairs Eastern Colorado Healthcare System, Aurora, CO, USA
| | - Daniel T Merrick
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Robert L Keith
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Veterans Affairs Eastern Colorado Healthcare System, Aurora, CO, USA
| | - Maise Al Bakir
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Chris Bailey
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Mark S Hill
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Lao H Saal
- SAGA Diagnostics, Lund, Sweden
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Yilun Chen
- SAGA Diagnostics, Lund, Sweden
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Anthony M George
- SAGA Diagnostics, Lund, Sweden
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Christopher Abbosh
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Nnennaya Kanu
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nicholas McGranahan
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Genome Evolution Research Group, Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | | | - Peter Sasieni
- Comprehensive Cancer Centre, King's College London, London, UK
| | - Richard Houlston
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Stephen Lam
- BC Cancer Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Eva Grönroos
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Julian Downward
- Oncogene Biology Laboratory, The Francis Crick Institute, London, UK
| | - Tyler Jacks
- David H. Koch Institute for Integrative Cancer Research, Cambridge, MA, USA
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Christopher Carlsten
- Department of Medicine, Division of Respiratory Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease, Vancouver Coastal Health Research Institute, UBC, Vancouver, British Columbia, Canada
| | - Ilaria Malanchi
- Tumour-Host Interaction Laboratory, The Francis Crick Institute, London, UK
| | - Allan Hackshaw
- Cancer Research UK and UCL Cancer Trials Centre, London, UK
| | - Kevin Litchfield
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Tumour Immunogenomics and Immunosurveillance Laboratory, University College London Cancer Institute, London, UK
| | - James DeGregori
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mariam Jamal-Hanjani
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Metastasis Laboratory, University College London Cancer Institute, London, UK
- Department of Oncology, University College London Hospitals, London, UK
| | - Charles Swanton
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK.
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK.
- Department of Oncology, University College London Hospitals, London, UK.
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11
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Speight B, Hanson H, Turnbull C, Hardy S, Drummond J, Khorashad J, Wragg C, Page P, Parkin NW, Rio-Machin A, Fitzgibbon J, Kulasekararaj AG, Hamblin A, Talley P, McVeigh TP, Snape K. Germline predisposition to haematological malignancies: Best practice consensus guidelines from the UK Cancer Genetics Group (UKCGG), CanGene-CanVar and the NHS England Haematological Oncology Working Group. Br J Haematol 2023; 201:25-34. [PMID: 36744544 DOI: 10.1111/bjh.18675] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 02/07/2023]
Abstract
The implementation of whole genome sequencing and large somatic gene panels in haematological malignancies is identifying an increasing number of individuals with either potential or confirmed germline predisposition to haematological malignancy. There are currently no national or international best practice guidelines with respect to management of carriers of such variants or of their at-risk relatives. To address this gap, the UK Cancer Genetics Group (UKCGG), CanGene-CanVar and the NHS England Haematological Oncology Working Group held a workshop over two days on 28-29th April 2022, with the aim of establishing consensus guidelines on relevant clinical and laboratory pathways. The workshop focussed on the management of disease-causing germline variation in the following genes: DDX41, CEBPA, RUNX1, ANKRD26, ETV6, GATA2. Using a pre-workshop survey followed by structured discussion and in-meeting polling, we achieved consensus for UK best practice in several areas. In particular, high consensus was achieved on issues regarding standardised reporting, variant classification, multidisciplinary team working and patient support. The best practice recommendations from this meeting may be applicable to an expanding number of other genes in this setting.
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Affiliation(s)
- Beverley Speight
- East Anglian Medical Genetics Service, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, UK
| | - Helen Hanson
- South West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK
- Institute of Cancer Research, Sutton, London, UK
| | - Clare Turnbull
- Institute of Cancer Research, Sutton, London, UK
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Steven Hardy
- National Disease Registration Service, NHS Digital, London, UK
| | - James Drummond
- East Anglian Medical Genetics Service, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, UK
| | | | - Christopher Wragg
- South West Genomics Laboratory Hub, Bristol Genetics Laboratory, North Bristol NHS Trust, Pathology Building, Southmead Hospital, Bristol, UK
| | - Paula Page
- West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Nicholas W Parkin
- Molecular Pathology Laboratory, Synnovis Analytics, King's College Hospital, London, UK
| | - Ana Rio-Machin
- Centre for Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Jude Fitzgibbon
- Centre for Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Austin Gladston Kulasekararaj
- King's College Hospital NHS Foundation Trust, London, UK
- National Institute for Health and Care Research and Wellcome King's Research Facility, London, UK
- King's College London, London, UK
| | - Angela Hamblin
- Oxford University Hospitals NHS Foundation Trust and Central and South Genomic Laboratory Hub, Oxford, UK
| | - Polly Talley
- Genomics Unit, NHS UK and NHS Improvement, Leeds, UK
- North East and Yorkshire Genomic Laboratory Hub, Leeds, UK
| | - Terri P McVeigh
- Institute of Cancer Research, Sutton, London, UK
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Katie Snape
- South West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
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12
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Swinney P, Dixon E, Williams F, Hardy S. Comparing ultraviolet with chlorine dioxide wipe system for vaginal ultrasound probe cleaning: critical analysis of the term 'cleaning'. Ultrasound Obstet Gynecol 2022; 60:146-147. [PMID: 35776008 DOI: 10.1002/uog.24952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/28/2022] [Indexed: 05/27/2023]
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13
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Hardy S, Patrick R, Liesinger L, Pöttler M, Rech L, Gindlhuber J, Mabotuwana N, Ashour D, Stangl V, Bigland M, Murtha L, Starkey M, Scherr D, Hansbro P, Höfler G, Ramos G, Cochain C, Harvey R, Birner-Gruenberger R, Boyle A, Rainer P. Extracellular Matrix Protein 1 as a Mediator of Inflammation-Induced Fibrosis After Myocardial Infarction. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Tavabi N, Stück D, Signorini A, Karjadi C, Al Hanai T, Sandoval M, Lemke C, Glass J, Hardy S, Lavallee M, Wasserman B, Ang TFA, Nowak CM, Kainkaryam R, Foschini L, Au R. Cognitive Digital Biomarkers from Automated Transcription of Spoken Language. J Prev Alzheimers Dis 2022; 9:791-800. [PMID: 36281684 DOI: 10.14283/jpad.2022.66] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although patients with Alzheimer's disease and other cognitive-related neurodegenerative disorders may benefit from early detection, development of a reliable diagnostic test has remained elusive. The penetration of digital voice-recording technologies and multiple cognitive processes deployed when constructing spoken responses might offer an opportunity to predict cognitive status. OBJECTIVE To determine whether cognitive status might be predicted from voice recordings of neuropsychological testing. DESIGN Comparison of acoustic and (para)linguistic variables from low-quality automated transcriptions of neuropsychological testing (n = 200) versus variables from high-quality manual transcriptions (n = 127). We trained a logistic regression classifier to predict cognitive status, which was tested against actual diagnoses. SETTING Observational cohort study. PARTICIPANTS 146 participants in the Framingham Heart Study. MEASUREMENTS Acoustic and either paralinguistic variables (e.g., speaking time) from automated transcriptions or linguistic variables (e.g., phrase complexity) from manual transcriptions. RESULTS Models based on demographic features alone were not robust (area under the receiver-operator characteristic curve [AUROC] 0.60). Addition of clinical and standard acoustic features boosted the AUROC to 0.81. Additional inclusion of transcription-related features yielded an AUROC of 0.90. CONCLUSIONS The use of voice-based digital biomarkers derived from automated processing methods, combined with standard patient screening, might constitute a scalable way to enable early detection of dementia.
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Affiliation(s)
- N Tavabi
- Rhoda Au, 72 E. Concord Street, Boston University School of Medicine, Boston, MA 02118. Telephone: (617) 358-0089;
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15
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Kutny MA, Alonzo TA, Abla O, Rajpurkar M, Gerbing RB, Wang YC, Hirsch BA, Raimondi S, Kahwash S, Hardy KK, Hardy S, Meshinchi S, Gamis AS, Kolb EA, Feusner JH, Gregory J. Assessment of Arsenic Trioxide and All-trans Retinoic Acid for the Treatment of Pediatric Acute Promyelocytic Leukemia: A Report From the Children's Oncology Group AAML1331 Trial. JAMA Oncol 2021; 8:79-87. [PMID: 34762093 DOI: 10.1001/jamaoncol.2021.5206] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance All-trans retinoic acid (ATRA) and arsenic trioxide therapy without the use of maintenance therapy has been found to be beneficial for the treatment of adults with standard-risk acute promyelocytic leukemia (APL). However, it is unclear whether similar regimens are safe and beneficial for the treatment of high-risk APL or pediatric patients with standard-risk APL. Objective To assess whether treatment with an ATRA and arsenic trioxide-based regimen is safe and allows for the elimination or substantial reduction of chemotherapy use among pediatric patients with standard-risk or high-risk APL, respectively. Design, Setting, and Participants The Children's Oncology Group AAML1331 study is a nonrandomized, noninferiority trial that examined survival outcomes among 154 pediatric patients with APL compared with a historical control group of patients with APL from the AAML0631 study. Patients aged 1 to 21 years were enrolled at 85 pediatric oncology centers (members of the Children's Oncology Group) in Australia, Canada, and the US from June 29, 2015, to May 7, 2019, with follow-up until October 31, 2020. All patients had newly diagnosed APL and were stratified into standard-risk APL (white blood cell count <10 000/μL) and high-risk APL (white blood cell count ≥10 000/μL) cohorts. Interventions All patients received ATRA and arsenic trioxide continuously during induction therapy and intermittently during 4 consolidation cycles. Patients with high-risk APL received 4 doses of idarubicin during induction therapy only. The duration of therapy was approximately 9 months, and no maintenance therapy was administered. Main Outcomes and Measures Event-free survival (EFS) at 2 years after diagnosis. Results Among 154 patients (median age, 14.4 years [range, 1.1-21.7 years]; 81 male participants [52.6%]) included in the analysis, 98 patients (63.6%) had standard-risk APL, and 56 patients (36.4%) had high-risk APL. The median follow-up duration was 24.7 months (range, 0-49.5 months) for patients with standard-risk APL and 22.8 months (range, 0-47.7 months) for patients with high-risk APL. Patients with standard-risk APL had a 2-year EFS rate of 98.0% and an overall survival rate of 99.0%; adverse events included 1 early death during induction therapy and 1 relapse. Patients with high-risk APL had a 2-year EFS rate of 96.4% and an overall survival rate of 100%; adverse events included 2 relapses and 0 deaths. These outcomes met predefined noninferiority criteria (noninferiority margin of 10% among those with standard-risk APL and 14.5% among those with high-risk APL). Conclusions and Relevance In this nonrandomized, noninferiority trial, pediatric patients with standard-risk APL who received treatment with a chemotherapy-free ATRA and arsenic trioxide regimen experienced positive outcomes. Patients with high-risk APL also had positive outcomes when treated with a novel ATRA and arsenic trioxide-based regimen that included 4 doses of idarubicin during induction therapy only and no maintenance therapy. The 2-year EFS estimates were noninferior to the historical comparator group, and advantages of the regimen included shorter treatment duration, lower exposure to anthracycline and intrathecal chemotherapy, and fewer days hospitalized. Trial Registration ClinicalTrials.gov Identifier: NCT02339740.
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Affiliation(s)
- Matthew A Kutny
- Division of Hematology/Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham
| | - Todd A Alonzo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Oussama Abla
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Madhvi Rajpurkar
- Pediatric Hematology/Oncology, Wayne State University, Detroit, Michigan
| | | | | | - Betsy A Hirsch
- Division of Laboratory Medicine, University of Minnesota Medical Center-Fairview, Minneapolis
| | - Susana Raimondi
- Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Samir Kahwash
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Kristina K Hardy
- Division of Behavioral Medicine/Neuropsychology, Children's National Medical Center, Washington, District of Columbia
| | - Steven Hardy
- Division of Behavioral Medicine/Neuropsychology, Children's National Medical Center, Washington, District of Columbia
| | - Soheil Meshinchi
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Alan S Gamis
- Division of Hematology/Oncology, Children's Mercy Hospital and Clinics, Kansas City, Missouri
| | - Edward A Kolb
- Division of Pediatric Hematology/Oncology, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, Delaware
| | - James H Feusner
- Division of Hematology/Oncology, Benioff Children's Hospital Oakland, Oakland, California
| | - John Gregory
- Division of Pediatric Hematology/Oncology, Atlantic Health System, Goryeb Children's Hospital, Morristown, New Jersey
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Zammit M, Hardy S, Harper J, Panarese A, Webb C. 544 Vasculitic Subglottic Stenosis: A Question of Immunosuppression? Br J Surg 2021. [DOI: 10.1093/bjs/znab134.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Subglottic stenosis (SGS) is the commonest manifestation of tracheobronchial disease in granulomatosis with polyangiitis (GPA) and carries a high degree of morbidity.
Management of SGS-GPA is a double-edged sword. Delayed treatment may cause respiratory compromise and infectious complications. However, aggressive surgical management may initiate a systemic inflammatory response, reactivating the vasculitic cascade and potentially lead to long-term complications including renal vasculitis and consequential end-stage renal failure.
There is currently no internationally agreed management strategy for this disease.
Method
This retrospective review was undertaken to analyse our unique combination of surgical dilatations and immunosuppressive-focused adjuvant management strategy between years 2011-2020.
Results
Sixteen of our one hundred and nine GPA patients (14.7%) had SGS and were included in our analysis. Whilst three patients (18.8%) improved solely on medical treatment, thirteen (81.3%) required combined surgery and immunosuppression (consisting of cyclophosphamide or Rituximab regimens). Thirty-nine surgical dilatations and two tracheostomies were performed over a mean 53-month follow-up period, with a calculated mean procedure rate of one every 24.8 months (2.7 - 89 months).
Conclusions
Our current management strategy affords a lower procedure rate at every 24.8 months compared to other published studies with combined procedure rate at every 14.9 months.
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Affiliation(s)
- M Zammit
- Broadgreen University Hospital, Liverpool, United Kingdom
| | - S Hardy
- Broadgreen University Hospital, Liverpool, United Kingdom
| | - J Harper
- Broadgreen University Hospital, Liverpool, United Kingdom
| | - A Panarese
- Broadgreen University Hospital, Liverpool, United Kingdom
| | - C Webb
- Broadgreen University Hospital, Liverpool, United Kingdom
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Abstract
Gender variations in health literacy have implications for engagement in preventive behaviours and the uptake of health services, especially in areas such as the Caribbean where there are marked disparities in life expectancy and health service utilization. A self-reported questionnaire was used to examine men's concepts of health, their help-seeking behaviours and their functional and interactive health literacy. Two hundred and forty-eight men across the life course participated at three sites in Trinidad. Data were analysed using descriptive statistics, with free-text responses analysed thematically. Men were concerned about, and accepted responsibility for their own health but social norms concerning sickness and masculinity were barriers to accessing health services. Almost one-third (31.5%) sought advice from a healthcare service when they were last sick because they were prompted to do so by their wife/partner or family. Levels of functional and interactive health literacy were not high among older men, who were reliant on healthcare professionals to communicate health messages. There was an age divide in e-health literacy. There is little published evidence on men's health literacy, particularly from Caribbean countries such as Trinidad and Tobago. This study highlights the importance of the design and implementation of specific policies focusing on men's health. A major challenge is to engage with men who do not access health services.
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Affiliation(s)
- J Wills
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - S Sykes
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - S Hardy
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - M Kelly
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - C Moorley
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - O Ocho
- University of West Indies, Cor. College and St Cecelia Roads, El Dorado, Trinidad and Tobago
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18
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Chaplin E, McCarthy J, Hardy S. Editorial. AIA 2020. [DOI: 10.1108/aia-10-2020-058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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19
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Hardy S, Milano M, Finkelstein A, Tivarus M, Usuki K, Lamay D, Gonsalves L, Venkataraman A, Mohile N, Lin E, Weber M, Culakova E, Schifitto G, Janelsins M. Impact of Radiation Dose to the Amygdala on Emotional and Social Cognition and Depressive Symptoms. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Hardy S, Mabotuwana NS, Murtha LA, Coulter B, Bezenilla SS, Al-Omary MS, Senanayake T, Loering S, Rech CLS, Starkey M, Lee RJ, Rainer P, Hansbro PM, Boyle AJ. P6296The role of extracellular matrix protein 1 (ECM1) - a novel link between inflammation and cardiac fibrosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0894] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Cardiac fibrosis is a severe consequence of cardiovascular disease and aging, in which we currently have no effective treatments. The mechanisms underpinning the development of cardiac fibrosis remains poorly understood. Our preliminary data suggested extracellular matrix protein 1 (ECM1) is involved in cardiac fibrosis. We therefore aimed to investigate the role of ECM1 in several fibrotic cardiac diseases.
Methods
Young and ageing (3m/18m) male C57BL/6 mice, and primary mouse cardiac fibroblast (cFB) cultures, commercial human cardiac fibroblasts (Hu-cFB), human coronary artery endothelial cell (HCAEC)/smooth muscle cell (HCASMC), and human cardiac myocyte (HCM) cell lines were used. Young mice were subject to myocardial infarction (MI, 3-day/28-day, n=6/6), or pressure overload (TAC, 3-day/13-week, n=4/4). Left ventricle (LV) was collected at all time-points, and at 18m (ageing; n=3). Spleen and bone marrow was extracted from young control mice. Hu-cFB cells were treated with recombinant ECM1 (20ng/ml) for either 10, 30 or 50 min, or 48h. Immunoblotting was conducted on all samples, qPCR on LV tissue only, density gradient centrifugation and multicolour flow cytometry coupled with fluorescent ECM1 mRNA in-situ hybridisation (FISH-Flow) on bone marrow cells.
Results
ECM1 expression was upregulated in ageing LV (mRNA 2.2±0.1-fold, p=0.0002; protein 2.0-fold, p=0.0006), day-3 post-MI (mRNA, 4.9±2.0-fold, p=0.004; protein, 3.0-fold, p=0.004), a trend of ECM1 upregulation was observed at day-28 post-MI (mRNA, 13.2±12.0-fold, p=0.003; protein, 1.8-fold, p=0.2), but no change post-TAC. Both ERK1/2 and AKT phosphorylation was upregulated 10 min post-ECM1 treatment of Hu-cFBs (ERK1/2, 2.0-fold, p<0.0001; AKT, 1.9-fold, p<0.0001), and Collagen-I protein expression was upregulated 48h post-ECM1 treatment (1.9-fold, p=0.004). ECM1 protein was not expressed in cFB, Hu-cFB, HCAEC, HCASMC or HCM, however ECM1 protein was highly expressed in spleen and bone marrow; to a greater extent in granulocytes compared to monocytes (p=0.004). tSNE analysis of ECM1 mRNA FISH-Flow revealed ECM1+ are highly granular, moderate to large in size, and express (to varying levels) CD45, CD11b, CD11c, F4/80, Ly6-C, Ly-6G, and FcεrI-α. However ECM1+ cells did not express markers indicative of smaller cells (CD3 or MHC II).
Conclusions
These data demonstrate that ECM1 plays a role in ageing and post-MI fibrosis. Although ECM1 was not produced by resident cardiac cells, it was highly expressed in spleen and bone marrow; specifically, large, granular bone marrow cell sub-types such as granulocytes and/or macrophages. Our data suggest ECM1 is expressed by cardiac infiltrating leukocytes to provoke fibroblast collagen expression in a disease specific manner; potentially via the ERK1/2 and/or AKT pathway activation. Therefore, ECM1 warrants further investigation, and may be a promising target for the treatment of fibrotic cardiac diseases.
Acknowledgement/Funding
John hunter hospital charitable trust, Hunter medical research institute (HMRI) grants
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Affiliation(s)
- S Hardy
- Medical University of Graz, Division of Cardiology, Graz, Austria
| | - N S Mabotuwana
- University of Newcastle, Cardiovascular Research Group, Newcastle, Australia
| | - L A Murtha
- University of Newcastle, Cardiovascular Research Group, Newcastle, Australia
| | - B Coulter
- University of Newcastle, Cardiovascular Research Group, Newcastle, Australia
| | - S S Bezenilla
- University of Newcastle, Priority Research Centre's for Health Lungs and GrowUpWell, Newcastle, Australia
| | - M S Al-Omary
- University of Newcastle, Cardiovascular Research Group, Newcastle, Australia
| | - T Senanayake
- University of Newcastle, Cardiovascular Research Group, Newcastle, Australia
| | - S Loering
- University of Newcastle, Priority Research Centre's for Health Lungs and GrowUpWell, Newcastle, Australia
| | - C L S Rech
- Medical University of Graz, Division of Cardiology, Graz, Austria
| | - M Starkey
- University of Newcastle, Priority Research Centre's for Health Lungs and GrowUpWell, Newcastle, Australia
| | - R J Lee
- University of California San Francisco, Division of Cardiology, San Francisco, United States of America
| | - P Rainer
- Medical University of Graz, Division of Cardiology, Graz, Austria
| | - P M Hansbro
- University of Technology, Sydney, Center for Inflammation, Faculty of Science, Sydney, Australia
| | - A J Boyle
- University of Newcastle, Cardiovascular Research Group, Newcastle, Australia
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21
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Doucette C, Hardy S, Pandya C, Milano M. Health-Related Quality of Life in Early Stage Lung Cancer: A SEER-MHOS Analysis. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Abstract
We evaluated the acceptability and usefulness of brief mental health screening during pediatric subspecialty clinic visits. Patients (8-17 years) and parents (of patients 5-17 years) in pediatric allergy, immunology, and hematology clinics completed the PROMIS (Patient-Reported Outcomes Measurement Information System) Pediatric Profile. Medical providers reviewed results and interpretations to guide discussion of mental health during visits. Almost all providers (96%) reported discussing mental health during visits but fewer parents (60%) said this discussion occurred. All parents who reported that mental health discussions occurred liked that this happened. Some parents (25%) who said no mental health discussion occurred wished it had. Most parents strongly agreed that screening completion was easy and appropriate. Most providers (79%) believed the screening was useful and 87% reported using screening results to guide discussion. Brief electronic mental health screening in pediatric subspecialty clinics is feasible, useful in guiding discussion, and viewed favorably by providers and parents of children with chronic illnesses.
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Affiliation(s)
- Linda Herbert
- 1 Children's National Health System, Washington, DC, USA
- 2 George Washington University School of Medicine, Washington, DC, USA
| | - Steven Hardy
- 1 Children's National Health System, Washington, DC, USA
- 2 George Washington University School of Medicine, Washington, DC, USA
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23
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Murtha L, Mabotuwana N, Hardy S, Bigland M, Coulter B, Hwang J, Ye J, Hume R, Chong J, Lee R, Boyle A. Fibulin-3 is Necessary for the Formation of Infarct-Induced Cardiac Fibrosis. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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24
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Hardy S, Yang H, Wachterman J, Bylund K. Comparison of Outcomes from Adjuvant Radiation Including Pelvic Lymph Nodes Versus Prostate Bed Only Radiation for Prostate Cancer after Prostatectomy and Interaction with Pelvic Lymph Node Dissection. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Weems PW, Coolen LM, Hileman SM, Hardy S, McCosh RB, Goodman RL, Lehman MN. Evidence That Dynorphin Acts Upon KNDy and GnRH Neurons During GnRH Pulse Termination in the Ewe. Endocrinology 2018; 159:3187-3199. [PMID: 30016419 PMCID: PMC6693042 DOI: 10.1210/en.2018-00435] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 05/03/2018] [Accepted: 07/09/2018] [Indexed: 11/19/2022]
Abstract
A subpopulation of neurons located within the arcuate nucleus, colocalizing kisspeptin, neurokinin B, and dynorphin (Dyn; termed KNDy neurons), represents key mediators of pulsatile GnRH secretion. The KNDy model of GnRH pulse generation proposes that Dyn terminates each pulse. However, it is unknown where and when during a pulse that Dyn is released to inhibit GnRH secretion. Dyn acts via the κ opioid receptor (KOR), and KOR is present in KNDy and GnRH neurons in sheep. KOR, similar to other G protein-coupled receptors, are internalized after exposure to ligand, and thus internalization can be used as a marker of endogenous Dyn release. Thus, we hypothesized that KOR will be internalized at pulse termination in both KNDy and GnRH neurons. To test this hypothesis, GnRH pulses were induced in gonad-intact anestrous ewes by injection of neurokinin B (NKB) into the third ventricle and animals were euthanized at times of either pulse onset or termination. NKB injections produced increased internalization of KOR within KNDy neurons during both pulse onset and termination. In contrast, KOR internalization into GnRH neurons was seen only during pulse termination, and only in GnRH neurons within the mediobasal hypothalamus (MBH). Overall, our results indicate that Dyn is released onto KNDy cells at the time of pulse onset, and continues to be released during the duration of the pulse. In contrast, Dyn is released onto MBH GnRH neurons only at pulse termination and thus actions of Dyn upon KNDy and GnRH cell bodies may be critical for pulse termination.
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Affiliation(s)
- Peyton W Weems
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lique M Coolen
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Stanley M Hileman
- Department of Physiology and Pharmacology, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Steven Hardy
- Department of Physiology and Pharmacology, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Rick B McCosh
- Department of Physiology and Pharmacology, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Robert L Goodman
- Department of Physiology and Pharmacology, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Michael N Lehman
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi
- Correspondence: Michael N. Lehman, PhD, Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, Mississippi 39232. E-mail:
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Bromfield SG, Hardy S, Sullivan S, Hammadah M, Shah A, Levantsevych O, Kaseer B, Elon L, Li L, Bremner JD, Quyyumi A, Vaccarino V, Lewis TT. 0705 Short Sleep Duration is Associated with Lower Stress-Induced Blood Pressure Reactivity in Young Women with Early-Onset Myocardial Infarction, But Not Men. Sleep 2018. [DOI: 10.1093/sleep/zsy061.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - S Hardy
- Emory University, Atlanta, GA
| | | | | | - A Shah
- Emory University, Atlanta, GA
| | | | | | - L Elon
- Emory University, Atlanta, GA
| | - L Li
- Emory University, Atlanta, GA
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Murtha L, Mabotuwana N, Hardy S, Boyle A. Understanding the Mechanisms of Murine Cardiac Fibrosis: Fibulin-3 May Play an Important Role in Extracellular Matrix Remodelling. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hardy S, Boyle A, Murth L, Mabotuwana N, Coulter B, Naudin C, Rainer P, Al-Omary M. The Role of Extracellular Matrix Protein 1 (ECM1) in Cardiac Fibrosis. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hardy S, Milano M. Death from Cerebrovascular Disease in Younger Patients Treated with Radiation Therapy for Head and Neck Cancer: A SEER Database Study. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Idica A, Hamdorf M, Tran B, Hardy S, Vente LRD, Everly MJ. P020 Increased IL-6 signaling in DSA positive renal transplant patients predicts graft failure. Hum Immunol 2017. [DOI: 10.1016/j.humimm.2017.06.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wentland C, Hersh C, Sally S, Fracchia MS, Hardy S, Liu B, Garcia JA, Hartnick CJ. Modified Best-Practice Algorithm to Reduce the Number of Postoperative Videofluoroscopic Swallow Studies in Patients With Type 1 Laryngeal Cleft Repair. JAMA Otolaryngol Head Neck Surg 2017; 142:851-6. [PMID: 27356238 DOI: 10.1001/jamaoto.2016.1252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
IMPORTANCE There is no consensus as to the timing of videofluoroscopic swallow studies (VFSSs) in determining resolving aspiration after laryngeal cleft repair. There is a growing literature on the effect of radiation exposure in children. OBJECTIVE To modify a previously published best-practice algorithm based on a literature review and our clinical experience to maintain the quality of care provided after successful type 1 laryngeal cleft repair, while reducing the total number of postoperative VFSSs by 10% or greater. DESIGN, SETTING, AND PARTICIPANTS The previously published algorithm was modified by a multidisciplinary group at a tertiary care academic medical center (Massachusetts Eye and Ear) and was prospectively applied to 31 children who underwent type 1 laryngeal cleft repair from January 1, 2013, to February 28, 2015. MAIN OUTCOMES AND MEASURES The number of VFSSs obtained in the first 7 months after surgery was compared with the peer-reviewed literature and with a retrospective cohort of 27 patients who underwent type 1 laryngeal cleft repair from January 1, 2008, to December 31, 2012. RESULTS The study cohort comprised 31 patients. Their ages ranged from 10 to 48 months, with a mean (SD) age of 23.94 (9.93) months, and 19% (6 of 31) were female. The mean (SD) number of postoperative VFSSs per patient before and after implementation of the algorithm was 1.22 (0.42) and 1.03 (0.55), respectively. The use of the algorithm reduced the number of VFSSs by 0.19 (95% CI, -0.07 to 0.45). This reduction in radiation exposure is equivalent to 1.47 chest radiographs per child per course of care. Surgical success was 87% (27 of 31) compared with our group's previously published success rate of 78% (21 of 27) (absolute difference, 0.09; 95% CI, -0.17 to 0.34). CONCLUSIONS AND RELEVANCE This modified algorithm to help guide decisions on when and how often to obtain VFSSs after type 1 laryngeal cleft repair can limit patients' radiation exposure, while maintaining high surgical success rates.
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Affiliation(s)
- Carissa Wentland
- Pediatric Otolaryngology Service, Massachusetts Eye and Ear, Boston
| | - Cheryl Hersh
- Department of Speech, Language and Swallowing Disorders, Massachusetts General Hospital, Boston
| | - Sarah Sally
- Department of Speech, Language and Swallowing Disorders, Massachusetts General Hospital, Boston
| | | | - Steven Hardy
- Pediatric Gastroenterology Service, Massachusetts General Hospital, Boston
| | - Bob Liu
- Department of Imaging, Massachusetts General Hospital, Boston
| | - Jordan A Garcia
- Department of Otolaryngology (ENT), Harvard Medical School, Massachusetts Eye and Ear, Boston
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Heckman EJ, Salazar R, Hardy S, Manders E, Liu Y, Au R, O’Connor G, Thomas R. 0780 WEARABLE SLEEP EPIDEMIOLOGY IN THE FRAMINGHAM HEART STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Purpose
The purpose of this paper is to support the use of unique identifiers for the authors of scientific publications. This, the authors believe, aligns with the views of many others, as it would solve the problem of author disambiguation. If every researcher had a unique identifier, there would be significant opportunities to provide even more services. These extensions are proposed in this paper.
Design/methodology/approach
The authors discuss the bibliographic services that are currently available. This leads to a discussion of how these services could be developed and extended.
Findings
The authors suggest a number of ways that a unique identifier for scientific authors could support many other areas of importance to the scientific community. This will provide a much more robust system that provides a much richer and more easily maintained, scientific environment.
Originality/value
The scientific community lags behind most other communities with regard to the way it identifies individuals. Even if the current vision for a unique identifier for authors was to become more widespread, there would still be many areas where the community could improve its operations. This viewpoint paper suggests some of these, along with a financial model that could underpin the functionality.
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Hardy S, Hashemi K, Catanese M, Candil M, Zufferey P, Gabison E, Guex-Crosier Y. Necrotising Scleritis and Peripheral Ulcerative Keratitis Associated with Rheumatoid Arthritis Treated with Rituximab. Klin Monbl Augenheilkd 2017; 234:567-570. [DOI: 10.1055/s-0042-121315] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S. Hardy
- Jules Gonin Eye Hospital, Ophthalmology Department, Lausanne University Hospital, Jules Gonin Eye Hospital chairman ad interim: Prof. Dr. med Thomas Wolfensberger, FAA, Lausanne Switzerland
| | - K. Hashemi
- Jules Gonin Eye Hospital, Ophthalmology Department, Lausanne University Hospital, Jules Gonin Eye Hospital chairman ad interim: Prof. Dr. med Thomas Wolfensberger, FAA, Lausanne Switzerland
| | - M. Catanese
- Jules Gonin Eye Hospital, Ophthalmology Department, Lausanne University Hospital, Jules Gonin Eye Hospital chairman ad interim: Prof. Dr. med Thomas Wolfensberger, FAA, Lausanne Switzerland
| | - M. Candil
- CHUV Centre Hospitalier Universitaire Vaudois (CHUV), Department of Rheumatology, Département de lʼappareil locomoteur, CHUV chairman: Prof. Dr. med Alexander So, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - P. Zufferey
- CHUV Centre Hospitalier Universitaire Vaudois (CHUV), Department of Rheumatology, Département de lʼappareil locomoteur, CHUV chairman: Prof. Dr. med Alexander So, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - E. Gabison
- Jules Gonin Eye Hospital, Ophthalmology Department, Lausanne University Hospital, Jules Gonin Eye Hospital chairman ad interim: Prof. Dr. med Thomas Wolfensberger, FAA, Lausanne Switzerland
| | - Y. Guex-Crosier
- Jules Gonin Eye Hospital, Ophthalmology Department, Lausanne University Hospital, Jules Gonin Eye Hospital chairman ad interim: Prof. Dr. med Thomas Wolfensberger, FAA, Lausanne Switzerland
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Padgett S, Green TD, Sharma HP, Hardy S, Herbert L. Peer Relations Among Youth with IgE-Mediated Allergic Disease and Eosinophilic Esophagitis. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kissiova K, Hardy S, Sharma HP, Herbert L. Agreement between Parents and Children regarding Child Mental and Behavioral Health Symptoms in Pediatric Allergy, Immunology, and Hematology Clinics. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Haque A, Rahi A, Al-Khaffaf H, Hardy S, Salaman R, O'Donnell M. Sartorius muscle flap as rescue management in infected, dehisced, vascular prosthetic graft wounds. A case series. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hersh C, Wentland C, Sally S, de Stadler M, Hardy S, Fracchia MS, Liu B, Hartnick C. Radiation exposure from videofluoroscopic swallow studies in children with a type 1 laryngeal cleft and pharyngeal dysphagia: A retrospective review. Int J Pediatr Otorhinolaryngol 2016; 89:92-6. [PMID: 27619036 DOI: 10.1016/j.ijporl.2016.07.032] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/22/2016] [Accepted: 07/22/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Radiation exposure is recognized as having long term consequences, resulting in increased risks over the lifetime. Children, in particular, have a projected lifetime risk of cancer, which should be reduced if within our capacity. The objective of this study is to quantify the amount of ionizing radiation in care for children being treated for aspiration secondary to a type 1 laryngeal cleft. With this baseline data, strategies can be developed to create best practice pathways to maintain quality of care while minimizing radiation exposure. METHODS Retrospective review of 78 children seen in a tertiary pediatric aerodigestive center over a 5 year period from 2008 to 2013 for management of a type 1 laryngeal cleft. The number of videofluoroscopic swallow studies (VFSS) per child was quantified, as was the mean effective dose of radiation exposure. The 78 children reviewed were of mean age 19.9 mo (range 4 mo-12 years). All children were evaluated at the aerodigestive center with clinical symptomatology and subsequent diagnosis of a type 1 laryngeal cleft. Aspiration was assessed via VFSS and exposure data collected. Imaging exams where dose parameters were not available were excluded. RESULTS The mean number of VFSS each child received during the total course of treatment was 3.24 studies (range 1-10). The average effective radiation dose per pediatric VFSS was 0.16 mSv (range: 0.03 mSv-0.59 mSv) per study. Clinical significance was determined by comparison to a pediatric CXR. At our facility a CXR yields an effective radiation dose of 0.017 mSv. Therefore, a patient receives an equivalent total of 30.6 CXR over the course of management. CONCLUSIONS Radiation exposure has known detrimental effects particularly in pediatric patients. The total ionizing radiation from VFSS exams over the course of management of aspiration has heretofore not been reported in peer reviewed literature. With this study's data in mind, future developments are indicated to create innovative clinical pathways and limit radiation exposure.
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Affiliation(s)
- Cheryl Hersh
- Department of Speech, Language and Swallowing Disorders, Massachusetts General Hospital, 275 Cambridge Street POB 3, Boston, MA 02114, United States.
| | - Carissa Wentland
- Pediatric Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, United States.
| | - Sarah Sally
- Department of Speech, Language and Swallowing Disorders, Massachusetts General Hospital, 275 Cambridge Street POB 3, Boston, MA 02114, United States.
| | - Marie de Stadler
- Department of Speech, Language and Swallowing Disorders, Massachusetts General Hospital, 275 Cambridge Street POB 3, Boston, MA 02114, United States.
| | - Steven Hardy
- Pediatric Gastroenterology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States.
| | - M Shannon Fracchia
- Pediatric Pulmonary Division, Massachusetts General Hospital, 275 Cambridge Street POB 5, Boston, MA 02114, United States.
| | - Bob Liu
- Department of Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States.
| | - Christopher Hartnick
- Pediatric Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, United States.
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Turner PJ, Baumert JL, Beyer K, Boyle RJ, Chan CH, Clark AT, Crevel RWR, DunnGalvin A, Fernández-Rivas M, Gowland MH, Grabenhenrich L, Hardy S, Houben GF, O'B Hourihane J, Muraro A, Poulsen LK, Pyrz K, Remington BC, Schnadt S, van Ree R, Venter C, Worm M, Mills ENC, Roberts G, Ballmer-Weber BK. Can we identify patients at risk of life-threatening allergic reactions to food? Allergy 2016; 71:1241-55. [PMID: 27138061 DOI: 10.1111/all.12924] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 12/31/2022]
Abstract
Anaphylaxis has been defined as a 'severe, life-threatening generalized or systemic hypersensitivity reaction'. However, data indicate that the vast majority of food-triggered anaphylactic reactions are not life-threatening. Nonetheless, severe life-threatening reactions do occur and are unpredictable. We discuss the concepts surrounding perceptions of severe, life-threatening allergic reactions to food by different stakeholders, with particular reference to the inclusion of clinical severity as a factor in allergy and allergen risk management. We review the evidence regarding factors that might be used to identify those at most risk of severe allergic reactions to food, and the consequences of misinformation in this regard. For example, a significant proportion of food-allergic children also have asthma, yet almost none will experience a fatal food-allergic reaction; asthma is not, in itself, a strong predictor for fatal anaphylaxis. The relationship between dose of allergen exposure and symptom severity is unclear. While dose appears to be a risk factor in at least a subgroup of patients, studies report that individuals with prior anaphylaxis do not have a lower eliciting dose than those reporting previous mild reactions. It is therefore important to consider severity and sensitivity as separate factors, as a highly sensitive individual will not necessarily experience severe symptoms during an allergic reaction. We identify the knowledge gaps that need to be addressed to improve our ability to better identify those most at risk of severe food-induced allergic reactions.
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Affiliation(s)
- P. J. Turner
- Section of Paediatrics (Allergy and Infectious Diseases) & MRC and Asthma UK Centre in Allergic Mechanisms of Asthma; Imperial College London; London UK
| | - J. L. Baumert
- Food Allergy Research and Resource Program; Department of Food Science and Technology; University of Nebraska; Lincoln NE USA
| | - K. Beyer
- Department of Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | - R. J. Boyle
- Section of Paediatrics (Allergy and Infectious Diseases) & MRC and Asthma UK Centre in Allergic Mechanisms of Asthma; Imperial College London; London UK
| | | | - A. T. Clark
- Cambridge University Hospitals NHS Foundation Trust; Cambridge UK
| | - R. W. R. Crevel
- Safety and Environmental Assurance Centre; Unilever; Colworth Science Park; Sharnbrook Bedford UK
| | - A. DunnGalvin
- Applied Psychology and Paediatrics and Child Health; University College Cork; Cork Ireland
| | | | | | - L. Grabenhenrich
- Institute for Social Medicine; Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Hardy
- Food Standards Agency; London UK
| | | | - J. O'B Hourihane
- Paediatrics and Child Health; University College Cork; Cork Ireland
| | - A. Muraro
- Department of Paediatrics; Centre for Food Allergy Diagnosis and Treatment; University of Padua; Veneto Italy
| | - L. K. Poulsen
- Allergy Clinic; Copenhagen University Hospital at Gentofte; Copenhagen Denmark
| | - K. Pyrz
- Applied Psychology and Paediatrics and Child Health; University College Cork; Cork Ireland
| | | | - S. Schnadt
- German Allergy and Asthma Association (Deutscher Allergie- und Asthmabund (DAAB)); Mönchengladbach Germany
| | - R. van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - C. Venter
- School of Health Sciences and Social Work; University of Portsmouth; Portsmouth UK
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight UK
| | - M. Worm
- Allergy-Center Charité; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - E. N. C. Mills
- Institute of Inflammation and Repair; Manchester Academic Health Science Centre; Manchester Institute of Biotechnology; The University of Manchester; Manchester UK
| | - G. Roberts
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust and Human Development and Health Academic Unit; University of Southampton Faculty of Medicine; Southampton UK
| | - B. K. Ballmer-Weber
- Allergy Unit; Department of Dermatology; University Hospital; University Zürich; Zürich Switzerland
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Dawson M, Hardy S, Blann AD. Book Reviews. Br J Biomed Sci 2016. [DOI: 10.1080/09674845.2007.11732785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vandemergel X, Ilisei D, Hardy S, Lefebvre M. [Incomplete form of hypertrophc osteoarthropathy in a patient with breast cancer]. Rev Med Liege 2015; 70:486-487. [PMID: 26727836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hypertrophic osteoarthropathy is sometimes the paraneoplasic manifestation of cancer of pulmonary origin. It is rarely present in case of breast cancer, even at a metastatic stage. In its complete form, this entity includes periostitis (predominantly bilateral and affecting upper and lower limbs), digital clubbing and, rarely, arthritis. We report the case of a female patient with metastatic breast cancer and an incomplete form of hypertrophic osteoarthropathy, clearly asymetric and without digital clubbing.
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Ratkiewicz A, Cizewski J, Pain S, Adekola A, Burke J, Casperson R, Fotiades N, McCleskey M, Burcher S, Shand C, Austin R, Baugher T, Carpenter M, Devlin M, Escher J, Hardy S, Hatarik R, Howard M, Hughes R, Jones K, Kozub R, Lister C, Manning B, O’Donnell J, Peters W, Ross T, Scielzo N, Seweryniak D, Zhu S. Validating (d,pγ) as a Surrogate for Neutron Capture. EPJ Web of Conferences 2015. [DOI: 10.1051/epjconf/20159302012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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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Winship G, Hardy S, Bray J. Skellern Lecture and the Journal of Psychiatric and Mental Health Nursing Lifetime Achievement Award 2015. J Psychiatr Ment Health Nurs 2015; 22:223-5. [PMID: 25912267 DOI: 10.1111/jpm.12218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G Winship
- School of Education, University of Nottingham, Nottingham; Institute of Mental Health, Universities Psychotherapy & Counselling Association Training Standards Chair, Nottingham
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Miramonti L, Bellini G, Benziger J, Bick D, Bonfini G, Bravo D, Buizza Avanzini M, Caccianiga B, Cadonati L, Calaprice F, Carraro C, Cavalcante P, Chavarria A, Chubakov V, D'Angelo D, Davini S, Derbin A, Etenko A, Fomenko K, Franco D, Galbiati C, Gazzana S, Ghiano C, Giammarchi M, Göger-Neff M, Goretti A, Grandi L, Guardincerri E, Hardy S, Ianni A, Ianni A, Kobychev V, Korablev D, Korga G, Koshio Y, Kryn D, Laubenstein M, Lewke T, Lissia M, Litvinovich E, Loer B, Lombardi F, Lombardi P, Ludhova L, Machulin I, Manecki S, Maneschg W, Mantovani F, Manuzio G, Meindl Q, Meroni E, Misiaszek M, Montanari D, Mosteiro P, Muratova V, Nisi S, Oberauer L, Obolensky M, Ortica F, Otis K, Pallavicini M, Papp L, Perasso L, Perasso S, Pocar A, Ranucci G, Razeto A, Re A, Romani A, Rossi N, Sabelnikov A, Saldanha R, Salvo C, Schönert S, Simgen H, Skorokhvatov M, Smirnov O, Sotnikov A, Sukhotin S, Suvorov Y, Tartaglia R, Testera G, Vignaud D, Vogelaar RB, von Feilitzsch F, Winter J, Wojcik M, Wright A, Wurm M, Xhixha G, Xu J, Zaimidoroga O, Zavatarelli S, Zuzel G. Lifetimes of (214)Po and (212)Po measured with Counting Test Facility at Gran Sasso National Laboratory. J Environ Radioact 2014; 138:444-446. [PMID: 24725806 DOI: 10.1016/j.jenvrad.2014.02.025] [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: 01/09/2013] [Revised: 12/16/2013] [Accepted: 02/27/2014] [Indexed: 06/03/2023]
Abstract
The decays of (214)Po into (210)Pb and of (212)Po into (208)Pb tagged by the previous decays from (214)Bi and (212)Bi have been studied inserting quartz vials inside the Counting Test Facility (CTF) at the underground laboratory in Gran Sasso (LNGS). We find that the mean lifetime of (214)Po is (236.00 ± 0.42(stat) ± 0.15(syst)) μs and that of (212)Po is (425.1 ± 0.9(stat) ± 1.2(syst)) ns. Our results are compatible with previous measurements, have a much better signal to background ratio, and reduce the overall uncertainties.
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Affiliation(s)
- L Miramonti
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - G Bellini
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - J Benziger
- Chemical Engineering Department, Princeton University, Princeton, NJ 08544, USA
| | - D Bick
- Institut für Experimentalphysik, Universität Hamburg, Germany
| | - G Bonfini
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - D Bravo
- Physics Department, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
| | - M Buizza Avanzini
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - B Caccianiga
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - L Cadonati
- Physics Department, University of Massachusetts, Amherst, MA 01003, USA
| | - F Calaprice
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - C Carraro
- Dipartimento di Fisica, Università e INFN, Genova 16146, Italy
| | - P Cavalcante
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - A Chavarria
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - V Chubakov
- Dipartimento di Fisica, Università di Ferrara and INFN Ferrara, 44100 Ferrara, Italy
| | - D D'Angelo
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - S Davini
- Dipartimento di Fisica, Università e INFN, Genova 16146, Italy
| | - A Derbin
- St. Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Etenko
- NRC Kurchatov Institute, Moscow 123182, Russia
| | - K Fomenko
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy; Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - D Franco
- Laboratoire AstroParticule et Cosmologie, 75231 Paris Cedex 13, France
| | - C Galbiati
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - S Gazzana
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - C Ghiano
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - M Giammarchi
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - M Göger-Neff
- Physik Department, Technische Universität München, Garching 85747, Germany
| | - A Goretti
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - L Grandi
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - E Guardincerri
- Dipartimento di Fisica, Università e INFN, Genova 16146, Italy
| | - S Hardy
- Physics Department, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
| | - Aldo Ianni
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - Andrea Ianni
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - V Kobychev
- Kiev Institute for Nuclear Research, Kiev 06380, Ukraine
| | - D Korablev
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - G Korga
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - Y Koshio
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - D Kryn
- Laboratoire AstroParticule et Cosmologie, 75231 Paris Cedex 13, France
| | - M Laubenstein
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - T Lewke
- Physik Department, Technische Universität München, Garching 85747, Germany
| | - M Lissia
- Istituto Nazionale di Fisica Nucleare, Sezione di Cagliari, I-09042 Monserrato, Italy
| | | | - B Loer
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - F Lombardi
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - P Lombardi
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - L Ludhova
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - I Machulin
- NRC Kurchatov Institute, Moscow 123182, Russia
| | - S Manecki
- Physics Department, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
| | - W Maneschg
- Max-Plank-Institut für Kernphysik, Heidelberg 69029, Germany
| | - F Mantovani
- Dipartimento di Fisica, Università di Ferrara and INFN Ferrara, 44100 Ferrara, Italy.
| | - G Manuzio
- Dipartimento di Fisica, Università e INFN, Genova 16146, Italy
| | - Q Meindl
- Physik Department, Technische Universität München, Garching 85747, Germany
| | - E Meroni
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - M Misiaszek
- M. Smoluchowski Institute of Physics, Jagellonian University, Krakow, 30059, Poland
| | - D Montanari
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy; Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - P Mosteiro
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - V Muratova
- St. Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - S Nisi
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - L Oberauer
- Physik Department, Technische Universität München, Garching 85747, Germany
| | - M Obolensky
- Laboratoire AstroParticule et Cosmologie, 75231 Paris Cedex 13, France
| | - F Ortica
- Dipartimento di Chimica, Università e INFN, Perugia 06123, Italy
| | - K Otis
- Physics Department, University of Massachusetts, Amherst, MA 01003, USA
| | - M Pallavicini
- Dipartimento di Fisica, Università e INFN, Genova 16146, Italy
| | - L Papp
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy; Physics Department, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
| | - L Perasso
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - S Perasso
- Dipartimento di Fisica, Università e INFN, Genova 16146, Italy
| | - A Pocar
- Physics Department, University of Massachusetts, Amherst, MA 01003, USA
| | - G Ranucci
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - A Razeto
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - A Re
- Dipartimento di Fisica, Università degli Studi e INFN, Milano 20133, Italy
| | - A Romani
- Dipartimento di Chimica, Università e INFN, Perugia 06123, Italy
| | - N Rossi
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | | | - R Saldanha
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - C Salvo
- Dipartimento di Fisica, Università e INFN, Genova 16146, Italy
| | - S Schönert
- Physik Department, Technische Universität München, Garching 85747, Germany; Max-Plank-Institut für Kernphysik, Heidelberg 69029, Germany
| | - H Simgen
- Max-Plank-Institut für Kernphysik, Heidelberg 69029, Germany
| | | | - O Smirnov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - A Sotnikov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - S Sukhotin
- NRC Kurchatov Institute, Moscow 123182, Russia
| | - Y Suvorov
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy; NRC Kurchatov Institute, Moscow 123182, Russia
| | - R Tartaglia
- INFN Laboratori Nazionali del Gran Sasso, Assergi 67010, Italy
| | - G Testera
- Dipartimento di Fisica, Università e INFN, Genova 16146, Italy
| | - D Vignaud
- Laboratoire AstroParticule et Cosmologie, 75231 Paris Cedex 13, France
| | - R B Vogelaar
- Physics Department, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
| | - F von Feilitzsch
- Physik Department, Technische Universität München, Garching 85747, Germany
| | - J Winter
- Physik Department, Technische Universität München, Garching 85747, Germany
| | - M Wojcik
- M. Smoluchowski Institute of Physics, Jagellonian University, Krakow, 30059, Poland
| | - A Wright
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - M Wurm
- Physik Department, Technische Universität München, Garching 85747, Germany
| | - G Xhixha
- Dipartimento di Fisica, Università di Ferrara and INFN Ferrara, 44100 Ferrara, Italy
| | - J Xu
- Physics Department, Princeton University, Princeton, NJ 08544, USA
| | - O Zaimidoroga
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - S Zavatarelli
- Dipartimento di Fisica, Università e INFN, Genova 16146, Italy
| | - G Zuzel
- Max-Plank-Institut für Kernphysik, Heidelberg 69029, Germany; M. Smoluchowski Institute of Physics, Jagellonian University, Krakow, 30059, Poland
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McCauley K, Cross W, Moss C, Walsh K, Schofield C, Handley C, Fitzgerald M, Hardy S. What does practice development (PD) offer mental health-care contexts? A comparative case study of PD methods and outcomes. J Psychiatr Ment Health Nurs 2014; 21:724-37. [PMID: 24698157 DOI: 10.1111/jpm.12134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/26/2013] [Indexed: 11/30/2022]
Abstract
Practice development (PD) in mental health nursing has been progressing over the last decade; however, the level and impact of PD activity in the field of mental health remains poorly understood outside localized project impact. More specific reporting and comparative analysis of PD outcomes will improve this situation. In response, this paper presents three case scenarios from work taking place in Australia and New Zealand, as working examples of how PD methodologies have been applied within mental health practice settings. Using a comparative framework that captures the contributing assumptions, practices, processes and conditions imperative to effective PD work within a mental health-care context, three case vignettes are reviewed. The critical question driving this paper is 'what mental health-care services does PD offer in terms of transformational change approaches and the promotion of effective workplace cultures?' Conditions considered necessary for successful PD initiatives within mental health contexts are explored such as how PD converges and diverges with mental health-related theories, plus where and how PD activity best integrates with the specific elements associated with mental health-care provision. The findings are further reviewed in line with reports of PD outcomes from other fields of health care.
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Affiliation(s)
- K McCauley
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton Campus, Melbourne, Vic
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Melchionda L, Haack TB, Hardy S, Abbink TEM, Fernandez-Vizarra E, Lamantea E, Marchet S, Morandi L, Moggio M, Carrozzo R, Torraco A, Diodato D, Strom TM, Meitinger T, Tekturk P, Yapici Z, Al-Murshedi F, Stevens R, Rodenburg RJ, Lamperti C, Ardissone A, Moroni I, Uziel G, Prokisch H, Taylor RW, Bertini E, van der Knaap MS, Ghezzi D, Zeviani M. Mutations in APOPT1, encoding a mitochondrial protein, cause cavitating leukoencephalopathy with cytochrome c oxidase deficiency. Am J Hum Genet 2014; 95:315-25. [PMID: 25175347 PMCID: PMC4157140 DOI: 10.1016/j.ajhg.2014.08.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/08/2014] [Indexed: 11/17/2022] Open
Abstract
Cytochrome c oxidase (COX) deficiency is a frequent biochemical abnormality in mitochondrial disorders, but a large fraction of cases remains genetically undetermined. Whole-exome sequencing led to the identification of APOPT1 mutations in two Italian sisters and in a third Turkish individual presenting severe COX deficiency. All three subjects presented a distinctive brain MRI pattern characterized by cavitating leukodystrophy, predominantly in the posterior region of the cerebral hemispheres. We then found APOPT1 mutations in three additional unrelated children, selected on the basis of these particular MRI features. All identified mutations predicted the synthesis of severely damaged protein variants. The clinical features of the six subjects varied widely from acute neurometabolic decompensation in late infancy to subtle neurological signs, which appeared in adolescence; all presented a chronic, long-surviving clinical course. We showed that APOPT1 is targeted to and localized within mitochondria by an N-terminal mitochondrial targeting sequence that is eventually cleaved off from the mature protein. We then showed that APOPT1 is virtually absent in fibroblasts cultured in standard conditions, but its levels increase by inhibiting the proteasome or after oxidative challenge. Mutant fibroblasts showed reduced amount of COX holocomplex and higher levels of reactive oxygen species, which both shifted toward control values by expressing a recombinant, wild-type APOPT1 cDNA. The shRNA-mediated knockdown of APOPT1 in myoblasts and fibroblasts caused dramatic decrease in cell viability. APOPT1 mutations are responsible for infantile or childhood-onset mitochondrial disease, hallmarked by the combination of profound COX deficiency with a distinctive neuroimaging presentation.
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Affiliation(s)
- Laura Melchionda
- Unit of Molecular Neurogenetics, Foundation IRCCS Institute of Neurology Besta, 20126 Milan, Italy
| | - Tobias B Haack
- Institute of Human Genetics, Technische Universität München, Munich 81675, Germany; Institute of Human Genetics, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Steven Hardy
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Truus E M Abbink
- Departments of Child Neurology and Functional Genomics, Neuroscience Campus Amsterdam, VU University and VU University Medical Center, Amsterdam 1081 HV, the Netherlands
| | | | - Eleonora Lamantea
- Unit of Molecular Neurogenetics, Foundation IRCCS Institute of Neurology Besta, 20126 Milan, Italy
| | - Silvia Marchet
- Unit of Molecular Neurogenetics, Foundation IRCCS Institute of Neurology Besta, 20126 Milan, Italy
| | - Lucia Morandi
- Neuromuscular Diseases and Neuroimmunology Unit, Foundation IRCCS Institute of Neurology Besta, 20133 Milan, Italy
| | - Maurizio Moggio
- Neuromuscular Unit, Department of Neurology, Centro Dino Ferrari, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Rosalba Carrozzo
- Unit of Neuromuscular Disorders, Laboratory of Molecular Medicine, Bambino Gesu' Children's Research Hospital, 00165 Rome, Italy
| | - Alessandra Torraco
- Unit of Neuromuscular Disorders, Laboratory of Molecular Medicine, Bambino Gesu' Children's Research Hospital, 00165 Rome, Italy
| | - Daria Diodato
- Unit of Molecular Neurogenetics, Foundation IRCCS Institute of Neurology Besta, 20126 Milan, Italy; Unit of Neuromuscular Disorders, Laboratory of Molecular Medicine, Bambino Gesu' Children's Research Hospital, 00165 Rome, Italy
| | - Tim M Strom
- Institute of Human Genetics, Technische Universität München, Munich 81675, Germany; Institute of Human Genetics, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Thomas Meitinger
- Institute of Human Genetics, Technische Universität München, Munich 81675, Germany; Institute of Human Genetics, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Pinar Tekturk
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, 34098 Istanbul, Turkey
| | - Zuhal Yapici
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, 34098 Istanbul, Turkey
| | - Fathiya Al-Murshedi
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - René Stevens
- Department of Paediatrics, CHC Clinique de l'Espérance at Liège, Liège 4000, Belgium
| | - Richard J Rodenburg
- Nijmegen Center for Mitochondrial Disorders, Laboratory for Genetic, Endocrine, and Metabolic Disorders, Department of Pediatrics, Radboud University Medical Center, 9101 Nijmegen, the Netherlands
| | - Costanza Lamperti
- Unit of Molecular Neurogenetics, Foundation IRCCS Institute of Neurology Besta, 20126 Milan, Italy
| | - Anna Ardissone
- Department of Child Neurology, Foundation IRCCS Institute of Neurology Besta, 20133 Milan, Italy
| | - Isabella Moroni
- Department of Child Neurology, Foundation IRCCS Institute of Neurology Besta, 20133 Milan, Italy
| | - Graziella Uziel
- Department of Child Neurology, Foundation IRCCS Institute of Neurology Besta, 20133 Milan, Italy
| | - Holger Prokisch
- Institute of Human Genetics, Technische Universität München, Munich 81675, Germany; Institute of Human Genetics, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Robert W Taylor
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Enrico Bertini
- Unit of Neuromuscular Disorders, Laboratory of Molecular Medicine, Bambino Gesu' Children's Research Hospital, 00165 Rome, Italy
| | - Marjo S van der Knaap
- Departments of Child Neurology and Functional Genomics, Neuroscience Campus Amsterdam, VU University and VU University Medical Center, Amsterdam 1081 HV, the Netherlands
| | - Daniele Ghezzi
- Unit of Molecular Neurogenetics, Foundation IRCCS Institute of Neurology Besta, 20126 Milan, Italy.
| | - Massimo Zeviani
- Unit of Molecular Neurogenetics, Foundation IRCCS Institute of Neurology Besta, 20126 Milan, Italy; MRC Mitochondrial Biology Unit, Cambridge CB2 0XY, UK.
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49
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Hardy S, Uetani N, Wong N, Kostantin E, Labbé DP, Bégin LR, Mes-Masson A, Miranda-Saavedra D, Tremblay ML. The protein tyrosine phosphatase PRL-2 interacts with the magnesium transporter CNNM3 to promote oncogenesis. Oncogene 2014; 34:986-95. [DOI: 10.1038/onc.2014.33] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 12/11/2013] [Accepted: 01/06/2014] [Indexed: 01/07/2023]
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50
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Gonem S, Hardy S, Buhl N, Soares M, Costanza R, Gustafsson P, Brightling CE, Owers-Bradley J, Siddiqui S. S120 Hyperpolarised 3HE diffusion MRI and multiple breath inert gas washout in patients with asthma: Abstract S120 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.127] [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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