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Wright B, Kingsley E, Cooper C, Biggs K, Bursnall M, Wang HI, Chater T, Coates E, Teare MD, McKendrick K, Gomez de la Cuesta G, Barr A, Solaiman K, Packham A, Marshall D, Varley D, Nekooi R, Parrott S, Ali S, Gilbody S, Le Couteur A. Play brick therapy to aid the social skills of children and young people with autism spectrum disorder: the I-SOCIALISE cluster RCT. Public Health Res (Southampt) 2023; 11:1-137. [PMID: 38095124 DOI: 10.3310/vgtr7431] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Background Social skills interventions are commonly recommended to help children and young people with autism spectrum disorder develop social skills, but some struggle to engage in these interventions. LEGO® (LEGO System A/S, Billund, Denmark) based therapy, a group social skills intervention, aims to be more interesting and engaging. Objective To evaluate the clinical effectiveness of LEGO® based therapy on the social and emotional skills of children and young people with autism spectrum disorder in school settings compared with usual support. Secondary objectives included evaluations of cost-effectiveness, acceptability and treatment fidelity. Design A cluster randomised controlled trial randomly allocating participating schools to either LEGO® based therapy and usual support or usual support only. Setting Mainstream schools in the north of England. Participants Children and young people (aged 7-15 years) with autism spectrum disorder, their parent/guardian, an associated teacher/teaching assistant and a facilitator teacher/teaching assistant (intervention schools only). Intervention Schools randomised to the intervention arm delivered 12 weekly sessions of LEGO® based therapy, which promotes collaborative play and encourages social problem-solving in groups of three children and young people with a facilitator (trained teacher or teaching assistant). Participants received usual support from school and community services. Participants in the control arm received usual support only. Research assistants and statisticians were blind to treatment allocation. Main outcome measure The social skills subscale of the Social Skills Improvement System (SSIS), completed by the children and young people's unblinded teacher pre randomisation and 20 weeks post randomisation. The SSIS social skills subscale measures social skills including social communication, co-operation, empathy, assertion, responsibility and self-control. Participants completed a number of other pre- and post-randomisation measures of emotional health, quality of life, loneliness, problem behaviours, academic competence, service resource utilisation and adverse events. Results A total of 250 children and young people from 98 schools were randomised: 127 to the intervention arm and 123 to the control arm. Intention-to-treat analysis of the main outcome measure showed a modest positive difference of 3.74 points (95% confidence interval -0.16 to 7.63 points, standardised effect size 0.18; p = 0.06) in favour of the intervention arm. Statistical significance increased in per-protocol analysis, with a modest positive difference (standardised effect size 0.21; p = 0.036). Cost-effectiveness of the intervention was found in reduced service use costs and a small increase in quality-adjusted life-years. Intervention fidelity and acceptability were positive. No intervention-related adverse events or effects were reported. Conclusions The primary and pre-planned sensitivity analysis of the primary outcome consistently showed a positive clinical difference, with modest standardised effect sizes of between 0.15 and 0.21. There were positive health economics and qualitative findings, corroborated by the difference between arms for the majority of secondary outcomes, which were not statistically significant but favoured the intervention arm. Post hoc additional analysis was exploratory and was not used in drawing this conclusion. Given the small positive change, LEGO® based therapy for children and young people with autism spectrum disorder in schools should be considered. Limitations The primary outcome measure was completed by an unblinded teacher (rather than by the facilitator). Future work The study team recommends future research into LEGO® based therapy, particularly in school environments. Trial registration This trial is registered as ISRCTN64852382. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/49/32) and is published in full in Public Health Research; Vol. 11, No. 12. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Barry Wright
- Hull York Medical School, University of York, York, UK
- Child Oriented Mental Health Innovation Collaborative, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Ellen Kingsley
- Child Oriented Mental Health Innovation Collaborative, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Katie Biggs
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Matthew Bursnall
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Han-I Wang
- Hull York Medical School, University of York, York, UK
| | - Tim Chater
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Elizabeth Coates
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - M Dawn Teare
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Kirsty McKendrick
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Amy Barr
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Kiera Solaiman
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Anna Packham
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | | | - Roshanak Nekooi
- Child Oriented Mental Health Innovation Collaborative, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Steve Parrott
- Hull York Medical School, University of York, York, UK
| | - Shehzad Ali
- Hull York Medical School, University of York, York, UK
| | - Simon Gilbody
- Hull York Medical School, University of York, York, UK
| | - Ann Le Couteur
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Wright B, Kingsley E, Cooper C, Biggs K, Bursnall M, Wang HI, Chater T, Coates E, Teare MD, McKendrick K, Gomez de la Cuesta G, Barr A, Solaiman K, Packham A, Marshall D, Varley D, Nekooi R, Parrott S, Ali S, Gilbody S, Le Couteur A. I-SOCIALISE: Results from a cluster randomised controlled trial investigating the social competence and isolation of children with autism taking part in LEGO ® based therapy ('Play Brick Therapy') clubs in school environments. Autism 2023; 27:13623613231159699. [PMID: 36991578 PMCID: PMC10576908 DOI: 10.1177/13623613231159699] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
LAY ABSTRACT Autism is characterised by keen interests and differences in social interactions and communication. Activities that help autistic children and young people with social skills are commonly used in UK schools. LEGO® based therapy is a new activity that provides interesting and fun social opportunities for children and young people and involves building LEGO® models together. This study looked at LEGO® based therapy for the social skills of autistic children and young people in schools. It was a randomised controlled trial, meaning each school was randomly chosen (like flipping a coin) to either run LEGO® based therapy groups in school over 12 weeks and have usual support from school or other professionals, or only have usual support from school or other professionals. The effect of the LEGO® based therapy groups was measured by asking children and young people, their parents/guardians, and a teacher at school in both arms of the study to complete some questionnaires. The main objective was to see if the teacher's questionnaire answers about the children and young people's social skills changed between their first and second completions. The social skills of participants in the LEGO® based therapy groups were found to have improved in a small way when compared to usual support only. The study also found that LEGO® based therapy was not very costly for schools to run and parents/guardians and teachers said they thought it was good for their children and young people. We suggest further research into different potential benefits of LEGO® based therapy.
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Affiliation(s)
| | - Ellen Kingsley
- COMIC Research, Leeds and York Partnership NHS Foundation Trust, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, University of Sheffield, UK
| | - Katie Biggs
- Clinical Trials Research Unit, University of Sheffield, UK
| | | | | | - Tim Chater
- Clinical Trials Research Unit, University of Sheffield, UK
| | | | | | | | | | - Amy Barr
- Clinical Trials Research Unit, University of Sheffield, UK
| | - Kiera Solaiman
- Clinical Trials Research Unit, University of Sheffield, UK
| | - Anna Packham
- Clinical Trials Research Unit, University of Sheffield, UK
| | | | | | - Roshanak Nekooi
- COMIC Research, Leeds and York Partnership NHS Foundation Trust, UK
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Fenton C, Kingsley E. Scoping review: Alternatives to self-harm recommended on mental health self-help websites. Int J Ment Health Nurs 2023; 32:76-94. [PMID: 36104975 DOI: 10.1111/inm.13067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 01/14/2023]
Abstract
Less than half of all young people with mental health difficulties will seek professional treatment. Due to the private nature of self-harm it is estimated that only 1:28 young males and 1:18 young females who self-harm ever present to hospital. Self-help supports improved coping strategies and life changes without reliance on a clinical intervention which could be used to reduce self-harming behaviours. The study objective is to review self-help alternatives to self-harm on mental health websites that can be accessed by young people. Google, Bing, and Yahoo search engines were used to search for appropriate websites. Eighty-two unique websites on mental health were identified, of which 55 met the inclusion criteria. A total of 1177 self-help suggestions were found for those struggling with self-harm urges. The average number of suggestions per site was 42 (Range 3-252). The main techniques suggested were: seeking social contact/help, physical activity, displacement/mimicking techniques, relaxing/comforting techniques, sensory techniques, fun/diverting techniques, aggressive techniques, creative/reflective techniques. This review found not all strategies were suitable for young people and that the large number of possible strategies could be challenging for a young person to navigate. However, mental health self-help websites were generally of high quality and gave a range of potentially helpful strategies. The categories created from this review could be used as a guide to consider with the young person when making an individualized self-help plan to manage self-harm urges. Further research is required to assess if and how these techniques could be used individually or in combination to reduce self-harm.
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Affiliation(s)
- Clare Fenton
- COMIC Research, Leeds and York Partnership NHS Foundation Trust, York, England.,Hull York Medical School, University of York, York, England
| | - Ellen Kingsley
- COMIC Research, Leeds and York Partnership NHS Foundation Trust, York, England
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Barr A, Coates E, Kingsley E, de la Cuesta GG, Biggs K, Le Couteur A, Wright B. A mixed methods evaluation of the acceptability of therapy using LEGO® bricks (LEGO® based therapy) in mainstream primary and secondary education. Autism Res 2022; 15:1237-1248. [PMID: 35396821 PMCID: PMC9324108 DOI: 10.1002/aur.2725] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 03/15/2022] [Accepted: 03/21/2022] [Indexed: 11/19/2022]
Abstract
Many autistic children and young people need extra support with social skills. Social skills programmes, such as LEGO® based therapy (LBT), are commonly used to help with these difficulties. The aim of this study was to examine the acceptability of LBT using qualitative interviews and questionnaires with facilitators and parents/guardians on behalf of autistic children and young people. Acceptability was measured in line with constructs of the Theoretical Framework of Acceptability. Questionnaires were analyzed descriptively and between group comparisons were undertaken using the Mann–Whitney U Test. Telephone interviews were undertaken with a sub‐sample of facilitators. All interviews were recorded, transcribed verbatim, and framework analysis was performed by two researchers supported by NVivo. The questionnaire response rate was 80% for facilitators and 77% for parents/guardians. Overall acceptability, measured on a 1–5 (minimum–maximum) scale, was high for both facilitators and parents/guardians with a median (range) of 5 (4–5) and 4 (3–5), respectively. Facilitators rated the acceptability of the programme significantly higher overall than parents (p < 0.001). Facilitators reported that participants and wider school staff viewed the programme positively. They observed improvements in communication and social skills during the sessions. Potential barriers to programme delivery, such as resources and staff schedules, were identified but facilitators reported that these challenges did not outweigh the benefits. There is increasing emphasis on the role of schools in seeking to improve social outcomes for autistic children therefore this high degree of acceptability makes this an attractive school‐based programme for schools, autistic children and their families.
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Affiliation(s)
- Amy Barr
- Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Elizabeth Coates
- Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Ellen Kingsley
- COMIC, Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | | | - Katie Biggs
- Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Ann Le Couteur
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Wang HI, Wright BD, Bursnall M, Cooper C, Kingsley E, Le Couteur A, Teare D, Biggs K, McKendrick K, de la Cuesta GG, Chater T, Barr A, Solaiman K, Packham A, Marshall D, Varley D, Nekooi R, Gilbody S, Parrott S. Cost-utility analysis of LEGO based therapy for school children and young people with autism spectrum disorder: results from a randomised controlled trial. BMJ Open 2022; 12:e056347. [PMID: 35039300 PMCID: PMC8765033 DOI: 10.1136/bmjopen-2021-056347] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/07/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To assess the cost-effectiveness of LEGO-based therapy compared with usual support. DESIGN Cost-utility analysis alongside randomised control trial. SETTING Mainstream primary and secondary schools in the UK. PARTICIPANTS 248 children and young people (CYP) with autism spectrum disorder (ASD) aged 7-15 years. INTERVENTION LEGO-based therapy is a group social skills intervention designed specifically for CYP with ASD. Through play, CYP learn to use the skills such as joint attention, sharing, communication and group problem-solving. CYP randomised to the intervention arm received 12 weekly sessions of LEGO-based therapy and usual support, while CYP allocated to control arm received usual support only. MAIN OUTCOME MEASURES Average costs based on National Health Service (NHS) and personal social services perspective and quality-adjusted life years (QALYs) measured by EQ-5D-Y over time horizon of 1 year were collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated, and non-parametric bootstrapping was conducted. The uncertainty around the ICER estimates was presented using cost-effectiveness acceptability curve (CEAC). A set of sensitivity analyses were conducted to assess the robustness of the primary findings. RESULTS After adjustment and bootstrapping, on average, CYP in LEGO-based therapy group incurred less costs (incremental cost was -£251 (95% CI -£752 to £268)) and gained marginal improvement in QALYs (QALYs gained 0.009 (95% CI -0.008 to 0.028)). The CEAC shows that the probability of LEGO-based therapy being cost-effective was 94% at the willingness-to-pay threshold of £20 000 per QALY gained. Results of sensitivity analyses were consistent with the primary outcomes. CONCLUSION Compared with usual support, LEGO-based therapy produced marginal reduction in costs and improvement in QALYs. Results from both primary and sensitivity analyses suggested that LEGO-based therapy was likely to be cost-effective. TRIAL REGISTRATION NUMBER ISRCTN64852382.
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Affiliation(s)
- Han-I Wang
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Barry Debenham Wright
- Department of Health Sciences, University of York, York, North Yorkshire, UK
- COMIC Research Team, Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - Matthew Bursnall
- Clinical Trials Research Unit, ScHARR, The University of Sheffield, Sheffield, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, ScHARR, The University of Sheffield, Sheffield, UK
| | - Ellen Kingsley
- COMIC Research Team, Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - Ann Le Couteur
- Sir James Spence Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Teare
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Katie Biggs
- Clinical Trials Research Unit, ScHARR, The University of Sheffield, Sheffield, UK
| | - Kirsty McKendrick
- Clinical Trials Research Unit, ScHARR, The University of Sheffield, Sheffield, UK
| | | | - Tim Chater
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, Merseyside, UK
| | - Amy Barr
- Clinical Trials Research Unit, ScHARR, The University of Sheffield, Sheffield, UK
| | - Kiera Solaiman
- Clinical Trials Research Unit, ScHARR, The University of Sheffield, Sheffield, UK
| | - Anna Packham
- Clinical Trials Research Unit, ScHARR, The University of Sheffield, Sheffield, UK
| | - David Marshall
- Centre for Reviews and Dissemination, University of York, York, North Yorkshire, UK
| | - Danielle Varley
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Roshanak Nekooi
- COMIC Research Team, Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, North Yorkshire, UK
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Bas‐Hoogendam JM, Groenewold NA, Aghajani M, Freitag GF, Harrewijn A, Hilbert K, Jahanshad N, Thomopoulos SI, Thompson PM, Veltman DJ, Winkler AM, Lueken U, Pine DS, Wee NJA, Stein DJ, Agosta F, Åhs F, An I, Alberton BAV, Andreescu C, Asami T, Assaf M, Avery SN, Nicholas L, Balderston, Barber JP, Battaglia M, Bayram A, Beesdo‐Baum K, Benedetti F, Berta R, Björkstrand J, Blackford JU, Blair JR, Karina S, Blair, Boehme S, Brambilla P, Burkhouse K, Cano M, Canu E, Cardinale EM, Cardoner N, Clauss JA, Cividini C, Critchley HD, Udo, Dannlowski, Deckert J, Demiralp T, Diefenbach GJ, Domschke K, Doruyter A, Dresler T, Erhardt A, Fallgatter AJ, Fañanás L, Brandee, Feola, Filippi CA, Filippi M, Fonzo GA, Forbes EE, Fox NA, Fredrikson M, Furmark T, Ge T, Gerber AJ, Gosnell SN, Grabe HJ, Grotegerd D, Gur RE, Gur RC, Harmer CJ, Harper J, Heeren A, Hettema J, Hofmann D, Hofmann SG, Jackowski AP, Andreas, Jansen, Kaczkurkin AN, Kingsley E, Kircher T, Kosti c M, Kreifelts B, Krug A, Larsen B, Lee S, Leehr EJ, Leibenluft E, Lochner C, Maggioni E, Makovac E, Mancini M, Manfro GG, Månsson KNT, Meeten F, Michałowski J, Milrod BL, Mühlberger A, Lilianne R, Mujica‐Parodi, Munjiza A, Mwangi B, Myers M, Igor Nenadi C, Neufang S, Nielsen JA, Oh H, Ottaviani C, Pan PM, Pantazatos SP, Martin P, Paulus, Perez‐Edgar K, Peñate W, Perino MT, Peterburs J, Pfleiderer B, Phan KL, Poletti S, Porta‐Casteràs D, Price RB, Pujol J, Andrea, Reinecke, Rivero F, Roelofs K, Rosso I, Saemann P, Salas R, Salum GA, Satterthwaite TD, Schneier F, Schruers KRJ, Schulz SM, Schwarzmeier H, Seeger FR, Smoller JW, Soares JC, Stark R, Stein MB, Straube B, Straube T, Strawn JR, Suarez‐Jimenez B, Boris, Suchan, Sylvester CM, Talati A, Tamburo E, Tükel R, Heuvel OA, Van der Auwera S, Nieuwenhuizen H, Tol M, van Velzen LS, Bort CV, Vermeiren RRJM, Visser RM, Volman I, Wannemüller A, Wendt J, Werwath KE, Westenberg PM, Wiemer J, Katharina, Wittfeld, Wu M, Yang Y, Zilverstand A, Zugman A, Zwiebel HL. ENIGMA-anxiety working group: Rationale for and organization of large-scale neuroimaging studies of anxiety disorders. Hum Brain Mapp 2022; 43:83-112. [PMID: 32618421 PMCID: PMC8805695 DOI: 10.1002/hbm.25100] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/09/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022] Open
Abstract
Anxiety disorders are highly prevalent and disabling but seem particularly tractable to investigation with translational neuroscience methodologies. Neuroimaging has informed our understanding of the neurobiology of anxiety disorders, but research has been limited by small sample sizes and low statistical power, as well as heterogenous imaging methodology. The ENIGMA-Anxiety Working Group has brought together researchers from around the world, in a harmonized and coordinated effort to address these challenges and generate more robust and reproducible findings. This paper elaborates on the concepts and methods informing the work of the working group to date, and describes the initial approach of the four subgroups studying generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobia. At present, the ENIGMA-Anxiety database contains information about more than 100 unique samples, from 16 countries and 59 institutes. Future directions include examining additional imaging modalities, integrating imaging and genetic data, and collaborating with other ENIGMA working groups. The ENIGMA consortium creates synergy at the intersection of global mental health and clinical neuroscience, and the ENIGMA-Anxiety Working Group extends the promise of this approach to neuroimaging research on anxiety disorders.
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Affiliation(s)
- Janna Marie Bas‐Hoogendam
- Department of Developmental and Educational PsychologyLeiden University, Institute of Psychology Leiden The Netherlands
- Department of PsychiatryLeiden University Medical Center Leiden The Netherlands
- Leiden Institute for Brain and Cognition Leiden The Netherlands
| | - Nynke A. Groenewold
- Department of Psychiatry & Mental HealthUniversity of Cape Town Cape Town South Africa
| | - Moji Aghajani
- Department of PsychiatryAmsterdam UMC / VUMC Amsterdam The Netherlands
- Department of Research & InnovationGGZ inGeest Amsterdam The Netherlands
| | - Gabrielle F. Freitag
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Anita Harrewijn
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Kevin Hilbert
- Department of PsychologyHumboldt‐Universität zu Berlin Berlin Germany
| | - Neda Jahanshad
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute Los Angeles California USA
| | - Sophia I. Thomopoulos
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute Los Angeles California USA
| | - Paul M. Thompson
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute Los Angeles California USA
| | - Dick J. Veltman
- Department of PsychiatryAmsterdam UMC / VUMC Amsterdam The Netherlands
| | - Anderson M. Winkler
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Ulrike Lueken
- Department of PsychologyHumboldt‐Universität zu Berlin Berlin Germany
| | - Daniel S. Pine
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Nic J. A. Wee
- Department of PsychiatryLeiden University Medical Center Leiden The Netherlands
- Leiden Institute for Brain and Cognition Leiden The Netherlands
| | - Dan J. Stein
- Department of Psychiatry & Mental HealthUniversity of Cape Town Cape Town South Africa
- University of Cape TownSouth African MRC Unit on Risk & Resilience in Mental Disorders Cape Town South Africa
- University of Cape TownNeuroscience Institute Cape Town South Africa
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Shadman M, Sharman JP, Levy MY, Porter R, Zafar SF, Burke JM, Chaudhry A, Freeman B, Misleh J, Yimer HA, Cultrera JL, Guthrie TH, Kingsley E, Rao SS, Chen DY, Zhang X, Idoine A, Cohen A, Feng S, Huang J, Flinn I. PRELIMINARY RESULTS OF THE PHASE 2 STUDY OF ZANUBRUTINIB IN PATIENTS WITH PREVIOUSLY TREATED B‐CELL MALIGNANCIES INTOLERANT TO IBRUTINIB AND/OR ACALABRUTINIB. Hematol Oncol 2021. [DOI: 10.1002/hon.42_2880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- M. Shadman
- Fred Hutchinson Cancer Research Center University of Washington Clinical Research Division Seattle, Washington USA
| | - J. P. Sharman
- Willamette Valley Cancer Institute and Research Center Clinical Research Division Eugene USA
| | - M. Y. Levy
- Texas Oncology‐Baylor Charles A. Sammons Cancer Center Hematology Dallas USA
| | - R. Porter
- SSM Health Dean Medical Group Hematology Madison USA
| | - S. F. Zafar
- Florida Cancer Specialists & Research Institute Oncology Fort Myers USA
| | - J. M. Burke
- Rocky Mountain Cancer Centers Oncology Aurora Colorado USA
| | | | - B. Freeman
- Summit Medical Group Oncology Florham Park USA
| | - J. Misleh
- Medical Oncology Hematology Consultants PA Hematology Newark USA
| | | | - J. L. Cultrera
- Florida Cancer Specialists & Research Institute Oncology Leesburg USA
| | | | - E. Kingsley
- Comprehensive Cancer Centers of Nevada Oncology Las Vegas USA
| | - S. S. Rao
- Alpha Med Physicians Group Oncology & Hematology Tinley Park USA
| | - D. Y. Chen
- BeiGene (Beijing) Co. Ltd. Beijing, China and BeiGene USA, Inc. Hematology San Mateo USA
| | - X. Zhang
- BeiGene (Beijing) Co. Ltd. Beijing, China and BeiGene USA, Inc. Hematology San Mateo USA
| | - A. Idoine
- BeiGene (Beijing) Co. Ltd. Beijing, China and BeiGene USA, Inc. Hematology San Mateo USA
| | - A. Cohen
- BeiGene (Beijing) Co. Ltd. Beijing, China and BeiGene USA, Inc. Hematology San Mateo USA
| | - S. Feng
- BeiGene (Beijing) Co. Ltd. Beijing, China and BeiGene USA, Inc. Hematology San Mateo USA
| | - J. Huang
- BeiGene (Beijing) Co. Ltd. Beijing, China and BeiGene USA, Inc. Hematology San Mateo USA
| | - I. Flinn
- Sarah Cannon Research Institute/Tennessee Oncology Oncology Nashville USA
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Carlo‐Stella C, Depaus J, Hess BT, Kingsley E, Zinzani PL, Ungar D, Dai V, Wang L, Ardeshna KM. A PHASE 2 RANDOMIZED STUDY OF LONCASTUXIMAB TESIRINE (LONCA) VERSUS (VS) IDELALISIB IN PATIENTS (PTS) WITH RELAPSED OR REFRACTORY (R/R) FOLLICULAR LYMPHOMA (FL) – LOTIS‐6. Hematol Oncol 2021. [DOI: 10.1002/hon.176_2880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- C. Carlo‐Stella
- Humanitas Clinical and Research Center – IRCCS, and Humanitas University Department of Oncology and Hematology Rozzano Milan Italy
| | - J. Depaus
- CHU UCL Namur site Godinne Department of Hematology Yvoir Belgium
| | - B. T. Hess
- Medical University of South Carolina Division of Hematology and Medical Oncology Department of Medicine Charleston USA
| | - E. Kingsley
- Comprehensive Cancer Centers of Nevada Las Vegas USA
| | - P. L. Zinzani
- IRCCS Azienda Ospedaliero‐Universitaria di Bologna Istituto di Ematologia "Seràgnoli" and Diagnostica e Sperimentale Università di Bologna Dipartimento di Medicina Specialistica Bologna Italy
| | - D. Ungar
- ADC Therapeutics America, Inc Clinical Development Murray Hill USA
| | - V. Dai
- ADC Therapeutics America, Inc Clinical Development Murray Hill USA
| | - L. Wang
- ADC Therapeutics America, Inc Clinical Development Murray Hill USA
| | - K. M. Ardeshna
- University College London Hospitals NHS Foundation Trust Department of Haematology London UK
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Wright B, Teige C, Watson J, Hodkinson R, Marshall D, Varley D, Allgar V, Mandefield L, Parrott S, Kingsley E, Hargate R, Mitchell N, Ali S, McMillan D, Wang H, Hewitt C. Autism Spectrum Social Stories In Schools Trial 2 (ASSSIST2): study protocol for a randomised controlled trial analysing clinical and cost-effectiveness of Social Stories™ in primary schools. BMC Psychol 2020; 8:60. [PMID: 32532354 PMCID: PMC7291714 DOI: 10.1186/s40359-020-00427-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/05/2020] [Indexed: 11/14/2022] Open
Abstract
Background Interventions designed to support children with a diagnosis of Autism Spectrum Conditions (ASC) can be time consuming, needing involvement of outside experts. Social Stories™ are a highly personalised intervention aiming to give children with ASC social information or describing an otherwise difficult situation or skill. This can be delivered daily by staff in education settings. Studies examining Social Story™ use have yielded mostly positive results but have largely been single case studies with a lack of randomised controlled trials (RCTs). Despite this numerous schools are utilising Social Stories™, and a fully powered RCT is timely. Methods A multi-site pragmatic cluster RCT comparing care as usual with Social Stories™ and care as usual. This study will recruit 278 participants (aged 4–11) with a clinical diagnosis of ASC, currently attending primary school in the North of England. Approximately 278 school based staff will be recruited to provide school based information about participating children with approximately 140 recruited to deliver the intervention. The study will be cluster randomised by school. Potential participants will be screened for eligibility prior to giving informed consent. Follow up data will be collected at 6 weeks and 6 months post randomisation and will assess changes in participants’ social responsiveness, goal based outcomes, social and emotional health. The primary outcome measure is the Social Responsiveness Scale Second Edition (SRS-2) completed by school based staff at 6 months. Approvals have been obtained from the University of York’s Research Governance Committee, Research Ethics Committee and the Health Research Authority. Study results will be submitted for publication in peer-reviewed journals and disseminated to participating families, educational staff, local authority representatives, community groups and Patient and Participant Involvement representatives. Suggestions will be made to NICE about treatment evidence dependent on findings. Discussion This study addresses a much used but currently under researched intervention and results will inform school based support for primary school children with a diagnosis of ASC. Trial registration The trial is registered on the ISRCTN registry (registration number: ISRCTN11634810). The trial was retrospectively registered on 23rd April 2019.
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Affiliation(s)
- B Wright
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK. .,Hull York Medical School, University of York, York, UK. .,COMIC, IT Centre, Innovation Way, Heslington, York, YO10 5NP, UK.
| | - C Teige
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - J Watson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - R Hodkinson
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - D Marshall
- Centre for Reviews and Dissemination, University of York, York, UK
| | - D Varley
- Department of Health Sciences, University of York, York, UK
| | - V Allgar
- Department of Health Sciences, University of York, York, UK
| | - L Mandefield
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - S Parrott
- Department of Health Sciences, University of York, York, UK
| | - E Kingsley
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - R Hargate
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - N Mitchell
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - S Ali
- Department of Health Sciences, University of York, York, UK.,Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - D McMillan
- Department of Health Sciences, University of York, York, UK
| | - H Wang
- Department of Health Sciences, University of York, York, UK
| | - C Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
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10
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Varley D, Wright B, Cooper C, Marshall D, Biggs K, Ali S, Chater T, Coates E, Gilbody S, Gomez de la Cuesta G, Kingsley E, Le Couteur A, McKelvey A, Shephard N, Teare D. Investigating SOcial Competence and Isolation in children with Autism taking part in LEGO-based therapy clubs In School Environments (I-SOCIALISE): study protocol. BMJ Open 2019; 9:e030471. [PMID: 31154316 PMCID: PMC6549632 DOI: 10.1136/bmjopen-2019-030471] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Social skills training interventions for children with autism spectrum disorder (ASD) typically focus on a skills deficit model rather than building on existing skills or encouraging the child to seek their own solutions. LEGO-based therapy is a child-oriented intervention to help improve social interactional skills and reduce isolation. The therapy is designed for school-age children with ASD and uses group-based play in a school setting to encourage peer relationships and social learning. Despite the reported potential benefits of LEGO-based therapy in a prior randomised controlled trial (RCT) and its adoption by many schools, the evidence to support its effectiveness on the social and emotional well-being of children with ASD is limited and includes no assessment of cost-effectiveness. METHODS AND ANALYSIS This multicentre, pragmatic, cluster RCT will randomise 240 participants (aged 7-15 years) with a clinical diagnosis of ASD to receive usual care or LEGO-based therapy with usual care. Cluster randomisation will be conducted on a school level, randomising each school as opposed to each individual child within a school. All prospective participants will be screened for eligibility before assenting to the study (with parents giving informed consent on behalf of their child). All participants will be followed up at 20 and 52 weeks after randomisation to assess for social, emotional and behavioural changes. The primary outcome measure is the social skills subscale of the Social Skills Improvement System completed by a teacher or teaching assistant associated with participating children at the 20-week follow-up time point. ETHICS AND DISSEMINATION Ethics approval has been obtained via the University of York Research Ethics Committee. The results of the trial will be submitted for publication in a peer-reviewed journal and will be disseminated to participating families, education practitioners and the third sector including voluntary and community organisations. TRIAL REGISTRATION NUMBER ISRCTN64852382; Pre-results.
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Affiliation(s)
- Danielle Varley
- COMIC, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Barry Wright
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, University of York, York, England
| | | | - David Marshall
- Department of Health Sciences, University of York, York, UK
| | - Katie Biggs
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Shehzad Ali
- Department of Health Sciences, University of York, York, UK
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Tim Chater
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Elizabeth Coates
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, UK
| | | | - Ellen Kingsley
- Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Ann Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Neil Shephard
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Dawn Teare
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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11
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Kingsley E, Samuel O, Isaac C, Esosa E. Approximation of the Dew Point Temperature Using a Cost Effective Weather Monitoring System. ACTA ACUST UNITED AC 2017. [DOI: 10.9734/psij/2017/32862] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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12
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Laille E, Conkling P, Kolibaba K, Morris J, Rifkin R, Kingsley E, Wang X, Dong Q, Kellerman A, Skikne B. P-197 A study of gastric acid pH modulation on the pharmacokinetics of oral azacitidine (CC-486) in subjects with hematologic malignancies. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70244-3] [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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13
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Kingsley E, Richards D, Garbo L, Gersh R, Robbins G, Leopold L, Brill J, Di Bella N. An open-label, multicenter, phase II study of AT-101 in combination with rituximab (R) in patients with untreated, grade 1-2, follicular non-Hodgkin's lymphoma (FL). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8582] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8582 Background: Bcl-2 family proteins are overexpressed in the majority of patients with FL and contribute to resistance to therapy. AT-101 is a pan-Bcl-2 inhibitor (Bcl-2, Bcl-XL, Bcl-W, and Mcl-1) and potent inducer of proapoptotic proteins. It is active as a single agent and in combination with R in NHL tumor models. Methods: Patients with untreated FL who did not require immediate chemotherapy were eligible. Treatment consisted of an induction cycle of AT-101 (30mg po daily × 21) and R (375 mg/m2 weekly × 4) followed by up to 4 maintenance cycles of AT-101 (30mg po daily × 21) and R (375 mg/m2) every 8 weeks in nonprogressors. Endpoints evaluated the response rate (RR) at week 8 (primary), overall response rate (ORR), molecular response rate (BCL-2JH rearrangement in blood and bone marrow), and safety of the combination. A mini-Max, 2-stage design (52 pts planned) was used to detect >70% RR with power of 90% and alpha of 0.10. Results: 23 pts enrolled: median age 64 yrs; FLIPI 0–5: 0%/17%/65%/13%/4%; Grade 1/2: 61%/39%; bulky disease (>5cm3): 35%; stage: 1–4 4%/4%/30%/61%; bone marrow + 48%. All pts received induction and 18 pts received 1 or more maintenance cycles. RR following induction was 26% (95%CI=10.2–48.4), 4% CR and the best ORR was 70% (95%CI=47.1–86.8), 35% CR. Molecular response analysis is ongoing. Grade 3/4 AEs that occurred in ≥2 pts: nausea 4(17%), vomiting 2(9%), abdominal pain 2(9%), fatigue 2(9%), and small bowel obstruction 2(9%). AT-101 was reduced to 20mg daily x 21 which improved GI tolerability. Conclusions: The combination of AT-101 and R was well tolerated. The week 8 RR did not meet statistical criteria to enroll stage II. The best ORR is at the upper limit of reported ORR for R alone; therefore a randomized trial is required to definitively determine activity of the combination. [Table: see text]
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Affiliation(s)
- E. Kingsley
- Comp Cancer Center of Nevada, Las Vegas, NV; Tyler Cancer Center, Tyler, TX; New York Oncology Hematology, Albany, NY; Cancer Care Northwest, Spokane, WA; Florida Cancer Institute, New Port Richey, FL; Ascenta Therapeutics, Inc., Malvern, PA; Rocky Mountain Cancer Centers, Aurora, CO
| | - D. Richards
- Comp Cancer Center of Nevada, Las Vegas, NV; Tyler Cancer Center, Tyler, TX; New York Oncology Hematology, Albany, NY; Cancer Care Northwest, Spokane, WA; Florida Cancer Institute, New Port Richey, FL; Ascenta Therapeutics, Inc., Malvern, PA; Rocky Mountain Cancer Centers, Aurora, CO
| | - L. Garbo
- Comp Cancer Center of Nevada, Las Vegas, NV; Tyler Cancer Center, Tyler, TX; New York Oncology Hematology, Albany, NY; Cancer Care Northwest, Spokane, WA; Florida Cancer Institute, New Port Richey, FL; Ascenta Therapeutics, Inc., Malvern, PA; Rocky Mountain Cancer Centers, Aurora, CO
| | - R. Gersh
- Comp Cancer Center of Nevada, Las Vegas, NV; Tyler Cancer Center, Tyler, TX; New York Oncology Hematology, Albany, NY; Cancer Care Northwest, Spokane, WA; Florida Cancer Institute, New Port Richey, FL; Ascenta Therapeutics, Inc., Malvern, PA; Rocky Mountain Cancer Centers, Aurora, CO
| | - G. Robbins
- Comp Cancer Center of Nevada, Las Vegas, NV; Tyler Cancer Center, Tyler, TX; New York Oncology Hematology, Albany, NY; Cancer Care Northwest, Spokane, WA; Florida Cancer Institute, New Port Richey, FL; Ascenta Therapeutics, Inc., Malvern, PA; Rocky Mountain Cancer Centers, Aurora, CO
| | - L. Leopold
- Comp Cancer Center of Nevada, Las Vegas, NV; Tyler Cancer Center, Tyler, TX; New York Oncology Hematology, Albany, NY; Cancer Care Northwest, Spokane, WA; Florida Cancer Institute, New Port Richey, FL; Ascenta Therapeutics, Inc., Malvern, PA; Rocky Mountain Cancer Centers, Aurora, CO
| | - J. Brill
- Comp Cancer Center of Nevada, Las Vegas, NV; Tyler Cancer Center, Tyler, TX; New York Oncology Hematology, Albany, NY; Cancer Care Northwest, Spokane, WA; Florida Cancer Institute, New Port Richey, FL; Ascenta Therapeutics, Inc., Malvern, PA; Rocky Mountain Cancer Centers, Aurora, CO
| | - N. Di Bella
- Comp Cancer Center of Nevada, Las Vegas, NV; Tyler Cancer Center, Tyler, TX; New York Oncology Hematology, Albany, NY; Cancer Care Northwest, Spokane, WA; Florida Cancer Institute, New Port Richey, FL; Ascenta Therapeutics, Inc., Malvern, PA; Rocky Mountain Cancer Centers, Aurora, CO
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14
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Watt F, Martorana A, Brookes DE, Ho T, Kingsley E, O'Keefe DS, Russell PJ, Heston WD, Molloy PL. A Tissue-Specific Enhancer of the Prostate-Specific Membrane Antigen Gene, FOLH1. Genomics 2001; 73:243-54. [PMID: 11350116 DOI: 10.1006/geno.2000.6446] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.3] [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] [Indexed: 11/22/2022]
Abstract
Prostate-specific membrane antigen (PSMA) is an integral membrane protein that is highly expressed on the surface of prostate epithelial cells. It is also expressed on the vascular endothelium of a number of tumor types. We have used an enhancer trap approach with randomly cleaved overlapping DNA fragments from an approximately 55-kb P1 cosmid insert encompassing the 5' half and upstream sequences of the PSMA gene (FOLH1) to isolate an enhancer that strongly activates the FOLH1 core promoter region. The enhancer (PSME) is located in the third intron about 12 kb downstream from the start site of transcription and is characterized by a 72-bp direct repeat within a 331-bp core region. The PSME activates transcription from its own and heterologous promoters in prostate cell lines; enhancement is greatest in the PSMA-expressing cell line LNCaP (>250-fold). The PSME shows essentially no activity in five nonprostate cell lines. PSME-enhanced expression is repressed in the presence of androgen, mimicking the repression of the endogenous FOLH1 gene. The data demonstrate that both cell-type specificity and androgen regulation are intrinsic properties of the enhancer. These properties make the PSME an excellent candidate for regulation of gene expression in gene therapy approaches to prostate cancer.
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Affiliation(s)
- F Watt
- CSIRO Molecular Science, North Ryde, New South Wales, 2113, Australia
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15
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Jackson P, Millar D, Kingsley E, Yardley G, Ow K, Clark S, Russell PJ. Methylation of a CpG island within the promoter region of the KAI1 metastasis suppressor gene is not responsible for down-regulation of KAI1 expression in invasive cancers or cancer cell lines. Cancer Lett 2000; 157:169-76. [PMID: 10936677 DOI: 10.1016/s0304-3835(00)00483-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The molecular basis for downregulation of the KAI1 metastasis suppressor gene in invasive and metastatic human cancers is unknown. We have used bisulphite methylation analysis of DNA from paraffin-embedded invasive bladder tumour samples and from bladder cancer cell lines to determine if hypermethylation of a CpG island within the KAI1 promoter is responsible for this effect. Representative invasive tumour cell lines were also exposed to 5-aza-2-deoxycytidine. We found no evidence for hypermethylation of the CpG island and suggest that mechanisms other than promoter hypermethylation are responsible for reduced KAI1 expression in invasive bladder tumours and tumour cell lines.
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MESH Headings
- Antigens, CD
- Antimetabolites, Antineoplastic/therapeutic use
- Azacitidine/therapeutic use
- Base Sequence
- Carcinoma, Transitional Cell/drug therapy
- Carcinoma, Transitional Cell/genetics
- Carcinoma, Transitional Cell/metabolism
- Carcinoma, Transitional Cell/pathology
- CpG Islands/genetics
- Down-Regulation
- Gene Expression Regulation, Neoplastic
- Humans
- In Situ Hybridization
- Kangai-1 Protein
- Membrane Glycoproteins
- Methylation
- Molecular Sequence Data
- Neoplasm Invasiveness
- Promoter Regions, Genetic/genetics
- Proto-Oncogene Proteins
- RNA, Messenger/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Tumor Cells, Cultured
- Urinary Bladder Neoplasms/drug therapy
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/metabolism
- Urinary Bladder Neoplasms/pathology
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Affiliation(s)
- P Jackson
- Oncology Research Centre, Level 2 Old Theatre Block, Prince of Wales Hospital, New South Wales 2031, Randwick, Australia.
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16
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Roy-Byrne PP, Pages KP, Russo JE, Jaffe C, Blume AW, Kingsley E, Cowley DS, Ries RK. Nefazodone treatment of major depression in alcohol-dependent patients: a double-blind, placebo-controlled trial. J Clin Psychopharmacol 2000; 20:129-36. [PMID: 10770449 DOI: 10.1097/00004714-200004000-00003] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Depression is the most common comorbid psychiatric illness in patients with alcohol dependence. This double-blind study tested the efficacy of nefazodone versus placebo for the treatment of depression in actively drinking alcohol-dependent patients who were also participating in weekly group treatment for alcoholism. Sixty-four subjects with major depression disorder and alcohol dependence with a history of at least one prior episode of depression when not drinking were randomly assigned to receive 12 weeks of either nefazodone or placebo and participated in a weekly psychoeducational group on alcoholism. Subjects were assessed every 2 weeks for depression, anxiety, side effects, and drinking frequency. Subjects taking nefazodone were significantly more likely to complete the study (62%) than those taking placebo (34%). Analyses of covariance using drinks per week as a time-dependent covariate showed lower Hamilton Rating Scale for Depression scores at week 8 for end-point analysis and at weeks 8 and 12 for completers. The endpoint analysis demonstrated a significantly greater response in the nefazodone group (48%) than in the placebo group (16%). Both groups showed a similarly significant decrease in the average number of alcoholic drinks consumed per day over the course of the study. Although the number of adverse effects was significantly greater for the nefazodone group, there were no severe adverse events, and nefazodone was well tolerated. Nefazodone is a safe and effective antidepressant to use in a population of alcohol-dependent patients with depression who have a high degree of comorbidity. Nefazodone treatment was superior to placebo in alleviating depression in these patients but did not add any advantage over the psychoeducational group in terms of drinking outcomes.
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Affiliation(s)
- P P Roy-Byrne
- Department of Psychiatry and Behavioral Sciences at Harborview Medical Center, Seattle, Washington 98104, USA.
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17
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Russell PJ, Davis K, Kingsley E, Humphreys J, Hanley J, O'Grady H, Pearce N. Preclinical studies of monoclonal antibodies for intravesical radioimmunotherapy of human bladder cancer. Cell Biophys 1994; 24-25:155-61. [PMID: 7736520 DOI: 10.1007/bf02789226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Eighty percent of bladder cancers present as superficial disease. Many are multifocal, and apparently successful treatment is frequently followed by recurrence. The use of monoclonal antibodies (MAbs) to target radiotherapy to these tumors offers great potential, especially since they can be administered directly into the bladder (intravesically) bypassing many of the side effects encountered to date with systemic MAb-based therapy. Implantation of human bladder cancer cell lines in the bladder wall of nude rats results in tumor formation, providing an excellent model to test this. Tumor size can be monitored by X-ray analysis after administration of urograffin. Comparative studies of two murine MAbs, BLCA-8, IgG3, and C1-137, IgG1, against malignant human bladder cancer cells have been performed. Radioimmunoconjugates produced with 125Iodine (125I) have been used for biodistribution studies following administration directly into rat bladder. Radioiodinated intact MAbs or Fabs administered intravesically into nontumor bearing rats did not leak into the systemic circulation and were stable in urine for up to 100 h. Biodistribution studies carried out following intravesical administration of radioimmunoconjugates to tumor-bearing nude rats indicate better tumor uptake of C1-137 than BLCA-8. Further studies to test two-step intravesical administration of biotinylated MAb followed by radioiodinated streptavidin are in progress. Our studies indicate that the C1-137 MAb may have considerable potential for intravesical radioimmunotherapy of patients with superficial bladder tumors.
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Affiliation(s)
- P J Russell
- Oncology Research Centre, Prince of Wales Hospital, Randwick, NSW, Australia
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18
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Abstract
Sodium valproate is hepatotoxic in both humans and rat hepatocytes. The toxicity is dose related and frequently associated with simultaneous ingestion of drugs which induce the drug metabolizing system. For these reasons, metabolites of sodium valproate were tested for toxicity using rat hepatocyte cultures. The sodium salts of three metabolites, 2-propylpent-4-enoate, 4-hydroxyvalproate, and perhaps 5-hydroxyvalproate, were toxic in this system. In addition, 2-propylpent-4-enoate was toxic in a dose-related fashion. All are omega and omega-1 oxidation products in the microsome-mediated pathway of valproate metabolism.
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Abstract
Valproic acid has recently been shown to be associated with liver disease in man. Rat hepatocyte cultures were used to test the hepatotoxicity of valproic acid and several other anticonvulsants. Dose-related hepatotoxicity was demonstrated for valproic acid at concentrations ranging from 10 to 320 micrograms/ml, therapeutic concentrations being 50-100 micrograms/ml. Hepatotoxicity could not be demonstrated for phenobarbital, phenytoin, primidone, and clonazepam. It is concluded that valproic acid is a dose-related hepatotoxin.
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20
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Abstract
Previous work has shown that the application of the Joule heating temperature jump technique of Eigen and de Maeyer to an istonic suspension of human erythrocytes induced an interiorization of [3H-A1glucose and a hemolysis of the red cells (Tsong, T.Y., and E. Kingsley, J. Biol. Chem. 250:786 [1975]). The result was interpreted as due to the thermal osmosis effect. Further considerations of the various effects of the Joule heating technique indicate that the hemolysis of the red cells may also be caused by the rapid dielectric perturbation of the cell membranes. By means of turbidity measurements of the suspensions we have detected at least four relaxation times. Two of the faster ones (tau1 approximately 20 mus and tau2 approximately 5 ms) are tentatively attributed to water relaxations in the membrane structures. The other two are attributed to membrane ruptures (tlag approximately 0.1s) and the hemolysis reaction (tau3 approximately 0.5 s). Studies with the erythrocytes from different hematological disorders indicate that whereas the two slower relaxations are sensitive to the overall physical property of the red cell membranes the two faster relaxations are not. These observations are consistent with the above assignment of the relaxation processes. The apparent activation energies are, above assignment of the relaxation processes. The apparent activation energies are, respectively, 8.4, 12.0, and 11.8 kcal/mol for the tau1, tau2, and tau3 reactions. Experiments with erythrocyte ghosts indicate a single relaxation for the water permeation, and biphasic kinetics for the membrane rupture and resealing reactions. The phenomena reported here may contribute to our understanding of water transport and molecular release in cellular systems.
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21
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Tsong TY, Kingsley E. Hemolysis of human erythrocyte induced by a rapid temperature jump. J Biol Chem 1975; 250:786-9. [PMID: 1112789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
When an isotonic suspension of human erythrocytes was subjected to a rapid temperature jump (heating time of 2 mus), the following phenomena were observed. Although a jump of 0.05 degrees caused no visible damage to the cell membranes, it facilitated the permeation of [3H]glucose into the cells. A jump of 0.5 degrees induced a hemolysis of the cells. The hemolysis was accompanied by extensive alterations of membrane morphology possibly caused by ruptures of the membranes. Turbidity changes of the suspension after the temperature jump were consistent with a swelling of erythrocytes followed by a shrinking of the swollen cells. The phenomena of the water transport and the hemolysis induced by the temperature jump may be understood by the theory of thermal osmosis (Spanner, D. C. (1954) Symp. Soc. Exp. Biol. 8, 76). Slow heating of the suspension shows no such effects. Thermal osmosis may be an important factor in the water transport and bioenergetics of the living cells.
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May H, Kingsley E. Thorotrast-exposed persons in the Chicago area. ANL-7360. ANL Rep 1966:42-4. [PMID: 5302727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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