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Hamilton SJ, Muller PA, Isaacson D, Kolehmainen V, Newell J, Rajabi Shishvan O, Saulnier G, Toivanen J. Fast absolute 3D CGO-based electrical impedance tomography on experimental tank data. Physiol Meas 2022; 43:10.1088/1361-6579/aca26b. [PMID: 36374007 PMCID: PMC10028616 DOI: 10.1088/1361-6579/aca26b] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022]
Abstract
Objective.To present the first 3D CGO-based absolute EIT reconstructions from experimental tank data.Approach.CGO-based methods for absolute EIT imaging are compared to traditional TV regularized non-linear least squares reconstruction methods. Additional robustness testing is performed by considering incorrect modeling of domain shape.Main Results.The CGO-based methods are fast, and show strong robustness to incorrect domain modeling comparable to classic difference EIT imaging and fewer boundary artefacts than the TV regularized non-linear least squares reference reconstructions.Significance.This work is the first to demonstrate fully 3D CGO-based absolute EIT reconstruction on experimental data and also compares to TV-regularized absolute reconstruction. The speed (1-5 s) and quality of the reconstructions is encouraging for future work in absolute EIT.
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Affiliation(s)
- S J Hamilton
- Department of Mathematical and Statistical Sciences; Marquette University, Milwaukee, WI 53233 United States of America
| | - P A Muller
- Department of Mathematics & Statistics; Villanova University, Villanova, PA 19085 United States of America
| | - D Isaacson
- Department of Mathematics, Rensselaer Polytechnic Institute, Troy, NY 12180, United States of America
| | - V Kolehmainen
- Department of Applied Physics, University of Eastern Finland, FI-70210 Kuopio, Finland
| | - J Newell
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY 12180, United States of America
| | - O Rajabi Shishvan
- Department of Electrical and Computer Engineering, University at Albany-SUNY, Albany, NY 12222, United States of America
| | - G Saulnier
- Department of Electrical and Computer Engineering, University at Albany-SUNY, Albany, NY 12222, United States of America
| | - J Toivanen
- Department of Applied Physics, University of Eastern Finland, FI-70210 Kuopio, Finland
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Waterbury JS, Teves ME, Gaynor A, Han AX, Mavodza G, Newell J, Strauss JF, McAllister JM. The PCOS GWAS Candidate Gene ZNF217 Influences Theca Cell Expression of DENND1A.V2, CYP17A1, and Androgen Production. J Endocr Soc 2022; 6:bvac078. [PMID: 35668995 PMCID: PMC9155636 DOI: 10.1210/jendso/bvac078] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Indexed: 12/25/2022] Open
Abstract
Polycystic ovary syndrome (PCOS), a common endocrine disorder of women, is characterized by increased ovarian androgen production and anovulatory infertility. Genome-wide association studies (GWAS) have identified more than 20 PCOS candidate loci. One GWAS candidate locus encompasses ZNF217, a zinc finger transcription factor. Immunohistochemical staining of ovarian tissue demonstrated significantly lower staining intensity for ZNF217 protein in PCOS theca interna compared to ovarian tissue from normal ovulatory women. Immunofluorescence staining of normal and PCOS theca cells demonstrated nuclear localization of ZNF217, with lower intensity in PCOS cells. Western blotting showed reduced ZNF217 protein in PCOS theca cells compared to normal theca cells, and that treatment with forskolin, which mimics the action of luteinizing hormone (LH), reduces ZNF217 expression. Lower ZNF217 expression in PCOS theca cells was confirmed by quantitative reverse transcription polymerase chain reaction. Notably, there was an inverse relationship between ZNF217 messenger RNA (mRNA) levels and theca cell androgen (dehydroepiandrosterone; DHEA) synthesis. The abundance of mRNA encoding a splice variant of DENND1A (DENND1A.V2), a PCOS candidate gene that positively regulates androgen biosynthesis, was also inversely related to ZNF217 mRNA levels. This relationship may be driven by increased miR-130b-3p, which targets DENND1A.V2 transcripts and is directly correlated with ZNF217 expression. Forced expression of ZNF217 in PCOS theca cells reduced androgen production, CYP17A1 and DENND1A.V2 mRNA, while increasing mIR-130b-3p. Conversely, knockdown of ZNF217 in normal theca cells with short hairpin RNA-expressing lentivirus particles increased DENND1A.V2 and CYP17A1 mRNA. These observations suggest that ZNF217 is part of a network of PCOS candidate genes regulating thecal cell androgen production involving DENND1A.V2 and miR-130b-3p.
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Affiliation(s)
- Jamaia S Waterbury
- Department of Pathology, Penn State Hershey College of Medicine, Hershey, Pennsylvania 17033, USA
| | - Maria E Teves
- Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, USA
| | - Alison Gaynor
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, USA
| | - Angela X Han
- Department of Pathology, Penn State Hershey College of Medicine, Hershey, Pennsylvania 17033, USA
| | - Grace Mavodza
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, USA
| | - Jordan Newell
- Department of Pathology, Penn State Hershey College of Medicine, Hershey, Pennsylvania 17033, USA
| | | | - Jan M McAllister
- Correspondence: Jan M. McAllister, PhD, Department of Pathology, Penn State Hershey College of Medicine, 500 University Dr, Hershey, PA 17033, USA.
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Jug R, Booth AL, Buckley AF, Newell J, Kesterson J, Gardner JM, Ozcan L, Liu B, Green CL, Joseph L, Cummings TJ. Multisite Quality Improvement Study of a Patient-Pathologist Consultation Program. Am J Clin Pathol 2021; 155:887-894. [PMID: 33367493 DOI: 10.1093/ajcp/aqaa202] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this multisite quality improvement study was to evaluate patients' experiences with the patient-centered pathology (PCP) consultation program and to determine whether PCP enhanced their care experience. METHODS Patients were invited to attend PCP consultations to review their pathology report and slides and have their questions answered by the pathologist privately, with the option to attend the appointment with family members or friends for support. A patient experience questionnaire (PEQ) was administered to patients, who participated voluntarily in the PCP, and survey data were collected and stored in REDCap. Statistical analysis was performed using SAS 9.4 (SAS Institute). RESULTS Sixty-seven patients (95.5% female) aged 18 to 84 years across 4 institutions completed the PEQ. Overall, 58% and 15.8% of patients had breast and brain tumors, respectively, and 59.7% of tumors were newly diagnosed. Most patients thought it was important for them to learn as much as they could about their health condition. However, the majority of patients reported some degree of difficulty learning about their health condition based on written information, despite 97% having completed high school and/or further education. The majority of patients rated their pathologist as "excellent" across communication metrics. Ultimately, 100% of respondents were satisfied, found their visits to be useful, and would recommend the PCP to other patients. CONCLUSIONS Patients found that personalized clinical encounters with pathologists improved their understanding of their health condition and their satisfaction with their care experience. Patients thought pathologists communicated respectfully, effectively, and empathetically.
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Affiliation(s)
| | - Adam L Booth
- Department of Pathology, University of Texas Medical Branch at Galveston
| | | | | | - Joshua Kesterson
- Gynecologic Oncology, Pennsylvania State University Milton S. Hershey Medical Center, Hershey
| | - Jerad M Gardner
- Department of Laboratory Medicine, Geisinger Medical Center, Danville, PA
| | | | - Beiyu Liu
- Biostatistics and Bioinformatics, Duke Health, Durham, NC
| | | | - Lija Joseph
- Pathology, Lowell General Hospital, Lowell, MA
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Casey B, Byrne M, Casey D, Gillespie P, Hobbins A, Newell J, Morrissey E, Dinneen SF. Improving Outcomes Among Young Adults with type 1 diabetes: The D1 Now Randomised Pilot Study Protocol. Diabet Med 2020; 37:1590-1604. [PMID: 32511803 DOI: 10.1111/dme.14337] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Accepted: 06/02/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Young adults (18-25 years old) living with type 1 diabetes mellitus often have sub-optimal glycaemic levels which can increase their risk of long term diabetes complications. Informed by health psychology theory and using a (public and patient involvement) young adult-centred approach, we have developed a complex intervention, entitled D1 Now, to improve outcomes in this target group. The D1 Now intervention includes three components; 1) a support-worker, 2) an interactive messaging system and 3) an agenda setting tool for use during clinic consultations. AIMS The aim of the D1 Now pilot study is to gather and analyse acceptability and feasibility data to allow us to (1) refine the D1 Now intervention, and (2) determine the feasibility of a definitive Randomised Control Trial (RCT) of the intervention. METHODS Diabetes clinics on the island of Ireland will be recruited and randomised to a D1 Now intervention arm or a usual care control arm. For a participant to be eligible they should be 18-25 years old and living with type 1 diabetes for at least 12 months. Participant outcomes (influenced by a Core Outcome Set) include change in HbA1c, clinic attendance, number of episodes of severe hypoglycaemia and of diabetic ketoacidosis, diabetes distress, self-management, quality of life and perceived level of control over diabetes; these will be will be measured at baseline and after 12 months follow-up for descriptive statistics only. An assessment of treatment fidelity, a health economic analysis and a qualitative sub-study will also be incorporated into the pilot study. ISRCTN (ref: ISRCTN74114336).
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Affiliation(s)
- B Casey
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland
| | - M Byrne
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland
| | - D Casey
- School of Nursing & Midwifery, NUI Galway, Galway, Ireland
| | - P Gillespie
- Health Economics & Policy Analysis Centre, Centre for Research in Medical Devices, NUI Galway, Galway, Ireland
| | - A Hobbins
- Centre for Research in Medical Devices (Cúram) and Health Economics and Policy Analysis Centre (HEPAC), NUI Galway, Galway, Ireland
| | - J Newell
- School of Mathematics, Statistics & Applied Mathematics, NUI Galway, Galway, Ireland
| | - E Morrissey
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland
- School of Nursing & Midwifery, NUI Galway, Galway, Ireland
| | - S F Dinneen
- School of Medicine, NUI Galway, Galway, Ireland
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospitals, Galway, Ireland
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Huque R, Elsey H, Fieroze F, Hicks JP, Huque S, Bhawmik P, Walker I, Newell J. "Death is a better option than being treated like this": a prevalence survey and qualitative study of depression among multi-drug resistant tuberculosis in-patients. BMC Public Health 2020; 20:848. [PMID: 32493337 PMCID: PMC7268321 DOI: 10.1186/s12889-020-08986-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 01/07/2020] [Accepted: 05/24/2020] [Indexed: 12/03/2022] Open
Abstract
Background Understanding of the relationship between multi-drug resistant tuberculosis and mental health is limited. With growing prevalence of multi-drug resistant tuberculosis, addressing mental ill-health has potential to improve treatment outcomes and well-being. In several low and middle-income contexts hospitalisation during treatment is common. Understanding of the impact on mental ill-health are required to inform interventions for patients with multi-drug resistant tuberculosis. Our aim was to identify the prevalence of comorbid depression among in-patients being treated for multi-drug resistant tuberculosis and to explore their experiences of comorbid disease and the care they received in a large specialist chest hospital in Dhaka, Bangladesh. Methods We conducted a quantitative cross-sectional survey among 150 multi-drug resistant tuberculosis in-patients (new cases = 34%, previously treated = 66%) in 2018. A psychiatrist assessed depression was assessed with the Structured Clinical Interview for Depression (SCID DSM-IV). We used multi-level modelling to identify associations with depression. Experience Bangladeshi researchers conducted qualitative interviews with 8 patients, 4 carers, 4 health professionals and reflective notes recorded. Qualitative data was analysed thematically. Results We found 33.8% (95% CI 26.7%; 41.7%) of patients were depressed. While more women were depressed 39.3% (95% CI 27.6%; 52.4%) than men 30.4% (95% CI 22%; 40.5%) this was not significant. After controlling for key variables only having one or more co-morbidity (adjusted odds ratio [AOR] = 2.88 [95% CI 1.13; 7.33]) and being a new rather than previously treated case (AOR = 2.33 [95% CI 1.06; 5.14]) were associated (positively) with depression. Qualitative data highlighted the isolation and despair felt by patients who described a service predominantly focused on providing medicines. Individual, familial, societal and health-care factors influenced resilience, nuanced by gender, socio-economic status and home location. Conclusions Patients with multi-drug resistant tuberculosis are at high risk of depression, particularly those with co- and multi-morbidities. Screening for depression and psycho-social support should be integrated within routine TB services and provided throughout treatment.
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Affiliation(s)
- R Huque
- The ARK Foundation, Suite C-3 & C-4, House 06, Road 109, Gulshan-2, Dhaka-1212, Dhaka, Bangladesh
| | - H Elsey
- Department of Health Sciences, University of York, Seebohm Rowntree Building, York, YO10 5DD, UK.
| | - F Fieroze
- The ARK Foundation, Suite C-3 & C-4, House 06, Road 109, Gulshan-2, Dhaka-1212, Dhaka, Bangladesh
| | - J P Hicks
- Leeds Institute of Health Sciences, University of Leeds, 10.31 Worsley, Leeds, LS2 9JT, UK
| | - S Huque
- The ARK Foundation, Suite C-3 & C-4, House 06, Road 109, Gulshan-2, Dhaka-1212, Dhaka, Bangladesh
| | - P Bhawmik
- The ARK Foundation, Suite C-3 & C-4, House 06, Road 109, Gulshan-2, Dhaka-1212, Dhaka, Bangladesh
| | - I Walker
- Leeds Institute of Health Sciences, University of Leeds, 10.31 Worsley, Leeds, LS2 9JT, UK
| | - J Newell
- Leeds Institute of Health Sciences, University of Leeds, 10.31 Worsley, Leeds, LS2 9JT, UK
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Questa K, Das M, King R, Everitt M, Rassi C, Cartwright C, Ferdous T, Barua D, Putnis N, Snell AC, Huque R, Newell J, Elsey H. Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews. Int J Equity Health 2020; 19:51. [PMID: 32252778 PMCID: PMC7137248 DOI: 10.1186/s12939-020-01169-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/25/2020] [Indexed: 12/20/2022] Open
Abstract
Background Community engagement (CE) interventions include a range of approaches to involve communities in the improvement of their health and wellbeing. Working with communities defined by location or some other shared interest, these interventions may be important in assisting equity and reach of communicable disease control (CDC) in low and lower-middle income countries (LLMIC). We conducted an umbrella review to identify approaches to CE in communicable disease control, effectiveness of these approaches, mechanisms and factors influencing success. Methods We included systematic reviews that: i) focussed on CE interventions; ii) involved adult community members; iii) included outcomes relevant to communicable diseases in LLMIC; iv) were written in English. Quantitative results were extracted and synthesised narratively. A qualitative synthesis process enabled identification of mechanisms of effect and influencing factors. We followed guidance from the Joanna Briggs Institute, assessed quality with the DARE tool and reported according to standard systematic review methodology. Results Thirteen systematic reviews of medium-to-high quality were identified between June and July 2017. Reviews covered the following outcomes: HIV and STIs (6); malaria (2); TB (1); child and maternal health (3) and mixed (1). Approaches included: CE through peer education and community health workers, community empowerment interventions and more general community participation or mobilisation. Techniques included sensitisation with the community and involvement in the identification of resources, intervention development and delivery. Evidence of effectiveness of CE on health outcomes was mixed and quality of primary studies variable. We found: i) significantly reduced neonatal mortality following women’s participatory learning and action groups; ii) significant reductions in HIV and other STIs with empowerment and mobilisation interventions with marginalised groups; iii) significant reductions in malaria incidence or prevalence in a small number of primary studies; iv) significant reductions in infant diarrhoea following community health worker interventions. Mechanisms of impact commonly occurred through social and behavioural processes, particularly: changing social norms, increasing social cohesion and social capacity. Factors influencing effectiveness of CE interventions included extent of population coverage, shared leadership and community control over outcomes. Conclusion Community engagement interventions may be effective in supporting CDC in LLMIC. Careful design of CE interventions appropriate to context, disease and community is vital.
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Affiliation(s)
- K Questa
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - M Das
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - R King
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK.
| | - M Everitt
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - C Rassi
- Malaria Consortium, London, UK
| | - C Cartwright
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | | | - D Barua
- ARK Foundation, Dhaka, Bangladesh
| | - N Putnis
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - A C Snell
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - R Huque
- ARK Foundation, Dhaka, Bangladesh
| | - J Newell
- Nuffield Centre for International Health and Development, University of Leeds, Room 1029, Level 10, Worsley Building, Leeds, LS2 9NL, UK
| | - H Elsey
- University of York, York, UK
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Bainbridge E, Hallahan B, McGuinness D, Higgins A, Murphy K, Gunning P, Newell J, McDonald C. A Three-Month Follow-Up Study Evaluating Changes in Clinical Profile and Attitudes Towards Involuntary Admission. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.1746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IntroductionInvoluntary admission and treatment is often a traumatic experience for patients and there is a wide variation in attitudes towards care even when patients are recovered.Objectives/aimsThe purpose of this large prospective study was to identify clinical predictors of attitudes towards care during involuntary admission.MethodsThree hundred and ninety-one consecutively admitted involuntarily patients to three psychiatric inpatient units over a 30-month period were invited to participate in the study. Comprehensive assessments at admission and 3 months after discharge were attained including measures of symptoms, insight, functioning, attitudes towards involuntary admission and coercive experiences. Multiple linear regression modelling was used to determine the optimal explanatory variables for attitudes towards care.ResultsTwo hundred and sixty-three individuals participated at baseline and 156 (59%) successfully completed follow-up assessments. Individuals improved significantly over time clinically and in their attitudes towards their care. At baseline greater insight (P < 0.001) and less symptoms (P = 0.02) were associated with more positive attitudes towards care as was older age (P = 0.001). At follow-up, greater insight (P < 0.001), less symptoms (P = 0.02) and being older (P = 0.04) were associated with more positive attitudes towards care. More positive attitudes towards care at follow-up were associated with greater improvements in insight over time (P < 0.001) and having a diagnosis of an affective psychosis (P = 0.0009).ConclusionsThe best predictors of positive attitudes towards care during and after involuntary admission are illness related factors, such as levels of insight and improvement in insight, rather than service or legislation related factors, such as the use of coercive measures, seclusion and restraint.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Neu D, Van Eycken S, Newell J, Mairesse O. Are the therapeutic effects of dental appliances in sleep related bruxism going way beyond physical teeth-protection? Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Donaldson K, Buchanich JM, Grigson PS, Deneke E, Donaldson K, Vrana KE, Sacks DB, Kuehn GJ, Cardamone D, Pesce A, Smiley S, Nickley J, Krock K, Thomas R, Wilkerson ML, Farag HA, Challa SR, Tice AM, Wolk DM, Prichard J, Grant ML, Regmi S, Kerbacher B, Quinton LE, Farag HA, Tice AM, Wolk DM, Olson J, Haynes A, Yu E, McCully KS, Assi J, Wong M, Zarrin-Khameh N, Nifong TP, Hawker CD, Carlton GT, Rivera JM, Foulis PR, Zuraw A, Morlote D, Peker D, Reddy V, Harada S, Crutchfield C, Zander D, Barbhuiya MA, Pederson EC, Straub ML, Scott SC, Neibauer TL, Salter WF, Creer MH, Zhu Y, Bornhorst JA, Theobald JP, Algeciras-Schimnich A, Cao L, Knox J, Hardy R, Texas HJ, McGuire MF, Hunter RL, Brown RE, Hicks J, Hicks J, Cai Z, Brown RE, Ali Y, Cheng KC, Katz SR, Ding Y, Vanselow DJ, Yakovlev MA, Lin AY, Clark DP, Vargas P, Xin X, Copper JE, Canfield VA, Ang KC, Wang Y, Xiao X, De Carlo F, van Rossum DB, La Rivière PJ, Newell J, Hossler C, Roche M, Warrick J, Phaeton R, Kesterson J, Donaldson K, Myers C, Barrios R, Mintz P, Robyak K, Hamilton C, McGhee P, Pederson C, Straub M, Scott S, Neibauer T, Salter W, Creer M, Zhu Y, Hamilton C, Robyak K, McGhee P, Pederson C, Straub M, Scott S, Neibauer T, Salter W, Creer M, Zhu Y, Singh N, Morlote D, Vnencak-Jones C, Yemelyanova A, Harada S, Shah M, Moghadamtousi SZ, Lan C, Duose D, Hu P, Esquenazi Y, Luthra R, Ballester LY, Koenig AN, Liu CG, Zhang J, Kalia A, Al-Habib A, Van Arsdall M, Dhingra S, Patel K, Tatevian N. Abstracts of Presentations at the Association of Clinical Scientists 139 th Meeting Hershey, PA, May 15-18, 2019. Ann Clin Lab Sci 2019; 49:403-416. [PMID: 31308044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Robert E Brown
- UT Health McGovern Medical School at Houston, Houston, TX
| | | | | | | | | | | | - Keith C Cheng
- Department of Pathology, Penn State College of Medicine
| | | | - Yifu Ding
- Department of Pathology, Penn State College of Medicine
| | | | | | - Alex Y Lin
- Department of Pathology, Penn State College of Medicine
| | | | | | - Xuying Xin
- Department of Pathology, Penn State College of Medicine
| | - Jean E Copper
- Department of Pathology, Penn State College of Medicine
| | | | - Khai C Ang
- Department of Pathology, Penn State College of Medicine
| | - Yuxin Wang
- Omnivision Technologies, Santa Clara, CA
| | - Xianghui Xiao
- Advanced Photon Source, Argonne National Laboratory, University of Chicago
- Brookhaven National Laboratory, University of Chicago
| | - Francesco De Carlo
- Advanced Photon Source, Argonne National Laboratory, University of Chicago
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mauli Shah
- Graduate Program in Diagnostic Genetics, School of Health Professions, UT MD Anderson Cancer Center, Houston, TX
| | | | - Chieh Lan
- Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Dzifa Duose
- Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Peter Hu
- Graduate Program in Diagnostic Genetics, School of Health Professions, UT MD Anderson Cancer Center, Houston, TX
| | - Yoshua Esquenazi
- Department of Neurosurgery, McGovern Medical School, University of Texas Health Science Center, Houston, TX
| | - Rajyalakshmi Luthra
- Department of Hematopathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Leomar Y Ballester
- Department of Neurosurgery, McGovern Medical School, University of Texas Health Science Center, Houston, TX
| | | | | | | | | | - Ali Al-Habib
- The University of Texas Health Science Center, Houston, TX
| | | | | | | | - Nina Tatevian
- The University of Texas Health Science Center, Houston, TX
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Gupta S, Vargas A, Saulnier G, Newell J, Kelley R. 76: Comparison of electrical properties between tumor-bearing and non tumor-bearing uterus at the time of hysterectomy. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.01.106] [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: 10/27/2022]
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Benton A, Sood S, Wagner S, Newell J, Harkins G. Disseminated Peritoneal Leiomyomatosis Following Hysteroscopic Leiomyoma Morcellation. J Gynecol Surg 2018. [DOI: 10.1089/gyn.2018.0028] [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: 11/12/2022] Open
Affiliation(s)
- Andrea Benton
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Shelly Sood
- Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA
| | - Stephen Wagner
- Departments of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Jordan Newell
- Departments of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Gerald Harkins
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical Center, Hershey, PA
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Smith V, Begley C, Newell J, Higgins S, Murphy DJ, White MJ, Morrison JJ, Canny S, O'Donovan D, Devane D. Admission cardiotocography versus intermittent auscultation of the fetal heart in low-risk pregnancy during evaluation for possible labour admission - a multicentre randomised trial: the ADCAR trial. BJOG 2018; 126:114-121. [PMID: 30126064 DOI: 10.1111/1471-0528.15448] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 08/02/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the effect of admission cardiotocography (ACTG) versus intermittent auscultation (IA) of the fetal heart (FH) in low-risk pregnancy during assessment for possible labour on caesarean section rates. DESIGN A parallel multicentre randomised trial. SETTING Three maternity units in the Republic of Ireland. POPULATION Healthy, low-risk pregnant women, at term and ≥ 18 years old, who provided written informed consent. METHODS Women were randomised to receive IA of the FH or 20 minutes ACTG on admission for possible labour onset, using remote telephone randomisation. Both groups received IA during labour, with conversion to continuous CTG as clinically indicated. MAIN OUTCOME MEASURES Caesarean section (primary outcome), obstetric interventions (e.g. continuous CTG during labour, fetal blood sampling, augmentation of labour) and neonatal morbidity (e.g. metabolic acidosis, admission to the neonatal intensive care unit, neonatal death). RESULTS Based on 3034 women (1513 and 1521 randomised to IA and ACTG, respectively), there was no statistical difference between the groups in caesarean section [130 (8.6%) and 105 (6.9%) for IA and ACTG groups, respectively; relative risk (RR) 1.24; 95% CI 0.97-1.58], or in any other outcome except for use of continuous CTG during labour, which was lower in the IA group (RR 0.90, 95% CI 0.86-0.93). CONCLUSION Our study demonstrates no differences in obstetric or neonatal outcomes between IA and ACTG for women with possible labour onset, other than an increased risk for continuous CTG in women receiving ACTG. TWEETABLE ABSTRACT No differences in outcomes between intermittent auscultation and admission cardiotocography for women with possible labour onset.
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Affiliation(s)
- V Smith
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - C Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - J Newell
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland, Galway, Ireland
| | - S Higgins
- Department of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland
| | - D J Murphy
- Department of Obstetrics, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Department of Obstetrics and Gynaecology, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - M J White
- Department of Neonatology/Paediatrics, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - J J Morrison
- Department of Obstetrics and Gynaecology, University College Hospital Galway, Galway, Ireland
| | - S Canny
- Department of Obstetrics and Gynaecology, University College Hospital Galway, Galway, Ireland
| | - D O'Donovan
- Department of Neonatology/Paediatrics, University College Hospital Galway, Galway, Ireland
| | - D Devane
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland.,Health Research Board, Trials Methodology Research Network, National University of Ireland, Galway, Ireland
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Noone C, Dwyer CP, Murphy J, Newell J, Molloy GJ. Comparative effectiveness of physical activity interventions and anti-hypertensive pharmacological interventions in reducing blood pressure in people with hypertension: protocol for a systematic review and network meta-analysis. Syst Rev 2018; 7:128. [PMID: 30131071 PMCID: PMC6103808 DOI: 10.1186/s13643-018-0791-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 07/31/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The prevalence of hypertension is a major public health challenge. Despite it being highly preventable, hypertension is responsible for a significant proportion of global morbidity and mortality. Common methods for controlling hypertension include prescribing anti-hypertensive medication, a pharmacological approach, and increasing physical activity, a behavioural approach. In general, little is known about the comparative effectiveness of pharmacological and behavioural approaches for reducing blood pressure in hypertension. A previous network meta-analysis suggested that physical activity interventions may be just as effective as many anti-hypertensive medications in preventing mortality; however, this analysis did not provide the comparative effectiveness of these disparate modes of intervention on blood pressure reduction. The primary objective of this study is to use network meta-analysis to compare the relative effectiveness, for blood pressure reduction, of different approaches to increasing physical activity and different first-line anti-hypertensive therapies in people with hypertension. METHODS A systematic review will be conducted to identify studies involving randomised controlled trials which compare different types of physical activity interventions and first-line anti-hypertensive therapy interventions to each other or to other comparators (e.g. placebo, usual care) where blood pressure reduction is the primary outcome. We will search the Cochrane Library, MEDLINE and PsycInfo. For studies which meet our inclusion criteria, two reviewers will extract data independently and assess the quality of the literature using the Cochrane Risk of Bias Tool. Network meta-analyses will be conducted to generate estimates of comparative effectiveness of each intervention class and rankings of their effectiveness, in terms of reduction of both systolic and diastolic blood pressure. DISCUSSION This study will provide evidence regarding the comparability of two common first-line treatment options for people with hypertension. It will also describe the extent to which there is direct evidence regarding the comparative effectiveness of increasing physical activity and initiating anti-hypertensive therapy. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017070579.
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Affiliation(s)
- C. Noone
- School of Psychology, National University of Ireland, Galway, Newcastle Road, Galway, H91 TK33 Ireland
| | - C. P. Dwyer
- School of Psychology, National University of Ireland, Galway, Newcastle Road, Galway, H91 TK33 Ireland
| | - J. Murphy
- School of Psychology, National University of Ireland, Galway, Newcastle Road, Galway, H91 TK33 Ireland
| | - J. Newell
- School of Mathematics, Statistics & Applied Mathematics, National University of Ireland, Galway, Newcastle Road, Galway, H91 TK33 Ireland
| | - G. J. Molloy
- School of Psychology, National University of Ireland, Galway, Newcastle Road, Galway, H91 TK33 Ireland
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Hossler C, Newell J, Roche M, Warrick J, Phaeton R, Kesterson J. HER2 and p95HER2 protein expression varies in primary versus metastatic serous endometrial cancer tumors. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.146] [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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Affiliation(s)
- G. J. Molloy
- School of Psychology, National University of Ireland, Galway, Ireland
| | - C. Noone
- School of Psychology, National University of Ireland, Galway, Ireland
| | - D. Caldwell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - N. J. Welton
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J. Newell
- School of Mathematics, Statistics & Applied Mathematics, National University of Ireland, Galway, Ireland
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Newell J. [Treatment-resistant constipation and the need for chronic use of laxatives following lithium administration]. Tijdschr Psychiatr 2018; 60:481-484. [PMID: 30019743] [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: 06/08/2023]
Abstract
Just a few days after the introduction of lithium therapy to treat a 35-year old man suffering from a bipolar disorder, complaints of constipation arose. The issue persisted despite numerous trials with first and second line laxatives at adequate dose and duration over a period of several weeks. After the singular administration of highly dosed macrogol laxatives with electrolytes, a lower dosage was established as maintenance treatment, yielding promising results. However, the potential interactions as well as the possible fluctuations in serum lithium levels when combining a maintenance treatment of both lithium and laxatives remains to be evaluated.
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Newell J, Mairesse O, Neu D. Clinical contributions of a sleep positioning pillow in the treatment of positional sleep apnea. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Newell J, Mairesse O, Smith P, Neu D. Preliminary data of a prospective study on the effectiveness and compliance of a mandibular advancement device alone versus a mandibular advancement device combined with a sleep positioning pillow in the treatment of mild to moderate sleep apnea. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.700] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Neu D, Hardy De Buisseret FX, Newell J, Mairesse O. The underestimated impact of nocturnal limb movements. isolated PLMD and comorbid RLS can present with similarly decreased sleep depth and altered sleep efficiency. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Kuosmanen T, Fleming T, Newell J, Barry M. A pilot evaluation of the SPARX-R gaming intervention for preventing depression and improving wellbeing among adolescents in alternative education. Internet Interv 2017; 8:40-47. [PMID: 30135827 PMCID: PMC6096202 DOI: 10.1016/j.invent.2017.03.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/06/2017] [Accepted: 03/06/2017] [Indexed: 11/19/2022] Open
Abstract
AIM The use of computerized mental health programs with vulnerable youth, such as early school leavers, remains relatively unstudied. This pilot study examined the feasibility of delivering a computerized cognitive behavioral therapy (cCBT) gaming intervention (SPARX-R) for young people (age 15-20 years) who have left school early and are attending Youthreach, an alternative education (AE) program in Ireland. METHOD Students (n = 146) from twenty-one Youthreach Centers were randomized to SPARX-R and no-intervention control. All students within the group were included in the study whether or not they were exhibiting heightened levels of depression. Program impact was examined on both negative and positive indicators of mental health, including depression (primary outcome), generalized anxiety, general mental wellbeing, coping and emotion regulation. Assessments were conducted at baseline and post-intervention (7 weeks). Participants that provided data at post-assessment (n = 66) were included in the analysis. RESULTS The participants completed on average 5.3 modules of SPARX-R with 30% (n = 9) completing the entire program. A significant improvement in emotion regulation strategies was detected, with expressive suppression decreasing significantly in the SPARX-R group in comparison to the control (- 2.97, 95% CI - 5.48 to - 0.46, p = 0.03). CONCLUSIONS Findings suggest that SPARX-R has a positive impact on emotion regulation. The lack of significant findings on other outcome measures may be attributed to inadequate sample size, and therefore, further research with larger samples are required to establish the effectiveness of the program in reducing depression and anxiety and improving psychological wellbeing among young people attending AE.
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Affiliation(s)
- T. Kuosmanen
- Health Promotion Research Centre, National University of Ireland Galway, Galway, Ireland
| | - T.M. Fleming
- Department of Paediatrics: Child and Youth Health & Department of Psychological Medicine, Adolescent Health Research Group & Youth e-Therapy, University of Auckland, Auckland, New Zealand
| | - J. Newell
- HRB Clinical Research Facility and School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Ireland
| | - M.M. Barry
- Health Promotion Research Centre, National University of Ireland Galway, Galway, Ireland
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21
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Pacis M, Newell J, Harkins G. Fibrotic Plaque of Endometriosis on the Round Ligament. J Minim Invasive Gynecol 2017; 24:1065-1066. [PMID: 28161496 DOI: 10.1016/j.jmig.2017.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Michelle Pacis
- Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, Hershey, Pennsylvania.
| | - Jordan Newell
- Department of Anatomic Pathology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Gerald Harkins
- Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, Hershey, Pennsylvania
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McGrath E, Espie C, Power A, Murphy A, Newell J, Kelly C, Duffy N, Gunning P, Gibson I, O’Donnell M. [OP.4C.06] SLEEP TO LOWER ELEVATED BLOOD PRESSURE. J Hypertens 2016. [DOI: 10.1097/01.hjh.0000491462.58358.ca] [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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23
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Elsey H, Thomson DR, Lin RY, Maharjan U, Agarwal S, Newell J. Addressing Inequities in Urban Health: Do Decision-Makers Have the Data They Need? Report from the Urban Health Data Special Session at International Conference on Urban Health Dhaka 2015. J Urban Health 2016; 93:526-37. [PMID: 27184570 PMCID: PMC4899330 DOI: 10.1007/s11524-016-0046-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Rapid and uncontrolled urbanisation across low and middle-income countries is leading to ever expanding numbers of urban poor, defined here as slum dwellers and the homeless. It is estimated that 828 million people are currently living in slum conditions. If governments, donors and NGOs are to respond to these growing inequities they need data that adequately represents the needs of the urban poorest as well as others across the socio-economic spectrum.We report on the findings of a special session held at the International Conference on Urban Health, Dhaka 2015. We present an overview of the need for data on urban health for planning and allocating resources to address urban inequities. Such data needs to provide information on differences between urban and rural areas nationally, between and within urban communities. We discuss the limitations of data most commonly available to national and municipality level government, donor and NGO staff. In particular we assess, with reference to the WHO's Urban HEART tool, the challenges in the design of household surveys in understanding urban health inequities.We then present two novel approaches aimed at improving the information on the health of the urban poorest. The first uses gridded population sampling techniques within the design and implementation of household surveys and the second adapts Urban HEART into a participatory approach which enables slum residents to assess indicators whilst simultaneously planning the response. We argue that if progress is to be made towards inclusive, safe, resilient and sustainable cities, as articulated in Sustainable Development Goal 11, then understanding urban health inequities is a vital pre-requisite to an effective response by governments, donors, NGOs and communities.
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Affiliation(s)
- H Elsey
- NCIHD, University of Leeds, Leeds, Yorkshire, UK.
| | - D R Thomson
- Department of Social Statistics and Demography, University of Southampton, Southampton, UK
| | - R Y Lin
- The ARK Foundation, Dhaka, Bangladesh
| | - U Maharjan
- Health Research and Social Development Forum (HERD), Kathmandu, Nepal
| | - S Agarwal
- Urban Health Resource Centre (UHRC), New Delhi, India
| | - J Newell
- NCIHD, University of Leeds, Leeds, Yorkshire, UK
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24
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Kelley R, Tran A, Isaacson D, Newell J, Saulnier G, Vargas A, Zakashansky K, Ascher-Walsh C. 44: Complex conductivity of normal and neoplastic uterus. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.01.075] [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: 10/22/2022]
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Healy DA, Boyle E, McCartan D, Bourke M, Medani M, Ferguson J, Yagoub H, Bashar K, O’Donnell M, Newell J, Canning C, McMonagle M, Dowdall J, Cross S, O'Daly S, Manning B, Fulton G, Kavanagh EG, Burke P, Grace PA, Moloney MC, Walsh SR. A MultiCenter Pilot Randomized Controlled Trial of Remote Ischemic Preconditioning in Major Vascular Surgery. Vasc Endovascular Surg 2015; 49:220-7. [DOI: 10.1177/1538574415614404] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A pilot randomized controlled trial that evaluated the effect of remote ischemic preconditioning (RIPC) on clinical outcomes following major vascular surgery was performed. Eligible patients were those scheduled to undergo open abdominal aortic aneurysm repair, endovascular aortic aneurysm repair, carotid endarterectomy, and lower limb revascularization procedures. Patients were randomized to RIPC or to control groups. The primary outcome was a composite clinical end point comprising any of cardiovascular death, myocardial infarction, new-onset arrhythmia, cardiac arrest, congestive cardiac failure, cerebrovascular accident, renal failure requiring renal replacement therapy, mesenteric ischemia, and urgent cardiac revascularization. Secondary outcomes were components of the primary outcome and myocardial injury as assessed by serum troponin values. The primary outcome occurred in 19 (19.2%) of 99 controls and 14 (14.1%) of 99 RIPC group patients ( P = .446). There were no significant differences in secondary outcomes. Our trial generated data that will guide future trials. Further trials are urgently needed.
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Affiliation(s)
- D. A. Healy
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - E. Boyle
- Department of Surgery Cork, University Hospital, Cork, Ireland
| | - D. McCartan
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - M. Bourke
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - M. Medani
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - J. Ferguson
- Department of Medicine, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - H. Yagoub
- Department of Medicine, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - K. Bashar
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - M. O’Donnell
- Clinical Research Facility, National University of Ireland Galway, Galway, Ireland
| | - J. Newell
- Clinical Research Facility, National University of Ireland Galway, Galway, Ireland
| | - C. Canning
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - M. McMonagle
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - J. Dowdall
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - S. Cross
- Department of Surgery, University Hospital Waterford, Waterford, Ireland
| | - S. O'Daly
- Clinical Research Facility, National University of Ireland Galway, Galway, Ireland
| | - B. Manning
- Department of Surgery Cork, University Hospital, Cork, Ireland
| | - G. Fulton
- Department of Surgery Cork, University Hospital, Cork, Ireland
| | - E. G. Kavanagh
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - P. Burke
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - P. A. Grace
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - M. Clarke Moloney
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - S. R. Walsh
- Department of Surgery, National University of Ireland Galway, Galway, Ireland
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Murphy AW, Cupples ME, Murphy E, Newell J, Scarrott CJ, Vellinga A, Gillespie P, Byrne M, Kearney C, Smith SM. Six-year follow-up of the SPHERE RCT: secondary prevention of heart disease in general practice. BMJ Open 2015; 5:e007807. [PMID: 26534729 PMCID: PMC4636612 DOI: 10.1136/bmjopen-2015-007807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To determine the long-term effectiveness of a complex intervention in primary care aimed at improving outcomes for patients with coronary heart disease. DESIGN A 6-year follow-up of a cluster randomised controlled trial, which found after 18 months that both total and cardiovascular hospital admissions were significantly reduced in intervention practices (8% absolute reduction). SETTING 48 general practices in the Republic of Ireland and Northern Ireland. PARTICIPANTS 903 patients with established coronary heart disease at baseline in the original trial. INTERVENTION The original intervention consisted of tailored practice and patient plans; training sessions for practitioners in medication prescribing and behavioural change; and regular patient recall system. Control practices provided usual care. Following the intervention period, all supports from the research team to intervention practices ceased. PRIMARY OUTCOME hospital admissions, all cause and cardiovascular; secondary outcomes: mortality; blood pressure and cholesterol control. RESULTS At 6-year follow-up, data were collected from practice records of 696 patients (77%). For those who had died, we censored their data at the point of death and cause of death was established. There were no significant differences between the intervention and control practices in either total (OR 0.83 (95% CI 0.54 to 1.28)) or cardiovascular hospital admissions (OR 0.91 (95% CI 0.49 to 1.65)). We confirmed mortality status of 886 of the original 903 patients (98%). There were no significant differences in mortality (15% in intervention and 16% in control) or in the proportions of patients above target control for systolic blood pressure or total cholesterol. CONCLUSIONS Initial significant differences in the numbers of total and cardiovascular hospital admissions were not maintained at 6 years and no differences were found in mortality or blood pressure and cholesterol control. Policymakers need to continue to assess the effectiveness of previously efficacious programmes. TRIAL REGISTRATION NUMBER Current Controlled Trials ISRCTN24081411.
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Affiliation(s)
- A W Murphy
- Discipline of General Practice, National University of Ireland, Galway, Ireland
| | - M E Cupples
- UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University Belfast, Belfast, Northern Ireland
| | - E Murphy
- Discipline of General Practice, National University of Ireland, Galway, Ireland
| | - J Newell
- Health Research Board Clinical Research Facility, National University of Ireland, Galway, Ireland
| | - C J Scarrott
- School of Mathematic and Statistics, University of Canterbury, Christchurch, New Zealand
| | - A Vellinga
- Discipline of General Practice, National University of Ireland, Galway, Ireland
| | - P Gillespie
- School of Business and Economics, National University of Ireland, Galway, Ireland
| | - M Byrne
- School of Psychology, National University of Ireland, Galway, Ireland
| | - C Kearney
- Discipline of General Practice, National University of Ireland, Galway, Ireland
| | - S M Smith
- Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
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Deimling T, Riley K, Newell J, Harkins G. Incidence of uterine malignancy: a review at a teaching institution. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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28
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Riley K, Newell J, Zaino R, Kesterson J. Robotic-assisted Laparoscopic Management of Chemoresistant Myoinvasive Complete Molar Pregnancy. J Minim Invasive Gynecol 2015; 22:1100-3. [DOI: 10.1016/j.jmig.2015.05.012] [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] [Received: 04/06/2015] [Revised: 05/14/2015] [Accepted: 05/15/2015] [Indexed: 11/26/2022]
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29
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Neu D, Mairesse O, Newell J, Verbanck P, Peigneux P, Deliens G. Does more sleep matter? Differential effects of NREM- and REM-dominant sleep on sleepiness and vigilance. Neurophysiol Clin 2015; 45:167-75. [DOI: 10.1016/j.neucli.2014.10.004] [Citation(s) in RCA: 3] [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] [Received: 04/12/2014] [Revised: 10/17/2014] [Accepted: 10/25/2014] [Indexed: 11/26/2022] Open
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Kelly M, Dowell J, Husbands A, Kropmans T, Jackson AE, Dunne F, O'Flynn S, Newell J, Murphy AW. Can Multiple Mini Interviews work in an Irish setting? A feasibility study. Ir Med J 2014; 107:210-212. [PMID: 25226716] [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: 06/03/2023]
Abstract
Multiple Mini Interview (MMI) is a new selection tool for medical school applicants. Developed at McMaster University in 2004 it comprises a series of interview stations designed to measure performance across a range of competencies including communication skills, team work, and ethical reasoning. In September 2012, 109 First Year Medical students underwent the MMI. It consisted of 10 stations. The median total score, out of 150, was 100 (min 63, max 129). Cronbach Alphas for the 10 individual stations range from 0.74 to 0.80. Overall Cronbach Alpha of MMI items was 0.78. Staff and student feedback was positive. The outline cost per student was estimated at Euro 145. This study demonstrates that it is feasible to hold a MMI with acceptable levels of reliability and stakeholder approval in an Irish setting. Further work is ongoing to establish the concurrent and predictive validity of MMI in this cohort of medica students.
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Loftus A, Loftus BG, Muircheartaigh IO, Newell J, Scarrott C, Jennings S. Acute childhood asthma in Galway city from 1985-2005: relationship to air pollution and climate. Ir Med J 2014; 107:198-201. [PMID: 25226712] [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: 06/03/2023]
Abstract
We examine the relationship of air pollution and climatic variables to asthma admission rates of children in Galway city over a 21 year period. Paediatric asthma admissions were recorded from 1985-2005, and admission rates per thousand calculated for pre-school (1-4 years), school aged (5-14 years) and all children (1-14 years) on a monthly and annual basis. These data were compared to average monthly and annual climatic variables (rainfall, humidity, sunshine, wind speed and temperature) and black smoke levels for the city. Simple correlation and Poisson Generalized Additive Models (GAM) were used. Admission rates each month are significantly correlated with smoke levels (p = 0.007). Poisson GAM also shows a relationship between admissions and pollution (p = 0.07). Annual smoke levels impact more on admission rates of preschoolers (p = 0.04) than school age children (p = 0.10). These data suggest that air pollution is an important factor in the epidemiology of acute childhood asthma.
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Jackson D, Cotter D, Newell J, O'Donohoe P, Kane F, McDermott T, Kelly S, Drumm A. Response to M Krkošek, C W Revie, B Finstad and C D Todd's comment on Jackson et al. 'Impact of Lepeophtheirus salmonis infestations on migrating Atlantic salmon, Salmo salar L., smolts at eight locations in Ireland with an analysis of lice-induced marine mortality'. J Fish Dis 2014; 37:419-421. [PMID: 24611448 PMCID: PMC4314703 DOI: 10.1111/jfd.12239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- D Jackson
- Marine Environment and Food Safety Services, Marine InstituteGalway, Ireland
| | - D Cotter
- Marine Environment and Food Safety Services, Marine InstituteGalway, Ireland
| | - J Newell
- School of Mathematics, Statistics and Applied Mathematics, National University of IrelandGalway, Ireland
| | - P O'Donohoe
- Marine Environment and Food Safety Services, Marine InstituteGalway, Ireland
| | - F Kane
- Marine Environment and Food Safety Services, Marine InstituteGalway, Ireland
| | - T McDermott
- Marine Environment and Food Safety Services, Marine InstituteGalway, Ireland
| | - S Kelly
- Marine Environment and Food Safety Services, Marine InstituteGalway, Ireland
| | - A Drumm
- Marine Environment and Food Safety Services, Marine InstituteGalway, Ireland
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Catterson P, Moore B, Hodgson A, Lewis N, Newell J, Charles P. A CASE STUDY OF TWO PREMIERSHIP FOOTBALLERS WITH SICKLE CELL TRAIT USING NOVEL TESTS OF REDOX HOMEOSTASIS. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.47] [Citation(s) in RCA: 3] [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: 11/04/2022]
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Counihan TJ, Duignan JA, Gormley G, Saidha S, Dooley C, Newell J. Does long-term partial sodium channel blockade alter disease progression in MS? Evidence from a retrospective study. Ir J Med Sci 2013; 183:117-21. [PMID: 24287594 DOI: 10.1007/s11845-013-1042-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 11/13/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND There is accumulating evidence that long-term disability and disease progression in multiple sclerosis (MS) are due to prolonged sodium channel opening along demyelinated axons. Despite good evidence in animal models of MS that partial voltage-gated sodium channel (VGSC) blockade reduces disease progression, little is known about its effects in patients, despite widespread use of such agents in the symptomatic management of MS. OBJECTIVE To determine if long-term exposure to the VGSC-blocking drug carbamazepine (CBZ) alters disease progression in MS. METHODS Using a retrospective chart review of patients diagnosed with MS, we compared progression of disability between patients exposed the VGSC blocker CBZ with those who were not exposed to the drug. Both whole-group and matched case-control analyses were performed after correcting for the influence of age, gender, MS subtype, expanded disability status score at diagnosis, use of disease-modifying therapy, and year of initial therapy. The multiple sclerosis severity scale (MSSS) was used as a measure of disease severity. The primary outcome measure was MSSS score difference between groups. RESULTS Four hundred patients were included; 51 received CBZ symptomatic therapy (average duration of therapy 27 months). There was no significant difference in mean MSSS between the two groups in either the whole group comparison (p = 0.63) or the matched analysis (p = 0.12). CONCLUSION Despite preclinical evidence suggesting a neuroprotective role of VGSC blockers in animal models of MS, this retrospective study suggests that long-term exposure to the VGSC-blocking drug CBZ fails to alter long-term disability and disease progression in MS patients.
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Affiliation(s)
- T J Counihan
- School of Medicine, National University of Ireland, Galway, Ireland,
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Mohammad A, Lohan D, Bergin D, Mooney S, Newell J, O'Donnell M, Coughlan RJ, Carey JJ. The prevalence of vertebral fracture on vertebral fracture assessment imaging in a large cohort of patients with rheumatoid arthritis. Rheumatology (Oxford) 2013; 53:821-7. [DOI: 10.1093/rheumatology/ket353] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Noctor E, Crowe C, Carmody LA, Avalos GM, Kirwan B, Infanti JJ, O'Dea A, Gillespie P, Newell J, McGuire B, O'Neill C, O'Shea PM, Dunne FP. ATLANTIC DIP: simplifying the follow-up of women with previous gestational diabetes. Eur J Endocrinol 2013; 169:681-7. [PMID: 24092597 DOI: 10.1530/eje-13-0491] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [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: 12/24/2022]
Abstract
OBJECTIVE Previous gestational diabetes (GDM) is associated with a significant lifetime risk of type 2 diabetes. In this study, we assessed the performance of HbA1c and fasting plasma glucose (FPG) measurements against that of 75 g oral glucose tolerance testing (OGTT) for the follow-up screening of women with previous GDM. METHODS Two hundred and sixty-six women with previous GDM underwent the follow-up testing (mean of 2.6 years (s.d. 1.0) post-index pregnancy) using HbA1c (100%), and 75 g OGTT (89%) or FPG (11%). American Diabetes Association (ADA) criteria for abnormal glucose tolerance were used. DESIGN, COHORT STUDY, AND RESULTS The ADA HbA1c high-risk cut-off of 39 mmol/mol yielded sensitivity of 45% (95% CI 32, 59), specificity of 84% (95% CI 78, 88), negative predictive value (NPV) of 87% (95% CI 82, 91) and positive predictive value (PPV) of 39% (95% CI 27, 52) for detecting abnormal glucose tolerance. ADA high-risk criterion for FPG of 5.6 mmol/l showed sensitivity of 80% (95% CI 66, 89), specificity of 100% (95% CI 98, 100), NPV of 96% (95% CI 92, 98) and PPV of 100% (95% CI 91, 100). Combining HbA1c ≥39 mmol/mol with FPG ≥5.6 mmol/l yielded sensitivity of 90% (95% CI 78, 96), specificity of 84% (95% CI 78, 88), NPV of 97% (95% CI 94, 99) and PPV of 56% (95% CI 45, 66). CONCLUSIONS Combining test cut-offs of 5.6 mmol/l and HbA1c 39 mmol/mol identifies 90% of women with abnormal glucose tolerance post-GDM (mean 2.6 years (s.d.1.0) post-index pregnancy). Applying this follow-up strategy will reduce the number of OGTT tests required by 70%, will be more convenient for women and their practitioners, and is likely to lead to increased uptake of long-term retesting by these women whose risk for type 2 diabetes is substantially increased.
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Affiliation(s)
- E Noctor
- Galway Diabetes Research Centre, National University of Ireland, Galway, Ireland
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Jackson D, Cotter D, Newell J, McEvoy S, O'Donohoe P, Kane F, McDermott T, Kelly S, Drumm A. Impact of Lepeophtheirus salmonis infestations on migrating Atlantic salmon , Salmo salar L., smolts at eight locations in Ireland with an analysis of lice-induced marine mortality. J Fish Dis 2013; 36:273-81. [PMID: 23298412 PMCID: PMC3593185 DOI: 10.1111/jfd.12054] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 10/05/2012] [Accepted: 10/17/2012] [Indexed: 05/10/2023]
Abstract
Sea lice infestation as a source of marine mortality of outwardly migrating Atlantic salmon smolts has been investigated by treating groups of ranched salmon, prior to release, with a prophylactic sea lice treatment conferring protection from sea lice infestation. A number of studies have been carried out in Ireland using both established ranched populations and groups of hatchery reared fish imprinted for 5-8 weeks in the sites of experimental releases. In this study, data on 352 142 migrating salmon from twenty-eight releases, at eight locations along Ireland's South and West coasts covering a 9-year period (2001 to 2009) are reviewed. Both published and new data are presented including a previously unpublished time series. The results of a meta-analysis of the combined data suggest that while sea lice-induced mortality on outwardly migrating smolts can be significant, it is a minor and irregular component of marine mortality in the stocks studied and is unlikely to be a significant factor influencing conservation status of salmon stocks.
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Affiliation(s)
- D Jackson
- Marine Environment and Food Safety Services, Marine Institute, Rinville, Oranmore, Co. Galway, Ireland.
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Jackson D, Kane F, O'Donohoe P, Mc Dermott T, Kelly S, Drumm A, Newell J. Sea lice levels on wild Atlantic salmon, Salmo salar L., returning to the coast of Ireland. J Fish Dis 2013; 36:293-298. [PMID: 23297706 DOI: 10.1111/jfd.12059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 10/24/2012] [Accepted: 10/25/2012] [Indexed: 06/01/2023]
Abstract
The sea lice population structure, prevalence and intensity of Lepeophtheirus salmonis have been studied over a period extending from 2004 to 2011. Infestation data were collected from the interceptor drift net fishery from 2004 until it was closed in 2006. From 2010, data were collected from the inshore draft net fishery. In all, 34 samples from the drift and draft net fisheries have been analysed to date. Prevalence of infestation with L. salmonis regularly approached 100% in samples of hosts recovered from the offshore drift net fishery. Abundance was variable both within and between years with a maximum mean abundance of 25.8 lice per fish recorded in 2004. The population structure of L. salmonis on hosts recovered in the inshore and estuarine draft net fisheries was different from that observed in the more offshore drift net samples. There is clear evidence of recent infestation with L. salmonis in the draft net samples.
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Affiliation(s)
- D Jackson
- Marine Environment and Food Safety Services, Marine Institute, Rinville, Oranmore, Co. Galway, Ireland.
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Hershko K, Simhadri VL, Blaisdell A, Hunt RC, Newell J, Tseng SC, Hershko AY, Choi JW, Sauna ZE, Wu A, Bram RJ, Komar AA, Kimchi-Sarfaty C. Cyclosporin A impairs the secretion and activity of ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeat). J Biol Chem 2012; 287:44361-71. [PMID: 23144461 DOI: 10.1074/jbc.m112.383968] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The protease ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeat) cleaves multimers of von Willebrand factor, thus regulating platelet aggregation. ADAMTS13 deficiency leads to the fatal disorder thrombotic thrombocytopenic purpura (TTP). It has been observed that cyclosporin A (CsA) treatment, particularly in transplant patients, may sometimes be linked to the development of TTP. Until now, the reason for such a link was unclear. Here we provide evidence demonstrating that cyclophilin B (CypB) activity plays an important role in the secretion of active ADAMTS13. We found that CsA, an inhibitor of CypB, reduces the secretion of ADAMTS13 and leads to conformational changes in the protein resulting in diminished ADAMTS13 proteolytic activity. A direct, functional interaction between CypB (which possesses peptidyl-prolyl cis-trans isomerase (PPIase) and chaperone functions) and ADAMTS13 is demonstrated using immunoprecipitation and siRNA knockdown of CypB. Finally, CypB knock-out mice were found to have reduced ADAMTS13 levels. Taken together, our findings indicate that cyclophilin-mediated activity is an important factor affecting secretion and activity of ADAMTS13. The large number of proline residues in ADAMTS13 is consistent with the important role of cis-trans isomerization in the proper folding of this protein. These results altogether provide a novel mechanistic explanation for CsA-induced TTP in transplant patients.
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Affiliation(s)
- Klilah Hershko
- Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland 20982, USA
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Byrne M, Newell J, Coffey N, O' Hara MC, Cooke D, Dinneen SF. Predictors of quality of life gains among people with type 1 diabetes participating in the Dose Adjustment for Normal Eating (DAFNE) structured education programme. Diabetes Res Clin Pract 2012; 98:243-8. [PMID: 23018180 DOI: 10.1016/j.diabres.2012.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 05/23/2012] [Accepted: 09/04/2012] [Indexed: 10/27/2022]
Abstract
AIMS To examine predictors of quality of life gains among people with type 1 diabetes following the Dose Adjustment for Normal Eating (DAFNE) self-management training programme. METHODS Clinical and questionnaire data were collected from 437 patients from 6 hospital centres before, and 18 months post-DAFNE intervention. Glycated haemoglobin (HbA(1c)), weight, height, and blood pressure levels were recorded by clinicians during clinic appointments. Questionnaires included the Diabetes-Specific Quality of Life Scale (DSQOLS), the Problem Areas in Diabetes Scale (PAID) and the Hospital Anxiety and Depression Scale (HADS). Basic demographics were recorded at baseline. Linear mixed models were fitted to identify predictors of change in quality of life at an 18 month follow-up assessment. RESULTS Patients with high levels of diabetes-related distress experienced greatest improvement in DSQOLS quality of life scores (p = 0.001). Patients with poor glycaemic control (higher levels of HbA(1c); p = 0.03) and those with high levels of anxiety (p = 0.001) experienced the greatest reductions in diabetes-related distress. CONCLUSIONS Patients with higher baseline levels of anxiety, higher levels of diabetes-related distress and higher baseline levels of HbA(1c) are most likely to experience quality of life gain from participation in self-management programmes such as DAFNE.
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Affiliation(s)
- M Byrne
- School of Psychology, National University of Ireland, Galway, Ireland.
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Waters P, Dwyer R, Wall D, McDermott A, Newell J, Kerin M. 832 Relationship Between Circulating and Tissue MiRNAs in a Murine Model of Breast Cancer. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71465-x] [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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Khan S, Ryan J, Brougham C, Wall D, Newell J, Kerin M, Dwyer R. 409 Identification of a Tumour Suppressor MiRNA That Correlates With RARb Expression in Breast Cancer. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71091-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Edwards NC, Hing ZA, Perry A, Blaisdell A, Kopelman DB, Fathke R, Plum W, Newell J, Allen CE, S. G, Shapiro A, Okunji C, Kosti I, Shomron N, Grigoryan V, Przytycka TM, Sauna ZE, Salari R, Mandel-Gutfreund Y, Komar AA, Kimchi-Sarfaty C. Characterization of coding synonymous and non-synonymous variants in ADAMTS13 using ex vivo and in silico approaches. PLoS One 2012; 7:e38864. [PMID: 22768050 PMCID: PMC3387200 DOI: 10.1371/journal.pone.0038864] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [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: 01/04/2012] [Accepted: 05/13/2012] [Indexed: 12/20/2022] Open
Abstract
Synonymous variations, which are defined as codon substitutions that do not change the encoded amino acid, were previously thought to have no effect on the properties of the synthesized protein(s). However, mounting evidence shows that these “silent” variations can have a significant impact on protein expression and function and should no longer be considered “silent”. Here, the effects of six synonymous and six non-synonymous variations, previously found in the gene of ADAMTS13, the von Willebrand Factor (VWF) cleaving hemostatic protease, have been investigated using a variety of approaches. The ADAMTS13 mRNA and protein expression levels, as well as the conformation and activity of the variants have been compared to that of wild-type ADAMTS13. Interestingly, not only the non-synonymous variants but also the synonymous variants have been found to change the protein expression levels, conformation and function. Bioinformatic analysis of ADAMTS13 mRNA structure, amino acid conservation and codon usage allowed us to establish correlations between mRNA stability, RSCU, and intracellular protein expression. This study demonstrates that variants and more specifically, synonymous variants can have a substantial and definite effect on ADAMTS13 function and that bioinformatic analysis may allow development of predictive tools to identify variants that will have significant effects on the encoded protein.
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Affiliation(s)
- Nathan C. Edwards
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Zachary A. Hing
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Avital Perry
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Adam Blaisdell
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - David B. Kopelman
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Robert Fathke
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - William Plum
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Jordan Newell
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Courtni E. Allen
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Geetha S.
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Aaron Shapiro
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Chinyere Okunji
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Idit Kosti
- Department of Biology, Technion-Israel Institute of Technology, Haifa, Israel
| | - Noam Shomron
- Department of Cell and Developmental Biology, Tel Aviv University, Tel Aviv, Israel
| | - Vahan Grigoryan
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Teresa M. Przytycka
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Zuben E. Sauna
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
| | - Raheleh Salari
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, Maryland, United States of America
| | | | - Anton A. Komar
- Center for Gene Regulation in Health and Disease, Department of Biological, Geological and Environmental Sciences, Cleveland State University, Cleveland, Ohio, United States of America
- * E-mail: (CKS); (AAK)
| | - Chava Kimchi-Sarfaty
- Laboratory of Hemostasis, Division of Hematology, Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland, United States of America
- * E-mail: (CKS); (AAK)
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Dorairaj JJ, Miller N, Newell J, Kerin MJ, Weidhaas JB. P1-09-05: A 3′UTR Functional Variant in BRCA1: A Predictor of Poor Outcome in Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-09-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: MicroRNAs (miRNAs) are class of gene regulators which exert their effects through binding with partial complementarity to sequences in the 3'untranslated region (3'UTR) of the target mRNA. Single nucleotide polymorphisms (SNPs) in the 3'UTR of target mRNA have the potential to disrupt or create new illegitimate miRNA targets and have been associated with cancer predisposition as well as tumor biology. An association between rs8176318 and risk for familial breast and ovarian cancer as well as risk for triple negative breast cancer in African American women has previously been established. We aimed to evaluate the phenotypic effect of rs8176318 in a west of Ireland breast cancer cohort, and also its role as a biomarker of prognosis.
Methods: DNA from 727 unselected breast cancer cases and 387 controls were extracted from whole blood and genotyped for rs8176318 in the 3'UTR of the BRCA1 oncogene. The association with disease specific parameters and outcome were evaluated.
Results: Overall, there was a significant difference in the distribution of the three genotypes between cases and controls (p=0.035). The dominant variant model was predictive of breast cancer (OR=1.4, 95% CI 1.1−1.8). Fifty-two percent of breast cancer cases had the variant, with similar prevalence between subtypes: Luminal A (279 [54%] of 519 cases), Luminal B (37 [43%] of 85 cases), HER2 (21 [53%] of 40 cases) and triple negative breast cancer (41 [49%] of 83 cases). Comparing the prevalence of the variant within respective subtypes with controls however, Luminal A breast cancer was most strongly associated with rs8176318 (OR=1.5, 95%CI 1.1−1.9). The variant was not significantly associated with disease free survival (DFS) in all cancer cases (Log-rank test=0.084). However, rs8176318 was predictive of a poorer DFS (Log-rank test=0.041) in Luminal A patients with a 10-year DFS of 54% (95% CI 0.4−0.7) and 77% (95%CI 0.7−0.9) for the variant versus the non-variant, respectively. In addition, patients with Stage IV disease had a 6-fold increased risk of carrying the variant (p = 0.035), with 17 (73%) of 23 patients with metastasis at presentation positive for the variant compared to 324 (50%) of 642 patients without metastasis (p=0.034). Luminal A patients with Stage IV disease had a 13-fold risk of carrying the variant (p=0.043) in regression analysis, controlling for all other clinicopathological variables. Similarly, the variant was associated with distant metastasis in Luminal A patients, with 11 (92%) of 12 patients with metastasis positive for the variant compared to 242 (52%) of 463 patients without metastasis (p=0.028).
Conclusion: These findings suggest that rs8176318, a variant in the 3'UTR of BRCA1, is a genetic marker for modest breast cancer risk but aggressive tumor biology in breast cancer, and highlights the need for further clinical and biological evaluation of such markers.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-09-05.
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Affiliation(s)
- JJ Dorairaj
- 1National University of Ireland, Galway, Ireland; Yale University, New Haven, CT
| | - N Miller
- 1National University of Ireland, Galway, Ireland; Yale University, New Haven, CT
| | - J Newell
- 1National University of Ireland, Galway, Ireland; Yale University, New Haven, CT
| | - MJ Kerin
- 1National University of Ireland, Galway, Ireland; Yale University, New Haven, CT
| | - JB Weidhaas
- 1National University of Ireland, Galway, Ireland; Yale University, New Haven, CT
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Dorairaj JJ, Wall D, Newell J, Blamey RW, Sweeney KJ, Ball G, Kerin MJ. P2-12-15: GAINS: A Breast Cancer Prognostic Index Utilizing Lymph Node Ratio. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p2-12-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Axillary lymph node status is an important predictor of overall survival (OS), hence its inclusion in clinical prognostic tools. The Nottingham Prognostic Index (NPI) which incorporates Lymph Node (LN) stage, tumor size and grade generates a score which predicts a percentage 10-year survival. Despite its status as a benchmark model for breast cancer prognosis, newer prognostic factors do exist. Lymph Node Ratio (LNR) is a superior prognostic indicator compared to absolute positive lymph node number, warranting re-evaluation of breast cancer prognostication. The aims of this study were threefold: identify the strength of LNR as a prognostic indicator compared to LN stage and NPI; establish a new prognostic index (Galway Index of Survival [GAINS]), taking into account the effect of LNR and breast cancer subtype on traditional clinicopathological features in breast cancer prognostication; and evaluate the prognostic efficacy of the new index compared to NPI.
Methods: Two cohorts were used: Galway Cohort-a prospectively compiled cohort of 1668 cases with histologically proven Stage 1, 2 and 3 primary operable breast cancer treated between 1990–2010 in a single institution; and ONCOPOOL-a retrospectively compiled database of 16944 cases treated across 12 European breast cancer units between 1990–1999. A Cox Proportional Hazards model was fitted to evaluate the strength of LNR compared to LN stage (within the NPI model) in both cohorts. The effect of clinicopathological variables on OS was analyzed using multivariable analysis in the Galway cohort. Three models were created (Model 1: Traditional prognostic variables excluding NPI and LNR; Model 2: Model 1 and LNR; Model 3: Model 1 and NPI) and compared using Likelihood-ratio tests.
Stepwise variable selection was used to identify the best model to create a prognostic index and performance of the two indices was evaluated using Receiver Operating Curves (ROC). Results: Controlling for tumor size and histological grade, LNR is a stronger prognostic factor than LN Stage in both the Galway (β values of 1.2 and 0.3 respectively) and ONCOPOOL (b values of 1.3 and 0.3 respectively) cohorts, with LNR rendering LN stage non significant (p=0.135) in the former. In the Galway cohort, separate comparisons of Model 2 and 3 with Model 1 demonstrated that traditional clinicopathological variables in addition to LNR (Model 2) best predicted OS (p=0.019). Within Model 2, LNR was a significant predictor of survival (p=0.014, Hazard Ratio 7.4). Age, LNR, stage and molecular subtype were significant prognostic factors, and corresponded to distinct survival patterns when included in the new prognostic index. GAINS performed almost identically to NPI, with similar areas under the curve (AUC) (GAINS AUC=0.745 [95%CI0.67−0.82]; NPI AUC=0.742 [95%CI0.67−0.82]).
Conclusion: LNR is a better prognostic indicator compared to LN Stage. GAINS performs just as well as NPI as a prognostic index and has the potential for clinical utility given further validation.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-15.
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Affiliation(s)
- JJ Dorairaj
- 1National University of Ireland, Galway, Ireland; Breast Institute, Nottingham City Hospital, Nottingham, United Kingdom; Nottingham Trent University, Nottingham, United Kingdom
| | - D Wall
- 1National University of Ireland, Galway, Ireland; Breast Institute, Nottingham City Hospital, Nottingham, United Kingdom; Nottingham Trent University, Nottingham, United Kingdom
| | - J Newell
- 1National University of Ireland, Galway, Ireland; Breast Institute, Nottingham City Hospital, Nottingham, United Kingdom; Nottingham Trent University, Nottingham, United Kingdom
| | - RW Blamey
- 1National University of Ireland, Galway, Ireland; Breast Institute, Nottingham City Hospital, Nottingham, United Kingdom; Nottingham Trent University, Nottingham, United Kingdom
| | - KJ Sweeney
- 1National University of Ireland, Galway, Ireland; Breast Institute, Nottingham City Hospital, Nottingham, United Kingdom; Nottingham Trent University, Nottingham, United Kingdom
| | - G Ball
- 1National University of Ireland, Galway, Ireland; Breast Institute, Nottingham City Hospital, Nottingham, United Kingdom; Nottingham Trent University, Nottingham, United Kingdom
| | - MJ Kerin
- 1National University of Ireland, Galway, Ireland; Breast Institute, Nottingham City Hospital, Nottingham, United Kingdom; Nottingham Trent University, Nottingham, United Kingdom
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McElwain J, Simpkin A, Newell J, Laffey JG. Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes. Anaesthesia 2011; 66:1127-33. [DOI: 10.1111/j.1365-2044.2011.06891.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Hartmann MC, Dwyer RM, Costello M, Potter SM, Curran C, Hennessy E, Newell J, Griffin DG, Kerin MJ. Relationship between CCL5 and transforming growth factor-β1 (TGFβ1) in breast cancer. Eur J Cancer 2011; 47:1669-75. [PMID: 21658938 DOI: 10.1016/j.ejca.2011.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 02/18/2011] [Accepted: 05/06/2011] [Indexed: 01/22/2023]
Abstract
PURPOSE Investigate circulating CCL5 in breast cancer patients and healthy controls, along with gene expression levels in corresponding tumour tissue and isolated primary stromal cells. Hormonal control of CCL5, and a potential relationship with TGFβ1, was also investigated. METHODS Circulating levels of CCL5 and TGFβ1 were measured in 102 breast cancer patients and 66 controls using ELISA. Gene expression levels (CCL5, CCR5, TGFβ1, TGFβRII) were quantified in corresponding tumour tissue (n = 43), normal tissue (n = 16), and isolated tumour (n = 22) and normal (n = 3) stromal cells using RQ-PCR. CCL5 and circulating menstrual hormones (LH, FSH, Oestradiol, Progesterone) were analysed in serum samples from healthy, premenopausal volunteers (n = 60). RESULTS TGFβ1 was significantly higher in breast cancer patients (Mean(SEM) 27.4(0.9)ng/ml) compared to controls (14.9(0.9)ng/ml). CCL5 levels decreased in the transition from node negative (59.6(3.7)ng/ml) to node positive disease (40.5(6.3)ng/ml) and increased again as the number of positive lymph nodes increased (⩾3 positive 50.95(9.8)ng/ml). A significant positive correlation between circulating CCL5 and TGFβ1 (r = 0.423, p<0.0001) was observed, and mirrored at the gene expression level in tumour tissue from the same patients (r = 0.44, p<0.001). CCL5, CCR5 and TGFβ1 expression was significantly higher in tumour compared to normal breast tissue (p < 0.001). A significant negative correlation was observed between circulating CCL5, Oestradiol and Progesterone (r = -0.50, r = -0.39, respectively, p < 0.05). CONCLUSION CCL5 expression is elevated in the tumour microenvironment. The data support a role for hormonal control of circulating CCL5 and also highlight a potentially important relationship between CCL5 and TGFβ1 in breast cancer.
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Affiliation(s)
- M C Hartmann
- Division of Surgery, School of Medicine, National University of Ireland Galway, Ireland
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Heneghan HM, Miller N, Healy N, Newell J, Kerin MJ. Abstract P3-10-02: Circulating miRNA Signature: Potential Screening and Prognostic Tool for Breast Cancer. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-10-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Genetic profiling of breast tumors revolutionized the classification of breast cancer and unravelled the complexity of this phenotypically diverse disease. However there appears to be discordance between the various mRNA-based single sample predictors which stratify tumors into subgroups. Clinical decision making based on a tumor's mRNA expression is therefore concerning. The potential of mi(cro) RNAs as novel tumor markers has been the focus of recent scrutiny due to their tissue specificity, stability and superiority to mRNA in tumor classification. Additionally, the ability to quantify tumor-associated miRNAs in the circulation and their correlations with clinicopathologic variables, highlights their potential to improve upon existing breast tumor classification methods. Systemic miR-195 and let-7a have been shown to hold properties as breast tumor markers. The aim of this study was to identify a larger panel of miRNAs which augment the sensitivity and specificity of circulating miRNAs as diagnostic and prognostic markers for breast cancer.
Methods: The expression levels of 9 miRNAs were evaluated in 345 preoperative cancer patients including 265 breast cancers and 80 non-breast malignancies, and 63 age-matched disease-free controls using RQ-PCR. MiRNA quantification was also performed on tumor tissue from 83 age and stage matched breast cancer patients. Advanced QBase Plus software and SPSS were used for biostatistical analysis of the data and correlation with clinicopathologic variables.
Results: This study confirmed significantly deranged expression levels of systemic miR-195 and let-7a in an independent validation cohort of breast cancer patients (p < 0.001 and p < 0.001 respectively). In addition miR-181c and miR-342 were identified as breast cancer specific biomarkers. Elevated levels of this 4-miRNA signature in breast cancer patients, including those with in-situ carcinoma, increased the discriminatory power of this test for breast cancer (all types) to 94% (P<0.001).
Circulating levels of these 4 miRNAs correlated with tumor miRNA expression, and decreased to basal levels by 2 weeks following curative tumor resection. Additionally circulating miRNA levels correlated with clinicopathological variables such as tumor size and hormone receptor status. A subset of 2 systemic miRNAs was predictive of the Luminal A subtype of breast cancer (ER/PR positive, Her2/neu negative) with 91% accuracy.
Conclusion: This study validates the recent novel finding of dysregulated tumor-specific miRNAs in the circulation of breast cancer patients. Considering that the sensitivity of mammography is 75-90%, this circulating miRNA signature could improve upon existing breast cancer screening methods, given that it was significantly altered even in patients with in-situ carcinoma. These results indicate that circulating miRNA analysis holds immense potential in the future individualized management of breast cancer patients.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-02.
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Affiliation(s)
- HM Heneghan
- National University of Ireland Galway, Ireland
| | - N Miller
- National University of Ireland Galway, Ireland
| | - N Healy
- National University of Ireland Galway, Ireland
| | - J Newell
- National University of Ireland Galway, Ireland
| | - MJ. Kerin
- National University of Ireland Galway, Ireland
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Shomron N, Hamasaki-Katagiri N, Hunt R, Hershko K, Pommier E, Geetha S, Blaisdell A, Dobkin A, Marple A, Roma I, Newell J, Allen C, Friedman S, Kimchi-Sarfaty C. A splice variant of ADAMTS13 is expressed in human hepatic stellate cells and cancerous tissues. Thromb Haemost 2010; 104:531-5. [PMID: 20664912 DOI: 10.1160/th09-12-0860] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Accepted: 05/06/2010] [Indexed: 11/05/2022]
Abstract
Although ADAMTS13, the von Willebrand factor (VWF)-cleaving protease, is expressed in a range of tissues, the physiological significance of tissue-specific ADAMTS13 alternative splicing isoforms have yet to be clarified. Screening a panel of human tissues and cell lines revealed a spliced ADAMTS13 transcript in hepatic stellate cells and a hepatoma cell line that retains the 25th intron. A nonsense codon within the intron truncates the protease, which gains 64 novel amino acids in lieu of both CUB domains. This isoform, while retaining VWF-cleaving capability, accumulates intracellularly and its biological inaccessibility may prevent its participation in regulating haemostasis and other physiologic functions.
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Affiliation(s)
- Noam Shomron
- Department of Cell and Developmental Biology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Stokes M, Davey P, McKillen J, Majury C, Newell J, Kennedy R, Kirk S. 343 Value of axillary ultrasound as a pre-operative staging procedure in breast cancer – a pilot study. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70369-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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