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Bondarchuk C, Lemon T, Earnshaw V, Rousseau E, Sindelo S, Bekker LG, Butler L, Katz I. Disclosure Events and Psychosocial Well-Being Among Young South African Adults Living with HIV. Int J Behav Med 2024:10.1007/s12529-024-10291-5. [PMID: 38658438 DOI: 10.1007/s12529-024-10291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Poor psychological well-being is both prevalent among South Africans living with HIV and has been associated with poor HIV clinical outcomes. However, the relationship between disclosure and psychological well-being remains unclear. This analysis sought to examine the relationship between two disclosure-related variables, disclosure status and reaction received, and psychosocial well-being among a sample of young adults living with HIV (YALWH) in urban South Africa. METHOD This was a secondary analysis using observational data from Standing Tall, a randomized controlled trial that recruited 100 participants ages 18-24 who tested positive for HIV after initially presenting to two well-established mobile clinics for HIV testing. Interviews investigating primary and secondary outcomes of interest were done at baseline and 6 months following recruitment. RESULTS About half (51%) of participants disclosed their HIV status within 6 months after recruitment. Simple linear regression analyses revealed that disclosure of HIV status within 6 months after study enrollment predicted significantly lower levels of disclosure concerns and internalized stigma (p < 0.05). Reactions to disclosure were not significantly associated with any of the measures of psychosocial well-being considered in this analysis (p > 0.05). CONCLUSION The results suggest that the act of disclosure among newly diagnosed YALWH may be associated with reductions in internalized stigma. In addition, the finding that the act of disclosure may be a more important determinant of psychosocial well-being than the reaction to disclosure has important implications for interventions designed to promote disclosure and psychosocial well-being in YALWH.
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Affiliation(s)
| | - Tiffany Lemon
- Harvard Global Health Institute, Harvard University, Cambridge, MA, USA
| | - Valerie Earnshaw
- Department of Human Development and Family Services, University of Delaware, Newark, DE, USA
| | - Elzette Rousseau
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Siyaxolisa Sindelo
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Linda-Gail Bekker
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Lisa Butler
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Ingrid Katz
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Hamilton R, Mulvihill A, Butler L, Chow A, Irving E, McCulloch DL, McNeil A, Michael K, Spowart KM, Waterson-Wilson J, Mactier H. Impaired vision in children prenatally exposed to methadone: an observational cohort study. Eye (Lond) 2024; 38:118-126. [PMID: 37402864 PMCID: PMC10764882 DOI: 10.1038/s41433-023-02644-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND/OBJECTIVES To examine prevalence of failed visual assessment at 8-10 years in children born to methadone-maintained opioid dependent (MMOD) mothers and relate this to known in utero substance exposure. SUBJECTS/METHODS Follow up of observational cohort study of methadone-exposed and comparison children matched for birthweight, gestation and postcode of residence at birth. Participants were 144 children (98 exposed, 46 comparison). Prenatal drug exposure was previously established via comprehensive maternal and neonatal toxicology. Children were invited to attend for visual assessment and casenotes were reviewed. Presence of acuity poorer than 0.2 logMAR, strabismus, nystagmus and/or impaired stereovision constituted a 'fail'. Fail rates were compared between methadone-exposed and comparison children after adjusting for known confounding variables. RESULTS 33 children attended in person: data were also derived from casenote review for all children. After controlling for maternal reported tobacco use, methadone-exposed children were more likely to have a visual 'fail' outcome, adjusted odds ratio 2.6, 95% CI 1.1-6.2; adjusted relative risk 1.8 (95% CI 1.1-3.4). Visual 'fail' outcome rates did not differ between methadone-exposed children who had (n = 47) or had not (n = 51) received pharmacological treatment for neonatal abstinence/opioid withdrawal syndrome (NAS/NOWS); fail rate 62% vs 53% (95% CI of difference-11-27%). CONCLUSIONS Children born to MMOD mothers are almost twice as likely as unexposed peers to have significant visual abnormalities at primary school age. Prenatal methadone exposure should be considered in the differential diagnosis of nystagmus. Findings support visual assessment prior to school entry for children with any history of prenatal opioid exposure. TRIAL REGISTRATION The study was prospectively registered on ClinicalTrials.gov (NCT03603301), https://clinicaltrials.gov/ct2/show/NCT03603301 .
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Affiliation(s)
- R Hamilton
- Royal Hospital for Children, NHS Greater Glasgow & Clyde and the University of Glasgow, Glasgow, G51 4TF, UK.
| | - A Mulvihill
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, EH3 9HA, UK
| | - L Butler
- Tennant Institute of Ophthalmology, NHS Greater Glasgow & Clyde, Glasgow, G12 0YN, UK
| | - A Chow
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - E Irving
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - D L McCulloch
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - A McNeil
- Royal Hospital for Children, NHS Greater Glasgow & Clyde, Glasgow, G51 4TF, UK
| | - K Michael
- Crosshouse Hospital, NHS Ayrshire & Arran, Kilmarnock, KA2 0BE, UK
| | - K M Spowart
- Specialist Children's Services, NHS Greater Glasgow & Clyde, Glasgow, G40 1DA, UK
| | - J Waterson-Wilson
- Royal Hospital for Children, NHS Greater Glasgow & Clyde, Glasgow, G51 4TF, UK
| | - H Mactier
- NHS Greater Glasgow & Clyde and the University of Glasgow, Glasgow, UK
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Johnson JK, Loiselle AR, Butler L, Begolka WS. Action plans for atopic dermatitis: A survey of patient and caregiver attitudes. JAAD Int 2023; 12:184-185. [PMID: 37538370 PMCID: PMC10393786 DOI: 10.1016/j.jdin.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Affiliation(s)
- Jessica K. Johnson
- Correspondence to: Jessica K. Johnson, MPH, National Eczema Association, 505 San Marin Drive #B300, Novato, CA 94945
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Bacci ED, Correll JR, Pierce EJ, Atwater AR, Dawson Z, Begolka WS, Butler L. Burden of adult atopic dermatitis and unmet needs with existing therapies. J DERMATOL TREAT 2023; 34:2202288. [PMID: 37042571 DOI: 10.1080/09546634.2023.2202288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
OBJECTIVE Patients with atopic dermatitis (AD) have low treatment satisfaction. In this study, we evaluated the humanistic burden, treatment satisfaction, and treatment expectations in patients with AD in the United States. METHODS Adults with AD recruited through the National Eczema Association and clinical sites completed a web-based survey comprising the Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD), Dermatology Life Quality Index; Work Productivity and Activity Impairment Questionnaire-Atopic Dermatitis; Treatment Satisfaction Questionnaire for Medication (TSQM); and answered questions on healthcare provider visits, treatment history, and treatment goals. Descriptive analyses were performed to compare participants by severity. RESULTS Among 186 participants (mean [standard deviation] age 39.7 [15.3] years, 79.6% female), 26.9%, 44.6%, and 26.3% of the participants had mild, moderate, or severe AD, respectively based on PO-SCORAD. Greater disease severity was associated with a greater impact on work and daily life, decreased TSQM scores, and increased healthcare provider visits. Corticosteroid topical cream or ointment (53.8%) and oral antihistamines (31.2%) were most commonly used for the treatment of AD. Participants reported declining/stopping/changing AD treatment due to the potential for side effects or lack of efficacy. "Leading normal lives" (28.0%) and "being itch-free" (33.9%) were important treatment goals. CONCLUSION Individuals with AD, especially severe disease, face a considerable humanistic burden even while using treatment.
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Sardar S, Ravindranath L, McNair C, Chand S, Yuan W, Bogdan D, Welti J, Sharp A, Schiewer M, Butler L, de Bono J, Frese K, Brooks N, Pegg N, Knudsen K, Shafi A. Abstract 1449: Targeting CBP/p300 and its downstream transcriptional machinery in advanced prostate cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-1449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Prostate cancer (PCa) is the second leading cause of cancer-related deaths in men in the US. There is a largely unmet clinical need to identify and develop novel strategies, that work either alone or in concert with AR-directed therapeutics, to combat CRPC. The highly conserved histone acetyltransferases CBP/p300 are potent co-activators for AR, and high p300 expression is associated with locally advanced disease and castration-resistant AR function. This study shows that CBP and p300 are highly expressed and correlate closely with AR gene expression and AR activity score in primary PCa and CRPC. By employing clinically relevant PCa models, the clinical significance of CBP/p300 expression in PCa patients as well as mechanistic evaluation of CBP/p300 transcriptional reprogramming and DNA damage response pathways have been undertaken. The molecular response to CBP/p300 inhibition will be assessed to discern novel metrics for precision medicine for PCa patients to improve therapeutic efficacy. Previous studies have relied on non-specific compounds and genetic silencing to target CBP/p300. CCS1477 (inobrodib) is a first-in-class bromodomain inhibitor developed by Cell Centric and targeted to inhibit CBP/p300 mediated bromodomain activity, and thus regulate cell survival. Inhibition of the CBP/p300 bromodomain resulted in significant downregulation of AR-FL, AR-V7, and its targets’ mRNA expression, as well as inhibition of associated factors such c-MYC and its downstream targets, in multiple PCa models. Transcriptomic analysis indicated that both CBP and p300 expression correlate with expression of genes involved in double strand break (DSB) DNA repair process including homologous recombination (HR) and non-homologous end joining (NHEJ) in both primary PCa and CRPC models. CCS1477 directly impacted DNA damage response and repair dynamics, as shown via delay in time to resolution of DNA damage foci formation, including RAD51 and γH2AX foci. Inhibition of CBP/p300 activity decreased tumor cell proliferation, blocked CRPC xenograft growth in vivo, and decreased proliferation ex vivo in patient-derived prostate tumor explants. Importantly, CBP/p300 expression correlated with HR genes in human prostate tissue samples in different cohorts. Lastly, inhibition of CBP/p300 activity also decreased HR gene expression in patients further supporting the essential role CBP/p300 plays in DNA repair. In sum, CBP/p300 inhibition mediates HR repair and impacts patient outcome. In conclusion, these studies identify CBP/p300 as a driver of PCa tumorigenesis through coordinated control of critical transcriptional events and lay the groundwork to optimize therapeutic strategies for advanced PCa via CBP/p300 inhibition, potentially in combination with AR-directed therapies. Combined, these studies have the capacity for significant near-term impact in the prevention and/or management of metastatic disease.
Citation Format: Sumaira Sardar, Lakshmi Ravindranath, Christopher McNair, Saswati Chand, Wei Yuan, Denisa Bogdan, Jon Welti, Adam Sharp, Matthew Schiewer, Lisa Butler, Johann de Bono, Kris Frese, Nigel Brooks, Neil Pegg, Karen Knudsen, Ayesha Shafi. Targeting CBP/p300 and its downstream transcriptional machinery in advanced prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1449.
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Affiliation(s)
- Sumaira Sardar
- 1Center for Prostate Disease Research (CPDR), Uniformed Services University (USU), Bethesda, MD
| | - Lakshmi Ravindranath
- 1Center for Prostate Disease Research (CPDR), Uniformed Services University (USU), Bethesda, MD
| | - Christopher McNair
- 2Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Saswati Chand
- 2Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Wei Yuan
- 3The Institute of Cancer Research, London, United Kingdom
| | - Denisa Bogdan
- 3The Institute of Cancer Research, London, United Kingdom
| | - Jon Welti
- 3The Institute of Cancer Research, London, United Kingdom
| | - Adam Sharp
- 3The Institute of Cancer Research, London, United Kingdom
| | - Matthew Schiewer
- 2Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Lisa Butler
- 4The University of Adelaide, Adelaide, Australia
| | - Johann de Bono
- 3The Institute of Cancer Research, London, United Kingdom
| | - Kris Frese
- 5CellCentric Ltd., Cambridge, United Kingdom
| | | | - Neil Pegg
- 5CellCentric Ltd., Cambridge, United Kingdom
| | | | - Ayesha Shafi
- 1Center for Prostate Disease Research (CPDR), Uniformed Services University (USU), Bethesda, MD
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Rodrigues SD, Ribeiro C, Teixeira I, Pakula H, Fanelli GN, Socciarelli F, Butler L, Swinnen J, Loda M. Abstract 6039: ELOVL5 affects prostate cancer cell proliferation and modulates the AR pathway. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-6039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Prostate cancer (PCa) is characterized by alterations in lipid metabolism, exemplified by increased rates of de novo lipogenesis and elongation by fatty acid elongase enzymes known as ELOVLs (elongation of very long chain fatty acids). We have previously shown that the ELOVL family members ELOVL2, 5, and 7 are Androgen Receptor (AR)-regulated proteins; and that ELOVL5 is overexpressed in both primary and castration-resistant prostate cancer. To confirm the role of ELOVL5 activity in prostate carcinogenesis, we generated genetically engineered mouse models (GEMM) with deletion of Elovl5, validated by immunohistochemistry, in combination with the overexpression of c-Myc, an oncogene known to affect lipid metabolism in cancer cells. As expected, we observed alterations in the lipid profile of the murine prostate with the partial deletion of Elovl5, as determined by a significant reduction in levels of phosphatidylcholine (PC) and phosphatidylethanolamine (PE) with long-chain fatty acids (22 carbons) and increased levels of PE with short-chain fatty acids (14 carbons), suggesting an overall shortening on acyl chains of the most common phospholipid species. Interestingly, we also observed that the heterozygous deletion of Elovl5 reduced the expression levels of the AR on the anterior lobe of the murine prostate, in comparison to tissue from Elovl5 wild type mice. Preliminary data also indicates a modulation in prostate volume when Elovl5 is genetically deleted in comparison to tissue from wild type mice. Heterozygous Elovl5 deletion did not affect healthy tissue.To explore biological effects, we generated a 3D organoid line derived from the prostate of mice with homozygous deletion of Elovl5 and overexpression of c-Myc. We found that Elovl5 knock-out decreased organoid diameter and proliferation of c-Myc-driven cells compared to Elovl5 WT. This effect was potentiated when organoids were treated with Enzalutamide, suggesting that targeting Elovl5 may sensitize prostate cells to anti-androgen therapy.Our findings suggest lipid elongation via ELOVL5 as a potential therapeutic target for PCa.
Citation Format: Silvia D. Rodrigues, Caroline Ribeiro, Isadora Teixeira, Hubert Pakula, Giuseppe N. Fanelli, Fabio Socciarelli, Lisa Butler, Johannes Swinnen, Massimo Loda. ELOVL5 affects prostate cancer cell proliferation and modulates the AR pathway. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6039.
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Affiliation(s)
| | | | | | | | | | | | - Lisa Butler
- 3University of Adelaide, Adelaide, Australia
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7
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Scheinberg T, Mak B, Butler L, Selth L, Horvath LG. Targeting lipid metabolism in metastatic prostate cancer. Ther Adv Med Oncol 2023; 15:17588359231152839. [PMID: 36743527 PMCID: PMC9893394 DOI: 10.1177/17588359231152839] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 08/25/2022] [Accepted: 01/05/2023] [Indexed: 02/04/2023] Open
Abstract
Despite key advances in the treatment of prostate cancer (PCa), a proportion of men have de novo resistance, and all will develop resistance to current therapeutics over time. Aberrant lipid metabolism has long been associated with prostate carcinogenesis and progression, but more recently there has been an explosion of preclinical and clinical data which is informing new clinical trials. This review explores the epidemiological links between obesity and metabolic syndrome and PCa, the evidence for altered circulating lipids in PCa and their potential role as biomarkers, as well as novel therapeutic strategies for targeting lipids in men with PCa, including therapies widely used in cardiovascular disease such as statins, metformin and lifestyle modification, as well as novel targeted agents such as sphingosine kinase inhibitors, DES1 inhibitors and agents targeting FASN and beta oxidation.
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Affiliation(s)
- Tahlia Scheinberg
- Medical Oncology, Chris O’Brien Lifehouse, Camperdown NSW, Australia,Advanced Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia,University of Sydney, Camperdown, NSW, Australia
| | - Blossom Mak
- Medical Oncology, Chris O’Brien Lifehouse, Camperdown NSW, Australia,Advanced Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia,University of Sydney, Camperdown, NSW, Australia
| | - Lisa Butler
- Prostate Cancer Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia,South Australian Immunogenomics Cancer Institute and Freemason’s Centre for Male Health and Wellbeing, University of Adelaide, South Australia, Australia
| | - Luke Selth
- South Australian Immunogenomics Cancer Institute and Freemason’s Centre for Male Health and Wellbeing, University of Adelaide, South Australia, Australia,Dame Roma Mitchell Cancer Research Labs, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia,Flinders Health and Medical Research Institute, Flinders University, College of Medicine and Public Health, Bedford Park, Australia
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Loiselle AR, Thibau IJC, Guadalupe M, Butler L, Begolka WS. 315 A patient survey to identify atopic dermatitis prescription treatment access barriers. Br J Dermatol 2023. [DOI: 10.1093/bjd/ljac140.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Abstract
Atopic dermatitis (AD) is the most prevalent form of eczema and is a chronic disease with a relapsing-remitting nature. Multiple treatment options exist, yet little is known about patients’ ability to obtain recommended prescription treatments. The aim of this web-based survey was to ascertain the frequency, causes and patient impact of insurance delays and denials for AD prescription treatments. Adult AD patients (18 + years) or caregivers of pediatric AD patients were recruited to complete a survey about experiences with prescription treatment access in the last 12 months. Responses from 1234 AD patients (42.0 ± 16.7 years) and 248 caregivers (8.5 ± 4.7 years) were included in the analysis; 55.4% (n = 680) reported moderate or severe AD. Overall, there were 789 insurance delays or denials for AD prescriptions, with 37.0% (457/1234) of respondents experiencing at least one in the past 12 months. Overall, the majority of delays/denials were for topical steroids (38.3%; 302/789), which is likely due to the high number of patients using one or more topical steroid prescriptions (82.5%; 1018/1234). However, the highest individual drug class burden was on biologics, for which 38.7% of all prescriptions (122/315) faced a delay or denial. Coverage denials were caused primarily by step therapy (25.5%), and delays by prior authorization (61.1%), and only 62.0% of respondents said they would know what to do if they faced an issue getting a prescription covered by their insurer. Patient-reported impacts of prescription denials and delays included: AD flares (85.0%; n = 255), needing alternate medications (72.3%; n = 217), emergency care (49.0%; n = 147) and giving up on treatment altogether (59.0%; n = 177). Patients with AD and their families frequently experience issues obtaining recommended therapies which can result in detrimental health and quality of life impacts. As many as one-third of patients may not know how to respond if their prescriptions are met with insurance delays or denials, further exacerbating those impacts. These data may help identify strategies to improve timely and beneficial therapeutic access.
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Affiliation(s)
| | | | | | - Lisa Butler
- National Eczema Association , Novato, CA , USA
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Bacci ED, Correll J, Pierce EJ, DeLozier AM, Rueda MJ, Begolka WS, Butler L. 33639 Symptomatic burden and treatment needs in adult atopic dermatitis. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.859] [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: 10/14/2022]
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Elsawi R, Drucker A, Dainty K, Wu W, Butler L, Capozza K, Eftekhari S, Tullos KT, Begolka WS. 33184 The variable burden and impact of atopic dermatitis: A multi-method analysis of the More Than Skin Deep survey. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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McMahon DE, Chemtai L, Grant M, Singh R, Semeere A, Byakwaga H, Laker-Oketta M, Maurer T, Busakhala N, Martin J, Bassett IV, Butler L, Freeman EE. Understanding Diagnostic Delays for Kaposi Sarcoma in Kenya: A Qualitative Study. J Acquir Immune Defic Syndr 2022; 90:494-503. [PMID: 35499523 PMCID: PMC9283252 DOI: 10.1097/qai.0000000000003011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although HIV-associated Kaposi sarcoma (KS) is frequently diagnosed at an advanced stage in sub-Saharan Africa, reasons for diagnostic delays have not been well described. METHODS We enrolled patients >18 years with newly diagnosed KS between 2016 and 2019 into the parent study, based in western Kenya. We then purposively selected 30 participants with diversity of disease severity and geographic locations to participate in semistructured interviews. We used 2 behavioral models in developing the codebook for this analysis: situated Information, Motivation, and Behavior framework and Andersen model of total patient delay. We then analyzed the interviews using framework analysis. RESULTS The most common patient factors that delayed diagnosis were lack of KS awareness, seeking traditional treatments, lack of personal efficacy, lack of social support, and fear of cancer, skin biopsy, amputation, and HIV diagnosis. Health system factors that delayed diagnosis included previous negative health care interactions, incorrect diagnoses, lack of physical examination, delayed referral, and lack of tissue biopsy availability. Financial constraints were prominent barriers for patients to access and receive care. Facilitators for diagnosis included being part of an HIV care network, living near health facilities, trust in the health care system, desire to treat painful or disfiguring lesions, and social support. CONCLUSIONS Lack of KS awareness among patients and providers, stigma surrounding diagnoses, and health system referral delays were barriers in reaching KS diagnosis. Improved public health campaigns, increased availability of biopsy and pathology facilities, and health provider training about KS are needed to improve early diagnosis of KS.
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Affiliation(s)
- Devon E McMahon
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | | | - Rhea Singh
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Virginia Commonwealth University School of Medicine, Richmond, VA
| | | | | | | | - Toby Maurer
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN
| | | | | | - Ingrid V Bassett
- Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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McMahon DE, Singh R, Chemtai L, Semeere A, Byakwaga H, Grant M, Laker-Oketta M, Lagat C, Collier S, Maurer T, Martin J, Bassett IV, Butler L, Kiprono S, Busakhala N, Freeman EE. Barriers and facilitators to chemotherapy initiation and adherence for patients with HIV-associated Kaposi’s sarcoma in Kenya: a qualitative study. Infect Agent Cancer 2022; 17:37. [PMID: 35794634 PMCID: PMC9258164 DOI: 10.1186/s13027-022-00444-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
Background Kaposi sarcoma is one of the most prevalent HIV-associated malignancies in sub-Saharan Africa and is often diagnosed at advanced stage of disease. Only 50% of KS patients who qualify for chemotherapy receive it and adherence is sub-optimal. Methods 57 patients > 18 years with newly diagnosed KS within the AMPATH clinic network in Western Kenya were purposively selected to participate in semi-structured interviews stratified by whether they had completed, partially completed, or not completed chemotherapy for advanced stage KS. We based the interview guide and coding framework on the situated Information, Motivation, Behavioral Skills (sIMB) framework, in which the core patient centered IMB constructs are situated into the socioecological context of receiving care. Results Of the 57 participants, the median age was 37 (IQR 32–41) and the majority were male (68%). Notable barriers to chemotherapy initiation and adherence included lack of financial means, difficulty with convenience of appointments such as distance to facility, appointment times, long lines, limited appointments, intrapersonal barriers such as fear or hopelessness, and lack of proper or sufficient information about chemotherapy. Factors that facilitated chemotherapy initiation and adherence included health literacy, motivation to treat symptoms, improvement on chemotherapy, prioritization of self-care, resilience while experiencing side effects, ability to carry out behavioral skills, obtaining national health insurance, and free chemotherapy. Conclusion Our findings about the barriers and facilitators to chemotherapy initiation and adherence for KS in Western Kenya support further work that promotes public health campaigns with reliable cancer and chemotherapy information, improves education about the chemotherapy process and side effects, increases oncology service ability, supports enrollment in national health insurance, and increases incorporation of chronic disease care into existing HIV treatment networks.
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Collier S, Singh R, Semeere A, Byakwaga H, Laker‐Oketta M, McMahon DE, Chemtai L, Grant M, Butler L, Bogart L, Bassett IV, Kiprono S, Maurer T, Martin J, Busakhala N, Freeman EE. Telling the story of intersectional stigma in HIV-associated Kaposi's sarcoma in western Kenya: a convergent mixed-methods approach. J Int AIDS Soc 2022; 25 Suppl 1:e25918. [PMID: 35818882 PMCID: PMC9274375 DOI: 10.1002/jia2.25918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/28/2022] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The experience of stigma can be multifaceted for people with HIV and cancer. Kaposi's sarcoma (KS), one of the most common HIV-associated cancers in sub-Saharan Africa, often presents with visible skin lesions that may put people at risk for stigmatization. In this way, HIV-associated KS is unique, as people with KS can experience stigma associated with HIV, cancer, and skin disease simultaneously. The aim of this study is to characterize the intersectionality of HIV-related, cancer-related and skin disease-related stigma in people living with HIV and KS. METHODS We used a convergent mixed-methods approach nested within a longitudinal study of people with HIV-associated KS in western Kenya. Between February 2019 and December 2020, we collected quantitative surveys among all participants and conducted semi-structured interviews among a purposive sample of participants. Quantitative surveys were adapted from the abridged Berger HIV Stigma Scale to assess overall stigma, HIV-related stigma, cancer-related stigma, and skin disease-related stigma. Qualitative data were coded using stigma constructs from the Health Stigma and Discrimination Framework. RESULTS In 88 semi-structured interviews, stigma was a major barrier to KS diagnosis and treatment among people with HIV-associated KS. Participant's stories of stigma were dominated by HIV-related stigma, more than cancer-related or skin disease-related stigma. However, quantitative stigma scores among the 117 participants were similar for HIV-related (Median: 28.00; IQR: 28.0, 34.0), cancer-related (Median: 28.0; IQR: 28.0, 34.8), and skin disease-related stigma (Median: 28.0; IQR: 27.0, 34.0). In semi-structured interviews, cancer-related and skin disease-related stigma were more subtle contributors; cancer-related stigma was linked to fatalism and skin-related stigma was linked to visible disease. Participants reported resolution of skin lesions contributed to lessening stigma over time; there was a significant decline in quantitative scores of overall stigma in time since KS diagnosis (adjusted β = -0.15, p <0.001). CONCLUSIONS This study highlights the role mixed-method approaches can play in better understanding stigma in people living with both HIV and cancer. While HIV-related stigma may dominate perceptions of stigma among people with KS in Kenya, intersectional experiences of stigma may be subtle, and quantitative evaluation alone may be insufficient to understand intersectional stigma in certain contexts.
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Affiliation(s)
- Sigrid Collier
- Division of DermatologyUniversity of WashingtonSeattleWashingtonUSA
| | - Rhea Singh
- Virginia Commonwealth University School of MedicineRichmondVirginiaUSA
- Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Aggrey Semeere
- Infectious Disease InstituteMakerere UniversityKampalaUganda
| | - Helen Byakwaga
- Infectious Disease InstituteMakerere UniversityKampalaUganda
| | | | - Devon E. McMahon
- Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Linda Chemtai
- Academic Model Providing Access to HealthcareEldoretKenya
| | - Merridy Grant
- Centre for Rural HealthUniversity of KwaZulu‐NatalDurbanSouth Africa
| | - Lisa Butler
- Institute for Collaboration on HealthIntervention and PolicyUniversity of ConnecticutStorrsConnecticutUSA
| | | | - Ingrid V. Bassett
- Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Samson Kiprono
- Academic Model Providing Access to HealthcareEldoretKenya
- Department of Internal Medicine, School of MedicineCollege of Health SciencesMoi UniversityEldoretKenya
| | - Toby Maurer
- Department of DermatologyIndiana UniversityIndianapolisIndianaUSA
| | - Jeffrey Martin
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Naftali Busakhala
- Academic Model Providing Access to HealthcareEldoretKenya
- Department of Pharmacology and Toxicology, School of MedicineCollege of Health SciencesMoi UniversityEldoretKenya
| | - Esther E. Freeman
- Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
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Elsawi R, Dainty K, Smith Begolka W, Barta K, Butler L, Capozza K, Eftekhari S, Tullos KZ, Wu W, Drucker AM. The Multidimensional Burden of Atopic Dermatitis Among Adults: Results From a Large National Survey. JAMA Dermatol 2022; 158:887-892. [PMID: 35767267 PMCID: PMC9244770 DOI: 10.1001/jamadermatol.2022.1906] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Atopic dermatitis (AD) is long term and burdensome. Studies investigating disease burden in adults are limited in scope with gaps in understanding of the adult patient lived experience. Objective To describe the multidimensional burden of AD among mainly US adults. Design, Setting, and Participants This survey study for an externally led patient-focused drug development meeting with the US Food and Drug Administration on adult patients with AD was conducted between August 1, 2019, and October 11, 2019. Data were analyzed betwean March 26, 2021, and June 29, 2021. Main Outcomes and Measures We used multivariable ordinal regression to assess associations between demographic and clinical variables and patient-reported overall AD impact scores (ordinal scale from 1 [no impact] to 5 [significant impact]). Results Among 1065 survey respondents, 114 (11%) were aged 18 to 24 years, 235 (22%) were 25 to 34 years, 242 (23%) were 35 to 50 years, 288 (27%) were 51 to 64 years, and 186 (17%) were aged 65 years or older; 881 (83%) were women. Four hundred eighty-nine (46%) participants reported low-moderate AD impact scores (2-3), 544 (51%) reported high-significant impact scores (4-5), whereas 32 (3%) reported no association of AD with disease burden (impact score, 1). Variables strongly associated with overall impact scores were current AD severity (moderate: OR, 4.13; 95% CI, 2.94-5.79; severe: OR, 13.63; 95% CI, 8.65-21.50 vs mild), and time spent managing AD (11-20 hours: OR, 2.67; 95% CI, 1.77-4.03, ≥21 hours: OR, 5.34; 95% CI, 3.22-8.85, vs <5 hours). Conclusions and Relevance In this survey study, AD severity and time spent managing symptoms showed the strongest associations with disease burden. This analysis highlights the multidimensional burden of AD in adults and emphasizes the need for more effective treatment strategies that reduce the time patients spend managing their AD.
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Affiliation(s)
- Rawaan Elsawi
- Temerty Faculty of Medicine, University of Toronto and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Katie Dainty
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,North York General Hospital, North York, Ontario, Canada
| | | | | | - Lisa Butler
- National Eczema Association, Novato, California
| | - Korey Capozza
- Global Parents for Eczema Research, Santa Barbara, California
| | - Sanaz Eftekhari
- Asthma and Allergy Foundation of America, Arlington, Virginia
| | - Kathryn Z Tullos
- International Topical Steroid Awareness Network, Dacula, Georgia
| | - Wei Wu
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Aaron M Drucker
- Temerty Faculty of Medicine, University of Toronto and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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15
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Russell L, Butler L, Lovegrove C, Owens C, Roberts L, Yates P, Carrick R, Amoako A, Price C. Developing a multidisciplinary pathway for functional neurological disorders in a UK National Health Service: The Exeter model. ACNR 2022. [DOI: 10.47795/kazj3546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Functional neurological disorders remain common presentations to both outpatient and inpatient NHS services, but little consensus exists with respect to how such services and clinical pathways for patients should be structured and should function. This article sets out a model for an integrated multidisciplinary approach that takes full account of the number of specialties involved, constraint on resources and time involved, and that has functioned well in the NHS despite a pandemic.
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16
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Strach MC, Yeung N, Lin HM, Ansari N, Koh C, Shin JS, Kench J, Centenera M, Butler L, Horvath L, Mahon K. Patient-derived explant model of appendiceal cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.4160] [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: 11/20/2022] Open
Abstract
4160 Background: Appendiceal cancers (AC) are rare with 5-year survival of 15% for high grade (HG) adenocarcinomas and 75% for low grade (LG) mucinous neoplasms. There is limited literature on the AC tumour microenvironment (TME) in disease progression and drug resistance. Ex vivo cultures, such as patient derived explants (PDEs), have been used for other solid tumours to test anticancer agents, explore the TME, and are being developed as personalised models. The aim of our study was to develop a PDE model of AC, preserve the TME, study the biological profile of AC and test novel therapies. Methods: Fresh tissue was collected during cytoreductive surgery (CRS) from consenting patients with AC with peritoneal disease, Jul 2020-Mar 2021. Tissues from 10 patients were dissected and cultured as PDEs under varying conditions of tissue size, media, matrix support and duration (Table). Uncultured Day 0 tissues and PDEs were fixed in formalin prior to paraffin embedding (FFPE). Immunohistochemical staining was performed on sections of FFPE tissue to assess viability with antibodies against the tumour marker, Cytokeratin-20 (CK20), and cell death marker, cleaved caspase 3 (CC3). Tissue architecture was rated on a 4-point scale (MS, J-SS). Cancer cells were counted in 6 Day 0 samples and PDEs from 3 patients using QuPath v0.3.2. Apoptotic index (AI) was calculated as the proportion of cells positive for CC3 divided by the number of total CK20 positive cells. Results: The mean proportion of tumour and mucin in the tissues was 3% (0-60%) and 39% (0-95%) respectively. Day 0 samples were viable with mean AI of cancer cells 7% (0-4%). Tissue architecture was maintained, as compared to Day 0 control, for varying sizes of PDE and culture durations up to 4d. More small or medium-sized PDEs had improved architecture compared to large sized PDEs (Table). PDEs at 4d had poorer architecture compared to at 1-3d. There was improved architecture in PDEs using enriched media with support factors compared to base media, and in specimens with matrix support compared to none. The mean AI of PDE cancer cells was 21% (0-92%) and 51% of PDEs had no cancer cell death. Conclusions: This is the first study demonstrating that AC tissue is amenable to ex vivo culture as PDEs. The optimal PDE model was <10mm tissue placed on a gelatine sponge in enriched media for 1-3d. PDEs had preserved tissue architecture and viability compared to uncultured tissue. Protein expression was in keeping with the original tumour. We plan to use this model to test anticancer agents and explore the TME of AC.[Table: see text]
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Affiliation(s)
| | - Nicole Yeung
- Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Hui-Ming Lin
- Garvan Institute of Medical Research, Sydney, NSW, Australia
| | | | - Cherry Koh
- Royal Prince Alfred Hospital, Sydney, Australia
| | | | - James Kench
- Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Lisa Butler
- University of Adelaide Medical School, Adelaide, Australia
| | | | - Kate Mahon
- Chris O'Brien Lifehouse, Sydney, Australia
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17
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Pizzol D, Shin JI, Trott M, Ilie PC, Ippoliti S, Carrie AM, Ghayda RA, Lozano JMO, Muyor JM, Butler L, McDermott DT, Barnett Y, Markovic L, Grabovac I, Koyanagi A, Soysal P, Tully MA, Veronese N, Smith L. Social environmental impact of COVID-19 and erectile dysfunction: an explorative review. J Endocrinol Invest 2022; 45:483-487. [PMID: 34559402 PMCID: PMC8461150 DOI: 10.1007/s40618-021-01679-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/15/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND To date, no attempt has been made to collate literature on the relationship between the social environmental impact of COVID-19 and erectile dysfunction. The aim of this explorative review was to assess and compare the prevalence of erectile dysfunction (ED) in male healthcare workers and males during the COVID-19 pandemic. METHODS A systematic review of major databases from inception to February 2021 was conducted. Prevalence data were extracted, and a random-effects meta-analysis was undertaken. OUTCOMES The pooled prevalence of ED amongst healthcare workers working in COVID-19 specific environments, and non-healthcare during the COVID-19 pandemic. RESULTS Of 52 initial studies, six were included for the final analysis. The pooled prevalence of ED in healthcare workers working in a COVID-19 environment was 63.6% (95% CI 20.3-92.3%), and in non-healthcare workers during the COVID-19 pandemic was 31.9% (95% CI 19.5-47.6%). CONCLUSION The prevalence of ED in healthcare workers working in COVID-19 environments was higher than representative samples and is of concern. Sexual health (and by extension, overall health), should be a priority when considering ways to care for this population. Considering the social environmental impact of COVID-19 on sexual health and in particular on ED, it is important to provide adequate psychological support systems and to promote quality of life with particular attention to sexual health.
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Affiliation(s)
- D Pizzol
- Italian Agency for Development Cooperation, 33 Street, Amarat, Khartoum, Sudan.
| | - J I Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - M Trott
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - P-C Ilie
- Urology Department, The Queen Elizabeth Hospital King's Lynn, King's Lynn, UK
| | - S Ippoliti
- Urology Department, The Queen Elizabeth Hospital King's Lynn, King's Lynn, UK
| | - A M Carrie
- Urology Department, The Queen Elizabeth Hospital King's Lynn, King's Lynn, UK
| | - R A Ghayda
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - J M O Lozano
- Health Research Centre, University Almeria, Almeria, Spain
| | - J M Muyor
- Health Research Centre, University Almeria, Almeria, Spain
| | - L Butler
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - D T McDermott
- NTU Psychology, School of Social Science, Nottingham Trent University, Nottingham, UK
| | - Y Barnett
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - L Markovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
| | - P Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - M A Tully
- School of Health Sciences, Institute of Nursing and Health Research, Jordans Town, Northern Ireland, UK
| | - N Veronese
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - L Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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18
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Mak B, Lin HM, Mahon KL, Joshua AM, Stockler MR, Gurney H, Parnis F, Zhang AY, Scheinberg T, Wittert G, Butler L, Hoy A, Meikle P, Horvath L. Modulation of the plasma lipidomic profile with simvastatin in metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.154] [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: 11/20/2022] Open
Abstract
154 Background: Elevated circulating sphingolipids are associated with poorer outcomes across the natural history of prostate cancer (PC), including metastatic relapse in localised PC, earlier androgen deprivation failure in metastatic hormone-sensitive PC, and shorter overall survival (OS) in mCRPC. We have derived and validated a poor prognostic 3-lipid signature (3LS) [consisting of ceramide Cer(d18:1/24:1), sphingomyelin SM(d18:2/16:0) and phosphatidylcholine PC(16:0/16:0)], which was independently associated with shorter radiographic progression-free survival (rPFS) and OS in men with mCRPC commencing taxanes or androgen receptor signaling inhibitors (ARSI). Statins significantly reduce plasma levels of ceramides, sphingomyelin and cholesterol in cardiovascular disease. We hypothesised that this therapy could change the poor prognostic lipid profile of patients with mCRPC. This study assessed whether the addition of simvastatin to standard treatment for mCRPC modulates the circulating lipidomic profile. Methods: This investigator-initiated, multi-centre, single arm, pilot study enrolled men with mCRPC commencing taxanes or ARSI for disease progression, who were not on a lipid-lowering agent. Men were treated with simvastatin 40mg orally once daily for 12 weeks, commencing on day 1 of treatment for mCRPC. Plasma was taken at baseline and after 12 weeks of simvastatin, and underwent lipidomic profiling of ̃800 lipids. Differences in lipid levels between baseline and post-simvastatin samples and between those with and without the 3LS were assessed using t-tests. Results: 27 men (74% on taxanes, 26% on ARSI) were recruited between May 2018 to March 2021. 46% of the men had the poor prognostic 3LS at baseline, of whom 45% lost the 3LS after simvastatin. Comparison between all paired baseline and post-simvastatin samples showed significant reduction (p < 0.05) in free cholesterol, cholesteryl esters and some sphingolipids (sphingomyelins, hexosylceramides) with simvastatin treatment. Baseline profiles with the 3LS displayed significantly higher levels (p < 0.05) of ceramides, hexosylceramides and sphingomyelins, relative to baseline profiles without the 3LS. Men who lost the 3LS after treatment (n = 5) demonstrated significant reductions in ceramides (23-45%, p≤0.046), hexosylceramides (27-52%, p≤0.049) and sphingomyelins (28-44%, p≤0.047). These changes were not seen in men with persistent 3LS after treatment (n = 6). Conclusions: Simvastatin in addition to standard treatment for mCRPC can modulate the circulating lipidomic profile and eliminate the presence of a poor prognostic 3LS in 45% of participants with the 3LS. Further prospective randomised control studies are required to determine if modulation of the 3LS by simvastatin can improve clinical outcomes. Clinical trial information: ACTRN12617000965303.
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Affiliation(s)
| | - Hui-Ming Lin
- Garvan Institute of Medical Research, Sydney, NSW, Australia
| | | | - Anthony M. Joshua
- Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Martin R. Stockler
- NHMRC Clinical Trials Center, University of Sydney, Sydney, NSW, Australia
| | | | | | | | | | | | - Lisa Butler
- University of Adelaide Medical School, Adelaide, SA, Australia
| | | | - Peter Meikle
- Baker Heart and Diabetes Institute, Melbourne, Australia
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19
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Smith L, López Sánchez GF, Veronese N, Soysal P, Oh H, Barnett Y, Keyes H, Butler L, Allen P, Kostev K, Jacob L, Shin JI, Koyanagi A. Fruit and Vegetable Intake and Non-Communicable Diseases among Adults Aged ≥50 Years in Low- and Middle-Income Countries. J Nutr Health Aging 2022; 26:1003-1009. [PMID: 36437768 DOI: 10.1007/s12603-022-1855-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The relationship between consuming ≥2 servings of fruits and ≥3 servings of vegetables a day, which has been identified as optimal for health (i.e., adequate fruit/vegetable consumption), and non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) is largely unknown. Therefore, using data from six LMICs, we investigated the independent association between inadequate fruit/vegetable consumption and 12 NCDs, and estimated the prevalence of inadequate fruit/vegetable consumption among people with NCDs. DESIGN AND SETTING Cross-sectional, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. PARTICIPANTS Data on 34129 individuals aged ≥50 years were analyzed [mean (SD) age 62.4 (16.0); maximum age 114 years; 52.1% females]. MEASUREMENTS Information on the number of servings of fruits and vegetables consumed on a typical day was self-reported. Twelve NCDs were assessed. Multivariable logistic regression analysis was conducted. RESULTS Overall, 67.2% had inadequate fruit/vegetable consumption. Inadequate fruit/vegetable consumption was independently associated with significantly higher odds for chronic lung disease (OR=1.25), diabetes (OR=1.45), hearing problems (OR=1.75), and visual impairment (OR=2.50). The prevalence of inadequate fruit/vegetable consumption was particularly high among people with visual impairment (92.5%), depression (90.5%), asthma (79.8%), and hearing problems (78.4%). CONCLUSION Promotion of fruit and vegetable consumption (≥2 servings of fruits and ≥3 servings of vegetables a day) in LMICs may lead to prevention of some NCDs (e.g., diabetes, chronic lung disease). Furthermore, people with certain NCDs (e.g., visual impairment, depression) had particularly high prevalence of inadequate fruit/vegetable consumption, and it is thus important to target this population to increase fruit/vegetable consumption.
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Affiliation(s)
- L Smith
- Dr. Guillermo F. López Sánchez, Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain,
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20
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Begolka WS, Butler L, Guadalupe M. The ICER review is in: hope amidst uncertainty. J Manag Care Spec Pharm 2021; 28:115-118. [PMID: 34949117 PMCID: PMC10373011 DOI: 10.18553/jmcp.2022.28.1.115] [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: 11/05/2022]
Abstract
DISCLOSURES: No funding contributed to the writing of this commentary. Smith Begolka, Butler, and Guadalupe are salaried employees of the National Eczema Association, which has received grants and sponsorship awards from a variety of industry partners, including AbbVie, Eli Lilly, Incyte, LEO Pharma, Pfizer, Regeneron, and Sanofi. Smith Begolka has received grant funding from Pfizer and advisory board honoraria from Pfizer and Incyte. Butler and Guadalupe have received advisory board honoraria from Incyte.
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21
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Bacci E, Rentz A, Correll J, Pierce E, DeLozier A, Rueda M, Begolka W, Butler L. Patient-Reported Disease Burden and Unmet Therapeutic Needs in Atopic Dermatitis. J Drugs Dermatol 2021; 20:1222-1230. [PMID: 34784136 DOI: 10.36849/jdd.6329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a common, chronic, relapsing, inflammatory skin disease causing a variety of dermatologic signs and symptoms, affecting patient’s quality of life. While treatment options are available, they are of variable effectiveness. This study sought to characterize patient-reported AD signs and symptoms, flare, and associated bother, by disease severity and control. METHODS Adults diagnosed with AD were recruited through the National Eczema Association (NEA) and clinical sites and completed a web-based survey including the Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD), Recap of Atopic Eczema (RECAP), and Skin Pain numeric rating scale (NRS), as well as questions on previous/current clinical presentation, flare frequency and severity, past/ present AD treatment, and sociodemographic characteristics. RESULTS A total of 186 participants completed the survey (mean age 39.7 years, 80% female). The most frequently reported current AD signs and symptoms included dryness, itch, redness, roughness, and flaking skin, and the most bothersome were itch, dryness, and redness (63%). The majority of participants (84%) were either currently experiencing a flare or had experienced one within the past month. The most common signs and symptoms that grew worse during the most recent flare were itch and redness across all disease severity groups. Participants most often experienced one to three flares in the last three months. Flare frequency, duration, and average severity increased with greater disease severity and lack of disease control. CONCLUSIONS The results of this study demonstrate the diverse and considerable symptomatic burden experienced by people with AD, even while being treated for AD. J Drugs Dermatol. 2021;20(11):1222-1230. doi:10.36849/JDD.6329.
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22
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Esposito A, Patti L, Laumbach S, Polvino D, Butler L, Heinert S. 92 The Impact of the COVID-19 Pandemic on Medical Student Residency Specialty Selection. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.07.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Allen JA, Butler L, Levine T, Haudrich A. Correction to: A Global Survey of Disease Burden in Patients Who Carry a Diagnosis of Chronic Inflammatory Demyelinating Polyneuropathy. Adv Ther 2021; 38:1364-1367. [PMID: 33439475 PMCID: PMC7889557 DOI: 10.1007/s12325-020-01586-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jeffrey A Allen
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA.
| | - Lisa Butler
- GBS/CIDP Foundation International, Conshohocken, PA, USA
| | - Todd Levine
- Phoenix Neurological Associates, Phoenix, AZ, USA
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Allen JA, Butler L, Levine T, Haudrich A. A Global Survey of Disease Burden in Patients Who Carry a Diagnosis of Chronic Inflammatory Demyelinating Polyneuropathy. Adv Ther 2021; 38:316-328. [PMID: 33113101 PMCID: PMC7854453 DOI: 10.1007/s12325-020-01540-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/15/2020] [Indexed: 01/24/2023]
Abstract
Introduction The extent to which work productivity, emotional well-being, social interactions, and family life are impacted in patients who self-identify as having chronic inflammatory demyelinating polyneuropathy (CIDP) is not well characterized. Methods Data from an online survey of 595 individuals with self-reported CIDP, recruited by the Guillain–Barré syndrome (GBS)/CIDP Foundation, were used to assess disease and treatment burden. A total of 37% of patients were classified as “likely”, 34% as “somewhat likely”, and 28% as “unlikely” CIDP. Results Of ten symptoms that patients with CIDP may experience, each symptom was experienced by 77–94% of “likely”, 79–96% of “somewhat likely”, and 66–91% of “unlikely” patients. In “likely” CIDP patients 44% stopped working because of their symptoms and 24% moved to a new home. The most common treatments were intravenous immunoglobulin (IVIg) infusion and corticosteroids. IVIg was associated with venous access issues and work/school absenteeism. Conclusions CIDP diagnostic confirmation was not performed in any of the survey respondents. Our results do not add any knowledge on the diagnosis or treatment of CIDP. Our findings do provide insight into the symptoms that patients that think they have CIDP or have been told they have CIDP experience, explores how patients that are labeled as having CIDP view treatment expectations, and highlights how these symptoms affect home and work life. We hope that the findings are constructively used to get patients the services they need to improve quality of life, maintain employment, and ensure a safe home environment regardless of diagnostic accuracy.
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Nardell MF, Lee YS, Rousseau E, Julies R, Klaas P, Vundhla P, Butler L, Bassett IV, Mellins CA, Bekker LG, Katz IT. "You are not alone": a qualitative study to explore barriers to ART initiation and implications for a proposed community-based youth treatment club among young adults newly diagnosed with HIV in South Africa. AIDS Care 2020; 33:952-961. [PMID: 33345593 DOI: 10.1080/09540121.2020.1861179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In South Africa, despite universal antiretroviral therapy (ART) availability, 60% of persons living with HIV (PLWH) ages 15-24 are not on treatment. This qualitative study aimed to identify barriers to ART initiation and the implications for a proposed community-based Youth Treatment Club to improve ART initiation for young PLWH in limited-resource, high HIV-prevalence communities in Cape Town, South Africa. Recruiting participants at community testing sites from 2018 to 2019, we conducted semi-structured interviews, informed by Social Action Theory (SAT), with 20 young adults, ages 18- to 24-years-old, newly diagnosed with HIV, along with 10 healthcare providers. Through systematic qualitative analysis, we found that young PLWH face barriers to treatment initiation in three SAT domains: (1) stigmatizing social norms (social regulation processes); (2) challenges coping with a new diagnosis (self-regulation processes); and (3) anticipated stigma in the clinic environment (contextual factors). Participants shared that a proposed community-based Youth Treatment Club for newly diagnosed youth would be an acceptable strategy to promote ART initiation. They emphasized that it should include supportive peers, trained facilitator support for counseling and education, and a youth-friendly environment.
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Affiliation(s)
- Maria F Nardell
- Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Yeonsoo Sara Lee
- Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Elzette Rousseau
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Robin Julies
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Portia Klaas
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Prisca Vundhla
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa
| | - Lisa Butler
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA
| | - Ingrid V Bassett
- Harvard Medical School, Boston, MA, USA.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Linda-Gail Bekker
- The Desmond Tutu Health Foundation, University of Cape Town, Cape Town, Republic of South Africa.,Institute of Infectious Disease and Molecular Medicine, Department of Medicine, University of Cape Town, Cape Town, Republic of South Africa.,Governing Council, International AIDS Society, Geneva, Switzerland
| | - Ingrid T Katz
- Harvard Medical School, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Global Health Institute, Harvard University, Cambridge, MA, USA
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Rohaim MA, Clayton E, Sahin I, Vilela J, Khalifa ME, Al-Natour MQ, Bayoumi M, Poirier AC, Branavan M, Tharmakulasingam M, Chaudhry NS, Sodi R, Brown A, Burkhart P, Hacking W, Botham J, Boyce J, Wilkinson H, Williams C, Whittingham-Dowd J, Shaw E, Hodges M, Butler L, Bates MD, La Ragione R, Balachandran W, Fernando A, Munir M. Artificial Intelligence-Assisted Loop Mediated Isothermal Amplification (AI-LAMP) for Rapid Detection of SARS-CoV-2. Viruses 2020; 12:v12090972. [PMID: 32883050 PMCID: PMC7552048 DOI: 10.3390/v12090972] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 01/13/2023] Open
Abstract
Until vaccines and effective therapeutics become available, the practical solution to transit safely out of the current coronavirus disease 19 (CoVID-19) lockdown may include the implementation of an effective testing, tracing and tracking system. However, this requires a reliable and clinically validated diagnostic platform for the sensitive and specific identification of SARS-CoV-2. Here, we report on the development of a de novo, high-resolution and comparative genomics guided reverse-transcribed loop-mediated isothermal amplification (LAMP) assay. To further enhance the assay performance and to remove any subjectivity associated with operator interpretation of results, we engineered a novel hand-held smart diagnostic device. The robust diagnostic device was further furnished with automated image acquisition and processing algorithms and the collated data was processed through artificial intelligence (AI) pipelines to further reduce the assay run time and the subjectivity of the colorimetric LAMP detection. This advanced AI algorithm-implemented LAMP (ai-LAMP) assay, targeting the RNA-dependent RNA polymerase gene, showed high analytical sensitivity and specificity for SARS-CoV-2. A total of ~200 coronavirus disease (CoVID-19)-suspected NHS patient samples were tested using the platform and it was shown to be reliable, highly specific and significantly more sensitive than the current gold standard qRT-PCR. Therefore, this system could provide an efficient and cost-effective platform to detect SARS-CoV-2 in resource-limited laboratories.
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Affiliation(s)
- Mohammed A. Rohaim
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Emily Clayton
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Irem Sahin
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Julianne Vilela
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Manar E. Khalifa
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Mohammad Q. Al-Natour
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Mahmoud Bayoumi
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Aurore C. Poirier
- Department of Pathology and Infectious Diseases, School of Veterinary Medicine, University of Surrey, Guildford GU2 7AL, UK; (A.C.P.); (R.L.R.)
| | - Manoharanehru Branavan
- College of Engineering, Design and Physical Sciences, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK; (M.B.); (W.B.)
| | - Mukunthan Tharmakulasingam
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford GU2 7XH, UK; (M.T.); (N.S.C.); (A.F.)
| | - Nouman S. Chaudhry
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford GU2 7XH, UK; (M.T.); (N.S.C.); (A.F.)
| | - Ravinder Sodi
- Department of Biochemistry, Poole & Bournemouth Hospitals NHS Trust, Longfleet Road, Poole BH15 2JB, UK;
| | - Amy Brown
- The Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS, Foundation Trust, Kendal LA9 7RG, UK; (A.B.); (P.B.); (W.H.); (J.B.); (J.B.); (H.W.); (C.W.)
| | - Peter Burkhart
- The Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS, Foundation Trust, Kendal LA9 7RG, UK; (A.B.); (P.B.); (W.H.); (J.B.); (J.B.); (H.W.); (C.W.)
| | - Wendy Hacking
- The Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS, Foundation Trust, Kendal LA9 7RG, UK; (A.B.); (P.B.); (W.H.); (J.B.); (J.B.); (H.W.); (C.W.)
| | - Judy Botham
- The Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS, Foundation Trust, Kendal LA9 7RG, UK; (A.B.); (P.B.); (W.H.); (J.B.); (J.B.); (H.W.); (C.W.)
| | - Joe Boyce
- The Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS, Foundation Trust, Kendal LA9 7RG, UK; (A.B.); (P.B.); (W.H.); (J.B.); (J.B.); (H.W.); (C.W.)
| | - Hayley Wilkinson
- The Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS, Foundation Trust, Kendal LA9 7RG, UK; (A.B.); (P.B.); (W.H.); (J.B.); (J.B.); (H.W.); (C.W.)
| | - Craig Williams
- The Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS, Foundation Trust, Kendal LA9 7RG, UK; (A.B.); (P.B.); (W.H.); (J.B.); (J.B.); (H.W.); (C.W.)
| | - Jayde Whittingham-Dowd
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Elisabeth Shaw
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Matt Hodges
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Lisa Butler
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Michelle D. Bates
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
| | - Roberto La Ragione
- Department of Pathology and Infectious Diseases, School of Veterinary Medicine, University of Surrey, Guildford GU2 7AL, UK; (A.C.P.); (R.L.R.)
| | - Wamadeva Balachandran
- College of Engineering, Design and Physical Sciences, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK; (M.B.); (W.B.)
| | - Anil Fernando
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford GU2 7XH, UK; (M.T.); (N.S.C.); (A.F.)
| | - Muhammad Munir
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, The Lancaster University, Lancaster LA1 4YW, UK; (M.A.R.); (E.C.); (I.S.); (J.V.); (M.E.K.); (M.Q.A.-N.); (M.B.); (J.W.-D.); (E.S.); (M.H.); (L.B.); (M.D.B.)
- Correspondence:
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Horvath LG, Lin HM, Mak B, Mahon K, Yeung N, Docanto M, Sutherland P, Shepherd A, Tan W, Azad A, Kohli M, Meikle P, Butler L. Abstract 4761: Lipidomic analysis of circulating lipids across the natural history of prostate cancer identifies aberrant ceramide metabolism. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-4761] [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: Obesity is a well established risk factor not only for increased prostate cancer incidence, but for poorer survival from prostate cancer. However, there is limited knowledge on the role of the circulating lipidome in prostate cancer. In order to target lipid metabolism optimally, it is critical to understand the spectrum of changes in circulating lipid profiles and the association with clinical outcome across the natural history of prostate cancer.
Aim: To assess the relationship between the plasma lipidome and clinical outcome in localized and metastatic prostate cancer.
Methods: Liquid chromatography-tandem mass spectrometry was used to quantitate over 500 lipid species in plasma samples from 3 cohorts (1) 389 men with localized prostate cancer, (2) 44 men with metastatic hormone-sensitive prostate cancer (mHSPC), and (3) 137 men with metastatic castration-resistant prostate cancer (CRPC). Associations between circulating lipids with metastatic relapse, androgen-deprivation therapy (ADT) failure or overall survival for each relevant disease stage were examined by latent class analysis and cox regression.
Results: Circulating lipid profiles displaying elevated levels of ceramides were associated with metastatic relapse in localized prostate cancer (HR 5.8, 95% CI 3.0-11, P 1 × 10−6), early ADT failure in mHSPC (HR 2.4, 95% CI 1.1-5.3, P 0.03), and shorter overall survival in CRPC (HR 2.5, 95% CI 1.7-3.7, P 2 × 10−6). ADT failure in mHSPC and shorter overall survival in CRPC were also associated with elevated levels of other sphingolipids (sphingomyelins, hexosylceramides). The prognostic significance of the high risk lipid profiles in localized prostate cancer was independent of clinicopathological characteristics (lipid profile HR 4.7, 95%CI 2.4-9.3, P 7 × 10−6) when modeled with Gleason score (P<0.0001) and pathological stage (P<0.0001). Furthermore, the circulating lipid profiles were independent of metabolic factors (localized prostate cancer lipid profile HR 8.2, 95% CI 2.6-25, P 0.0003 when modeled with diabetes, statin, hypertension, body mass index [BMI]; CRPC lipid profile HR 2.6, 95% CI 1.7-3.8, P x10−6 when modeled with BMI).
Conclusion: Elevated circulating ceramides are associated with poorer clinical outcomes across the natural history of prostate cancer (from localized to metastatic hormone-sensitive to metastatic castration resistant prostate cancer). This demonstrates that aberrant lipid metabolism in the patients occurs early in prostate cancer and could be therapeutically targeted in prospective clinical trials to improve prostate cancer outcomes.
Citation Format: Lisa Glen Horvath, Hui-Ming Lin, Blossom Mak, Kate Mahon, Nicole Yeung, Maria Docanto, Peter Sutherland, andrew Shepherd, Winston Tan, Arun Azad, Manish Kohli, Peter Meikle, Lisa Butler. Lipidomic analysis of circulating lipids across the natural history of prostate cancer identifies aberrant ceramide metabolism [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4761.
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Affiliation(s)
| | - Hui-Ming Lin
- 2Garvan Institute for Medical Research, Sydney, Australia
| | | | - Kate Mahon
- 1Chris O'Brien Lifehouse, Sydney, Australia
| | - Nicole Yeung
- 2Garvan Institute for Medical Research, Sydney, Australia
| | | | | | - andrew Shepherd
- 6South Australian Health and Medical Research Institute, Australia
| | | | - Arun Azad
- 8Peter MacCallum Cancer Centre, Australia
| | | | | | - Lisa Butler
- 6South Australian Health and Medical Research Institute, Australia
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Mendenhall R, Henderson L, Scott B, Butler L, Turi KN, Greenlee A, Robinson GE, Roberts BW, Rodriguez-Zas SL, Brooks JE, Lleras CL. Involving Urban Single Low-Income African American Mothers in Genomic Research: Giving Voice to How Place Matters in Health Disparities and Prevention Strategies. Fam Med Prim Care Open Access 2020; 4:148. [PMID: 35373191 PMCID: PMC8970351 DOI: 10.29011/2688-7460.100048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This article describes the process of using principles from community-based participatory action research to involve low-income, single, African American mothers on the south side of Chicago in genomic research, including as citizen scientists. The South Chicago Black Mothers' Resiliency Project used a mixed methods design to investigate how the stress of living in neighborhoods with high levels of violence affects mothers' mental and physical health. This article seeks to serve as a model for physicians and scholars interested in successfully involving low-income African American mothers in genomic research, and other health-related activities in ways that are culturally sensitive and transformative. The lives of Black mothers who struggle under interlocking systems of oppression that are often hidden from view of most Americans are at the center of this article. Therefore, we provide extensive information about the procedures used to collect the various types of data, the rationale for our procedures, the setting, the responses of mothers in our sample and methodological challenges. This study also has implications for the current COVID-19 pandemic and the need to train a corps of citizen scientists in health and wellness to avoid future extreme loss of life such as the 106,195 lives lost in the United States as of June 1, 2020.
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Affiliation(s)
- Ruby Mendenhall
- Department of Sociology, African American Studies & Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, USA
| | - Loren Henderson
- Department of Sociology and Anthropology, University of Maryland, Baltimore County, USA
| | - Barbara Scott
- Department of Sociology, Northeastern Illinois University, USA
| | - Lisa Butler
- Independent Scholar, Northeastern Illinois University, USA
| | - Kedir N Turi
- Department of Medicine, Vanderbilt University, Nashville, USA
| | - Andrew Greenlee
- Urban and Regional Planning, University of Illinois at Urbana-Champaign, USA
| | - Gene E Robinson
- Institute for Genomic Biology, Integrative Biology, University of Illinois at Urbana-Champaign, USA
| | - Brent W Roberts
- Center for Social and Behavioral Science Psychology, University of Illinois at Urbana-Champaign, USA
| | | | | | - Christy L Lleras
- Human Development & Family Studies, University of Illinois at Urbana-Champaign, USA
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Irani YD, Pulford E, Mortimer L, Irani S, Butler L, Klebe S, Williams KA. Sex differences in corneal neovascularization in response to superficial corneal cautery in the rat. PLoS One 2019; 14:e0221566. [PMID: 31479468 PMCID: PMC6719872 DOI: 10.1371/journal.pone.0221566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 12/10/2018] [Accepted: 08/10/2019] [Indexed: 12/23/2022] Open
Abstract
Sex-based differences in susceptibility have been reported for a number of neovascular ocular diseases. We quantified corneal neovascularization, induced by superficial silver nitrate cautery, in male and female inbred albino Sprague-Dawley, inbred albino Fischer 344, outbred pigmented Hooded Wistar and inbred pigmented Dark Agouti rats of a range of ages. Corneal neovascular area was quantified on haematoxylin-stained corneal flatmounts by image analysis. Pro-and anti-angiogenic gene expression was measured early in the neovascular response by quantitative real-time polymerase chain reaction. Androgen and estrogen receptor expression was assessed by immunohistochemistry. Male rats from all strains, with or without ocular pigmentation, exhibited significantly greater corneal neovascular area than females: Sprague-Dawley males 43±12% (n = 8), females 25±5% (n = 12), p = 0.001; Fischer 344 males 38±10% (n = 12) females 27±8% (n = 8) p = 0.043; Hooded Wistar males 32±6% (n = 8) females 22±5% (n = 12) p = 0.002; Dark Agouti males 37±11% (n = 9) females 26±7% (n = 9) p = 0.015. Corneal vascular endothelial cells expressed neither androgen nor estrogen receptor. The expression in cornea post-cautery of Cox-2, Vegf-a and Vegf-r2 was significantly higher in males compared with females and Vegf-r1 was significantly lower in the cornea of males compared to females, p<0.001 for each comparison. These data suggest that male corneas are primed for angiogenesis through a signalling nexus involving Cox-2, Vegf-a, and Vegf receptors 1 and 2. Our findings re-enforce that pre-clinical animal models of human diseases should account for sex-based differences in their design and highlight the need for well characterized and reproducible pre-clinical studies that include both male and female animals.
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Affiliation(s)
- Yazad D. Irani
- Discipline of Ophthalmology, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Emily Pulford
- Discipline of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Lauren Mortimer
- Discipline of Ophthalmology, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Discipline of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Swati Irani
- Freemasons Foundation Centre for Men's Health, Adelaide Medical School, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa Butler
- Freemasons Foundation Centre for Men's Health, Adelaide Medical School, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Sonja Klebe
- Discipline of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Keryn A. Williams
- Discipline of Ophthalmology, College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Chakalisa U, Wirth K, Bennett K, Kadima E, Manyake K, Gaolathe T, Bachanas P, Marukutira T, Lebelonyane R, Dryden-Peterson S, Butler L, Mmalane M, Makhema J, Roland ME, Pretorius-Holme M, Essex M, Lockman S, Powis KM. Self-reported risky sexual practices among adolescents and young adults in Botswana. South Afr J HIV Med 2019; 20:899. [PMID: 31308965 PMCID: PMC6620511 DOI: 10.4102/sajhivmed.v20i1.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 03/25/2019] [Indexed: 12/05/2022] Open
Abstract
Background Adolescents and young adults account for more than one-third of incident Human Immunodeficiency Virus (HIV) infections globally. Understanding sexual practices of this high-risk group is critical in designing HIV targeted prevention programming. Objectives To describe self-reported risky sexual practices of adolescents and young adults aged 16–24 years from 30 Botswana communities. Methods Cross-sectional, self-reported age at sexual debut; number of sexual partners; condom and alcohol use during sex; intergenerational sex; and transactional sex data were collected. Modified Poisson estimating equations were used to obtain univariate and multivariate-adjusted prevalence ratios (PR) and 95% confidence intervals (CI) comparing engagement in different sexual practices according to gender, accounting for the clustered design of the study. Results Among the 3380 participants, 2311 reported being sexually active with more females reporting being sexually active compared to males (65% vs. 35%, respectively; p < 0.0001). In univariate analyses, female participants were more likely to report inconsistent condom use (PR 1.61; 95% CI 1.44–1.80), intergenerational sex (PR 9.00; 95% CI 5.84–13.88) and transactional sex (PR 3.46; 95% CI 2.07–5.77) than males, yet less likely to report engaging in sex before age 15 years (PR 0.59; 95% CI: 0.41–0.85), using alcohol around the time of intercourse (PR: 0.59; 95% CI 0.45–0.76) or having ≥ two partners in the last 12 months (PR 0.65; 95% CI 0.57–0.74). Conclusions Self-reported risky sexual practices of adolescents and young adults in Botswana differed significantly between males and females. Gender-specific risky sexual practices highlight the importance of developing tailored HIV prevention programming.
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Affiliation(s)
- Unoda Chakalisa
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Kathleen Wirth
- Harvard T.H. Chan School of Public Health, Boston, United States
| | - Kara Bennett
- Bennett Statistical Consulting, Ballston Lake, United States
| | - Etienne Kadima
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Kutlo Manyake
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | | | - Pam Bachanas
- Centers for Disease Control and Prevention, Division of Global HIV/AIDS and TB, Atlanta, United States
| | | | | | | | - Lisa Butler
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, United States
| | - Mompati Mmalane
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | | | | | - Max Essex
- Harvard T.H. Chan School of Public Health, Boston, United States
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Shafi AA, Schiewer MJ, Leeuw RD, Dylgjeri E, McCue PA, Shah N, Gomella L, Lallas C, Trabulsi E, Centerera M, Hickey T, Butler L, Raj G, Tilley W, Cukierman E, Knudsen KE. Abstract 112: Patient derived models reveal impact of the tumor microenvironment on therapeutic response. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-112] [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
Prostate cancer (PCa) is the most common non-cutanenous cancer and the second leading cause of cancer-related death in American men. Androgen receptor (AR) is a hormone-activated transcription factor that plays an important role in both the development and progression of PCa. Androgen deprivation therapy is a common first-line therapy for disseminated disease. However, virtually all tumors become resistant to such therapy and the tumor recurs. Thus, there is a vital need for the development of novel, more effective drugs. One major hurdle in this aspect is the lack of adequate preclinical models. Current models do not effectively recapitulate the heterogeneity and the microenvironment of human PCa tumors, significantly hindering the ability to accurately predict therapeutic response. Our collaborative group has utilized and characterized a method to culture patient tumors ex vivo, termed Patient Derived Explant (PDE). This approach maintains the integrity of the native tumor microenvironment, tumor tissue morphology, and molecular signaling. Importantly, our PDE model can be manipulated both chemically (drugs/compounds) and genetically (shRNA) in order to determine specific reactions and mechanisms of response on individual tumor growth. Furthermore, with this model we can quantitatively assess drug efficacy on numerous parameters (i.e. AR levels, Ki67 staining, apoptosis screening, and desmoplasmic indices). Data to be discussed will assess the variances in response to AR-directed therapeutics and underlying mechanisms of action, while also utilizing TME characteristics as a means to predict response to therapy. In addition, we can potentially identify clinically relevant subpopulations of patients and molecularly profile their cultured tissue to uncover new pathways for therapeutic intervention. Thus, the PDE model allows for a comprehensive evaluation of individual tumors in their native microenvironment to ultimately develop more effective therapies. This study will have transformative clinical impact discerning novel metrics for the inclusion of precision medicine for advanced PCa.
Citation Format: Ayesha A. Shafi, Matthew J. Schiewer, Renée de Leeuw, Emanuela Dylgjeri, Peter A. McCue, Neelima Shah, Leonard Gomella, Costas Lallas, Edouard Trabulsi, Margaret Centerera, Theresa Hickey, Lisa Butler, Ganesh Raj, Wayne Tilley, Edna Cukierman, Karen E. Knudsen. Patient derived models reveal impact of the tumor microenvironment on therapeutic response [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 112.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Ganesh Raj
- 4University of Texas Southwestern, Dallas, TX
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Bhandari S, Butler L, Otieno P, Weiser S, Cohen C, Frongillo E. An Agricultural and Finance Intervention Improved Dietary Intake and Nutritional Status of Children Living in HIV-affected Households in Western Kenya (P10-129-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz034.p10-129-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
To test whether an intervention that was shown previously to have improved food security, dietary intake of adults, and HIV health outcomes also improved dietary intake and nutritional status of children living in HIV-affected households.
Methods
The study was conducted in the Nyanza Region, Kenya where two health facilities were randomly assigned as intervention or control arms. The intervention included a human-powered water pump, a microfinance loan to purchase farm commodities, and training in sustainable farming practices and financial management. One hundred children (6 to 60 months of age) were enrolled in each arm from households with HIV-infected adults 18 to 49 years old on antiretroviral therapy and with access to surface water and land. Children were assessed beginning in April 2012 and every three months for one year. Data were collected on dietary intake, height, weight, and mid-upper arm circumference (MUAC). The difference in differences from first visit and in linear trends over visits were tested using fixed-effects regression models.
Results
Compared to the control arm, children in the intervention arm had a larger increase in weight at the 12-month visit (β: 0.42, 95% CI: 0.08, 0.76) and increase in MUAC at the 6-month visit (β: 0.28, 95% CI: 0.08, 0.49), with no difference in changes in height over time. Compared to the control arm, the intervention arm had a larger increasing linear trend over time in intake of staples (β: 0.22, 95% CI: 0.02, 0.44), fruits and vegetables (β: 0.42, 95% CI: 0.10, 0.75), and meat (β: 0.07, 95% CI: 0.03, 0.12), and a larger decreasing linear trend in intake of condiments (β: -0.16, 95% CI: -0.23, -0.09) and tea (β: -0.12, 95% CI: -0.19, -0.05), with no differences in intake of eggs, dairy and fat over time.
Conclusions
This intervention that improved food security, dietary intake, and HIV health outcomes of HIV-infected adults also improved dietary intake and nutritional status of children living in those households. Multisectoral agricultural and financial interventions have the potential to improve the nutritional status of HIV-affected children in rural Kenya and should be further explored.
Funding Sources
National Institute of Mental Health.
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Affiliation(s)
| | - Lisa Butler
- University of Connecticut - Institute for Collaboration on Health, Intervention and Policy
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Simpson J, Millman B, Nagakumar P, Desai M, Butler L, Colley J, Fairbank J, Haw S. P351 Baby PEP or percussion. Is there a clear winner? J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30643-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Wogan C, Butler L, Denniston S, Hull L. P427 Environmental infection risks in cystic fibrosis: a survey of UK practice. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30719-2] [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: 11/28/2022]
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Hull L, Wogan C, Denniston S, Butler L. P410 Evaluation of a cystic fibrosis young people's clinic: parents and young people's views. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30702-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Butler L, Irani S, Centenera M, Ryan N, Pegg N, Brooks AN. Preclinical investigation of a small molecule inhibitor of p300/CBP reveals efficacy in patient-derived prostate tumor explants. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e16534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16534 Background: Growth and survival of prostate cancer cells are initially dependent upon androgens, and androgen deprivation therapy (ADT) is used to control tumor growth. Unfortunately, resistance to ADT inevitably occurs, and patients relapse with lethal castrate-resistant prostate cancer (CRPC). Increased expression of the androgen receptor (AR) and constitutively active AR variants are hallmarks of CRPC, and treatments targeting aberrant AR signaling are urgently required. CCS1477 is an inhibitor of p300/CBP currently in a Phase I/IIa study for CRPC. CCS1477 enhances degradation of numerous cellular proteins including the AR and AR variants in prostate cancer cells. Our preclinical studies with this compound demonstrated potent single-agent efficacy of CCS1477 using in vitro and in vivo models of prostate cancer and, when used in combination, CCS1477 enhances the efficacy of enzalutamide, a clinical AR antagonist. Understanding the response of clinical tumors to CCS1477, and their potential adaptive evolution, is essential to personalize treatment and predict potential resistance mechanisms. Methods: To assess CCS1477 in human disease, we used a unique model in which clinical prostate tumors from radical prostatectomy are cultured as explants with maintenance of tissue integrity, cell proliferation and androgen signaling. Tumors from 13 patients were cultured in the absence or presence of CCS1477 (10µM) or enzalutamide (10µM) for 48 or 72 hours; micromolar doses were selected to account for altered small molecule uptake and penetration into tissues compared to cell lines, as previously reported. Proliferation, apoptosis and androgen signaling were all analyzed post-culture. Results: Whereas the tumor explants exhibited highly heterogenous proliferative responses to enzalutamide, tumors from all patients exhibited a marked antiproliferative response to CCS1477 (mean reduction in Ki67 immunoreactivity of > 90% compared to vehicle control; p < 0.0005). Culture with CCS1477 was associated with repression of androgen signaling in the prostate tissues, measured by expression and secretion of the clinical biomarker prostate specific antigen (PSA). Conclusions: The consistent and pronounced efficacy of CCS1477 in this patient-derived model would support further investigation of this class of epigenetic agents in the castrate-sensitive prostate cancer setting.
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Affiliation(s)
- Lisa Butler
- University of Adelaide Medical School, Adelaide, SA, Australia
| | - Swati Irani
- Univeristy of Adelaide Medical School, Adelaide, SA, Australia
| | | | - Natalie Ryan
- University of Adelaide Medical School, Adelaide, SA, Australia
| | - Neil Pegg
- CellCentric Ltd, Cambridge, United Kingdom
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Toda M, Beer K, O’Halloran A, Reingold A, Alden N, Yousey-Hindes K, Anderson EJ, Bohm S, McMahon M, Butler L, Pradhan E, Felsen CB, Billing L, Thomas A, Talbot K, Reed GM, Chiller T, Garg S, Jackson BR. 354. Evidence of Aspergillosis Among Patients With Influenza-Associated Hospitalizations—United States, 2005–2017. Open Forum Infect Dis 2018. [PMCID: PMC6254107 DOI: 10.1093/ofid/ofy210.365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Invasive aspergillosis primarily affects immunosuppressed persons, but it has also been observed in immunocompetent patients with severe influenza. Several case series suggest that severe influenza infection might be an under-recognized risk factor for aspergillosis. We examined the frequency of aspergillosis-related hospital discharge codes in a national surveillance database of influenza hospitalizations. Methods We analyzed laboratory-confirmed influenza-associated hospitalizations reported during 2005–2017 to Centers for Disease Control and Prevention (CDC)’s Influenza Hospitalization Surveillance Network (FluSurv-NET), which includes children and adults in 13 states. We obtained data on underlying conditions and clinical course through medical chart abstraction. We defined invasive aspergillosis cases as influenza hospitalizations with ≥1 of the following the International Classification of Diseases (ICD) 9th or 10th Clinical Modification discharge diagnosis codes: 117.3 (aspergillosis), 484.6 (pneumonia in aspergillosis), B44.0 (invasive pulmonary aspergillosis), B44.2 (tonsillar aspergillosis), and B44.7 (disseminated aspergillosis). Results Among 92,671 influenza hospitalizations, we identified 94 cases (0.1%) that had invasive aspergillosis codes. Characteristics of patients were: 60% male (56/94), 72% white race (60/83), and median age 58 years [interquartile range (IQR) 41–67]. Influenza A accounted for 80% (75/94) of cases. Seventy-nine percent (74/94) received antiviral therapy. Underlying conditions included 63% (59/94) immunocompromising condition, 51% (48/94) chronic lung disease, 22% (21/94) renal disease, and 15% (14/94) asthma. Forty-eight percent of patients (45/94) required intensive care. At the time of discharge, 60% (56/94) were diagnosed with pneumonia and 14% (13/94) died. Conclusion Over one-third of patients with invasive aspergillosis did not have a documented immunosuppressive condition. ICD codes are likely an imperfect way to identify invasive aspergillosis, and further studies are needed to characterize risk factors and verify diagnoses for aspergillosis among patients with severe influenza. Disclosures E. J. Anderson, NovaVax: Grant Investigator, Research grant. Pfizer: Grant Investigator, Research grant. AbbVie: Consultant, Consulting fee. MedImmune: Investigator, Research support. PaxVax: Investigator, Research support. Micron: Investigator, Research support. K. Talbot, sanofi pasteur: Investigator, Research support. Gilead: Investigator, Research support. MedImmune: Investigator, Research support. Seqirus: Scientific Advisor, Consulting fee. MedImmune: Scientific Advisor, Consulting fee.
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Affiliation(s)
- Mitsuru Toda
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Karlyn Beer
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alissa O’Halloran
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Nisha Alden
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Kimberly Yousey-Hindes
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut
| | - Evan J Anderson
- Departments of Pediatrics and Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Susan Bohm
- Michigan Department of Health and Human Services, Lansing, Michigan
| | | | - Lisa Butler
- New Mexico Emerging Infections Program, University of New Mexico, Albuquerque, New Mexico
| | - Eva Pradhan
- New York State Department of Health, Albany, New York
| | - Christina B Felsen
- NY Emerging Infections Program, Center for Community Health and Prevention, University of Rochester Medical Center, Rochester, New York
| | | | - Ann Thomas
- Emerging Infections Program, Oregon Public Health Division, Portland, Oregon
| | - Keipp Talbot
- Vanderbilt University Medical Center, Nashville, TN
| | - Gregg M Reed
- Bureau of Epidemiology, Utah Department of Health, Salt Lake City, Utah
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shikha Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brendan R Jackson
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
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McClurg UL, McCracken SR, Butler L, Riabowol KT, Binda O. Ex vivo Culture and Lentiviral Transduction of Benign Prostatic Hyperplasia (BPH) Samples. Bio Protoc 2018; 8:e3075. [PMID: 30515449 DOI: 10.21769/bioprotoc.3075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
To assess oncogenic potential, classical transformation assays are based on cell line models. However, cell line based models do not reflect the complexity of human tissues. We thus developed an inducible expression system for gene expression in ex vivo human tissues, which maintain native tissue architecture, such as epithelia and stroma. To validate the system, we transduced and expressed known tumor suppressors (p53, p33ING1b), oncoproteins (RasV12, p47ING3), or controls (empty vector, YFP) in ex vivo prostate tissues, then assessed proliferation by immunohistochemistry of markers (H3S10phos). Herein, we describe how to generate lentiviral vectors and particules, successfully transduce human prostate tissues, induce exogenous gene expression, and assess cellular proliferation.
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Affiliation(s)
- Urszula Lucja McClurg
- Newcastle Cancer Centre at the Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, England.,Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, England
| | - Stuart R McCracken
- Newcastle Cancer Centre at the Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, England
| | - Lisa Butler
- The University of Adelaide, Adelaide, Australia
| | - Karl T Riabowol
- Department of Biochemistry and Molecular Biology and Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Olivier Binda
- Newcastle Cancer Centre at the Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, England
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Alharbi M, Lamport D, Butler L, Spencer J. Habitual flavonoid intake and cognitive benefits: A longitudinal investigation in healthy elderly. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1999] [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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Lewinsohn R, Crankshaw T, Tomlinson M, Gibbs A, Butler L, Smit J. “This baby came up and then he said, “I give up!”: The interplay between unintended pregnancy, sexual partnership dynamics and social support and the impact on women's well-being in KwaZulu-Natal, South Africa. Midwifery 2018; 62:29-35. [DOI: 10.1016/j.midw.2018.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/02/2018] [Accepted: 03/04/2018] [Indexed: 12/16/2022]
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Chalmers JR, Thomas KS, Apfelbacher C, Williams HC, Prinsen CA, Spuls PI, Simpson E, Gerbens LAA, Boers M, Barbarot S, Stalder JF, Abuabara K, Aoki V, Ardeleanu M, Armstrong J, Bang B, Berents TL, Burton T, Butler L, Chubachi T, Cresswell-Melville A, DeLozier A, Eckert L, Eichenfield L, Flohr C, Futamura M, Gadkari A, Gjerde ES, van Halewijn KF, Hawkes C, Howells L, Howie L, Humphreys R, Ishii HA, Kataoka Y, Katayama I, Kouwenhoven W, Langan SM, Leshem YA, Merhand S, Mina-Osorio P, Murota H, Nakahara T, Nunes FP, Nygaard U, Nygårdas M, Ohya Y, Ono E, Rehbinder E, Rogers NK, Romeijn GLE, Schuttelaar MLA, Sears AV, Simpson MA, Singh JA, Srour J, Stuart B, Svensson Å, Talmo G, Talmo H, Teixeira HD, Thyssen JP, Todd G, Torchet F, Volke A, von Kobyletzki L, Weisshaar E, Wollenberg A, Zaniboni M. Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative). Br J Dermatol 2018; 178:e332-e341. [PMID: 29672835 DOI: 10.1111/bjd.16543] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 12/11/2022]
Abstract
This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12-14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long-term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole-group and small-group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small-group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole-group voting was carried out using handheld electronic voting pads according to predefined consensus rules. It was agreed by consensus that the long-term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long-term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon.
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Affiliation(s)
- J R Chalmers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - C Apfelbacher
- Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - C A Prinsen
- Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - P I Spuls
- Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands
| | - E Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, OR, U.S.A
| | - L A A Gerbens
- Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands
| | - M Boers
- VU University Medical Center, Amsterdam, the Netherlands
| | - S Barbarot
- Department of Dermatology, Nantes University Hospital (CHU de Nantes), France
| | - J F Stalder
- Department of Dermatology, Nantes University Hospital (CHU de Nantes), France
| | - K Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, CA, U.S.A
| | - V Aoki
- University of São Paulo Medical School, São Paulo, Brazil
| | - M Ardeleanu
- Regeneron Pharmaceuticals, Tarrytown, NY, U.S.A
| | | | - B Bang
- LEO Pharma, Ballerup, Denmark
| | | | | | - L Butler
- National Eczema Association, San Rafael, CA, U.S.A
| | - T Chubachi
- GlaxoSmithKline, Research Triangle Park, NC, U.S.A
| | | | - A DeLozier
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | | | - L Eichenfield
- Rady Children's Hospital, University of California San Francisco, San Diego, CA, U.S.A
| | - C Flohr
- St John's Institute of Dermatology, St Thomas' Hospital, London, U.K
| | | | - A Gadkari
- Regeneron Pharmaceuticals, Tarrytown, NY, U.S.A
| | - E S Gjerde
- The Psoriasis and Eczema Association of Norway, Oslo, Norway
| | - K F van Halewijn
- Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | | | - L Howells
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - L Howie
- Global Parents for Eczema Research, Brisbane, Australia
| | | | - H A Ishii
- Brazilian Atopic Dermatitis Association (AADA), São Paulo, Brazil
| | - Y Kataoka
- Osaka Prefectural Medical Center for Respiratory and Allergic Disease, Osaka, Japan
| | | | - W Kouwenhoven
- Dutch Association for People with Atopic Dermatitis, Nijkerk, the Netherlands
| | - S M Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, U.K
| | - Y A Leshem
- Beilinson Hospital and Tel Aviv University, Petah Tikva and Tel Aviv, Israel
| | - S Merhand
- Association Française de l'Eczéma, Redon, France
| | | | - H Murota
- Department of Dermatology, Osaka University, Suita, Japan
| | - T Nakahara
- Department of Dermatology, Kyushu University, Fukuoka, Japan
| | - F P Nunes
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - U Nygaard
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | | | - Y Ohya
- National Centre for Child Health and Development, Tokyo, Japan
| | - E Ono
- Osaka University, Osaka, Japan
| | - E Rehbinder
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - N K Rogers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - G L E Romeijn
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A V Sears
- St John's Institute of Dermatology, St Thomas' Hospital, London, U.K
| | | | - J A Singh
- Department of Medicine, University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, AL, U.S.A
| | - J Srour
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU - München, Munich, Germany
| | - B Stuart
- Primary Care and Population Sciences Division, University of Southampton, Southampton, U.K
| | - Å Svensson
- Department of Dermatology and Venereology, Lund University, Malmö, Sweden
| | - G Talmo
- The Psoriasis and Eczema Association of Norway, Haugesund, Norway
| | - H Talmo
- The Psoriasis and Eczema Association of Norway, Haugesund, Norway
| | | | - J P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - G Todd
- University of Cape Town, Cape Town, South Africa
| | - F Torchet
- Association Française de l'Eczéma, Redon, France
| | - A Volke
- Department of Dermatology, University of Tartu, Tartu, Estonia
| | - L von Kobyletzki
- Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.,Department of Public Health Sciences, Karlstad University, Karlstad, Sweden.,CF Wahlgren, Dermatology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Stockholm, Sweden.,Department of Dermatology, Venereology and Allergy University Hospital Schleswig-Holstein, Kiel, Germany
| | - E Weisshaar
- Department of Social Medicine, Occupational and Environmental Dermatology, Ruprecht Karls University, Heidelberg, Germany
| | | | - M Zaniboni
- University of São Paulo, Campinas, Brazil
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Laker-Oketta M, Butler L, Makanga P, Maurer T, Mbidde E, Martin J. Developing Media to Promote Community Awareness of Early Detection of Kaposi’s Sarcoma in Africa. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.12000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract 44 Purpose Despite overt presentation on the skin, most Kaposi’s sarcoma (KS) in Africa is diagnosed too late for treatment to be effective. Training health care workers to recognize KS early can increase knowledge, but is only clinically impactful if providers actually encounter early KS—that is, if patients with early KS present to care. Indeed, recent work from Zimbabwe has shown that facility-based KS training failed to increase early diagnosis, which is unsurprising given the public’s lack of awareness of KS. We hypothesized that educating affected populations about KS is critical to making progress in early detection and that enhanced community awareness about KS can be achieved through exposure to common media. Methods Working in Uganda, we used community-engaged research to learn about health-related behaviors in the context of skin disease, craft a culturally appropriate educational theme regarding the detection of KS, and develop three forms of media. We interacted with survivors of KS, HIV-infected patients, facility-based and community health workers, traditional healers, and media professionals. We tested our media among adults at community-based venues in rural Uganda. Participants were randomly assigned to be exposed to one of the three media and were evaluated for changes in knowledge and attitudes concerning KS before and after exposure to media. Results In comics, 90-second radio plays, and a 10-minute film, we developed a three-part theme that was aimed at the public: “look,” meaning to regularly examine one’s skin and mouth; “show” to bring to the attention of a health care worker any skin changes; and “test” to remind providers about skin biopsy for diagnosis. Among the 240 participants who were exposed to media, median age was 30 years, 50% were women, 6% were HIV infected, and 60% were literate. Exposure to media resulted in increases in the ability to recognize and/or name KS (+47%), awareness that anyone is at risk for KS (+15%), and knowledge of how to prevent KS from becoming a substantial problem (+34%). Conclusion Featuring the theme, “Look, show, and test,” we developed media—comics, radio plays, and film—for the public in Africa about the early detection of KS. Exposure to these media resulted in increases in knowledge and changes in attitudes concerning KS. Although the increases in knowledge were not large, they may be as much as can be expected from a single exposure. Optimal outcomes will likely require multiple exposures and facilitated discussions. Media elements are freely available online. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.
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Affiliation(s)
- Miriam Laker-Oketta
- Miriam Laker-Oketta, Infectious Diseases Institute, Kampala; Edward Mbidde, Uganda Virus Research Institute, Entebbe, Uganda; Lisa Butler and Philippa Makanga, University of Connecticut, Storrs, CT; and Toby Maurer and Jeffrey Martin, University of California, San Francisco, San Francisco, CA
| | - Lisa Butler
- Miriam Laker-Oketta, Infectious Diseases Institute, Kampala; Edward Mbidde, Uganda Virus Research Institute, Entebbe, Uganda; Lisa Butler and Philippa Makanga, University of Connecticut, Storrs, CT; and Toby Maurer and Jeffrey Martin, University of California, San Francisco, San Francisco, CA
| | - Philippa Makanga
- Miriam Laker-Oketta, Infectious Diseases Institute, Kampala; Edward Mbidde, Uganda Virus Research Institute, Entebbe, Uganda; Lisa Butler and Philippa Makanga, University of Connecticut, Storrs, CT; and Toby Maurer and Jeffrey Martin, University of California, San Francisco, San Francisco, CA
| | - Toby Maurer
- Miriam Laker-Oketta, Infectious Diseases Institute, Kampala; Edward Mbidde, Uganda Virus Research Institute, Entebbe, Uganda; Lisa Butler and Philippa Makanga, University of Connecticut, Storrs, CT; and Toby Maurer and Jeffrey Martin, University of California, San Francisco, San Francisco, CA
| | - Edward Mbidde
- Miriam Laker-Oketta, Infectious Diseases Institute, Kampala; Edward Mbidde, Uganda Virus Research Institute, Entebbe, Uganda; Lisa Butler and Philippa Makanga, University of Connecticut, Storrs, CT; and Toby Maurer and Jeffrey Martin, University of California, San Francisco, San Francisco, CA
| | - Jeffrey Martin
- Miriam Laker-Oketta, Infectious Diseases Institute, Kampala; Edward Mbidde, Uganda Virus Research Institute, Entebbe, Uganda; Lisa Butler and Philippa Makanga, University of Connecticut, Storrs, CT; and Toby Maurer and Jeffrey Martin, University of California, San Francisco, San Francisco, CA
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43
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Zhang AY, Chiam K, Haupt Y, Fox SB, Birch S, Tilley W, Butler L, Knudsen KE, Cornstock C, Rasiah K, Grogan J, Mahon KL, Bianco-Miotto T, Bohm M, Henshall SM, Delprado W, Stricker P, Horvath L, Kench J. An analysis of multiple biomarkers to better predict prostate cancer metastasis and death after radical prostatectomy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.54] [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: 11/20/2022] Open
Abstract
54 Background: Identification of potentially lethal disease at the time of diagnosis with localized prostate cancer (PCa) remains a significant clinical issue despite a plethora of candidate biomarkers. This study evaluates a range of biomarkers previously associated with biochemical relapse (BR) in localized PCa to determine whether a combined expression model can improve detection of clinically significant cases. Methods: The Australian PCa Research Centre NSW has completed 23 studies of molecular biomarkers associated with BR in a well-described localized PCa cohort (n=324, median followup 16 years). 12 studies were excluded due to missing data. Each biomarker was analyzed as a marker for metastatic-free survival (MFS) and prostate cancer specific survival (PCSS) and then used to develop a prognostic model for clinical outcomes incorporating clinico-pathological factors. This model is currently being validated in an independent cohort. Results: The PCa cohort experienced 39 metastatic relapses (12%) and 23 PCa deaths (7%). Of 12 biomarkers (AR, AZPG1, C0S, Cyclin D1a, Cyclin D1b, E6AP, H3K18Ac, H3K4me2, Ki67, p53, PML, SGTA) assessed, only AZGP1 and Ki67 were associated with MFS (HR 2.9, 95% CI, 1.4-5.6; P=0.002, and HR 1.2, 95% CI, 1.0-1.4; P=0.03, respectively) and PCSS (HR 4.2, 95% CI, 1.7-10.5; P=0.002; and HR 1.2, 95% CI, 1.0-1.5; P=0.04, respectively). The combined panel of AZGP1 and Ki67 was an independent predictor of MFS (HR 1.9, 95% CI, 1.1-3.2; P=0.01), and PCSS (HR 3.3, 95% CI, 1.5-7.3; P=0.002) when modeled with known clinicopathological variables. The panel was more robust in predicting MFS and PCSS compared to the individual biomarkers alone and superior to other prognostic models (See table). Data from the validation cohort will be available for the meeting. Conclusions: Our novel signature of AZPG1 and Ki67 improves existing prognostication tools in predicting PCa metastasis and death. [Table: see text]
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Affiliation(s)
| | - Karen Chiam
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
| | - Ygal Haupt
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Stephen B. Fox
- University of Newcastle/ Australian New Zealand Breast Cancer Trials Group, Newcastle, Australia
| | - Simone Birch
- Princess Alexandra Hospital, Brisbane, Australia
| | | | - Lisa Butler
- University of Adelaide Medical School Freemasons Foundation Centre for Men’s Health, Adelaide, Australia
| | - Karen E. Knudsen
- Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA
| | | | - Krishan Rasiah
- Royal North Shore Hospital, St. Leonard's, Sydney, Australia
| | - Judith Grogan
- Garvan Institute of Medical Research, Sydney, Australia
| | | | | | - Maret Bohm
- Garvan Institute of Medical Research, Sydney, Australia
| | | | | | | | | | - James Kench
- Royal Prince Alfred Hospital, Sydney, Australia
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44
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Xie J, Mølck C, Paquet-Fifield S, Butler L, Sloan E, Ventura S, Hollande F. High expression of TROP2 characterizes different cell subpopulations in androgen-sensitive and androgen-independent prostate cancer cells. Oncotarget 2018; 7:44492-44504. [PMID: 27283984 PMCID: PMC5190113 DOI: 10.18632/oncotarget.9876] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/19/2016] [Indexed: 12/15/2022] Open
Abstract
Progression of castration-resistant tumors is frequent in prostate cancer. Current systemic treatments for castration-resistant prostate cancer only produce modest increases in survival time and self-renewing Tumor-Initiating Cells (TICs) are suspected to play an important role in resistance to these treatments. However it remains unclear whether the same TICs display both chemo-resistance and self-renewing abilities throughout progression from early stage lesions to late, castration resistant tumors. Here, we found that treatment of mice bearing LNCaP-derived xenograft tumors with cytotoxic (docetaxel) and anti-androgen (flutamide) compounds enriched for cells that express TROP2, a putative TIC marker. Consistent with a tumor-initiating role, TROP2high cells from androgen-sensitive prostate cancer cell lines displayed an enhanced ability to re-grow in culture following treatment with taxane-based chemotherapy with or without androgen blockade. TROP2 down-regulation in these cells reduced their ability to recur after treatment with docetaxel, in the presence or absence of flutamide. Accordingly, in silico analysis of published clinical data revealed that prostate cancer patients with poor prognosis exhibit significantly elevated TROP2 expression level compared to low-risk patients, particularly in the case of patients diagnosed with early stage tumors. In contrast, in androgen-independent prostate cancer cell lines, TROP2high cells did not exhibit a differential treatment response but were characterized by their high self-renewal ability. Based on these findings we propose that high TROP2 expression identifies distinct cell sub-populations in androgen-sensitive and androgen-independent prostate tumors and that it may be a predictive biomarker for prostate cancer treatment response in androgen-sensitive tumors.
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Affiliation(s)
- Jinhan Xie
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia.,Current address: Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Kensington, Australia
| | - Christina Mølck
- Department of Pathology, The University of Melbourne, Parkville, Australia
| | | | - Lisa Butler
- School of Medicine, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Erica Sloan
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia.,Cousins Center for PNI, UCLA Semel Institute, Jonsson Comprehensive Cancer Center, and UCLA AIDS Institute, University of California Los Angeles, Los Angeles, CA, USA.,Peter MacCallum Cancer Centre, Division of Cancer Surgery, East Melbourne, Victoria, Australia
| | - Sabatino Ventura
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Frédéric Hollande
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia.,Department of Pathology, The University of Melbourne, Parkville, Australia
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45
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Fleck BW, Williams C, Juszczak E, Cocker K, Stenson BJ, Darlow BA, Dai S, Gole GA, Quinn GE, Wallace DK, Ells A, Carden S, Butler L, Clark D, Elder J, Wilson C, Biswas S, Shafiq A, King A, Brocklehurst P, Fielder AR. An international comparison of retinopathy of prematurity grading performance within the Benefits of Oxygen Saturation Targeting II trials. Eye (Lond) 2017; 32:74-80. [PMID: 28752837 PMCID: PMC5669461 DOI: 10.1038/eye.2017.150] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 06/21/2017] [Indexed: 12/19/2022] Open
Abstract
Purpose To investigate whether the observed international differences in retinopathy of prematurity (ROP) treatment rates within the Benefits of Oxygen Saturation Targeting (BOOST) II trials might have been caused by international variation in ROP disease grading. Methods Groups of BOOST II trial ophthalmologists in UK, Australia, and New Zealand (ANZ), and an international reference group (INT) used a web based system to grade a selection of RetCam images of ROP acquired during the BOOST II UK trial. Rates of decisions to treat, plus disease grading, ROP stage grading, ROP zone grading, inter-observer variation within groups and intra-observer variation within groups were measured. Results Forty-two eye examinations were graded. UK ophthalmologists diagnosed treat-requiring ROP more frequently than ANZ ophthalmologists, 13.9 (3.49) compared to 9.4 (4.46) eye examinations, P=0.038. UK ophthalmologists diagnosed plus disease more frequently than ANZ ophthalmologists, 14.1 (6.23) compared to 8.5 (3.24) eye examinations, P=0.021. ANZ ophthalmologists diagnosed stage 2 ROP more frequently than UK ophthalmologists, 20.2 (5.8) compared to 12.7 (7.1) eye examinations, P=0.026. There were no other significant differences in the grading of ROP stage or zone. Inter-observer variation was higher within the UK group than within the ANZ group. Intra-observer variation was low in both groups. Conclusions We have found evidence of international variation in the diagnosis of treatment-requiring ROP. Improved standardisation of the diagnosis of treatment-requiring ROP is required. Measures might include improved training in the grading of ROP, using an international approach, and further development of ROP image analysis software.
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Affiliation(s)
- B W Fleck
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
| | - C Williams
- Department of Paediatric Ophthalmology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - E Juszczak
- Clinical Trials Unit, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - K Cocker
- Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, UK
| | - B J Stenson
- Neonatal Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - B A Darlow
- Cure Kids Professor of Paediatric Research, Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - S Dai
- Department of Paediatric Ophthalmology, Starship Children's Hospital, University of Auckland, Auckland, New Zealand
| | - G A Gole
- Department of Ophthalmology, University of Queensland, Brisbane, Australia
| | - G E Quinn
- Department of Pediatric Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - D K Wallace
- Department of Pediatric Ophthalmology, Duke University, Durham, USA
| | - A Ells
- Department of Ophthalmology, University of Calgary, Alberta, Canada
| | - S Carden
- Department of Ophthalmology, Royal Children's Hospital, Victoria, Australia
| | - L Butler
- Department of Paediatric Ophthalmology, Birmingham and Midlands Eye Centre, Birmingham, UK
| | - D Clark
- Department of Ophthalmology, Aintree University Hospital, Liverpool, UK
| | - J Elder
- Department of Ophthalmology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - C Wilson
- Department of Ophthalmology, Chelsea and Westminster Hospital, London, UK
| | - S Biswas
- Department of Paediatric Ophthalmology, Manchester Royal Eye Hospital, Central Manchester Foundation Trust and Manchester Academic Health Sciences Centre, Manchester, UK
| | - A Shafiq
- Department of Ophthalmology, Newcastle Eye Centre, Newcastle, UK
| | - A King
- Clinical Trials Unit, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - P Brocklehurst
- Clinical Trials Unit, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - A R Fielder
- Department of Ophthalmology, Division of Optometry and Visual Sciences, City University, London, UK
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46
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Gibbs A, Carpenter B, Crankshaw T, Hannass-Hancock J, Smit J, Tomlinson M, Butler L. Prevalence and factors associated with recent intimate partner violence and relationships between disability and depression in post-partum women in one clinic in eThekwini Municipality, South Africa. PLoS One 2017; 12:e0181236. [PMID: 28727838 PMCID: PMC5519063 DOI: 10.1371/journal.pone.0181236] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 06/28/2017] [Indexed: 11/18/2022] Open
Abstract
Intimate partner violence (IPV) experienced by pregnant and post-partum women has negative health effects for women, as well as the foetus, and the new-born child. In this study we sought to assess the prevalence and factors associated with recent IPV amongst post-partum women in one clinic in eThekwini Municipality, South Africa, and explore the relationship between IPV, depression and functional limitations/disabilities. Past 12 month IPV-victimisation was 10.55%. Logistic regression modelled relationships between IPV, functional limitations, depressive symptoms, socio-economic measures, and sexual relationship power. In logistic regression models, overall severity of functional limitations were not associated with IPV-victimisation when treated as a continuous overall score. In this model relationship power (aOR0.22, p = 0.001) and depressive symptoms (aOR1.26, p = 0.001) were significant. When the different functional limitations were separated out in a second model, significant factors were relationship power (aOR0.20, p = 0.001), depressive symptoms (aOR1.20, p = 0.011) and mobility limitations (aOR2.96, p = 0.024). The study emphasises that not all functional limitations are associated with IPV-experience, that depression and disability while overlapping can also be considered different drivers of vulnerability, and that women’s experience of IPV is not dependent on pregnancy specific factors, but rather wider social factors that all women experience.
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Affiliation(s)
- Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
- * E-mail:
| | - Bradley Carpenter
- Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
- HIV-Prevention Research Unit, South African Medical Research Council, South African Medical Research Council, Durban, South Africa
| | - Tamaryn Crankshaw
- Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Jill Hannass-Hancock
- HIV-Prevention Research Unit, South African Medical Research Council, South African Medical Research Council, Durban, South Africa
| | - Jennifer Smit
- MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Lisa Butler
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, Connecticut, United States of America
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47
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Williams C, Dodd G, Lamport D, Spencer J, Butler L. EFFECTS OF ANTHOCYANIN-RICH BLUEBERRIES ON COGNITIVE FUNCTION IN HEALTHY YOUNGER AND OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C. Williams
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - G. Dodd
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - D. Lamport
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - J. Spencer
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - L. Butler
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
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48
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Nassar ZD, Centenera MM, Machiels J, Polacek SJ, Bloch K, Tilley WD, Selth LA, Swinnen JV, Butler L. Abstract 1152: Lipid elongation: an unexplored therapeutic target in prostate cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-1152] [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
Dysregulated lipid metabolism is one of the hallmarks of cancer, particularly for prostate cancer (PCa). PCa cells exhibit distinctive metabolic features such as upregulation of enzymes involved in de novo synthesis, uptake and beta-oxidation of lipids, which promote prostate cancer growth, metastasis, and drug resistance. Androgen signalling is a major driver of both PCa growth and lipid metabolism in PCa cells, however the precise effects of androgens on cellular lipid composition and the molecular pathways by which androgens regulate lipid metabolism in PCa cells are yet to be elucidated. In this study we investigated the effect of androgens on the lipid composition of PCa cell membranes and the enzymes involved in lipid metabolism, and explored the influence of these enzymes on tumour cell behaviour such as cell migration, proliferation and attachment. PCa cell lines (AR positive and negative) were cultured in the absence or presence of androgens or the anti-androgen enzalutamide, and changes in intact phospholipid species were assessed by ESI-MS/MS-based lipidomics. This analysis revealed a complexity of changes in phospholipid profiles in response to androgen treatment. Strikingly, elongation of the fatty acyl chains was consistently observed for multiple phospholipid classes in response to the androgens mibolerone or 5α-dihydotestosterone, whereas inhibition of elongation was observed in the presence of enzalutamide. Transcriptional analysis of critical lipid metabolism pathways revealed that the enzymes that catalyse lipid elongation (ELOVLs) were markedly induced by androgens in multiple PCa cell lines, and siRNA depletion of these enzymes, either alone or in combination, reversed the androgen-induced fatty acyl elongation phenotype. The androgenic regulation of ELOVL enzymes was confirmed in clinical PCa cohorts and in primary tumours cultured as explants. Targeting ELOVL gene expression also significantly attenuated the tumorigenic properties of PCa cells. ELOVL downregulation decreased LNCaP cell migration, and adhesion to fibronectin. Furthermore, ELOVL knock down significantly decreased three-dimensional spheroid growth of LNCaP cells using a hang drop assay. The impact of these enzymes on the lipid profile of PCa cell membrane and cell viability, adhesion and migration suggests that they may represent promising and previously unexplored therapeutic targets.
Citation Format: Zeyad D. Nassar, Margaret M. Centenera, Jelle Machiels, Samuel J. Polacek, Katarzyna Bloch, Wayne D. Tilley, Luke A. Selth, Johannes V. Swinnen, Lisa Butler. Lipid elongation: an unexplored therapeutic target in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1152. doi:10.1158/1538-7445.AM2017-1152
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lisa Butler
- 1University of Adelaide, Adelaide, Australia
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49
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Horwood C, Butler L, Barker P, Phakathi S, Haskins L, Grant M, Mntambo N, Rollins N. A continuous quality improvement intervention to improve the effectiveness of community health workers providing care to mothers and children: a cluster randomised controlled trial in South Africa. Hum Resour Health 2017; 15:39. [PMID: 28610590 PMCID: PMC5470211 DOI: 10.1186/s12960-017-0210-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 05/31/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Community health workers (CHWs) play key roles in delivering health programmes in many countries worldwide. CHW programmes can improve coverage of maternal and child health services for the most disadvantaged and remote communities, leading to substantial benefits for mothers and children. However, there is limited evidence of effective mentoring and supervision approaches for CHWs. METHODS This is a cluster randomised controlled trial to investigate the effectiveness of a continuous quality improvement (CQI) intervention amongst CHWs providing home-based education and support to pregnant women and mothers. Thirty CHW supervisors were randomly allocated to intervention (n = 15) and control (n = 15) arms. Four CHWs were randomly selected from those routinely supported by each supervisor (n = 60 per arm). In the intervention arm, these four CHWs and their supervisor formed a quality improvement team. Intervention CHWs received a 2-week training in WHO Community Case Management followed by CQI mentoring for 12 months (preceded by 3 months lead-in to establish QI processes). Baseline and follow-up surveys were conducted with mothers of infants <12 months old living in households served by participating CHWs. RESULTS Interviews were conducted with 736 and 606 mothers at baseline and follow-up respectively; socio-demographic characteristics were similar in both study arms and at each time point. At follow-up, compared to mothers served by control CHWs, mothers served by intervention CHWs were more likely to have received a CHW visit during pregnancy (75.7 vs 29.0%, p < 0.0001) and the postnatal period (72.6 vs 30.3%, p < 0.0001). Intervention mothers had higher maternal and child health knowledge scores (49 vs 43%, p = 0.02) and reported higher exclusive breastfeeding rates to 6 weeks (76.7 vs 65.1%, p = 0.02). HIV-positive mothers served by intervention CHWs were more likely to have disclosed their HIV status to the CHW (78.7 vs 50.0%, p = 0.007). Uptake of facility-based interventions were not significantly different. CONCLUSIONS Improved training and CQI-based mentoring of CHWs can improve quantity and quality of CHW-mother interactions at household level, leading to improvements in mothers' knowledge and infant feeding practices. TRIAL REGISTRATION ClinicalTrials.Gov NCT01774136.
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Affiliation(s)
- Christiane Horwood
- Centre for Rural Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal South Africa
| | - Lisa Butler
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT United States of America
| | - Pierre Barker
- Institute for Healthcare Improvement, Cambridge, MA United States of America
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC United States of America
| | - Sifiso Phakathi
- Centre for Rural Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal South Africa
| | - Lyn Haskins
- Centre for Rural Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal South Africa
| | - Merridy Grant
- Centre for Rural Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal South Africa
| | - Ntokozo Mntambo
- Centre for Rural Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal South Africa
| | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
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50
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Allen BA, Butler L. The Effects of Music and Movement Opportunity on the Analogical Reasoning Performance of African American and White School Children: A Preliminary Study. Journal of Black Psychology 2016. [DOI: 10.1177/00957984960223003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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
This study sought tofurther establish that contextualfactors informed by cultural experiences could influence performance on a learning task. Low-income African American and middle-income White children listened to stories read under two contexts thatdiffered in the degree to which movement and music were integrated with the presentation of the stories. The high-movement expressive (HME) context allowedfor children to coordinate movement with a musical accompaniment while listening to the stories, and the low-movement expressive (LME) context allowed for little movement opportunity and no music was played. Performance was measured via a multiple-choice test designed to assess the amount of information the children processed about the stories. Results revealed that whereas African American children perform better under the HME than the LME context, White children perform better under the LME than the HME context. The results are discussed in relation to future research.
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