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D'Silva A, Islam Z, Marshall DA, Vallance JK, Nasser Y, Rajagopalan V, MacKean G, Raman M. Experiences of Irritable Bowel Syndrome Patients in a Virtual Yoga Program: Qualitative Findings from a Clinical Trial. Dig Dis Sci 2024; 69:169-179. [PMID: 37914888 DOI: 10.1007/s10620-023-08125-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/23/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND AND AIMS In-person yoga interventions have shown feasibility and effectiveness in improving the outcomes of patients with irritable bowel syndrome (IBS), but experiences in virtual yoga interventions have not been examined. This study aimed to explore patients' experiences of a virtually delivered yoga intervention for IBS. METHODS An embedded qualitative substudy was included in a randomized controlled trial examining the feasibility and effectiveness of a virtual yoga program among adult patients with IBS. Semi-structured interviews captured participants' past and current experiences, program satisfaction, perceived impact on IBS symptoms and overall physical and mental health, facilitators and barriers to participation, perceptions of social support and supervised learning, and input on improving future programming. Data were coded and analyzed in duplicate using NVivo 12. An analytic template based on the interview guide was developed and thematic analysis identified themes, as well as the relationship between themes and subthemes. RESULTS Among the 14 participants (all female, mean age 47.7 years), three major themes were identified: (1) positive experience in the yoga program, (2) incorporating yoga into IBS management post-study, and (3) recommendations for program improvement. CONCLUSION Patients with IBS experience in a virtual yoga program was positive with improvements in physical and mental health outcomes. Considering the barriers and facilitators to participating in an online yoga program along with participant recommendations may improve future intervention design and delivery to increase self-efficacy and confidence among patients with IBS.
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Affiliation(s)
- Adrijana D'Silva
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Zarmina Islam
- Department of Medicine, Dow Medical College, Bab-E-Urdu Road, Karachi, 74200, Sindh, Pakistan
| | - Deborah A Marshall
- Arthur J.E. Child Chair, Department of Medicine, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, AB, T9S 3A3, Canada
| | - Yasmin Nasser
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, 3380 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Vidya Rajagopalan
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, 3380 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Gail MacKean
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Maitreyi Raman
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, 3380 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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Ilnytskyy Y, Petersen L, McIntyre JB, Konno M, D'Silva A, Dean M, Elegbede A, Golubov A, Kovalchuk O, Kovalchuk I, Bebb G. Genome-wide Detection of Chimeric Transcripts in Early-stage Non-small Cell Lung Cancer. Cancer Genomics Proteomics 2023; 20:417-432. [PMID: 37643782 PMCID: PMC10464939 DOI: 10.21873/cgp.20394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/23/2023] [Accepted: 07/06/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND/AIM Lung cancer remains the main culprit in cancer-related mortality worldwide. Transcript fusions play a critical role in the initiation and progression of multiple cancers. Treatment approaches based on specific targeting of discovered driver events, such as mutations in EGFR, and fusions in NTRK, ROS1, and ALK genes led to profound improvements in clinical outcomes. The formation of chimeric proteins due to genomic rearrangements or at the post-transcriptional level is widespread and plays a critical role in tumor initiation and progression. Yet, the fusion landscape of lung cancer remains underexplored. MATERIALS AND METHODS We used the JAFFA pipeline to discover transcript fusions in early-stage non-small cell lung cancer (NSCLC). The set of detected fusions was further analyzed to identify recurrent events, genes with multiple partners and fusions with high predicted oncogenic potential. Finally, we used a generalized linear model (GLM) to establish statistical associations between fusion occurrences and clinicopathological variables. RNA sequencing was used to discover and characterize transcript fusions in 270 NSCLC samples selected from the Glans-Look specimen repository. The samples were obtained during the early stages of disease prior to the initiation of chemo- or radiotherapy. RESULTS We identified a set of 792 fusions where 751 were novel, and 33 were recurrent. Four of the 33 recurrent fusions were significantly associated with clinicopathological variables. Several of the fusion partners were represented by well-established oncogenes ERBB4, BRAF, FGFR2, and MET. CONCLUSION The data presented in this study allow researchers to identify, select, and validate promising candidates for targeted clinical interventions.
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Affiliation(s)
| | | | | | - Mie Konno
- Alberta Health Services, Calgary, Alberta, Canada
| | | | | | | | | | | | | | - Gwyn Bebb
- University of Calgary, Calgary, Alberta, Canada
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Ford-Sahibzada C, Dean M, Peters C, Brenner D, Gibson A, D'Silva A, Elegbede A, Tudor R, Bebb G, Cheung W. EP04.02-001 Sex as a Potential Independent Prognostic Factor in Non-Small Cell Lung Cancer Survival. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.441] [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: 11/30/2022]
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D'Silva A, Fox DE, Raman M. Reply. Clin Gastroenterol Hepatol 2022; 20:1416-1417. [PMID: 34411710 DOI: 10.1016/j.cgh.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 02/07/2023]
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D'Silva A, Marshall DA, Vallance J, Nasser Y, Rajagopalan V, MacKean G, Raman M. Meditation and yoga for irritable bowel syndrome: study protocol for a randomised clinical trial (MY-IBS study). BMJ Open 2022; 12:e059604. [PMID: 35618329 PMCID: PMC9137346 DOI: 10.1136/bmjopen-2021-059604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION When delivered in person, yoga has been shown to be effective in managing irritable bowel syndrome (IBS) symptoms. Research is needed to test the feasibility and effectiveness of yoga as a therapeutic option when delivered virtually. The primary aim of the mind and yoga for IBS randomised controlled trial is to determine the effects of an 8-week virtual meditation and yoga intervention on IBS symptom severity compared with an advice-only active control group. METHODS AND ANALYSIS Adults diagnosed with IBS will be randomised to receive either a Upa Yoga intervention or an advice-only control group. The intervention will consist of weekly online classes for 8 weeks delivered by a facilitator using Microsoft Office Teams and daily home practice. Feasibility will be evaluated by examining recruitment and attrition rates, adherence, participant satisfaction with the programme and safety. The primary outcome is IBS symptom severity, and key secondary outcomes include (but not limited to) quality of life, anxiety and depression symptoms, COVID-19-related stress and anxiety, and fatigue. Outcomes will be assessed at baseline, 4 weeks and 8 weeks. An embedded design experimental model substudy will be conducted post intervention using qualitative research methods to identify participants' experiences in the yoga programme. ETHICS AND DISSEMINATION This study has been approved by the Conjoint Health Research Ethics Board (REB ID 20-0084). Findings will be disseminated through peer-reviewed publication, conference presentation and social media. TRIAL REGISTRATION NUMBER NCT04302623.
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Affiliation(s)
- Adrijana D'Silva
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Jeffrey Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Yasmin Nasser
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vidya Rajagopalan
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gail MacKean
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Maitreyi Raman
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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D'Silva A, Fox DE, Nasser Y, Vallance JK, Quinn RR, Ronksley PE, Raman M. Prevalence and Risk Factors for Fatigue in Adults With Inflammatory Bowel Disease: A Systematic Review With Meta-Analysis. Clin Gastroenterol Hepatol 2022; 20:995-1009.e7. [PMID: 34216824 DOI: 10.1016/j.cgh.2021.06.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/10/2021] [Accepted: 06/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Inflammatory bowel disease (IBD) is a chronic relapsing and remitting disease with high morbidity, substantial health care costs, and increasing incidence. Fatigue is one of the most common symptoms that impacts quality of life and is a leading concern for patients with IBD. The aim of this study was to determine the global prevalence, risk factors, and impact of fatigue in adults with IBD. METHODS A systematic review and meta-analysis was conducted. Data were retrieved from Medline, Embase, CINAHL, and PsycINFO from database inception to October 2019. A pooled prevalence of fatigue was calculated using a random-effects model. Stratified meta-analyses explored sources of between-study heterogeneity. Study quality was assessed using an adapted checklist from Downs and Black. RESULTS The search yielded 4524 studies, of which 20 studies were included in the systematic review and meta-analysis. Overall, the studies were of good quality. The pooled prevalence of fatigue was 47% (95% confidence interval, 41%-54%), though between-study heterogeneity was high (I2 = 98%). Fatigue prevalence varied significantly by the definition of fatigue (chronic: 28%; high: 48%; P < .01) and disease status (active disease: 72%; remission: 47%; P < .01). Sleep disturbance, anxiety, depression, and anemia were the most commonly reported fatigue-related risk factors. CONCLUSIONS The prevalence of fatigue in adults with IBD is high, emphasizing the importance of additional efforts to manage fatigue to improve the care and quality of life for patients with IBD.
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Affiliation(s)
- Adrijana D'Silva
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Danielle E Fox
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Yasmin Nasser
- Snyder Institute of Chronic Disease, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Alberta, Canada
| | - Robert R Quinn
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Nephrology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul E Ronksley
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Maitreyi Raman
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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7
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Islam Z, D'Silva A, Raman M, Nasser Y. The role of mind body interventions in the treatment of irritable bowel syndrome and fibromyalgia. Front Psychiatry 2022; 13:1076763. [PMID: 36620663 PMCID: PMC9814478 DOI: 10.3389/fpsyt.2022.1076763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Irritable bowel syndrome and fibromyalgia share similar pathophysiologic mechanisms including sensitization of peripheral and central pain pathways, autonomic dysfunction and are often co-diagnosed. Co-diagnosed patients experience increased symptom severity, mental health comorbidities, and decreased quality of life. The role of mind-body interventions, which have significant effects on central pain syndromes and autonomic dysregulation, have not been well-described in co-diagnosed patients. The aim of this state-of-the art narrative review is to explore the relationship between irritable bowel syndrome and fibromyalgia, and to evaluate the current evidence and mechanism of action of mind-body therapies in these two conditions. METHODS The PubMed database was searched without date restrictions for articles published in English using the following keywords: fibromyalgia, irritable bowel syndrome, mind-body interventions, cognitive behavioral therapy, mindfulness based stress reduction, and yoga. RESULTS Mind-body interventions resulted in improved patient-reported outcomes, and are effective for irritable bowel syndrome and fibromyalgia individually. Specifically, cognitive behavioral therapy and yoga trials showed decreased symptom severity, improved mental health, sleep and quality of life for both conditions individually, while yoga trials demonstrated similar benefits with improvements in both physical outcomes (gastrointestinal symptoms, pain/tenderness scores, insomnia, and physical functioning), mental health outcomes (anxiety, depression, gastrointestinal-specific anxiety, and catastrophizing), and quality of life, possibly due to alterations in autonomic activity. CONCLUSION Mind-body interventions especially CBT and yoga improve patient-reported outcomes in both irritable bowel syndrome and fibromyalgia individually. However, limited available data in co-diagnosed patients warrant high quality trials to better tailor programs to patient needs.
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Affiliation(s)
- Zarmina Islam
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Adrijana D'Silva
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Maitreyi Raman
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Yasmin Nasser
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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8
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Bhuva AN, D'Silva A, Torlasco C, Nadarajan N, Jones S, Boubertakh R, Van Zalen J, Scully P, Knott K, Benedetti G, Augusto JB, Bastiaenen R, Lloyd G, Sharma S, Moon JC, Parker KH, Manisty CH, Hughes AD. Non-invasive assessment of ventriculo-arterial coupling using aortic wave intensity analysis combining central blood pressure and phase-contrast cardiovascular magnetic resonance. Eur Heart J Cardiovasc Imaging 2021; 21:805-813. [PMID: 31501858 DOI: 10.1093/ehjci/jez227] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/01/2019] [Accepted: 08/20/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Wave intensity analysis (WIA) in the aorta offers important clinical and mechanistic insight into ventriculo-arterial coupling, but is difficult to measure non-invasively. We performed WIA by combining standard cardiovascular magnetic resonance (CMR) flow-velocity and non-invasive central blood pressure (cBP) waveforms. METHODS AND RESULTS Two hundred and six healthy volunteers (age range 21-73 years, 47% male) underwent sequential phase contrast CMR (Siemens Aera 1.5 T, 1.97 × 1.77 mm2, 9.2 ms temporal resolution) and supra-systolic oscillometric cBP measurement (200 Hz). Velocity (U) and central pressure (P) waveforms were aligned using the waveform foot, and local wave speed was calculated both from the PU-loop (c) and the sum of squares method (cSS). These were compared with CMR transit time derived aortic arch pulse wave velocity (PWVtt). Associations were examined using multivariable regression. The peak intensity of the initial compression wave, backward compression wave, and forward decompression wave were 69.5 ± 28, -6.6 ± 4.2, and 6.2 ± 2.5 × 104 W/m2/cycle2, respectively; reflection index was 0.10 ± 0.06. PWVtt correlated with c or cSS (r = 0.60 and 0.68, respectively, P < 0.01 for both). Increasing age decade and female sex were independently associated with decreased forward compression wave (-8.6 and -20.7 W/m2/cycle2, respectively, P < 0.01) and greater wave reflection index (0.02 and 0.03, respectively, P < 0.001). CONCLUSION This novel non-invasive technique permits straightforward measurement of wave intensity at scale. Local wave speed showed good agreement with PWVtt, and correlation was stronger using the cSS than the PU-loop. Ageing and female sex were associated with poorer ventriculo-arterial coupling in healthy individuals.
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Affiliation(s)
- Anish N Bhuva
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - A D'Silva
- Cardiovascular Sciences Research Centre, St. George's University of London, Blackshaw Road, Tooting, London SW17 0QT, UK
| | - C Torlasco
- IRCCS, Istituto Auxologico Italiano, Via Ludovico Ariosto 13, 20145 Milan, Italy, Italy
| | - N Nadarajan
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK
| | - S Jones
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK
| | - R Boubertakh
- Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - J Van Zalen
- Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - P Scully
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - K Knott
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - G Benedetti
- Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - J B Augusto
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - Rachel Bastiaenen
- Cardiovascular Sciences Research Centre, St. George's University of London, Blackshaw Road, Tooting, London SW17 0QT, UK
| | - G Lloyd
- Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - S Sharma
- Cardiovascular Sciences Research Centre, St. George's University of London, Blackshaw Road, Tooting, London SW17 0QT, UK
| | - J C Moon
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - K H Parker
- Department of Bioengineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - C H Manisty
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,Barts Heart Centre, West Smithfield, London EC1A 7BE, UK
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, 69 Chenies Mews, London WC1E6HX, UK.,MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London WC1E 7HB, UK
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Gibson A, Tudor R, Dean M, Elegbede A, D'Silva A, Hao D, Bebb D. P89.12 Real World Outcomes in EGFR-Mutant Relapsed and De Novo Stage IV Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1278] [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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Abstract
The aim of this state-of-the-art narrative review is to evaluate the current evidence about the effectiveness of yoga as therapy for IBS and explore its potential mechanisms of action. The current literature suggests yoga is effective and safe and may target multiple mechanisms involved in treatment of IBS. Evidence from randomized controlled trials identified yoga as more effective compared to pharmacological treatment and equally effective as dietary interventions or moderate-intensity walking. Improvements were seen in both physical health (IBS symptom severity, gastric motility, autonomic and somatic symptom scores, and physical functioning) and mental health outcomes (depression, anxiety, gastrointestinal-specific anxiety, and quality of life). Given favorable changes in IBS-related physical and mental health outcomes, preliminary data supports yoga as beneficial in this population. However, the relatively low-quality evidence resulting from heterogeneity of study designs, interventions, and outcome measures limit our ability to make specific recommendations about the use of yoga as therapy for patients with IBS.
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Affiliation(s)
- Adrijana D'Silva
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Glenda MacQueen
- Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Yasmin Nasser
- Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Lorian M Taylor
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, AB, T9S 3A3, Canada
| | - Maitreyi Raman
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada. .,Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada. .,University of Calgary, 6D33 TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
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11
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Enwere EK, Dean ML, Li H, D'Silva A, Bebb DG. The prevalence and prognostic significance of estrogen receptor beta expression in non-small cell lung cancer. Transl Lung Cancer Res 2020; 9:496-506. [PMID: 32676313 PMCID: PMC7354142 DOI: 10.21037/tlcr.2020.03.34] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Estrogen receptor beta (ERβ) is the predominant estrogen receptor (ER) expressed in non-small cell lung cancer (NSCLC); however, due to methodological disparities among prior studies, the prognostic value of ERβ expression in NSCLC remains unclear. Our objective was to apply improved detection and analysis techniques to assess the prognostic value of ERβ expression in NSCLC. Methods A tissue microarray (TMA) was used which contained resected and biopsy specimens from 299 patients diagnosed at a single center with stages I-IV NSCLC. Sections of this array were stained using high-sensitivity fluorescence immunohistochemistry, with the well-validated PPG5/10 monoclonal antibody. Digital images of the stained array slides were analyzed using software-based image analysis, which reported ERβ expression as a continuous variable in different subcellular domains. Results There were no differences in ERβ expression between male and female patients. High expression of ERβ was not a prognostic factor, but was significantly associated with stage IV disease in both tumor and stroma (P<0.001). In multivariable analysis, a high nuclear/cytoplasmic (N/C) ratio of ERβ expression was significantly associated with shorter overall survival, based on expression in the tumor [hazard ratio (HR): 1.65; 95% confidence interval (CI): 1.25-2.19; P<0.001] and in the stroma (HR: 1.57; 95% CI: 1.16-2.12; P=0.003). Conclusions These results suggest that subcellular localization of ERβ, but not absolute expression, is a prognostic factor in NSCLC.
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Affiliation(s)
- Emeka K Enwere
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michelle L Dean
- Translational Laboratories, Tom Baker Cancer Center, Calgary, Alberta, Canada
| | - Haocheng Li
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Oncology, Tom Baker Cancer Center, Calgary, Alberta, Canada
| | - Adrijana D'Silva
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - D Gwyn Bebb
- Translational Laboratories, Tom Baker Cancer Center, Calgary, Alberta, Canada.,Department of Oncology, Tom Baker Cancer Center, Calgary, Alberta, Canada
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12
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Gibson AJW, D'Silva A, Elegbede AA, Tudor RA, Dean ML, Bebb DG, Hao D. Impact of Asian ethnicity on outcome in metastatic EGFR-mutant non-small cell lung cancer. Asia Pac J Clin Oncol 2019; 15:343-352. [PMID: 31486229 DOI: 10.1111/ajco.13234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 07/22/2019] [Indexed: 12/12/2022]
Abstract
AIM To determine factors associated with survival in de novo stage IV, non-small cell lung cancer (NSCLC) patients possessing epidermal growth factor receptor mutations (EGFRmut+ ) receiving tyrosine kinase inhibitors (TKI) in the first-line setting. METHODS The Glans-Look Lung Cancer Database was used to retrospectively review stage IV EGFRmut+ NSCLC patients diagnosed 2010-2016 receiving first-line TKI. Patients with overall survival times in the upper quartile (≥34 months) were designated "long-term survivors" (LTS), the remaining deemed "average-term survivors" and characteristics between these groups were compared in univariate analysis, and multivariable models constructed to determine predictors of outcome. RESULTS Of 170 eligible patients, median overall survival was 21 months. LTS were significantly more likely to be of Asian ethnicity, be never-smokers and not possess brain or bone metastases at diagnosis. Asian and non-Asian patients were comparable, save for an increased propensity of Asian patients to be never smokers and have normal-range BMI. Multivariable analysis revealed Asian ethnicity [hazard ratio (HR) = 0.65; P = 0.016] and never-smoking history (HR = 0.65; P = 0.034) as indicators of improved outcome, and presence of brain metastasis at diagnosis an indicator of poor outcome (HR = 2.21; P < 0.001). CONCLUSIONS Analysis of this population-based cohort identifies never-smoking history and absence of brain metastasis along with Asian ethnicity as an independent prognosticators of favorable outcome, and reveals Asian patients to be clinicopathologically similar to non-Asian patients. These findings suggest Asian patients represent a unique subpopulation within EGFRmut+ NSCLC who may possess different biological underpinnings of NSCLC.
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Affiliation(s)
- Amanda J W Gibson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Adrijana D'Silva
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Anifat A Elegbede
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Roxana A Tudor
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Michelle L Dean
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Dafydd Gwyn Bebb
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Tom Baker Cancer Centre, Alberta Health Services, Calgary, Canada
| | - Desiree Hao
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Tom Baker Cancer Centre, Alberta Health Services, Calgary, Canada
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13
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Sweegers MG, Boyle T, Vallance JK, Chinapaw MJ, Brug J, Aaronson NK, D'Silva A, Kampshoff CS, Lynch BM, Nollet F, Phillips SM, Stuiver MM, van Waart H, Wang X, Buffart LM, Altenburg TM. Which cancer survivors are at risk for a physically inactive and sedentary lifestyle? Results from pooled accelerometer data of 1447 cancer survivors. Int J Behav Nutr Phys Act 2019; 16:66. [PMID: 31420000 PMCID: PMC6698042 DOI: 10.1186/s12966-019-0820-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 01/25/2019] [Accepted: 07/18/2019] [Indexed: 12/22/2022] Open
Abstract
Background Physical activity has beneficial effects on the health of cancer survivors. We aimed to investigate accelerometer-assessed physical activity and sedentary time in cancer survivors, and describe activity profiles. Additionally, we identify demographic and clinical correlates of physical activity, sedentary time and activity profiles. Methods Accelerometer, questionnaire and clinical data from eight studies conducted in four countries (n = 1447) were pooled. We calculated sedentary time and time spent in physical activity at various intensities using Freedson cut-points. We used latent profile analysis to identify activity profiles, and multilevel linear regression analyses to identify demographic and clinical variables associated with accelerometer-assessed moderate to vigorous physical activity (MVPA), sedentary time, the highly active and highly sedentary profile, adjusting for confounders identified using a directed acyclic graph. Results Participants spent on average 26 min (3%) in MVPA and 568 min (66%) sedentary per day. We identified six activity profiles. Older participants, smokers and participants with obesity had significantly lower MVPA and higher sedentary time. Furthermore, men had significantly higher MVPA and sedentary time than women and participants who reported less fatigue had higher MVPA time. The highly active profile included survivors with high education level and normal body mass index. Haematological cancer survivors were less likely to have a highly active profile compared to breast cancer survivors. The highly sedentary profile included older participants, males, participants who were not married, obese, smokers, and those < 12 months after diagnosis. Conclusions Cancer survivors engage in few minutes of MVPA and spend a large proportion of their day sedentary. Correlates of MVPA, sedentary time and activity profiles can be used to identify cancer survivors at risk for a sedentary and inactive lifestyle. Electronic supplementary material The online version of this article (10.1186/s12966-019-0820-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M G Sweegers
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T Boyle
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia Cancer Research Institute, Adelaide, Australia
| | - J K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - M J Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J Brug
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - N K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A D'Silva
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - C S Kampshoff
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - B M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global health, The University of Melbourne, Melbourne, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - F Nollet
- Department of Rehabilitation, Amsterdam Movement Sciences institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - S M Phillips
- Department of Behavioural Medicine, Northwestern University, Chicago, USA
| | - M M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H van Waart
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Anesthesiology, University of Auckland, Auckland, New Zealand
| | - X Wang
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - L M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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14
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Langelier DM, D'Silva A, Shank J, Grant C, Bridel W, Culos‐Reed SN. Exercise interventions and their effect on masculinity, body image, and personal identity in prostate cancer—A systematic qualitative review. Psychooncology 2019; 28:1184-1196. [DOI: 10.1002/pon.5060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/10/2019] [Accepted: 03/12/2019] [Indexed: 12/28/2022]
Affiliation(s)
- David Michael Langelier
- Clinical Neurosciences, Division of Physical Medicine and RehabilitationUniversity of Calgary Calgary
- Faculty of KinesiologyUniversity of Calgary Calgary
| | | | - Jena Shank
- Faculty of KinesiologyUniversity of Calgary Calgary
| | - Christopher Grant
- Clinical Neurosciences, Division of Physical Medicine and RehabilitationUniversity of Calgary Calgary
| | | | - S. Nicole Culos‐Reed
- Faculty of KinesiologyUniversity of Calgary Calgary
- Department of Psychosocial ResourcesTom Baker Cancer Centre Calgary
- Department of Oncology, Cumming School of MedicineUniversity of Calgary Calgary
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15
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Vallance JK, Gardiner PA, Lynch BM, D'Silva A, Boyle T, Taylor LM, Johnson ST, Buman MP, Owen N. Evaluating the Evidence on Sitting, Smoking, and Health: Is Sitting Really the New Smoking? Am J Public Health 2018; 108:1478-1482. [PMID: 30252516 PMCID: PMC6187798 DOI: 10.2105/ajph.2018.304649] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2018] [Indexed: 01/05/2023]
Abstract
Sitting has frequently been equated with smoking, with some sources even suggesting that smoking is safer than sitting. This commentary highlights how sitting and smoking are not comparable. The most recent meta-analysis of sedentary behavior and health outcomes reported a hazard ratio of 1.22 (95% confidence interval [CI] = 1.09, 1.41) for all-cause mortality. The relative risk (RR) of death from all causes among current smokers, compared with those who have never smoked, is 2.80 (95% CI = 2.72, 2.88) for men and 2.76 for women (95% CI = 2.69, 2.84). The risk is substantially higher for heavy smokers (> 40 cigarettes per day: RR = 4.08 [95% CI = 3.68, 4.52] for men, and 4.41 [95% CI = 3.70, 5.25] for women). These estimates correspond to absolute risk differences of more than 2000 excess deaths from any cause per 100 000 persons per year among the heaviest smokers compared with never smokers, versus 190 excess deaths per 100 000 persons per year when comparing people with the highest volume of sitting with the lowest. Conflicting or distorted information about health risks related to behavioral choices and environmental exposures can lead to confusion and public doubt with respect to health recommendations.
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Affiliation(s)
- Jeff K Vallance
- Jeff K. Vallance and Steven T. Johnson are with the Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada. Paul A. Gardiner is with the Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia. Brigid M. Lynch is with the Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Adrijana D'Silva is with the Faculty of Kinesiology, University of Calgary, Calgary, Alberta. Terry Boyle is with Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Lorian M. Taylor is with the Cumming School of Medicine, University of Calgary. Matthew P. Buman is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Neville Owen is with the Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne
| | - Paul A Gardiner
- Jeff K. Vallance and Steven T. Johnson are with the Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada. Paul A. Gardiner is with the Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia. Brigid M. Lynch is with the Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Adrijana D'Silva is with the Faculty of Kinesiology, University of Calgary, Calgary, Alberta. Terry Boyle is with Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Lorian M. Taylor is with the Cumming School of Medicine, University of Calgary. Matthew P. Buman is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Neville Owen is with the Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne
| | - Brigid M Lynch
- Jeff K. Vallance and Steven T. Johnson are with the Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada. Paul A. Gardiner is with the Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia. Brigid M. Lynch is with the Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Adrijana D'Silva is with the Faculty of Kinesiology, University of Calgary, Calgary, Alberta. Terry Boyle is with Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Lorian M. Taylor is with the Cumming School of Medicine, University of Calgary. Matthew P. Buman is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Neville Owen is with the Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne
| | - Adrijana D'Silva
- Jeff K. Vallance and Steven T. Johnson are with the Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada. Paul A. Gardiner is with the Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia. Brigid M. Lynch is with the Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Adrijana D'Silva is with the Faculty of Kinesiology, University of Calgary, Calgary, Alberta. Terry Boyle is with Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Lorian M. Taylor is with the Cumming School of Medicine, University of Calgary. Matthew P. Buman is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Neville Owen is with the Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne
| | - Terry Boyle
- Jeff K. Vallance and Steven T. Johnson are with the Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada. Paul A. Gardiner is with the Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia. Brigid M. Lynch is with the Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Adrijana D'Silva is with the Faculty of Kinesiology, University of Calgary, Calgary, Alberta. Terry Boyle is with Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Lorian M. Taylor is with the Cumming School of Medicine, University of Calgary. Matthew P. Buman is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Neville Owen is with the Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne
| | - Lorian M Taylor
- Jeff K. Vallance and Steven T. Johnson are with the Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada. Paul A. Gardiner is with the Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia. Brigid M. Lynch is with the Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Adrijana D'Silva is with the Faculty of Kinesiology, University of Calgary, Calgary, Alberta. Terry Boyle is with Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Lorian M. Taylor is with the Cumming School of Medicine, University of Calgary. Matthew P. Buman is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Neville Owen is with the Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne
| | - Steven T Johnson
- Jeff K. Vallance and Steven T. Johnson are with the Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada. Paul A. Gardiner is with the Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia. Brigid M. Lynch is with the Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Adrijana D'Silva is with the Faculty of Kinesiology, University of Calgary, Calgary, Alberta. Terry Boyle is with Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Lorian M. Taylor is with the Cumming School of Medicine, University of Calgary. Matthew P. Buman is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Neville Owen is with the Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne
| | - Matthew P Buman
- Jeff K. Vallance and Steven T. Johnson are with the Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada. Paul A. Gardiner is with the Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia. Brigid M. Lynch is with the Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Adrijana D'Silva is with the Faculty of Kinesiology, University of Calgary, Calgary, Alberta. Terry Boyle is with Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Lorian M. Taylor is with the Cumming School of Medicine, University of Calgary. Matthew P. Buman is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Neville Owen is with the Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne
| | - Neville Owen
- Jeff K. Vallance and Steven T. Johnson are with the Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada. Paul A. Gardiner is with the Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia. Brigid M. Lynch is with the Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Adrijana D'Silva is with the Faculty of Kinesiology, University of Calgary, Calgary, Alberta. Terry Boyle is with Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Lorian M. Taylor is with the Cumming School of Medicine, University of Calgary. Matthew P. Buman is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Neville Owen is with the Behavioural Epidemiology Laboratory, Baker Heart & Diabetes Institute, Melbourne
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16
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Gibson A, Li H, D'Silva A, Tudor R, Elegbede A, Otsuka S, Bebb G, Cheung W. P2.01-13 Number, Rather Than Location of Metastases, Dictates Outcome in Stage IV, M1b, Non-Small Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1067] [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: 11/27/2022]
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17
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Fung A, Kopciuk K, Dean M, D'Silva A, Otsuka S, Klimowicz A, Hao D, Morris D, Bebb G. P3.03-21 CXCR4 Overexpression is Associated with Poor Survival Outcome After Recurrence in Early Stage Non-Small Cell Lung Cancer Patients. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1698] [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: 11/27/2022]
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18
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Gibson A, D'Silva A, Tudor R, Elegbede A, Otsuka S, Bebb G, Hao D. P3.13-10 Factors Associated with Long-Term Survival of Stage IV NSCLC Patients on First-Line EGFR-Targeting Therapy. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1850] [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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19
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Dean M, Chan A, Enwere E, Li H, Gibson A, D'Silva A, Elegbede A, Tudor R, Otsuka S, Morris D, Bebb G. P3.13-28 Heterogeneity, Prevalence and Prognostic Significance of PDL1 Expression in Early Resected NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1869] [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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20
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Elegbede A, Li H, D'Silva A, Gibson A, Tudor R, Dean M, Otsuka S, Bebb G. P2.01-28 Gender and Systemic Treatment Patterns: Impacts on the Overall Survival of Stage IV NSCLC 2010 – 2014 Diagnoses. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1082] [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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21
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Petersen L, D'Silva A, Dean M, Konno M, Ilnytskyy Y, Kovalchuk O, Bebb G. P3.09-16 Transcriptome Profiling for Subtyping NSCLC: Off the Beaten Path(Ologist). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1785] [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: 11/30/2022]
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22
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Gibson AJW, Li H, D'Silva A, Tudor RA, Elegbede AA, Otsuka SM, Bebb DG, Cheung WY. Impact of number versus location of metastases on survival in stage IV M1b non-small cell lung cancer. Med Oncol 2018; 35:117. [PMID: 30073425 DOI: 10.1007/s12032-018-1182-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 07/31/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND To assess the impact of location versus number of extra-pulmonary metastatic sites (EPMS) on survival in stage IV non-small cell lung cancer (NSCLC). METHODS AND MATERIALS Retrospective analysis was conducted on patients diagnosed during 1999-2013 with stage IV, M1b (AJCC 7th edition) NSCLC using the large, institutional Glans-Look Database, which contains patient demographic, clinical, pathological, treatment, and outcome information. We assessed the impact of location and number of EPMS and identified correlates of overall survival using the Kaplan-Meier method and Cox regression. RESULTS We identified a total of 2065 NSCLC patients with EPMS. Median age was 67 (IQR 58-75) years, 52% were men, and 78% were current or former smokers. 60% had one EPMS, and 40% had two or more EPMS. Among those with only one EPMS, most frequent organ involvement included bone (40%), brain (32%), and liver (13%). Median overall survival (mOS) was worst in those with liver metastasis and best in those with adrenal metastasis (2.0 vs. 5.2 months, p = 0.015). However, outcomes based on site of organ involvement were not significantly different in multivariable analysis. Compared to patients with one EPMS, individuals with two or more EPMS experienced worse outcomes (mOS ≤ 2.9 vs. 3.9 months, p < 0.001), and were associated with worse prognosis in Cox regression analysis (HR 1.5, 95% CI 1.3-1.7, p < 0.001). CONCLUSIONS Number rather than location of EPMS is a prognostic factor in patients with stage IV M1b NSCLC. This information is relevant for accurate prognostication, stratification of participants in future clinical trials, and timely and appropriate advanced care planning.
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Affiliation(s)
- Amanda Jane Williams Gibson
- Department of Oncology, Cumming School of Medicine, University of Calgary, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada
| | - Haocheng Li
- Department of Oncology, Cumming School of Medicine, University of Calgary, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada
| | - Adrijana D'Silva
- Department of Oncology, Cumming School of Medicine, University of Calgary, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada
| | - Roxana A Tudor
- Department of Oncology, Cumming School of Medicine, University of Calgary, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada
| | - Anifat A Elegbede
- Department of Oncology, Cumming School of Medicine, University of Calgary, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada
| | - Shannon Mary Otsuka
- Department of Oncology, Cumming School of Medicine, University of Calgary, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada
| | - D Gwyn Bebb
- Department of Oncology, Cumming School of Medicine, University of Calgary, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada
- Tom Baker Cancer Centre, Alberta Health Services, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada
| | - Winson Y Cheung
- Department of Oncology, Cumming School of Medicine, University of Calgary, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada.
- Tom Baker Cancer Centre, Alberta Health Services, 1331 29th St NW, Calgary, AB, T2N 4N2, Canada.
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23
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Torlasco C, D'Silva A, Augusto J, Faini A, Knott K, Bhuva A, Benedetti G, Scully P, Jones S, Lobascio I, Parati G, Lloyd G, Manisty C, Moon JC, Sharma S. P3688Age matters: differences in cardiac response to training in young and middle aged first-time marathon runners. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Torlasco
- S.Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - A D'Silva
- St George's University of London, London, United Kingdom
| | - J Augusto
- Barts Health NHS Trust, London, United Kingdom
| | - A Faini
- S.Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - K Knott
- Barts Health NHS Trust, London, United Kingdom
| | - A Bhuva
- Barts Health NHS Trust, London, United Kingdom
| | - G Benedetti
- Barts Health NHS Trust, London, United Kingdom
| | - P Scully
- Barts Health NHS Trust, London, United Kingdom
| | - S Jones
- University College London, London, United Kingdom
| | - I Lobascio
- Barts Health NHS Trust, London, United Kingdom
| | - G Parati
- University of Milano-Bicocca - Cardiology II, S. Luca Hospital, Milano, Italy
| | - G Lloyd
- Barts Health NHS Trust, London, United Kingdom
| | - C Manisty
- Barts Health NHS Trust, London, United Kingdom
| | - J C Moon
- Barts Health NHS Trust, London, United Kingdom
| | - S Sharma
- St George's University of London, London, United Kingdom
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24
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D'Silva A, Bhuva AN, Jones S, Van Zalen J, Bastiaenen R, Captur G, Gati S, Willis J, Liu S, Hughes A, Sharma R, Mainstay C, Lloyd G, Moon JC, Sharma S. P650Exercise-induced left ventricular trabeculation: real entity or fake news? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A D'Silva
- St George's Healthcare NHS Trust, London, United Kingdom
| | - A N Bhuva
- University College London, Institute for Cardiovascular Science, London, United Kingdom
| | - S Jones
- University College London, London, United Kingdom
| | - J Van Zalen
- Eastbourne District General Hospital, Eastbourne, United Kingdom
| | | | - G Captur
- University College London, London, United Kingdom
| | - S Gati
- Royal Brompton Hospital, London, United Kingdom
| | - J Willis
- Royal United Hospital Bath NHS Trust, Bath, United Kingdom
| | - S Liu
- Barts Health NHS Trust, London, United Kingdom
| | - A Hughes
- University College London, London, United Kingdom
| | - R Sharma
- St George's Healthcare NHS Trust, London, United Kingdom
| | - C Mainstay
- University College London, Institute for Cardiovascular Science, London, United Kingdom
| | - G Lloyd
- University College London, Institute for Cardiovascular Science, London, United Kingdom
| | - J C Moon
- University College London, Institute for Cardiovascular Science, London, United Kingdom
| | - S Sharma
- St George's Healthcare NHS Trust, London, United Kingdom
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25
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Van Zalen JJ, D'Silva A, Badiani S, Bhuva A, Jones S, Torlasco C, Hughes AD, Manisty C, Sharma S, Moon JC, Lloyd G. P852Linking myocardial mechanical function to exercise performance: a cardiopulmonary stress echo study in first time London marathon participants. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J J Van Zalen
- Eastbourne District General Hospital, Eastbourne, United Kingdom
| | - A D'Silva
- St Georges Hospital, London, United Kingdom
| | - S Badiani
- Barts Health NHS Trust, London, United Kingdom
| | - A Bhuva
- University College London, London, United Kingdom
| | - S Jones
- University College London, London, United Kingdom
| | - C Torlasco
- Barts Health NHS Trust, London, United Kingdom
| | - A D Hughes
- University College London, London, United Kingdom
| | - C Manisty
- Barts Health NHS Trust, London, United Kingdom
| | - S Sharma
- St Georges Hospital, London, United Kingdom
| | - J C Moon
- University College London, London, United Kingdom
| | - G Lloyd
- Barts Health NHS Trust, London, United Kingdom
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26
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D'Silva A, Bebb G, Boyle T, Johnson ST, Vallance JK. Demographic and clinical correlates of accelerometer assessed physical activity and sedentary time in lung cancer survivors. Psychooncology 2017; 27:1042-1049. [PMID: 29226994 DOI: 10.1002/pon.4608] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/07/2017] [Accepted: 11/30/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To determine demographic and clinical correlates of accelerometer assessed physical activity and sedentary time among a population-based sample of lung cancer survivors. METHODS Lung cancer survivors in Southern Alberta, Canada (N = 527) were invited to complete a mailed survey assessing socio-demographics and wear an Actigraph® GT3X+ accelerometer for 7 days. Average daily minutes of physical activity and sedentary time were derived from the accelerometer data. Accelerometer data were processed using standard Freedson cutpoints, and correlates of physical activity and sedentary time were determined with linear regression. RESULTS A total of 127 lung cancer survivors participated (mean age = 71 years), for a 24% response rate. Moderate-to-vigorous physical activity was negatively associated with being >60 years of age (β = -7.4, CI: -14.7, -0.10). Moderate-to-vigorous physical activity accumulated in 10-minute bouts was associated with receiving surgery and adjuvant chemotherapy (β = 9.1, CI: 2.1, 16.1). Sedentary time was associated with being >60 years of age (β = 32.4, CI: 3.1, 61.7), smoking (β = 63.9, CI: 22.5, 105.4), and being overweight/obese (β = 28.6, CI: 6.4, 50.1). CONCLUSION Age, smoking history, and body mass index emerged as correlates of accelerometer assessed light, moderate, and vigorous physical activity, and sedentary time among lung cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Identifying correlates of physical activity and sedentary time may aid in the development of targeted behavioral interventions for this population.
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Affiliation(s)
- Adrijana D'Silva
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - Gwyn Bebb
- Faculty of Medicine, University of Calgary, Calgary, Canada
| | - Terry Boyle
- School of Public Health, Curtin University, Perth, Australia
| | - Steven T Johnson
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
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Fung A, D'Silva A, Li H, Otsuka S, Bebb D. P2.01-026 Distribution of Metastatic Disease in Survival Outliers with Stage IV Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1128] [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: 11/16/2022]
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28
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Elegbede A, Koebel M, D'Silva A, Dean M, Enwere E, Tudor R, Gibson A, Li H, Otsuka S, Bebb G. P2.02-068 BRG1 and p53 Expression in Resected Stage I – III Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1246] [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: 11/27/2022]
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Papatheodorou E, Papadakis M, Ensam B, Finocchiaro G, Mellor G, Prakash K, D'Silva A, Wijeyeratne Y, Miles C, Malhotra A, Tome-Esteban M, Batchvarov V, Sheppard M, Sharma S, Behr E. P2115Validation of the proposed Shanghai Brugada Syndrome Score (SBrS) in a cohort of relatives of Sudden Arrhythmic Death Syndrome (SADS) victims. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E. Papatheodorou
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - M. Papadakis
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - B. Ensam
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - G. Finocchiaro
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - G. Mellor
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - K. Prakash
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - A. D'Silva
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - Y. Wijeyeratne
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - C. Miles
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - A. Malhotra
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - M. Tome-Esteban
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - V. Batchvarov
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - M.N. Sheppard
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - S. Sharma
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | - E.R. Behr
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
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Malhotra A, Dhutia H, Rao P, Gati S, Keteepe-Arachi T, Finnochiaro G, Yeo T, Basu J, Parry-White G, D'Silva A, Papatheodorou S, Ensam B, Tome M, Papadakis M, Sharma S. P3244The mixed race heart: not so black and white. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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31
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D'Silva A, Bebb G, Boyle T, Johnson S, Vallance J. P1.01-044 Accelerometer-Determined Physical Activity and Sedentary Time among Lung Cancer Survivors. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Fung A, D'Silva A, Li H, Otsuka S, Bebb DG. P1.06-022 Clinical Characteristics of Survival Outliers in Stage IV Adenocarcinoma Lung Cancer Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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33
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Van Der Merwe C, D'Silva A, Otsuka S, Gelfand G, Graham A, Grondin S, Mcfadden S, Bebb G. MA06.01 Overall Survival Characterization of Incidental N2 Non-Small Cell Lung Cancer over 14 Years at a Single Canadian Institution. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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34
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Tudor R, Kopciuk K, D'Silva A, Brenner D, Morris D, Bebb D. Addressing disease progression in EGFRmut+ NSCLC patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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D'Silva A, Lau H, Otsuka S, Tudor R, Bebb D. Reaching the pinnacle of stage III NSCLC treatment. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw382.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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36
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Grendarova P, Arora R, Bebb G, D'Silva A, Banerjee R. Sarcopenia Is Associated With Worse Overall Survival in Patients With Locally Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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37
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D'Silva A, Otsuka S, Li H, Wu J, Morris D, Bebb G. 163: Cumulative Incidence of Brain Metastasis after Diagnosis of Non-Small Cell Lung Cancer: Estimates from a Regional Cancer Centre Cohort. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33562-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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38
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Grendarova P, Arora R, Bebb G, D'Silva A, Robyn B. 239: Sarcopenia is Associated with Worse Overall Survival in Patients with Locally Advanced Non-Small Cell Lung Cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33638-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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D'Silva A, Jassim I, Greenwood J, Grosser K. Chasing the ACE of hearts. Case Reports 2013; 2013:bcr-2013-009668. [DOI: 10.1136/bcr-2013-009668] [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: 11/03/2022] Open
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McGhee DJM, Royle PL, Counsell CE, Abbas A, Sethi P, Manku L, Narayan A, Clegg K, Bardai A, Brown SHM, Hafeez U, Abdelhafiz AH, McGovern A, Breckenridge A, Seenan P, Samani A, Das S, Khan S, Puffett AJ, Morgan J, Ross G, Cantlay A, Khan N, Bhalla A, Sweeting M, Nimmo CAMD, Fleet J, Igbedioh C, Harari D, Downey CL, Handforth C, Stothard C, Cracknell A, Barnes C, Shaw L, Bainbridge L, Crabtree L, Clark T, Root S, Aitken E, Haroon K, Sudlow M, Hanley K, Welsh S, Hill E, Falconer A, Miller H, Martin B, Tidy E, Pendlebury S, Thompson S, Burnett E, Taylor H, Lonan J, Adler B, McCallion J, Sykes E, Bancroft R, Tullo ES, Young TJ, Clift E, Flavin B, Roberts HC, Sayer AA, Belludi G, Aithal S, Verma A, Singh I, Barne M, Wilkinson I, Sakoane R, Singh N, Wilkinson I, Cottee M, Irani TS, Martinovic O, Abdulla AJJ, Irani TS, Abdulla AJJ, Riglin J, Husk J, Lowe D, Treml J, Vasilakis JN, Buttery A, Reid J, Healy P, Grant-Casey J, Pendry K, Richards J, Singh A, Jarrett D, Hewitt J, Slevin J, Barwell G, Youde J, Kennedy C, Romero-Ortuno R, O'Shea D, Robinson D, O'Shea D, Kenny RA, O'Connell J, Kennedy C, Romero-Ortuno R, O'Shea D, Robinson D, O'Shea D, Robinson D, O'Connell J, Topp JD, Topp JD, Warburton K, Simpson L, Bryce K, Suntharalingam S, Grosser K, D'Silva A, Southern L, Bielawski C, Cook L, Sutton GM, Flanagan L, Storr A, Charlton L, Kerr S, Robinson L, Shaw F, Finch LK, Weerasuriya N, Walker M, Sahota O, Logan P, Brown F, Rossiter F, Baxter M, Mucci E, Brown A, Jackson SHD, de Savary N, Hasan S, Jones H, Birrell J, Hockley J, Hensey N, Meiring R, Athavale N, Simms J, Brown S, West A, Diem P, Simms J, Brown S, West A, Diem P, Davies R, Kings R, Coleman H, Stevens D, Campbell C, Hope S, Morris A, Ong T, Harwood R, Dasgupta D, Mitchell S, Dimmock V, Collin F, Wood E, Green V, Hendrickse-Welsh N, Singh N, Cracknell A, Eccles J, Beezer J, Garside M, Baxter J. Clinical effectiveness. Age Ageing 2013. [DOI: 10.1093/ageing/aft016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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