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Grimes H, Ansari M, Ashraf T, Cueto-González AM, Calder A, Day M, Fernandez Alvarez P, Foster A, Lahiri N, Repetto GM, Scurr I, Varghese V, Low KJ. PUF60-related developmental disorder: A case series and phenotypic analysis of 10 additional patients with monoallelic PUF60 variants. Am J Med Genet A 2023; 191:2610-2622. [PMID: 37303278 DOI: 10.1002/ajmg.a.63313] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 01/07/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023]
Abstract
PUF60-related developmental disorder (also referred to as Verheij syndrome), resulting from haploinsufficiency of PUF60, is associated with multiple congenital anomalies affecting a wide range of body systems. These anomalies include ophthalmic coloboma, and congenital anomalies of the heart, kidney, and musculoskeletal system. Behavioral and intellectual difficulties are also observed. While less common than other features associated with PUF60-related developmental disorder, for instance hearing impairment and short stature, identification of specific anomalies such as ophthalmic coloboma can aid with diagnostic identification given the limited spectrum of genes linked with this feature. We describe 10 patients with PUF60 gene variants, bringing the total number reported in the literature, to varying levels of details, to 56 patients. Patients were recruited both via locally based exome sequencing from international sites and from the DDD study in the United Kingdom. Eight of the variants reported were novel PUF60 variants. The addition of a further patient with a reported c449-457del variant to the existing literature highlights this as a recurrent variant. One variant was inherited from an affected parent. This is the first example in the literature of an inherited variant resulting in PUF60-related developmental disorder. Two patients (20%) were reported to have a renal anomaly consistent with 22% of cases in previously reported literature. Two patients received specialist endocrine treatment. More commonly observed were clinical features such as: cardiac anomalies (40%), ocular abnormalities (70%), intellectual disability (60%), and skeletal abnormalities (80%). Facial features did not demonstrate a recognizable gestalt. Of note, but remaining of unclear causality, we describe a single pediatric patient with pineoblastoma. We recommend that stature and pubertal progress should be monitored in PUF60-related developmental disorder with a low threshold for endocrine investigations as hormone therapy may be indicated. Our study reports an inherited case with PUF60-related developmental disorder which has important genetic counseling implications for families.
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Affiliation(s)
- H Grimes
- Department of Clinical Genetics, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - M Ansari
- South East Scotland Genetics Service, Western General Hospital, Edinburgh, UK
| | - T Ashraf
- Department of Clinical Genetics, Great Ormond Street Hospital, London, UK
| | - Anna Mª Cueto-González
- Department of Clinical and Molecular Genetics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Medicine Genetics Group, Vall Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Autonomous University of Barcelona, Barcelona, Spain
| | - A Calder
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - M Day
- Exeter Genetics Laboratory, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - P Fernandez Alvarez
- Department of Clinical and Molecular Genetics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - A Foster
- Department of Clinical Genetics, West Midlands Regional Genetics Centre, Birmingham, UK
| | - N Lahiri
- Department of Clinical Genetics, St Georges University Hospital NHS Foundation Trust, London, UK
- Department of Clinical and Molecular Science, St Georges University of London, London, UK
| | - G M Repetto
- Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - I Scurr
- Department of Clinical Genetics, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - V Varghese
- All Wales Medical Genomics Services, University Hospital of Wales, Cardiff, UK
| | - Karen J Low
- Department of Clinical Genetics, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
- Centre for Academic Child Health, University of Bristol, Bristol, UK
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Foster A, Holding E, Lumley E, Roxby S, Portman D, Holliday J, Peace A, Del Rosario I, Khan W, Brenman A, Gillett M, Goyder E. Learning from the challenges of undertaking an evaluation of a multi-partner housing support initiative delivered within a hospital setting. Public Health in Practice 2022; 4:100333. [PMID: 36345288 PMCID: PMC9636567 DOI: 10.1016/j.puhip.2022.100333] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/05/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives We present learning from a mixed-methods evaluation of a housing support initiative for hospital inpatients. Study design A mixed-methods process evaluation. Methods A social housing provider delivered a housing support service in two hospitals (mental health unit and general hospital). Healthcare providers, the social housing provider and academic researchers designed and undertook a co-produced, mixed-methods process evaluation of the intervention. The evaluation included questionnaires, semi-structured interviews, analysis of routinely collected data and economic analysis. Despite commitment from the partners, the evaluation faced challenges. We reflect on the lessons learnt within our discussion paper. Results Despite the commitment of the partners, we faced several challenges. We took an iterative approach to the design and processes of the evaluation to respond to arising challenges. Recruitment of service-users was more difficult than anticipated, requiring additional staff resources. Given the small-scale nature of the intervention, and the quality of data recorded in hospital records, the planned economic analysis was not feasible. Positive factors facilitating evaluation included involvement of staff delivering the intervention, as well as managers. Being able to offer payment to partner organisations for staff time also facilitated ongoing engagement. Conclusions Multi-partner evaluations are useful, however, researchers and partners need to be prepared to take an iterative, resource intensive approach. Both availability and quality of routine data, and the resources required to support data collection, may limit feasibility of specific methods when evaluating small-scale cross-sector initiatives. Thus, this necessitates a flexible approach to design and analysis.
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Affiliation(s)
- A. Foster
- School of Health and Related Research, University of Sheffield, Sheffield, UK,Corresponding author. University of Sheffield, Regents Court, Regent Street, Sheffield, S1 4DA, UK.
| | - E. Holding
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - E. Lumley
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - S. Roxby
- Wakefield District Housing, Wakefield, UK
| | - D. Portman
- Wakefield District Housing, Wakefield, UK
| | | | - A. Peace
- School of Health and Related Research, University of Sheffield (Formerly at South West Yorkshire Partnership NHS Foundation Trust), Yorkshire, UK
| | | | - W. Khan
- South West Yorkshire Partnership NHS Foundation Trust, Yorkshire, UK
| | - A. Brenman
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - M. Gillett
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - E. Goyder
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Fisher T, Evans E, Mallow C, Foster A, Boise M, Smith E, Leonard J, Chaney M, Beck J, Hager S, Saba N, Steuer C, Adkins D, Burtness B, Zauderer M. Phase 1/2 Study of Pepinemab in Combination with Pembrolizumab as First-Line Treatment of Advanced, Recurrent or Metastatic Head and Neck Cancer (KEYNOTE B84). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hamann M, Shimada T, Duce S, Foster A, To ATY, Limpus C. Patterns of nesting behaviour and nesting success for green turtles at Raine Island, Australia. ENDANGER SPECIES RES 2022. [DOI: 10.3354/esr01175] [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: 11/23/2022] Open
Abstract
To understand how turtles use the nesting habitat at Raine Island across a nesting season, and how the turtles respond to the restoration of the island’s dune systems, we identified 534 nesting events for 39 green turtles Chelonia mydas across 2 breeding seasons using data derived from satellite tags. Tracked turtles laid between 4 and 10 clutches of eggs. Patterns of nesting success varied between individuals, within and between seasons. Nesting success was higher in 2018-19 (57%) than 2017-18 (45%), and in both years, nesting success was lowest between October and early January (<50%). In 2017-18, increased rainfall in January corresponded with increased nesting success (>50%). The density of female turtles ashore was lower in 2018-19, and likely explains higher nesting success in 2018-19 because competition for nest space was lower. In 2017-18, females had more attempts per clutch, and the attempts were around 90 min longer. Consequently, energy required to lay a clutch of eggs in 2017-18 was significantly higher than in 2018-19, highlighting potential costs of lower nesting success rates on reproductive output. The area of beach re-profiled as an intervention in 2014 and 2017 was a nesting hotspot in 2017-18. However, in 2018-19, the area was not used to the same extent, and the nesting hotspot occurred on the north-eastern unaltered beach. Collectively, the tracking of turtles across the whole nesting season enabled us to assess overall beach use and nesting site fidelity of green turtles at Raine Island. Results will aid future planning and management of beach restoration activities at turtle nesting sites.
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Affiliation(s)
- M Hamann
- College of Science and Engineering, James Cook University, Townsville, Qld 4811, Australia
| | - T Shimada
- College of Science and Engineering, James Cook University, Townsville, Qld 4811, Australia
- Queensland Department of Environment and Science, Brisbane, Qld 4102, Australia
| | - S Duce
- College of Science and Engineering, James Cook University, Townsville, Qld 4811, Australia
| | - A Foster
- College of Science and Engineering, James Cook University, Townsville, Qld 4811, Australia
| | - ATY To
- College of Science and Engineering, James Cook University, Townsville, Qld 4811, Australia
| | - C Limpus
- Queensland Department of Environment and Science, Brisbane, Qld 4102, Australia
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Essa H, Oguguo E, Douglas H, Foster A, Walker L, Hadcroft J, Bellieu J, Kahn M, Rao A, Cuthbertson D, Akpan A, Wong C, Sankaranarayanan R. One year outcomes of heart failure multispecialty multidisciplinary team virtual meetings. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Heart Failure is frequently associated with several comorbidities such as ischaemic heard disease, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease and frailty. This level of complexity is best dealt with by a multispecialty multidisciplinary team (MDT) model.
This was a single centre observational study (January 2020-December 2020) that was undertaken in a British university hospital looking at effect of HF multispecialty virtual MDT meetings on HF outcomes. Patients acted as their own controls outcomes compared for equal period pre versus post MDT meeting. The multi-specialty meeting was conducted once monthly via video-conferencing. It consisted of heart failure cardiologists (from primary secondary and tertiary care), heart failure specialist nurses (hospital and community), nephrologist, endocrinologist, palliative care specialists, chest physician, pharmacist, pharmacologist and geriatrician. Recommendations were made as consensus from the multispecialty meeting. The main outcome measures were 1) number of hospitalisations and 2) outpatient clinic attendances 3) cost savings.
A total of 189 patients were discussed from January-December 2020. This was uninterrupted during the COVID-19 pandemic. The mean age was 70.3±18.1 years and median follow-up 6 months (range 1–13 months). The mean Charlson Co-morbidity score was 5.3±1.2 and Rockwood Frailty Score was 4.9±1. The mean number of outpatient clinic attendances avoided was 1.7±0.4. This reduced inconvenience to patients, saved patients money (transport and parking costs) and led to carbon footprint reduction. The MDT meeting total costs were £15,400 and the 31 clinic appointments they generated cost an estimated £3720. However, the MDT meetings prevented 277 clinic appointments (cost saving £33,352). Finally, the mean number of hospitalisations pre-MDT was 0.7 Vs 0.2 post MDT (p<0.01) with a saving of around 730 bed days (estimated cost-saving £260,000).
The HF multispecialty virtual MDT approach provides seamless integration of primary care community services with secondary and tertiary care. Consensus decision from MDT meetings provides holistic approach for HF patients with comorbidities and frailty, and reduces inconvenience to patients by preventing the need to attend multiple specialty clinics. This approach can also lead to significant cost-savings to the healthcare system.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Essa
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - E Oguguo
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - H Douglas
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - A Foster
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - L Walker
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - J Hadcroft
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - J Bellieu
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - M Kahn
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - A Rao
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - D Cuthbertson
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - A Akpan
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - C Wong
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
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Foster A, Nigam S, Tatum DS, Raphael I, Xu J, Kumar R, Plakseychuk E, Latoche JD, Vincze S, Li B, Giri R, McCarl LH, Edinger R, Ak M, Peddagangireddy V, Foley LM, Hitchens TK, Colen RR, Pollack IF, Panigrahy A, Magda D, Anderson CJ, Edwards WB, Kohanbash G. Novel theranostic agent for PET imaging and targeted radiopharmaceutical therapy of tumour-infiltrating immune cells in glioma. EBioMedicine 2021; 71:103571. [PMID: 34530385 PMCID: PMC8446777 DOI: 10.1016/j.ebiom.2021.103571] [Citation(s) in RCA: 3] [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: 02/18/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Malignant gliomas are deadly tumours with few therapeutic options. Although immunotherapy may be a promising therapeutic strategy for treating gliomas, a significant barrier is the CD11b+ tumour-associated myeloid cells (TAMCs), a heterogeneous glioma infiltrate comprising up to 40% of a glioma's cellular mass that inhibits anti-tumour T-cell function and promotes tumour progression. A theranostic approach uses a single molecule for targeted radiopharmaceutical therapy (TRT) and diagnostic imaging; however, there are few reports of theranostics targeting the tumour microenvironment. METHODS Utilizing a newly developed bifunctional chelator, Lumi804, an anti-CD11b antibody (αCD11b) was readily labelled with either Zr-89 or Lu-177, yielding functional radiolabelled conjugates for PET, SPECT, and TRT. FINDINGS 89Zr/177Lu-labeled Lumi804-αCD11b enabled non-invasive imaging of TAMCs in murine gliomas. Additionally, 177Lu-Lumi804-αCD11b treatment reduced TAMC populations in the spleen and tumour and improved the efficacy of checkpoint immunotherapy. INTERPRETATION 89Zr- and 177Lu-labeled Lumi804-αCD11b may be a promising theranostic pair for monitoring and reducing TAMCs in gliomas to improve immunotherapy responses. FUNDING A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.
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Affiliation(s)
- Alexandra Foster
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Shubhanchi Nigam
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - David S Tatum
- Lumiphore, Inc., 600 Bancroft Way Berkeley, CA 94710, USA
| | - Itay Raphael
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Jide Xu
- Lumiphore, Inc., 600 Bancroft Way Berkeley, CA 94710, USA
| | - Rajeev Kumar
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | | | - Joseph D Latoche
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Sarah Vincze
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Bo Li
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Rajan Giri
- Department of Biochemistry, University of Missouri, Columbia, MO, 65211, USA
| | - Lauren H McCarl
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Robert Edinger
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Murat Ak
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | | | - Lesley M Foley
- Animal Imaging Center, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - T Kevin Hitchens
- Animal Imaging Center, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Rivka R Colen
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Ian F Pollack
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Ashok Panigrahy
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Darren Magda
- Lumiphore, Inc., 600 Bancroft Way Berkeley, CA 94710, USA.
| | - Carolyn J Anderson
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Pharmacology & Chemical Biology, University of Pittsburgh, Pittsburgh 15213, USA; Department of Chemistry, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Chemistry, University of Missouri, Columbia, MO, 65211 USA.
| | - W Barry Edwards
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Biochemistry, University of Missouri, Columbia, MO, 65211, USA.
| | - Gary Kohanbash
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Immunology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Broderick L, Chen WH, Levy R, Foster A, Umanzor C, Chauhan D. POS0739 DEVELOPMENT OF A CONCEPTUAL MODEL TO UNDERSTAND DISEASE BURDEN IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND LONG-TERM ORGAN DAMAGE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1907] [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: 11/03/2022]
Abstract
Background:Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease resulting in increased morbidity and mortality and reduced health-related quality of life (HRQoL). Patients with SLE are at risk of developing irreversible long-term organ damage (LTOD) caused by both disease activity and cumulative medication toxicities. Data regarding the overall disease burden and impact of LTOD in patients with SLE are limited.Objectives:The primary objective of this qualitative study was to develop a conceptual model to describe the burden experienced by patients with SLE and LTOD.Methods:This study (GSK Study 209754) was conducted in three phases. First, a targeted literature review was performed to aid the development of an initial draft conceptual model. Key opinion leaders (KOLs) with experience in SLE and LTOD were then interviewed to assess the clarity, language, comprehensibility, and potential use of the conceptual model, and to help shape the patient interview materials. Finally, one-on-one interviews were performed with patients with SLE and LTOD in any of the 12 organ areas (defined by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), to gather patient perspectives on the common symptoms, functional impacts, treatment experiences, and HRQoL factors associated with LTOD. Data from the interviews were coded and analysed using NVivo software to identify patterns in responses concerning the key concepts of the overall patient burden of LTOD, and used to identify concepts to include in the model.Results:The literature review produced the preliminary conceptual model of LTOD. Results of the KOL interviews (n=5 clinicians and n=1 patient advocate) indicated that the preliminary conceptual model broadly captured the patient experience of LTOD. KOLs emphasised the difference between SLE activity (flares) and LTOD; the conceptual model was subsequently updated in accordance with these recommendations. Interviews conducted with patients with confirmed single (n=9) and multiple LTOD (n=31) indicated that the burden of LTOD associated with SLE was more severe, debilitating, and life threatening than that caused by SLE flares. Almost all patients (39/40) reported aspects of their lives that were more severely affected since their LTOD diagnosis. All 40 patients reported LTOD-related physical impacts, which often affected patients’ ability to perform everyday tasks. The most frequent physical impacts reported were a loss of vitality (39/40), long-term complications (e.g. unstable blood pressure, extreme pain, poor mobility, inflammation, dialysis, infection; 36/40), and severe fatigue (29/40). Cognitive impairments that became more pronounced after their LTOD diagnosis were reported by 27/40 of patients. Typically characterised as “brain fog”, these impairments were described as slower cognitive processing, forgetfulness, confusion, and aphasia. Economic impacts associated with LTOD included patients’ inability to work (31/40), costs of care (33/40), and non-medical-related costs (17/30). Psychosocial impacts reported by patients with LTOD affected their emotional state (39/40), ability to socialise (40/40) and relationships (30/40). Additionally, 30/40 patients reported symptoms as more severe since their LTOD diagnosis, including pain (14/40), fatigue (9/40), and oedema (8/40). Patients’ treatment goals were largely aligned with their experienced impacts of LTOD, including managing the disease and symptoms (25/40), limiting further organ damage (15/40), and improving HRQoL (11/40).Conclusion:The findings from this research clearly indicate that the patient burden of LTOD far surpasses that of SLE without LTOD. These data were incorporated and refined into a conceptual model that fully represents the patient experience of LTOD. The model will help researchers, clinicians, and patients to better understand the impact of SLE-related LTOD progression.Funding:GSKAcknowledgements:Medical writing assistance was provided by Casmira Brazaitis, PhD, Fishawack Indicia Ltd., UK, part of Fishawack Health, and was funded by GSK.Disclosure of Interests:Lynne Broderick Consultant of: GSK, Wen-Hung Chen Shareholder of: GSK, Employee of: GSK, Roger Levy Shareholder of: GSK, Employee of: GSK, April Foster Consultant of: GSK, Cindy Umanzor Consultant of: GSK, Deven Chauhan Shareholder of: GSK, Employee of: GSK
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Raphael I, Kumar R, McCarl LH, Shoger K, Wang L, Sandlesh P, Sneiderman CT, Allen J, Zhai S, Campagna ML, Foster A, Bruno TC, Agnihotri S, Hu B, Castro BA, Lieberman FS, Broniscer A, Diaz AA, Amankulor NM, Rajasundaram D, Pollack IF, Kohanbash G. TIGIT and PD-1 Immune Checkpoint Pathways Are Associated With Patient Outcome and Anti-Tumor Immunity in Glioblastoma. Front Immunol 2021; 12:637146. [PMID: 34025646 PMCID: PMC8137816 DOI: 10.3389/fimmu.2021.637146] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/12/2021] [Indexed: 12/11/2022] Open
Abstract
Glioblastoma (GBM) remains an aggressive brain tumor with a high rate of mortality. Immune checkpoint (IC) molecules are expressed on tumor infiltrating lymphocytes (TILs) and promote T cell exhaustion upon binding to IC ligands expressed by the tumor cells. Interfering with IC pathways with immunotherapy has promoted reactivation of anti-tumor immunity and led to success in several malignancies. However, IC inhibitors have achieved limited success in GBM patients, suggesting that other checkpoint molecules may be involved with suppressing TIL responses. Numerous IC pathways have been described, with current testing of inhibitors underway in multiple clinical trials. Identification of the most promising checkpoint pathways may be useful to guide the future trials for GBM. Here, we analyzed the The Cancer Genome Atlas (TCGA) transcriptomic database and identified PD1 and TIGIT as top putative targets for GBM immunotherapy. Additionally, dual blockade of PD1 and TIGIT improved survival and augmented CD8+ TIL accumulation and functions in a murine GBM model compared with either single agent alone. Furthermore, we demonstrated that this combination immunotherapy affected granulocytic/polymorphonuclear (PMN) myeloid derived suppressor cells (MDSCs) but not monocytic (Mo) MDSCs in in our murine gliomas. Importantly, we showed that suppressive myeloid cells express PD1, PD-L1, and TIGIT-ligands in human GBM tissue, and demonstrated that antigen specific T cell proliferation that is inhibited by immunosuppressive myeloid cells can be restored by TIGIT/PD1 blockade. Our data provide new insights into mechanisms of GBM αPD1/αTIGIT immunotherapy.
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Affiliation(s)
- Itay Raphael
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rajeev Kumar
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lauren H McCarl
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Karsen Shoger
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lin Wang
- Departments of Neurological Surgery, University of California, San Francisco, CA, United States
| | - Poorva Sandlesh
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Chaim T Sneiderman
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jordan Allen
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shuyan Zhai
- University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center Biostatistics Facility, University of Pittsburgh, Pittsburgh, PA, United States
| | - Marissa Lynn Campagna
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Alexandra Foster
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tullia C Bruno
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sameer Agnihotri
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Baoli Hu
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brandyn A Castro
- Departments of Neurology, University of Chicago, Chicago, IL, United States
| | - Frank S Lieberman
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Alberto Broniscer
- Department of Pediatrics, Division of Health Informatics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Aaron A Diaz
- Departments of Neurological Surgery, University of California, San Francisco, CA, United States
| | - Nduka M Amankulor
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dhivyaa Rajasundaram
- Department of Pediatrics, Division of Health Informatics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Ian F Pollack
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gary Kohanbash
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United States
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Shepherd T, Foster A. 244 Does Direct Admission to ICU In Emergency Laparotomy Patients with A NELA Score ≥ 10% Affect Outcome at Fiona Stanley Hospital? Br J Surg 2021. [DOI: 10.1093/bjs/znab134.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
The Australian and New Zealand Emergency Laparotomy Audit (ANZELA) is a quality improvement project based on UK NELA. Direct admission to ICU post-operatively for patients with a NELA ≥ 10% is recommended. In the current pandemic, the use of critical care beds must be rationalised. We investigated if patients with NELA ≥ 10% experienced worse outcomes if admitted to the ward post-operatively (instead of ICU).
Method
We performed a retrospective audit of emergency laparotomies at Fiona Stanley Hospital over 6 months December 2019 – May 2020. NELA scores were obtained from the ANZELA database and patient notes reviewed to identify post-operative unplanned ICU admissions and mortalities.
Results
Twenty-four (30%) emergency laparotomy patients had a NELA ≥ 10%. Ten (42%) patients were admitted to the ward post-operatively. There were no unplanned ICU admissions in this group. Two (20%) patients had a documented ‘code blue’ but were managed conservatively on the ward. No patients in this group died within 30 days.
Conclusions
Post-operative ward admission in selected patients with NELA ≥ 10% does not result in unplanned ICU admissions or increased mortality at a tertiary Acute Surgical Unit. This data is reassuring as we expect future ICU bed shortages for non-COVID surgical patients during the pandemic.
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Affiliation(s)
- T Shepherd
- Fiona Stanley Hospital, Perth, Australia
| | - A Foster
- Fiona Stanley Hospital, Perth, Australia
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10
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Mulder PA, van Balkom IDC, Landlust AM, Priolo M, Menke LA, Acero IH, Alkuraya FS, Arias P, Bernardini L, Bijlsma EK, Cole T, Coubes C, Dapia I, Davies S, Di Donato N, Elcioglu NH, Fahrner JA, Foster A, González NG, Huber I, Iascone M, Kaiser AS, Kamath A, Kooblall K, Lapunzina P, Liebelt J, Lynch SA, Maas SM, Mammì C, Mathijssen IB, McKee S, Mirzaa GM, Montgomery T, Neubauer D, Neumann TE, Pintomalli L, Pisanti MA, Plomp AS, Price S, Salter C, Santos-Simarro F, Sarda P, Schanze D, Segovia M, Shaw-Smith C, Smithson S, Suri M, Tatton-Brown K, Tenorio J, Thakker RV, Valdez RM, Van Haeringen A, Van Hagen JM, Zenker M, Zollino M, Dunn WW, Piening S, Hennekam RC. Development, behaviour and sensory processing in Marshall-Smith syndrome and Malan syndrome: phenotype comparison in two related syndromes. J Intellect Disabil Res 2020; 64:956-969. [PMID: 33034087 PMCID: PMC8957705 DOI: 10.1111/jir.12787] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 08/19/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ultrarare Marshall-Smith and Malan syndromes, caused by changes of the gene nuclear factor I X (NFIX), are characterised by intellectual disability (ID) and behavioural problems, although questions remain. Here, development and behaviour are studied and compared in a cross-sectional study, and results are presented with genetic findings. METHODS Behavioural phenotypes are compared of eight individuals with Marshall-Smith syndrome (three male individuals) and seven with Malan syndrome (four male individuals). Long-term follow-up assessment of cognition and adaptive behaviour was possible in three individuals with Marshall-Smith syndrome. RESULTS Marshall-Smith syndrome individuals have more severe ID, less adaptive behaviour, more impaired speech and less reciprocal interaction compared with individuals with Malan syndrome. Sensory processing difficulties occur in both syndromes. Follow-up measurement of cognition and adaptive behaviour in Marshall-Smith syndrome shows different individual learning curves over time. CONCLUSIONS Results show significant between and within syndrome variability. Different NFIX variants underlie distinct clinical phenotypes leading to separate entities. Cognitive, adaptive and sensory impairments are common in both syndromes and increase the risk of challenging behaviour. This study highlights the value of considering behaviour within developmental and environmental context. To improve quality of life, adaptations to environment and treatment are suggested to create a better person-environment fit.
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Affiliation(s)
- P A Mulder
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
| | - I D C van Balkom
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
- Rob Giel Research Centre, Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
| | - A M Landlust
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
| | - M Priolo
- Unità Operativa di Genetica Medica, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - L A Menke
- Department of Paediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - I H Acero
- Genetics Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - F S Alkuraya
- Saudi Human Genome Project, King Abdulaziz City for Science and Technology, and Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - P Arias
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - L Bernardini
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - E K Bijlsma
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, Netherlands
| | - T Cole
- Department of Clinical Genetics, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - C Coubes
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, CHRU Montpellier, Montpellier, France
| | - I Dapia
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - S Davies
- Institute of Medical Genetics, University Hospital of Wales, Cardiff, UK
| | - N Di Donato
- Institute for Clinical Genetics, TU Dresden, Dresden, Germany
| | - N H Elcioglu
- Department of Pediatric Genetics, Marmara University Medical School, Istanbul and Eastern Mediterranean University, Mersin, Turkey
| | - J A Fahrner
- McKusick-Nathans Institute of Genetic Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Foster
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - N G González
- Unit Hospital Universitario Central de Asturias, Oviedo, Spain
| | - I Huber
- Sørland Hospital, Kristiansand, Norway
| | - M Iascone
- Medical Genetics Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - A-S Kaiser
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - A Kamath
- Institute of Medical Genetics, University Hospital of Wales, Cardiff, UK
| | - K Kooblall
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - P Lapunzina
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - J Liebelt
- South Australian Clinical Genetics Services, Women's and Children's Hospital, North Adelaide, Australia
| | - S A Lynch
- UCD Academic Centre on Rare Diseases, School of Medicine and Medical Sciences, University College Dublin, and Clinical Genetics, Temple Street Children's University Hospital, Dublin, Ireland
| | - S M Maas
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, Netherlands
| | - C Mammì
- Unità Operativa di Genetica Medica, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - I B Mathijssen
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, Netherlands
| | - S McKee
- Northern Ireland Regional Genetics Service, Belfast Health and Social Care Trust, Belfast, UK
| | - G M Mirzaa
- Center for Integrative Brain Research, Seattle Children's Research Institute, and Division of Genetic Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - T Montgomery
- Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - D Neubauer
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - T E Neumann
- Mitteldeutscher Praxisverbund Humangenetik, Halle, Germany
| | - L Pintomalli
- Unità Operativa di Genetica Medica, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - M A Pisanti
- Medical Genetic and Laboratory Unit, "Antonio Cardarelli" Hospital, Naples, Italy
| | - A S Plomp
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, Netherlands
| | - S Price
- Department of Clinical Genetics, Northampton General Hospital NHS Trust, Northampton, UK
| | - C Salter
- Wessex Clinical Genetics Service, Princess Ann Hospital, Southampton, UK
| | - F Santos-Simarro
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - P Sarda
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, CHRU Montpellier, Montpellier, France
| | - D Schanze
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - M Segovia
- CENAGEM, Centro Nacional de Genética, Buenos Aires, Argentina
| | - C Shaw-Smith
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - S Smithson
- University Hospitals Bristol NHS Trust, Bristol, UK
| | - M Suri
- Nottingham Clinical Genetics Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - K Tatton-Brown
- Division of Genetics and Epidemiology, Institute of Cancer Research, London and South West Thames Regional Genetics Service, St. George's University Hospitals NHS Foundation Trust, London, UK
| | - J Tenorio
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - R V Thakker
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - R M Valdez
- Genetics Unit, Hospital Militar Central "Cirujano Mayor Dr. Cosme Argerich", Buenos Aires, Argentina
| | - A Van Haeringen
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, Netherlands
| | - J M Van Hagen
- Department of Clinical Genetics, VU University Medical Centre, Amsterdam, Netherlands
| | - M Zenker
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - M Zollino
- Department of Laboratory Medicine, Institute of Medical Genetics, Catholic University, Rome, Italy
| | - W W Dunn
- Department of Occupational Therapy Education, School of Health Professions, University of Missouri, Columbia, MO, USA
| | - S Piening
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
- Rob Giel Research Centre, Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
| | - R C Hennekam
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Paediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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11
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Fortier E, Foster A, Ali A. P66 Exploring the experiences and health needs of young womxn living in Ontario, Canada: An action-oriented study dedicated to interpersonal reproductive coercion. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Fleischl W, Barrett K, Meredith I, Foster A. P11 Metastatic breast cancer in Wellington, New Zealand. How do we do? Breast 2020. [DOI: 10.1016/j.breast.2020.01.025] [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: 10/24/2022] Open
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13
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Nadolski A, Vieira JD, Sobrin JA, Kofman AM, Ade PAR, Ahmed Z, Anderson AJ, Avva JS, Basu Thakur R, Bender AN, Benson BA, Bryant L, Carlstrom JE, Carter FW, Cecil TW, Chang CL, Cheshire JR, Chesmore GE, Cliche JF, Cukierman A, de Haan T, Dierickx M, Ding J, Dutcher D, Everett W, Farwick J, Ferguson KR, Florez L, Foster A, Fu J, Gallicchio J, Gambrel AE, Gardner RW, Groh JC, Guns S, Guyser R, Halverson NW, Harke-Hosemann AH, Harrington NL, Harris RJ, Henning JW, Holzapfel WL, Howe D, Huang N, Irwin KD, Jeong O, Jonas M, Jones A, Korman M, Kovac J, Kubik DL, Kuhlmann S, Kuo CL, Lee AT, Lowitz AE, McMahon J, Meier J, Meyer SS, Michalik D, Montgomery J, Natoli T, Nguyen H, Noble GI, Novosad V, Padin S, Pan Z, Paschos P, Pearson J, Posada CM, Quan W, Rahlin A, Riebel D, Ruhl JE, Sayre JT, Shirokoff E, Smecher G, Stark AA, Stephen J, Story KT, Suzuki A, Tandoi C, Thompson KL, Tucker C, Vanderlinde K, Wang G, Whitehorn N, Yefremenko V, Yoon KW, Young MR. Broadband, millimeter-wave antireflection coatings for large-format, cryogenic aluminum oxide optics. Appl Opt 2020; 59:3285-3295. [PMID: 32400613 DOI: 10.1364/ao.383921] [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] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/25/2020] [Indexed: 06/11/2023]
Abstract
We present two prescriptions for broadband ($ {\sim} 77 - 252\;{\rm GHz} $), millimeter-wave antireflection coatings for cryogenic, sintered polycrystalline aluminum oxide optics: one for large-format (700 mm diameter) planar and plano-convex elements, the other for densely packed arrays of quasi-optical elements-in our case, 5 mm diameter half-spheres (called "lenslets"). The coatings comprise three layers of commercially available, polytetrafluoroethylene-based, dielectric sheet material. The lenslet coating is molded to fit the 150 mm diameter arrays directly, while the large-diameter lenses are coated using a tiled approach. We review the fabrication processes for both prescriptions, then discuss laboratory measurements of their transmittance and reflectance. In addition, we present the inferred refractive indices and loss tangents for the coating materials and the aluminum oxide substrate. We find that at 150 GHz and 300 K the large-format coating sample achieves $ (97 \pm 2)\% $ transmittance, and the lenslet coating sample achieves $ (94 \pm 3)\% $ transmittance.
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14
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Al Yaarubi Z, Foster A, Avinashi V, Lam G, Soller L, Chan E. A198 EOSINOPHILIC ESOPHAGITIS WITH STRICTURE PRESENTING SHORTING AFTER INITIATION OF ORAL PEANUT IMMUNOTHERAPY. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Oral immunotherapy (OIT) is increasingly practiced outside of research settings with reasonable success (Soller 2019).
With OIT, a patient eats their food allergen daily, gradually increasing the dose, with the goal to prevent or reduce the severity of an anaphylactic reaction.
One of the described adverse events of OIT is a risk of developing Eosinophilic Esophagitis (EoE), with cited frequency of 2.7% (Lucendo 2014). In addition, OIT is typically contraindicated in patients with known EoE but patients are not routinely screened for EoE prior to initiation of OIT.
Aims
To present a case of a 12 year old boy with peanut anaphylaxis who developed eosinophilic esophagitis and an esophageal stricture shortly after starting peanut immunotherapy
Methods
Patient chart review was conducted. A literature review was done using the words “eosinophilic esophagitis” and “immunotherapy”.
Results
A12 year old boy with asthma, allergic rhinitis and multiple anaphylactic food allergies, started peanut OIT with an allergist. Prior to OIT, the patient had no symptoms suggestive of EoE such as dysphagia, heartburn, chest pain or washing of food. Approximately 3.5 weeks into treatment, the patient developed daily vomiting. The patient was advised to stop the peanut OIT three days after symptom onset, but the vomiting continued for another 8 days. By the time of endoscopy (16 days after onset of vomiting), the vomiting had completely subsided for the previous five days.
The upper GI endoscopy demonstrated signs of EoE throughout the length of the esophagus. In the mid esophagus there was resistance where the 9.8 mm gastroscope was unable to pass. A smaller gastroscope with a 5.9 mm width was easily able to pass through the stricture. Histology showed marked eosinophilia throughout the esophagus with basal cell hyperplasia, spongiosis, superficial microabscesses and stromal fibrosis consistent with EoE. The patient continued to be ‘asymptomatic’ at the time of endoscopy and after despite the presence of a stricture. After discussion, the patient was started on oral viscous budesonide (OVB) 1mg PO BID.
The patient was re-scoped 4 weeks into OVB therapy with complete resolution of the stricture with neither macroscopic nor histologic findings of EoE. Patient is now off OVB for over a month, remains asymptomatic, and will undergo repeat endoscopy in the upcoming month to ensure normal histology
Conclusions
This is the first case describing EoE with an esophageal stricture shortly after initiation of OIT. Pediatric Gastroenterologists need to be increasingly aware that patients undergoing OIT are at an increasing risk of ‘developing’ or at least ‘unmasking’ EoE. More research is required to evaluate whether EoE screening, by symptom questionnaire or endoscopy is warranted prior to beginning OIT, and whether OIT is truly needed.
Upper GI endoscopy showing signs of EoE and an esophageal stricture
Funding Agencies
CAG
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Affiliation(s)
- Z Al Yaarubi
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - A Foster
- BC Children’s Hospital, Vancouver, BC, Canada
| | - V Avinashi
- BC Children’s Hospital, Vancouver, BC, Canada
| | - G Lam
- Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - L Soller
- BC Children’s Hospital, Vancouver, BC, Canada
| | - E Chan
- BC Children’s Hospital, Vancouver, BC, Canada
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15
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Tadesse BT, Foster A, Aklillu E. Rebuttal: Response to the comments by Buck
et al
. on our published article: Hepatic and renal toxicity and associated factors among
HIV
‐infected children on antiretroviral therapy: a prospective cohort study;
HIV
Medicine
(2019), 20, 147–156. HIV Med 2019; 20:e13-e14. [DOI: 10.1111/hiv.12742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- BT Tadesse
- Hawassa University College of Medicine and Health Sciences Hawassa Ethiopia
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Stockholm Sweden
| | - A Foster
- Departments of Dermatology and Pediatrics, Oregon Health Sciences University Portland, OR USA
| | - E Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Stockholm Sweden
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16
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Foster A, Scott D, Layfield R, Rea S. An FTLD-associated SQSTM1 variant impacts Nrf2 and NF-κB signalling and is associated with reduced phosphorylation of p62. Mol Cell Neurosci 2019; 98:32-45. [DOI: 10.1016/j.mcn.2019.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 12/12/2022] Open
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17
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Briglia F, Lawrence S, Foster A, Briglia E, Jacobson K. A69 INFLIXIMAB DOSE OPTIMIZATION DURING MAINTENANCE THERAPY IN CHILDREN WITH IBD. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.068] [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)
- F Briglia
- BC Children’s Hospital, Vancouver, BC, Canada
| | - S Lawrence
- BC Children’s Hospital, Vancouver, BC, Canada
| | - A Foster
- BC Children’s Hospital, Vancouver, BC, Canada
| | - E Briglia
- BC Children’s Hospital, Vancouver, BC, Canada
| | - K Jacobson
- BC Children’s Hospital, Vancouver, BC, Canada
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18
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Becerra C, Hoof P, Paulson S, Manji G, Gardner O, Malankar A, Shaw J, Blass D, Ballard B, Yi X, Anumula M, Foster A, Senesac J, Woodard P. Ligand-inducible, prostate stem cell antigen (PSCA)-directed GoCAR-T™ cells in advanced solid tumors: Preliminary results from a dose escalation study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Rajakumar PD, Gowers GOF, Suckling L, Foster A, Ellis T, Kitney RI, McClymont DW, Freemont PS. Rapid Prototyping Platform for Saccharomyces cerevisiae Using Computer-Aided Genetic Design Enabled by Parallel Software and Workcell Platform Development. SLAS Technol 2018; 24:291-297. [DOI: 10.1177/2472630318798304] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Biofoundries have enabled the ability to automate the construction of genetic constructs using computer-aided design. In this study, we have developed the methodology required to abstract and automate the construction of yeast-compatible designs. We demonstrate the use of our in-house software tool, AMOS, to coordinate with design software, JMP, and robotic liquid handling platforms to successfully manage the construction of a library of 88 yeast expression plasmids. In this proof-of-principle study, we used three fluorescent genes as proxy for three enzyme coding sequences. Our platform has been designed to quickly iterate around a design cycle of four protein coding sequences per plasmid, with larger numbers possible with multiplexed genome integrations in Saccharomyces cerevisiae. This work highlights how developing scalable new biotechnology applications requires a close integration between software development, liquid handling robotics, and protocol development.
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Affiliation(s)
| | - G-O. F. Gowers
- Imperial College Centre for Synthetic Biology, Imperial College London, London, UK
- Department of Bioengineering, Imperial College London, London, UK
| | - L. Suckling
- The London DNA Foundry, Imperial College London, London, UK
| | - A. Foster
- The London DNA Foundry, Imperial College London, London, UK
| | - T. Ellis
- Imperial College Centre for Synthetic Biology, Imperial College London, London, UK
- Department of Bioengineering, Imperial College London, London, UK
| | - R. I. Kitney
- The London DNA Foundry, Imperial College London, London, UK
- Department of Bioengineering, Imperial College London, London, UK
| | | | - P. S. Freemont
- The London DNA Foundry, Imperial College London, London, UK
- Section of Structural Biology, Department of Medicine, Imperial College London, London, UK
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Davey V, Raturaga T, Shirley R, Barrett K, Harvey V, Campbell I, Foster A, Harris G. PO6 Consolidation of the four New Zealand breast cancer registers. Breast 2018. [DOI: 10.1016/j.breast.2018.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Carney D, Mongelluzzo J, Foster A, Fee C, Ekman E. 379TF Understanding Emotions: Combating Burnout With Empathy During Emergency Medicine Residency. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.349] [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: 11/16/2022]
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22
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Foster A, Boyes L, Burgess L, Carless S, Bowyer V, Jenkinson H, Parulekar M, Ainsworth J, Hungerford J, Onadim Z, Sagoo M, Rosser E, Reddy MA, Cole T. Patient understanding of genetic information influences reproductive decision making in retinoblastoma. Clin Genet 2017; 92:587-593. [PMID: 28397259 DOI: 10.1111/cge.13035] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 04/04/2017] [Accepted: 04/06/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Retinoblastoma is the most common malignant tumour of the eye in childhood, with nearly all bilateral tumours and around 17% to 18% of unilateral tumours due to an oncogenic mutation in the RB1 gene in the germline. Genetic testing enables accurate risk assessment and optimal clinical management for the affected individual, siblings, and future offspring. MATERIAL AND METHODS We carried out the first UK-wide audit of understanding of genetic testing in individuals with retinoblastoma. A total of 292 individuals aged 16 to 45 years were included. RESULTS Patients with bilateral disease were significantly more likely to understand the implications of retinoblastoma for siblings and children. There was a significant association between not knowing the results of genetic testing or not understanding the implications and not having children, particularly in women. Surprisingly, this was also true for individuals treated for unilateral disease with a low risk of retinoblastoma for their offspring. CONCLUSION We are concerned that individuals may be making life choices based on insufficient information regarding risks of retinoblastoma and reproductive options. We suggest that improvement in transition care is needed to enable individuals to make informed reproductive decisions and to ensure optimal care for children born at risk of retinoblastoma.
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Affiliation(s)
- A Foster
- Department of Clinical Genetics, Birmingham Women's Hospital NHS Foundation Trust, Birmingham, UK
| | - L Boyes
- Department of Clinical Genetics, Birmingham Women's Hospital NHS Foundation Trust, Birmingham, UK
| | - L Burgess
- Department of Clinical Genetics, Birmingham Women's Hospital NHS Foundation Trust, Birmingham, UK
| | - S Carless
- Department of Clinical Genetics, Birmingham Women's Hospital NHS Foundation Trust, Birmingham, UK
| | - V Bowyer
- Department of Clinical Genetics, Birmingham Women's Hospital NHS Foundation Trust, Birmingham, UK
| | - H Jenkinson
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - M Parulekar
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - J Ainsworth
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - J Hungerford
- Retinoblastoma Service, Royal London Hospital, Barts Health NHS Trust, London, UK.,Moorfields Eye Hospital NHS Trust, London, UK
| | - Z Onadim
- Retinoblastoma Genetic Screening Unit, Barts Health NHS Trust, London, UK
| | - M Sagoo
- Retinoblastoma Service, Royal London Hospital, Barts Health NHS Trust, London, UK.,Moorfields Eye Hospital NHS Trust, London, UK.,UCL Institute of Ophthalmology, London, UK
| | - E Rosser
- Retinoblastoma Service, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - M A Reddy
- Retinoblastoma Service, Royal London Hospital, Barts Health NHS Trust, London, UK.,Moorfields Eye Hospital NHS Trust, London, UK
| | - T Cole
- Department of Clinical Genetics, Birmingham Women's Hospital NHS Foundation Trust, Birmingham, UK
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Fain W, Farmer S, Owens S, Fausset C, Foster A. MEDICATION ADHERENCE FACILITATORS AND BARRIERS FOR OLDER ADULTS WITH DISABILITIES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- W.B. Fain
- Georgia Tech Research Institute, Georgia Institute of Technology, Waco, Georgia
| | - S. Farmer
- Georgia Tech Research Institute, Georgia Institute of Technology, Waco, Georgia
| | - S. Owens
- Georgia Tech Research Institute, Georgia Institute of Technology, Waco, Georgia
| | - C. Fausset
- Georgia Tech Research Institute, Georgia Institute of Technology, Waco, Georgia
| | - A. Foster
- Georgia Tech Research Institute, Georgia Institute of Technology, Waco, Georgia
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Abstract
PURPOSE The quality of cataract surgery delivered in sub-Saharan Africa (SSA) is a significant constraint to achieving the elimination of avoidable blindness. No published reports from routine SSA cataract services attain the WHO benchmarks for visual outcomes; poor outcomes (<6/60) often comprise 20% in published case series. This Delphi exercise aimed to identify and prioritise potential interventions for improving the quality of cataract surgery in SSA to guide research and eye health programme development. METHODS An initial email open-question survey created a ranked list of priorities for improving quality of surgical services. A second-round face-to-face discussion facilitated at a Vision 2020 Research Mentorship Workshop in Tanzania created a refined list for repeated ranking. RESULTS Seventeen factors were agreed that might form target interventions to promote quality of cataract services. Improved training of surgeons was the top-ranked item, followed by utilisation of biometry, surgical equipment availability, effective monitoring of outcomes of cataract surgery by the surgeon, and well-trained support staff for the cataract pathway (including nurses seeing post-operative cases). CONCLUSION Improving the quality of cataract surgery in SSA is a clinical, programmatic and public health priority. In the absence of other evidence, the collective expert opinion of those involved in ophthalmic services regarding the ranking of factors to promote quality improvement, refined through this Delphi exercise, provides us with candidate intervention areas to be evaluated.
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Affiliation(s)
- J C Buchan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - W H Dean
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - A Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - M J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Schwartz EC, Renk J, Hopkins AD, Huss R, Foster A. A method to determine the coverage of ivermectin distribution in onchocerciasis-control programmes. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1998.11813341] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Foster A. Location, location, location: documenting women's abortion experiences in Canada. Contraception 2016. [DOI: 10.1016/j.contraception.2016.07.164] [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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Williams D, Foster A, Sefton C, Regan S, Woods A, Morgan P, Haddrick M. Development of an automated, high-throughput hepatocyte spheroid screen for use within the pharmaceutical industry. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Redmond CE, Healy GM, Murphy CF, O'Doherty A, Foster A. The use of ultrasonography and digital mammography in women under 40 years with symptomatic breast cancer: a 7-year Irish experience. Ir J Med Sci 2016; 186:63-67. [PMID: 27271165 DOI: 10.1007/s11845-016-1472-0] [Citation(s) in RCA: 8] [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: 03/23/2016] [Accepted: 05/27/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Breast cancer in women under 40 years of age is rare and typically presents symptomatically. The optimal imaging modality for this patient group is controversial. Most women undergo ultrasonography with/without mammography. Young women typically have dense breasts, which can obscure the features of malignancy on film mammography, however, initial studies have suggested that digital mammography may have a more accurate diagnostic performance in younger women. Ultrasound generally performs well in this age group, although it is poor at detecting carcinoma in situ (DCIS). AIMS To evaluate the comparative diagnostic performance of ultrasonography and digital mammography in the initial diagnostic evaluation of women under 40 years of age with symptomatic breast cancer. METHODS Retrospective review of all women under the age of 40 years managed at our symptomatic breast cancer unit from January 2009 to December 2015. RESULTS There were 120 patients that met the inclusion criteria for this study. The sensitivity of ultrasonography and digital mammography for breast cancer in this patient group was 95.8 and 87.5 %, respectively. The patients with a false negative mammographic examination were more likely to have dense breasts (p < 0.01). Five patients had a false negative ultrasonographic examination, withal of whom were diagnosed with DCIS detected by mammography. CONCLUSION This study demonstrates the superior sensitivity of ultrasound for breast cancer in women under the age of 40 years, however, the results show that digital mammography has an important complimentary role in the comprehensive assessment of these patients, particularly in the diagnosis of DCIS.
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Affiliation(s)
- C E Redmond
- Department of Breast Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
| | - G M Healy
- Department of Breast Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - C F Murphy
- Department of Breast Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - A O'Doherty
- Department of Breast Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - A Foster
- Department of Breast Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Titloye NA, Foster A, Omoniyi-Esan GO, Komolafe AO, Daramola AO, Adeoye OA, Adisa AO, Manoharan A, Pathak D, D'Cruz MN, Alizadeh Y, Lewis PD, Shaaban AM. Histological Features and Tissue Microarray Taxonomy of Nigerian Breast Cancer Reveal Predominance of the High-Grade Triple-Negative Phenotype. Pathobiology 2016; 83:24-32. [PMID: 26730581 DOI: 10.1159/000441949] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 10/26/2015] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Little is known about the biology, molecular profile and hence optimal treatment of African Nigerian breast cancer. The aim of this work, therefore, was to characterize the histology and molecular profile of Nigerian breast cancer. METHODS Breast carcinomas from women at 6 centres of similar tribal origin in Nigeria were reviewed and assembled into tissue microarrays (TMAs), and sections were stained for hormone receptors, i.e. estrogen receptor (ER)α, ERβ1, ERβ progesterone receptor (PR) and androgen receptor, cyclin D, HER2, Ki67 and cytokeratins (CKs), i.e. CK5/6 and CK14 (basal) and CK18 and 19 (luminal). RESULTS A total of 835 tumours were analysed. The mean age at diagnosis was 48.62 ± 12.41 years. The most common histological subtype was ductal NST (no-special-type) carcinoma (87.3%). Over 90% of the tumours were grade 2 or 3. The predominant molecular phenotype was the non-basal, triple-negative type (47.65%) followed by the HER2-positive group (19.6%). The percentage of ER-, PR- and HER2-positive tumours was 22.4, 18.9 and 18.8%, respectively. CONCLUSION Nigerian breast cancer predominantly has a high-grade, triple-negative profile. It occurs at a younger age and bears similarities at the molecular level to pre-menopausal breast cancer in white women, with remarkably lower levels of ERβ expression. The early presentation and histological and molecular phenotype may explain the poor prognosis, and tailoring treatment strategies to target this unique profile are required.
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Affiliation(s)
- N A Titloye
- School of Medical Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Foster A, Jones DL, Cooper EJ, Roberts P. Freeze-thaw cycles have minimal effect on the mineralisation of low molecular weight, dissolved organic carbon in Arctic soils. Polar Biol 2016; 39:2387-2401. [PMID: 32669755 PMCID: PMC7346978 DOI: 10.1007/s00300-016-1914-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 04/20/2015] [Revised: 01/23/2016] [Accepted: 02/26/2016] [Indexed: 12/04/2022]
Abstract
Warmer winters in Arctic regions may melt insulating snow cover and subject soils to more freeze–thaw cycles. The effect of freeze–thaw cycles on the microbial use of low molecular weight, dissolved organic carbon (LMW-DOC) is poorly understood. In this study, soils from the Arctic heath tundra, Arctic meadow tundra and a temperate grassland were frozen to −7.5 °C and thawed once and three times. Subsequently, the mineralisation of 3 LMW-DOC substrates types (sugars, amino acids and peptides) was measured over an 8-day period and compared to controls which had not been frozen. This allowed the comparison of freeze–thaw effects between Arctic and temperate soil and between different substrates. The results showed that freeze–thaw cycles had no significant effect on C mineralisation in the Arctic tundra soils. In contrast, for the same intensity freeze–thaw cycles, a significant effect on C mineralisation was observed for all substrate types in the temperate soil although the response was substrate specific. Peptide and amino acid mineralisation were similarly affected by FT, whilst glucose had a different response. Further work is required to fully understand microbial use of LMW-DOC after freeze–thaw, yet these results suggest that relatively short freeze–thaw cycles have little effect on microbial use of LMW-DOC in Arctic tundra soils after thaw.
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Affiliation(s)
- A Foster
- School of the Environment, Natural Resources and Geography, Bangor University, Bangor, UK
| | - D L Jones
- School of the Environment, Natural Resources and Geography, Bangor University, Bangor, UK
| | - E J Cooper
- Department of Arctic and Marine Biology, Faculty of Biosciences, Fisheries and Economics, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - P Roberts
- School of the Environment, Natural Resources and Geography, Bangor University, Bangor, UK
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Lok B, Pietanza M, Foster A, Rudin C, Perez C, Ong L, Krug L, Rimner A, Wu A. The Factors Influencing the Utilization of Prophylactic Cranial Irradiation in Patients With Limited-Stage Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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32
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Foster A, Gaisa M, Turner S, Morey T, Jacobson K, Fierer D. P11.23 Evaluation of hepatitis c virus in the rectum of hiv-infected men who have sex with men. Sex Transm Infect 2015. [DOI: 10.1136/sextrans-2015-052270.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Turner S, Yip M, Smith D, Weibel S, van Seggelen W, Foster A, Morey T, Barbati Z, Branch A, Fierer D. O22.2 Detection of hepatitis c virus (hcv) in semen from hiv-infected men who have sex with men (msm) during acute hcv infection. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.198] [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]
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Turner S, Yip M, Smith D, Weibel S, van Seggelen W, Foster A, Morey T, Barbati Z, Branch A, Fierer D. 007.3 Detection of hepatitis c virus (hcv) in semen from hiv-infected men who have sex with men (msm) during acute hcv infection. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Heyes GJ, Tucker A, Marley D, Foster A. Predictors for 1-year mortality following hip fracture: a retrospective review of 465 consecutive patients. Eur J Trauma Emerg Surg 2015; 43:113-119. [PMID: 26260068 DOI: 10.1007/s00068-015-0556-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 02/22/2015] [Accepted: 07/31/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION In Europe, trauma admissions and in particular hip fractures are on the rise. In recent years, health care systems have placed particular emphasis, including financial incentives, on delivering patients quickly and safely to surgery. At our unit, we have observed that hip fracture patients appear to be at significant risk of mortality even up to a year following injury. This study reviews a consecutive population of hip fracture patients to identify predictors of excess risk. MATERIALS AND METHODS Four hundred and sixty-five consecutive patients were treated over a 2-year period at our district general hospital with no ward-based orthogeriatricians. Follow-up was for 1 year following hip fracture admission. Statistical analysis of variables and their influence on 1-year mortality were performed by calculating odd's ratio (OR) using a logistic regression model and a p value <0.05 was considered statistically significant. RESULTS Four patients were lost to follow-up, 18 patients (4.1 %) were managed conservatively, 16 were too unwell for surgery and their mortality rate at 1 year was 50 %. Following hip fracture, we found an overall 1-year mortality rate of 15.1 %. Patients with a time to surgery ≥36 h were at significantly increased risk of mortality even up to 1 year. We did not identify a further reduction in mortality in those operated on within 24 h. Raised ORs (p > 0.05) were found with increasing comorbidity, surgery type, independence on discharge, alcohol ingestion, history of smoking, readmission and several biochemical markers. CONCLUSION Minimising mortality risk, even over the longer term, should begin on admission with prompt optimisation of any acute medical or biochemical abnormalities, followed by early surgery and intensive rehabilitation to maintain patients' functional independence.
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Affiliation(s)
- G J Heyes
- , Apartment 1001, 70 Chichester Street, Belfast, BT1 4JQ, UK.
| | - A Tucker
- Department of Trauma and Orthopaedics, Altnagelvin Hospital, Glenshane Road, County Londonderry, BT47 6SB, Northern Ireland
| | - D Marley
- Department of Trauma and Orthopaedics, Altnagelvin Hospital, Glenshane Road, County Londonderry, BT47 6SB, Northern Ireland
| | - A Foster
- Department of Trauma and Orthopaedics, Altnagelvin Hospital, Glenshane Road, County Londonderry, BT47 6SB, Northern Ireland
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Leidhin CN, Heeney A, Connolly C, Swan N, Foster A, Geraghty J. A Rare Case of BRCA2-Associated Breast Cancer in Pregnancy. Ir Med J 2015; 108:217-218. [PMID: 26349355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 30-year old woman was referred to our department with symptomatic breast cancer at 35 weeks gestation. Genetic testing revealed a pathogenic BRCA2 mutation. Labour was induced at 38 weeks. Mastectomy and axillary clearance were performed with a view to adjuvant chemotherapy, radiation and hormonal therapy. Multidisciplinary involvement is crucial for management of BRCA-associated breast cancer, especially in the context of pregnancy. Bilateral mastectomy may be indicated given the increased risk of ipsilateral and contralateral breast cancers. Tamoxifen may lower contralateral breast cancer risk in those in whom risk-reducing surgery is not performed.
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Ibrahim O, Foster A, Oluleye T. BARRIERS TO AN EFFECTIVE DIABETIC RETINOPATHY SERVICE IN IBADAN, NIGERIA (SUB -SAHARAN AFRICA) - A PILOT QUALITATIVE STUDY. Ann Ib Postgrad Med 2015; 13:36-43. [PMID: 26807085 PMCID: PMC4715371] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Diabetic retinopathy is an increasing cause of blindness. The prevalence of retinopathy in hospital attending diabetics in Ibadan is reported to be 42 %. This study assessed the barriers identified by patients and service providers to delivering good services for diabetic retinopathy in Ibadan, Nigeria, Sub-Saharan Africa. METHODS A qualitative survey using non-participatory observation, in-depth interviews (patients and healthcare providers), and focus group discussion for diabetic patients in the eye clinic in University College Hospital, Ibadan was done. Semistructured interview and topic guides were used to evaluate the barriers to effective service. The participants were selected using a non-probability, purposive sampling strategy. Twenty participants were involved in the pilot study. There were ten in-depth interviews of patients and two focus group discussions of patients (3 in each group). Four healthcare providers were interviewed (a retinal surgeon, a senior registrar, an endocrinologist and a public health nurse). RESULTS Lack of awareness that diabetes causes irreversible blindness was identified as a major barrier by both patients and providers. Cost of treatment of diabetes and treatment of retinopathy was also an important barrier. The long waiting time before consultation, staff attitudes to patients and appointment scheduling problems deterred patients from using the service. CONCLUSIONS More diabetic patients can be encouraged to use eye service by providing more detailed information/counselling and making clinic attendance less costly and more convenient.
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Affiliation(s)
- O.A. Ibrahim
- Ancilla Catholic Hospital, Eye Centre, Lagos State, Nigeria, Department of Ophthalmology, University College Hospital, Ibadan, Nigeria
| | - A. Foster
- International Centre for Eye Health (ICEH), London School of Hygiene and Tropical Medicine, UK
| | - T.S. Oluleye
- Department of Ophthalmology, University College Hospital, Ibadan, Nigeria
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Rimner A, Din S, Shaikh F, Foster A, Tyagi N, Abi Aad S, Paik P, Yorke E, Chaft J, Gelblum D, Rosenzweig K, Wu A. Stage III Non-Small Cell Lung Cancer Treated Without Concurrent Chemotherapy: What Is the Optimal Radiation Dose? Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.08.181] [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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39
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Patel S, Rimner A, Foster A, Zhang Z, Woo K, Yu H, Riely G, Wu A. Pattern of Failure in Metastatic EGFR-Mutant NSCLC Treated With Erlotinib: A Role for Upfront Radiation Therapy? Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.08.233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rimner A, Din S, Shaikh F, Foster A, Tyagi N, Abi Aad S, Paik P, Yorke E, Chaft J, Gelblum D, Rosenzweig K, Wu A. Stage III Non-Small Cell Lung Cancer Treated Without Concurrent Chemotherapy: What Is the Optimal Radiation Dose? Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1932] [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: 10/24/2022]
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41
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Patel S, Rimner A, Foster A, Zhang Z, Woo K, Yu H, Riely G, Wu A. Risk of Brain Metastasis in EGFR-Mutant NSCLC Treated With Erlotinib: A Role for Prophylactic Cranial Irradiation? Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1906] [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: 10/24/2022]
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Patel S, Rimner A, Foster A, Zhang Z, Woo K, Yu H, Riely G, Wu A. Pattern of Failure in Metastatic EGFR-Mutant NSCLC Treated With Erlotinib: A Role for Upfront Radiation Therapy? Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1904] [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: 10/24/2022]
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Rimner A, Adeseye V, Foster A, Woo K, Shaikh F, Din S, Zhang Z, Yorke E, Gewanter R, Rosenzweig K, Huang J, Wu A. Recurrence Patterns and Second Primary Lung Cancers After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer: Implications for Surveillance. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.788] [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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Mattes M, Ahsanuddin S, Apte A, Moshchinsky A, Rizk N, Foster A, Wu A, Ashamalla H, Deasy J, Weber W, Rimner A. The Ratio of Lymph Node to Primary Tumor SUV on PET/CT Accurately Predicts Nodal Malignancy in Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.781] [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: 10/24/2022]
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Wu A, Gillis A, Foster A, Woo K, Zhang Z, Gelblum D, Downey R, Rosenzweig K, Ong L, Perez C, Pietanza M, Krug L, Rimner A. Should All Limited-Stage Small Cell Lung Cancer Be Treated Alike? Impact of AJCC Stage on Brain Metastasis, Survival, and Patterns of Failure. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.210] [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: 10/24/2022]
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Ong L, Perez C, Foster A, Pietanza M, Rosenzweig K, Gelblum D, Dunphy M, Rimner A, Wu A. Prognostic Value of Pre- and Post-Radiation Therapy [18F]FDG-PET/CT Metrics in Limited-Stage Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zhang P, Yah R, Yorke E, Hu Y, Foster A, Mageras G, Wu A, Deasy J, Rimner A. Incorporating the Prediction of Residual Tumor Location Into Prospective Dose Painting for Locally-Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Modh A, Rimner A, Shah M, Foster A, Gelblum D, Rosenzweig K, Yorke E, Wu A. Survival and Toxicity After Stereotactic Body Radiation Therapy for Central Lung Tumors. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.089] [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: 11/29/2022]
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Din S, Yamada J, Yorke E, Foster A, Poppens E, Thompson M, Jackson A, Wu A, Rimner A. Brachial Plexopathy After High-Dose Stereotactic Body Radiation Therapy (SBRT). Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1372] [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: 11/28/2022]
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