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Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Cani A, Dolce E, Turnbull A, Hu K, Liu CJ, Darga E, Robinson D, Wu YM, Thomas DG, Paoletti C, Tomlins S, Rae J, Udager A, Chinnaiyan A, Cobain EF, Hayes DF. Abstract P4-02-04: Serial monitoring of circulating tumor cells and circulating tumor DNA in metastatic lobular breast cancer identifies intra-tumor heterogeneity and precision and immuno-oncology biomarkers of therapeutic importance. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-02-04] [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: 03/06/2023]
Abstract
Abstract
Clinical decisions on precision and immuno-oncology therapies are based on predictive biomarkers commonly obtained from a single metastatic biopsy or archived primary tumor tissue. Circulating genomic biomarkers offer a minimally invasive approach to monitor intra-patient tumor heterogeneity and detect in real-time the clinically-relevant evolving clonal architecture. Although currently underutilized, we hypothesize that single-cell DNA next generation sequencing (scNGS) of circulating tumor cells (CTC) is a particularly well-suited method to complement biomarker information obtained from tissue and cell-free circulating tumor DNA (ctDNA). In this study we analyzed 113 individual CTC, 21 ctDNA, and 15 white blood cells (WBC) samples, from 15 CTC-positive lobular breast cancer patients, four of whom had CTC available at both metastatic baseline and after progression on a variety of therapies chosen at their physician’s discretion. Clinical NGS data from 15 tumor tissue biopsies obtained using a ~1700-gene DNA panel and whole transcriptome sequencing were available for comparison. CTC were enriched with the CellSearch® system and isolated as single cells with the DEPArray™ system. Whole genome amplified CTC and WBC, as well as ctDNA underwent scNGS with the Oncomine Comprehensive Assay covering ~500 genes and 1.1Mb of genomic space to detect mutations, copy number alterations, tumor mutation burden (TMB) and microsatellite instability (MSI). 99.1% of single cells and 95.2% of ctDNA samples were informative, with a mean sequencing depth of 664x. Using our previously developed, CTC-based precision medicine reporting platform, MI-CTCSeq, CTC in 9 of 15 patients (60%) had mutations that were actionable by FDA-approved targeted therapies including in the oncogenes PIK3CA and FGFR2 and HER2. 3 of these 9 patients (33%) harbored actionable alterations not shared between all 3 analyte types (tissue, CTC and ctDNA). These included 3 actionable mutations found in CTC and ctDNA only, 1 in tissue and ctDNA only, and 1 in ctDNA only. However, 2 of those ctDNA mutations were identified near the limit of detection and with a priori knowledge of their presence from tissue or CTC. Further, 1 patient with plentiful CTC had no detectable ctDNA and one patient’s tissue biopsy was inadequate for sequencing while both liquid biopsy analytes were abundant. 13 patients (87%) displayed intra-patient, inter-CTC genomic heterogeneity of putative driver mutations. 1 of 4 (25%) patients with CTC available in >1 timepoint displayed fluctuations in their CTC subclonal makeup between timepoints. Data from this patient’s 2 tissue biopsies, 3 ctDNA samples, and 27 individual CTC over 4 timepoints combined to reveal in unprecedented detail inter-metastatic lesion and inter-CTC heterogeneity and tumor evolution in response to endocrine and immunotherapy selective pressures. ScNGS of CTC helped provide an additional level of detail not appreciated by sequencing of the other two analyte types. In another patient, CTC were composed of 2 subclones which were indistinguishable by ctDNA, 1 of which appears to have not been sampled by the tissue biopsy. Using a novel method, we enabled detection of single-cell CTC TMB and MSI. CTC TMB scores (dichotomized as above/below 10 mutations/Mb) were 100% concordant with those measured in the corresponding tissue biopsies. Further, in a novel observation, we detected intra patient, inter-CTC heterogeneity of TMB and MSI, which has potential implications for immunotherapy response and development of resistance. Taken together, these data support the non-invasive biomarker interrogation and monitoring by liquid biopsy that incorporates CTC scNGS and complements tissue in informing precision and immuno-oncology approaches. This may have important implications for appropriate treatment selection and identification of therapeutic resistance mechanisms.
Citation Format: Andi Cani, Emily Dolce, Alissa Turnbull, Kevin Hu, Chia-Jen Liu, Elizabeth Darga, Dan Robinson, Yi-Mi Wu, Dafydd G. Thomas, Costanza Paoletti, Scott Tomlins, James Rae, Aaron Udager, Arul Chinnaiyan, Erin F. Cobain, Daniel F. Hayes. Serial monitoring of circulating tumor cells and circulating tumor DNA in metastatic lobular breast cancer identifies intra-tumor heterogeneity and precision and immuno-oncology biomarkers of therapeutic importance [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-02-04.
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Affiliation(s)
- Andi Cani
- 1University of Michigan, Ann Arbor, Michigan
| | | | | | | | | | | | | | | | | | | | | | - James Rae
- 12University of Michigan Medical School
| | | | | | - Erin F. Cobain
- 15University of Michigan Rogel Cancer Center, Ann Arbor, Michigan
| | - Daniel F. Hayes
- 16University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian 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Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack 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Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Hesketh J, Dickinson E, Martin M, Hinds G, Turnbull A. Influence of H 2S on the pitting corrosion of 316L stainless steel in oilfield brine. Corros Sci 2021; 182:10.1016/j.corsci.2021.109265. [PMID: 34267394 PMCID: PMC8276138 DOI: 10.1016/j.corsci.2021.109265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Coupon immersion tests were performed on 316L stainless steel in a simulated oilfield environment to evaluate the effect of H2S partial pressure on pit depth and density. Pitting was most significant at intermediate partial pressures of H2S, for which free H2S in the pit solution is maximised. Inhibition of pitting at higher partial pressures is attributed to blocking of the pit surface by metal sulphide phases. The key role of pH in the pit solution is to determine the solubility of metal sulphides and the availability of free H2S to adsorb on the reacting pit surface and sustain activity.
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Affiliation(s)
- J. Hesketh
- National Physical Laboratory, Hampton Road, Teddington, TW11 OLW, United Kingdom
| | - E.J.F. Dickinson
- National Physical Laboratory, Hampton Road, Teddington, TW11 OLW, United Kingdom
| | - M.L. Martin
- NIST, 325 Broadway, MS 647, Boulder, CO, 80305, United States
| | - G. Hinds
- National Physical Laboratory, Hampton Road, Teddington, TW11 OLW, United Kingdom
| | - A. Turnbull
- National Physical Laboratory, Hampton Road, Teddington, TW11 OLW, United Kingdom
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Turnbull A, Tepe G, Mohammed S, Peraino N, Speyer C. Eliciting Cell Death Using Recombinant IgA Fc‐Folate Antibody Mimetics. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.00006] [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: 11/11/2022]
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Knight SR, Pearson R, Kiely C, Lee G, MacDonald AJ, Macdonald A, Ravi F, Ramsay G, Sellars H, Macleod C, Robertson J, Oliver W, Ventham N, Turnbull A, Dunstan E, Webber R, Norton A, Shearer R, Clement K, Kilkenny J, Lim J, Wilson M, Littlechild J, Joy M, Donoghue C, Mansouri D, Dreyer B, Stevenson R, Clark L, Yong K, Fostyk N, Tummon R, Jack R, Boland M, Speake D, Savioli F, Hughes D. Patient consent in the post-Montgomery era: A national multi-speciality prospective study. Surgeon 2019; 17:277-283. [DOI: 10.1016/j.surge.2018.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/15/2018] [Accepted: 08/25/2018] [Indexed: 11/26/2022]
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Clarke R, Dixon M, Jin L, Pearce D, Turnbull A, Selli C, Hu R, Zwart A, Wang Y, Xuan J, Sengupta S, Sims A, Liu MC. Abstract P5-04-17: Local network topology differences between early and late recurrence in ER+ breast cancers. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-04-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Late recurrence is characteristic of ER+ breast cancers. Despite an apparently effective adjuvant endocrine therapy, many breast cancers recur years after their initial endocrine treatment. Why some tumors recur early (<3 years) and some recur later (>5 years) is poorly understood. If systemic endocrine therapies killed all cells, recurrence would reflect only the appearance of new disease. Thus, we hypothesized that cells that survive and lie dormant may be driven, in part, by altered wiring of their cell death signaling. We, therefore, studied how cell death signaling is differentially wired in primary tumors that will recur early versus those that will recur later.
Method: Genes involved in apoptosis, autophagy, ferroptosis, necrosis, and pyroptosis were identified from KEGG to initiate network feature analysis of gene expression data from public and our first in-house gene expression dataset. Data were collected from ER+ breast cancer pre-endocrine treatment samples with up to 20 years follow-up. Publicly available datasets used were GSE6532, GSE2034, GSE7390, GSE17705, GSE12093, and TCGA. We applied our Knowledge-fused Differential Dependency Network (KDDN) analysis tool to the public datasets; KDDN has provided powerful new insights into signaling in breast and other cancers. Common gene-gene interactions (edges) predicted in at least two different datasets were extracted from all KDDN analyses results. To strengthen the relevance of these features, predicted network edges that represent known protein-protein interactions (PPI) were identified from the STRING database, and these edges were noted in the signaling graphs. Final network graphs were constructed using the common edges from all overlaid networks. We conducted IPA analysis on all nodes in the final network and selected those incorporating network hubs. We took a similar approach to our second in-house dataset, which we used for independent testing. Here, patients were included if their tumor exhibited an initial reduction in volume of at least 40% by four months in response to neo-adjuvant Letrozole. Patients were then classified into two groups during follow-up of up to 3.7 years: i) initial tumor size reduction followed by continued response (expected to recur late); ii) initial reduction followed by tumor regrowth (expected to recur early). KDDN analysis was performed on pretreatment samples from these two groups and a network created annotated with PPI information.
Results: MAPK8 and CYCS (Molecular Mechanisms of Cancer, p=1.58E-52), TNFRSF1A Neuroinflammation Signaling Pathway, p=1.26E-54), RELA, and NFKB1 (Colorectal Cancer Metastasis Signaling, p=7.94E-35), were identified as hubs. Hubs may be critical signaling components driving the differences between tumors that will become dormant and recur late. Connections between SLC25A6 and SQSTM1 (p = 0.008), BIRC2 and GABARAP (p = 0.021) in the early group, and AKT3 and IRS2 (p = 0.014) in the late group, were shared between the two final networks. With longer follow-up time on the second in-house dataset, we will better define the two groups and identify additional common phenotype specific gene-gene interactions.
Citation Format: Clarke R, Dixon M, Jin L, Pearce D, Turnbull A, Selli C, Hu R, Zwart A, Wang Y, Xuan J, Sengupta S, Sims A, Liu MC. Local network topology differences between early and late recurrence in ER+ breast cancers [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-17.
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Affiliation(s)
- R Clarke
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - M Dixon
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - L Jin
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - D Pearce
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - A Turnbull
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - C Selli
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - R Hu
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - A Zwart
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - Y Wang
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - J Xuan
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - S Sengupta
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - A Sims
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - MC Liu
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
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Clarke R, Dixon MJ, Jin L, Turnbull A, Hu R, Zwart A, Wang Y, Xuan J, Sengupta S, Renshaw L, Sims A, Liu MC. Abstract P4-04-10: Molecular features of dormancy in ER+ breast cancers. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-04-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:Late recurrence (emergence from dormancy) is characteristic of ER+ breast cancers. Despite adjuvant endocrine therapy, many breast cancers recur decades after their initial diagnosis and treatment. Why this occurs is poorly understood.
Methods: We studied 2 independent datasets of endocrine treated, ER+ breast cancers with up to 20 years follow-up. The 1st comprised matched samples from the primary tumor pretreatment at diagnosis and the first recurrence after or during adjuvant endocrine therapy (all FFPE). The 2nd dataset comprised pretreatment biopsies only (all snap frozen). For both datasets, high quality RNA was amplified, labelled, and subjected to transcriptome analysis using the Affymetrix technology (U133 Plus 2.0). Low quality data were identified using 'simpleaffy' and 'ffpe', and removed; all tools were from the R package unless otherwise noted. Remaining data were normalized using 'frma'. Genes differentially expressed between early (≤3 years) and late (≥ 5 years) were selected using limma. Unsupervised hierarchical clustering and PCA explored the structure of the data.
A similar molecular analysis was done on the 2nd dataset. A classification scheme that robustly separated early from late recurrences was validated in an independent public dataset of comparable patients, array platform, and frozen tissues. We also explored features in pretreatment samples that predetermined response duration.
Results: Genes that separated pretreatment specimens by recurrence time did not separate posttreatment specimens. Specimens did not cluster in patient pairs or by site of recurrence.
8245 genes were differentially expressed between early and late recurrences in the FFPE samples, while 2400 genes were significantly different in the same comparison in the frozen samples. Initial pathway analysis was done on each dataset independently using IPA (Ingenuity® Systems, www.ingenuity.com). 70 canonical pathways were identified in common between the two datasets (pretreatment). We then looked for genes regulated in both datasets (ignores FFPE and frozen tissue as source). There were 279 genes in common that differentially regulated in the same direction (upregulated; downregulated). IPA analysis of these genes identified 49 canonical pathways. We also explored the differentially expressed gene sets using 'GSEA' (www.software.broadinstitute.org/gsea/index.jsp). Pathways consistently associated with early vs. late recurrence include integrin signaling, the unfolded protein response, endoplasmic reticulum stress, actin-based motility, and estrogen biosynthesis.
Conclusion: Analysis of pretreatment tumors can predict early recurrences from those that will remain dormant and recur much later. Recurrent tumors exhibit a remodeled molecular landscape that likely reflects the effects of treatments and/or a recreation of a niche with potentially common features at the site of recurrence. Changes in molecular signaling associated with duration of recurrence are consistent with our experimental model studies in vitro implicating UPR signaling as a major integrator of response to endocrine therapy and duration of survival. Additional data sets are being arrayed and more detailed molecular signaling studies are in progress.
Citation Format: Clarke R, Dixon MJ, Jin L, Turnbull A, Hu R, Zwart A, Wang Y, Xuan J, Sengupta S, Renshaw L, Sims A, Liu MC. Molecular features of dormancy in ER+ breast cancers [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-04-10.
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Affiliation(s)
- R Clarke
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - MJ Dixon
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - L Jin
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - A Turnbull
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - R Hu
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - A Zwart
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - Y Wang
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - J Xuan
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - S Sengupta
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - L Renshaw
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - A Sims
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
| | - MC Liu
- Georgetown University Medical Center, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Virginia Tech, Arlington, VA; Mayo Clinic, Rochester, MN
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Palau HL, Simbo A, Turnbull A, Jones A, Davies J. 104 Clinical impact of Staphylococcus aureus co-infection in sputum-producing cystic fibrosis patients chronically infected with Pseudomonas aeruginosa. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30468-x] [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: 10/19/2022]
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Gennemark P, Trägårdh M, Lindén D, Ploj K, Johansson A, Turnbull A, Carlsson B, Antonsson M. Translational Modeling to Guide Study Design and Dose Choice in Obesity Exemplified by AZD1979, a Melanin-concentrating Hormone Receptor 1 Antagonist. CPT Pharmacometrics Syst Pharmacol 2017; 6:458-468. [PMID: 28556607 PMCID: PMC5529746 DOI: 10.1002/psp4.12199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 03/27/2017] [Accepted: 04/03/2017] [Indexed: 12/22/2022]
Abstract
In this study, we present the translational modeling used in the discovery of AZD1979, a melanin‐concentrating hormone receptor 1 (MCHr1) antagonist aimed for treatment of obesity. The model quantitatively connects the relevant biomarkers and thereby closes the scaling path from rodent to man, as well as from dose to effect level. The complexity of individual modeling steps depends on the quality and quantity of data as well as the prior information; from semimechanistic body‐composition models to standard linear regression. Key predictions are obtained by standard forward simulation (e.g., predicting effect from exposure), as well as non‐parametric input estimation (e.g., predicting energy intake from longitudinal body‐weight data), across species. The work illustrates how modeling integrates data from several species, fills critical gaps between biomarkers, and supports experimental design and human dose‐prediction. We believe this approach can be of general interest for translation in the obesity field, and might inspire translational reasoning more broadly.
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Affiliation(s)
- P Gennemark
- Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Mölndal, Sweden
| | - M Trägårdh
- Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Mölndal, Sweden.,University of Warwick, School of Engineering, Coventry, UK
| | - D Lindén
- Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Mölndal, Sweden
| | - K Ploj
- Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Mölndal, Sweden
| | - A Johansson
- Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Mölndal, Sweden
| | - A Turnbull
- Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Mölndal, Sweden
| | - B Carlsson
- Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Mölndal, Sweden
| | - M Antonsson
- Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Mölndal, Sweden
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Affiliation(s)
- L. P. Ku
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543
| | - P. R. Garabedian
- Courant Institute of Mathematical Sciences, New York University, New York, New York 10012
| | - J. Lyon
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831
| | - A. Turnbull
- General Atomics, San Diego, California 92186
| | - A. Grossman
- University of California, San Diego, San Diego, California 92093
| | - T. K. Mau
- University of California, San Diego, San Diego, California 92093
| | - M. Zarnstorff
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543
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Najmabadi F, Raffray AR, Abdel-Khalik SI, Bromberg L, Crosatti L, El-Guebaly L, Garabedian PR, Grossman AA, Henderson D, Ibrahim A, Ihli T, Kaiser TB, Kiedrowski B, Ku LP, Lyon JF, Maingi R, Malang S, Martin C, Mau TK, Merrill B, Moore RL, Peipert RJ, Petti DA, Sadowski DL, Sawan M, Schultz JH, Slaybaugh R, Slattery KT, Sviatoslavsky G, Turnbull A, Waganer LM, Wang XR, Weathers JB, Wilson P, Waldrop JC, Yoda M, Zarnstorffh M. The ARIES-CS Compact Stellarator Fusion Power Plant. Fusion Science and Technology 2017. [DOI: 10.13182/fst54-655] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- F. Najmabadi
- Center for Energy Research University of California, San Diego, MC 0417, La Jolla, California 92093-0417
| | - A. R. Raffray
- Center for Energy Research University of California, San Diego, MC 0417, La Jolla, California 92093-0417
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Mathur S, Serrano-Linares A, Turnbull A, Stevens C, Mincher D. A novel legumain-targeted fluorogenic theranostic prodrug. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32798-8] [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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Turnbull A, Lund-Palau H, Murphy R, Simbo A, Shoemark A, Wong K, Bush A, Alton E, Davies J. S75 The T2R38 bitter taste receptor as a modifier of host response to pseudomonas aeruginosa in cystic fibrosis: does T2R38 genotype impact on clinical infection? Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.81] [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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Turnbull A, Bush A, Davies J, Snelgrove R. WS04.4 Abnormal LTA 4 H-PGP pathway in early life: a novel mechanism underlying persistent neutrophilic inflammation in the CF airway. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30081-9] [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: 11/29/2022]
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Meehan J, Ward C, Jarman E, Xintaropoulou C, Martinez-Perez C, Turnbull A, Supuran C, Dixon M, Kunkler I, Langdon SP. Abstract P5-04-05: Targeting the pH regulatory mechanisms of breast cancer cells. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-04-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
The abnormal regulation of H+ ions, leading to a reversed pH gradient in tumor cells in comparison to normal cells, is considered to be one of the hallmarks of cancer. This feature, however, has yet to be exploited as a therapeutic target. The aim of this study was to assess whether targeting proteins (CAIX, NHE1 and V-ATPase) that permit hypoxic cancer cell adaptation to acidosis in the tumor microenvironment can produce an effective therapeutic response in breast cancer, using 2D and 3D models.
Method:
Western blotting and gene expression analysis were performed on MCF-7, MDA-MB-231 and HBL-100 cancer cells to assess target protein expression in differing O2 conditions in 2D, while IHC was used to measure protein levels in 3D using multicellular tumor spheroids. Sulforhodamine B assays were executed to analyze the effects of inhibitors targeting CAIX, NHE1 and V-ATPase on breast cancer cell proliferation in 2D. 3D invasion assays were performed with MDA-MB-231 spheroids and explant tissue derived from human patients to see if CAIX inhibition had any effect on cancer cell invasion. An MDA-MB-231 xenograft model was used to investigate the effects of CAIX inhibition in vivo. Clonogenic assays were performed with MDA-MB-231 spheroids to evaluate whether any of the drugs combined effectively with irradiation.
Results:
2D and 3D expression analysis showed that CAIX levels were extremely responsive to changes in O2 conditions in each of the cell lines, with HBL100 cells exhibiting the largest changes in both mRNA (42-fold increase) and protein (78-fold increase) levels at low (0.5%) O2 concentrations. NHE1 and V-ATPase mRNA/protein levels were, however, much more consistently expressed across the cell lines in different O2 conditions. Drugs targeting CAIX, NHE1 and V-ATPase had anti-proliferative effects on the breast cancer cells in 2D. Normoxic cancer cells were the most sensitive to drug treatment, acute hypoxic cancer cells showed increased resistance to the anti-proliferative effects of these drugs, while chronic hypoxic cells had IC50 values more similar to the normoxic cells. The results for the CAIX inhibitor were unexpected, as we had predicted that the increased levels of CAIX in the acute hypoxic cells would make them more sensitive to treatment. CAIX inhibition did, however, significantly reduce the invasion of cancer cells from both MDA-MB-231 spheroids (p≤0.01) and explant tissue (p≤0.001). Targeting pH regulation was also shown to have an effect in vivo on MDA-MB-231 xenografts, with CAIX inhibition significantly reducing the growth (p≤0.05) and proliferation (p≤0.05) of tumors within mice. Finally, clonogenic assays showed that drugs targeting both CAIX and NHE1 led to a significant reduction in colony number when combined with radiation (p≤0.05), compared to either drug individually or radiation treatment alone.
Conclusions:
This study shows that drugs targeting pH regulation molecules have potential in the treatment of breast cancer. This is highlighted by their ability to affect the proliferation and invasion of breast cancer cells, along with their ability to be combined with radiation. Of the 3 pH regulatory molecules, CAIX represents the target with the most promise.
Citation Format: Meehan J, Ward C, Jarman E, Xintaropoulou C, Martinez-Perez C, Turnbull A, Supuran C, Dixon M, Kunkler I, Langdon SP. Targeting the pH regulatory mechanisms of breast cancer cells. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-04-05.
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Affiliation(s)
- J Meehan
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
| | - C Ward
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
| | - E Jarman
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
| | - C Xintaropoulou
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
| | - C Martinez-Perez
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
| | - A Turnbull
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
| | - C Supuran
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
| | - M Dixon
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
| | - I Kunkler
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
| | - SP Langdon
- University of Edinburgh, Edinburgh, United Kingdom; University of Florence, Florence, Italy
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Turnbull A, Shoemark A, Lund-Palau H, Bush A, Alton E, Davies J. S69 Development of an in vitroassay to detect chemically-induced changes in ciliary beat frequency. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.75] [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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Khoo V, Pabary R, Lund Palau H, Turnbull A, Madden N, Schelenz S, Jones A, Morales S, Alton EWFW, Davies JC. S112 Variability in susceptibility to antibiotics and bacteriophages between individual colonies of Pseudomonas aeruginosa from cystic fibrosis sputum samples: implications for future clinical trial design. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.118] [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: 11/04/2022]
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Brohan E, Bonner N, Turnbull A, Khan S, Dewit O, Thomas G, Manson S. Development of a Patient-Led End of Study Questionnaire to Evaluate the Experience of Clinical Trial Participation. Value Health 2014; 17:A649. [PMID: 27202341 DOI: 10.1016/j.jval.2014.08.2358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- E Brohan
- Adelphi Values Ltd, Bollington, UK
| | - N Bonner
- Adelphi Values Ltd, Bollington, UK
| | | | - S Khan
- GlaxoSmithKline, Uxbridge, Middlesex, UK
| | - O Dewit
- GlaxoSmithKline, Cambridge, UK
| | - G Thomas
- GlaxoSmithKline, Uxbridge, Middlesex, UK
| | - S Manson
- GlaxoSmithKline, Uxbridge, Middlesex, UK
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Tame J, Turnbull A, Forton J. 183 Mycobacterium abscessus: stand alone hospital admission for agressive physiotherapy and nutritional review can extend periods between toxic IV antibiotic treatments. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60318-0] [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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Arthur L, Turnbull A, Webber V, Larionov A, Renshaw L, Kay C, Thomas J, Dixon J, Sims A. Molecular Changes in Lobular Breast Cancers in Response to Neoadjuvant Letrozole. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu065.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Turnbull A, May AT. Steady state electrochemical kinetics of BS 4360 50D structural steel in deaerated 3·5%NaCl solution of varying pH. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/000705987798271479] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Turnbull A. Theoretical Evaluation of the Dissolved Oxygen Concentration in a Crevice or Crack in a Metal in Aqueous Solution. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/000705980798275229] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Turnbull A, Gardner MK. Potential and pH Measurements in a Crevice of the Steel BS 4360 50D in 3·5% NaCl and in Artificial Sea Water. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/000705981798274887] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Larionov A, Turnbull A, Sims A, Renshaw L, Kay C, Harrison D, Dixon JM. Abstract P3-06-23: Predicting response to neoadjuvant letrozole. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-06-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Approximately 75% of older postmenopausal patients with large operable or locally advanced oestrogen receptor positive breast cancer respond to treatment with neoadjuvant letrozole. Prediction of response is required as approximately 25% fail to respond. The aim of this study was to design a response predicting classifier with two data sets, one published previously [1] and secondly a new dataset.
Methods: Patients were treated with Letrozole (Femara, 2.5 mg daily) and tissues were collected before treatment, 2 or 3 weeks on treatment, and between 3 and 5 months on treatment. Response was based on a 3D ultrasound, with response being classified as a 50% reduction in tumour volume at 3 months. To ensure biological relevance of the response groups we also separated patients into Quick Stable Responders (QSR) and Long-Term Non-responders (LNR), as summarised in Table 1.
Illumina HT-12 BeadArrays were used for gene expression profiling, allowing platform-independent cross-validation with our previous study using Affymetrix HGU-133 chips [1]. The probe IDs were re-annotated to Ensemble gene IDs and XPN batch correction has been applied to make the datasets directly comparable. A combination of Rank-Product, SAM and Random Forrest analyses have been used to design several alternative signatures separating extreme response groups, the patients who responded rapidly vs those who did not respond for a long time. One of the best performing signatures included 48 informative features: 24 at baseline, 12 at 2-weeks and 12 changes between 0 and 2 weeks. This signature was validated on the independent previously published test set by classifying extreme responses (quick stable responders vs long term non responders) using Support vector machines (SVM) with different kernel functions.
Results Are summarised in Table 2.
Conclusions – A new sample series has been collected to study neo-adjuvant endocrine response. It can be used for independent validation of previous results [1] and for design of new platform-independent response predictors.– Multi-gene predictors based upon change in gene expression outperform those from baseline or 14 day measurements alone. The best classifiers include all 3 time points.– A classifier has been derived with a 91% accuracy rate of predicting extreme response group in 21 of 23 patients.
References
[1] Miller 2009 J Clin Oncol 27:1382.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-06-23.
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Affiliation(s)
- A Larionov
- University of Edinburgh, Scotland, United Kingdom
| | - A Turnbull
- University of Edinburgh, Scotland, United Kingdom
| | - A Sims
- University of Edinburgh, Scotland, United Kingdom
| | - L Renshaw
- University of Edinburgh, Scotland, United Kingdom
| | - C Kay
- University of Edinburgh, Scotland, United Kingdom
| | - D Harrison
- University of Edinburgh, Scotland, United Kingdom
| | - JM Dixon
- University of Edinburgh, Scotland, United Kingdom
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Turnbull A, Marsh C. Peri-operative anisocoria - the importance of pupil assessment before general anaesthesia. Anaesthesia 2012; 67:1053-4. [DOI: 10.1111/j.1365-2044.2012.07282.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hu X, Summers JA, Turnbull A, Zuna N. The quantitative measurement of family quality of life: a review of available instruments. J Intellect Disabil Res 2011; 55:1098-1114. [PMID: 21883596 DOI: 10.1111/j.1365-2788.2011.01463.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Family quality of life (FQOL) has emerged as an important outcome of service delivery for individuals with disabilities and their families. The purpose of this review was to explore the disparity of scale development approaches between families with children with disabilities and families from other populations and identify strengths to serve as a source of recommendations to improve the measurements of FQOL in the disability field. METHOD We conducted a keyword search of 25 databases. Sixteen measurement tools on FQOL, family well-being and family satisfaction currently used in the disability field, healthcare field and general family studies published in journals from 1980 to 2009 were included in the analysis. RESULTS Three themes emerged from the detailed analysis and comparisons of the instruments: (1) description of the primary purpose and theoretical basis; (2) identification of the tool's respondents, domains, response formats and scoring strategies to assess family systems; and (3) summarisation of available psychometric information. CONCLUSIONS As family researchers continue their mission to conceptualise and theorise about FQOL, they should also promote the refinement of FQOL measurements and consider the implications from family instruments used in the healthcare and general family fields from the following aspects: (1) domains of FQOL; (2) units of analysis; (3) response format; (4) scoring choice; and (5) psychometric evaluation.
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Affiliation(s)
- X Hu
- Department of Special Education, Beijing Normal University, Beijing, China.
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Decramer M, Sibille Y, Bush A, Carlsen KH, Rabe KF, Clancy L, Turnbull A, Nemery B, Simonds A, Troosters T. The European Union conference on chronic respiratory disease: purpose and conclusions. Eur Respir J 2011; 37:738-42. [PMID: 21454890 DOI: 10.1183/09031936.00020211] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Trikha S, Turnbull A, Srikantha N, Krishnan R, Tappin A. Anterior keratouveitis secondary to Hydroa vaccineforme: a role for ophthalmic slit-lamp examination in this condition? BMJ Case Rep 2011; 2011:2011/apr12_1/bcr0920103309. [PMID: 22701003 DOI: 10.1136/bcr.09.2010.3309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The authors report the case of an 8-year-old girl of Caucasian origin who attended the Emergency Eye Clinic with a 3-week history of a red, light sensitive left eye during the month of April. Her Snellen visual acuities were 6/5 right and 6/9 left. Examination revealed perilimbal injection and anterior chamber inflammation in the left eye consistent with an anterior uveitis. Inferior stromal haze and fine keratic precipitates were noted in the left cornea. Intraocular pressures were normal, with no vitritis and healthy looking discs, maculae and peripheral retina. Systemic examination revealed a papular rash over the face consistent with previously diagnosed Hydroa vaccineforme. With intensive topical steroids the inflammation gradually resolved.
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Affiliation(s)
- S Trikha
- Ophthalmology Department, Queen Alexandra Hospital, Cosham, Portsmouth, UK.
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Chen Y, James J, Evans A, Turnbull A, Gale A. An investigation of workstation image manipulation usage when examining FFDM images. Breast Cancer Res 2010. [PMCID: PMC2978826 DOI: 10.1186/bcr2662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Kim JS, Zhao L, Bogatu IN, In Y, Turnbull A, Osborne T, Maraschek M, Comer K. Soft x-ray virtual diagnostics for tokamak simulations. Rev Sci Instrum 2009; 80:113503. [PMID: 19947727 DOI: 10.1063/1.3245344] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The numerical toolset, FAR-TECH Virtual Diagnostic Utility, for generating virtual experimental data based on theoretical models and comparing it with experimental data, has been developed for soft x-ray diagnostics on DIII-D. The virtual (or synthetic) soft x-ray signals for a sample DIII-D discharge are compared with the experimental data. The plasma density and temperature radial profiles needed in the soft x-ray signal modeling are obtained from experimental data, i.e., from Thomson scattering and electron cyclotron emission. The virtual soft x-ray diagnostics for the equilibriums have a good agreement with the experimental data. The virtual diagnostics based on an ideal linear instability also agree reasonably well with the experimental data. The agreements are good enough to justify the methodology presented here for utilizing virtual diagnostics for routine comparison of experimental data. The agreements also motivate further detailed simulations with improved physical models such as the nonideal magnetohydrodynamics contributions (resistivity, viscosity, nonaxisymmetric error fields, etc.) and other nonlinear effects, which can be tested by virtual diagnostics with various stability modeling.
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Affiliation(s)
- J S Kim
- FAR-TECH, Inc., 3550 General Atomics Court, Building 15, Suite 155, San Diego, California 92121, USA
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Nabavi A, Yeoh KM, Shidiac L, Appleyard R, Gillies RM, Turnbull A. Effects of positioning and notching of resurfaced femurs on femoral neck strength: a biomechanical test. J Orthop Surg (Hong Kong) 2009; 17:47-50. [PMID: 19398793 DOI: 10.1177/230949900901700111] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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: 11/17/2022] Open
Abstract
PURPOSE To assess the effects of positioning and notching of resurfaced femurs on the mechanical strength of third-generation saw bone (TGSB) femurs using an in vitro analogue bone model. METHODS 30 TGSB femurs were equally divided into 6 resurfaced femur groups (intact, anatomic, varus, valgus, anatomically notched, and valgus notched) for testing the load to failure, stiffness, and total energy. RESULTS Compared to the intact femurs, the load to failure in all resurfaced femurs was significantly decreased by 29 to 57%. Among the resurfaced femurs, valgus and anatomic femurs had the highest load to failure, followed by valgus notched, varus, and anatomically notched femurs. Notching weakened the construct by a further 24 to 30%. CONCLUSION To minimise the risk of femoral neck fracture, resurfaced femoral heads should be placed in an anatomic or valgus orientation, and the superior cortex of the femoral neck should remain intact.
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Affiliation(s)
- A Nabavi
- Whitlam Joint Replacement Centre, Fairfield Hospital,University of NSW, Sydney, Australia
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Ng J, Jenkins G, Turnbull A, Lansdown L, McQuillan B. The Different Patterns of Myocardial Velocity Curves as Assessed by Colour Tissue Velocity Imaging. Heart Lung Circ 2009. [DOI: 10.1016/j.hlc.2009.05.134] [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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Dickel T, Turnbull A, Pye M. Fatal acute cor pulmonale due to portopulmonary hypertension in a noncirrhotic patient. Int J Clin Pract 2008; 62:1453-4. [PMID: 18793380 DOI: 10.1111/j.1742-1241.2005.00792.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Turnbull A, Young B, Hayer K, Bacon J, York J, Farmer S. A practical perspective of computerised radiography on a mobile screening van. Breast Cancer Res 2008. [PMCID: PMC3332614 DOI: 10.1186/bcr2042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Mincher D, Van Valckenborgh E, Young L, Turnbull A, Di Salvo A, Vanderkerken K. Design of mechanisms of selective prodrug activation in the bone marrow microenvironment of experimental and human multiple myeloma. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)71276-x] [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: 10/21/2022] Open
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Wang M, Summers JA, Little T, Turnbull A, Poston D, Mannan H. Perspectives of fathers and mothers of children in early intervention programmes in assessing family quality of life. J Intellect Disabil Res 2006; 50:977-88. [PMID: 17100958 DOI: 10.1111/j.1365-2788.2006.00932.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Family quality of life (FQOL), as a family outcome measure of early intervention and other services, has increasingly drawn attention of researchers, policymakers and service providers. Developing an index of family QOL requires a measure suitable for use with multiple family members. The purpose of this study was to test whether mothers and fathers similarly view the conceptual model of FQOL embodied in one measure. METHOD This study involved fathers and mothers of 107 families who have a young child (birth to five) with a disability enrolled in an early intervention programme. Data from couples completing the Beach Center FQOL measure were analysed using structural equation modelling (SEM) to determine similarities or differences between fathers and mothers with respect to their assessment of FQOL. RESULTS The analysis of measurement invariance of the FQOL construct across the father and mother groups indicates that the Beach Center FQOL Scale measures equally the underlying FQOL construct across fathers and mothers in this sample. Fathers do not differ from mothers in perceived importance of factors related to FQOL items, nor did they differ in their overall satisfaction with FQOL. CONCLUSION These results suggest that fathers and mothers respond similarly to the latent constructs within the Beach Center FQOL Scale; therefore, it holds promise for use with both fathers and mothers in assessing FQOL across multiple family members. Further implications for research and practice are discussed.
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Affiliation(s)
- M Wang
- Department of Special Education, Rowan University, Glassboro, NJ, USA
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Mincher D, Young L, Downing H, Turnbull A, Kay G, Bibby M. 513 Design of the selective DNA topoisomerase I poison, NU:UB 235. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80521-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
OBJECTIVE To describe and compare the body mass index (BMI; weight/height2) profile of 11-12-year-old children in Hawkes Bay, New Zealand in 1989 and 2000. To subsequently determine the prevalence of overweight and obesity at the two time points using international definitions. METHODOLOGY As part of asthma prevalence studies in Hawkes Bay data on height, weight and ethnicity were collected from 871 school children in 1989, and 894 children in 2000 who reached 12 years of age during the year of testing. RESULTS In the total study population the geometric mean BMI increased from 18.1 kg/m2 (95% CI 17.9; 18.3) in 1989 to 19.8 kg/m2 (95% CI 19.6; 20.0) in 2000, a relative increase of 9.2% (95% CI 7.6; 10.9), P < 0.001. Significant relative increases were found for males (9.0%: 95% CI 6.8; 11.3), females (9.3%: 95% CI 6.8; 11.8), Maori (7.6%: 95% CI 4.3; 11.1), European (9.1%: 95% CI 7.3; 11.0) and Pacific Island children (11.0%: 95% CI 2.2; 20.5). In 2000 20.9% of Hawkes Bay children were classified as overweight and 9.1% as obese. The risk of being overweight in 2000 was 2.2 times greater than the risk in 1989, and the risk of being obese was 3.8 times greater, with these problems more pronounced among Maori (overweight 24.7%, obese 15.3%) and Pacific Island (overweight 35.0%, obese 15.0%) than European (overweight: 18.2%, obese 5.7%) children. However, the risk of being overweight (RR = 3.0, 95% CI 2.2-4.0) or obese (RR = 8.3, 95% CI 3.0-23.3) in 2000 compared to 1989 was greater among European children. CONCLUSION Higher percentages of Maori and Pacific Island children are overweight or obese compared to European, but in all ethnic groups there has been a statistically significant increase in mean BMI over an 11-year period. This increase reflects the trend observed in other developed countries and underlines childhood obesity as a major health problem in New Zealand.
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Affiliation(s)
- A Turnbull
- Healthcare Hawkes Bay, Hastings, New Zealand.
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Abstract
The purpose of this study was to define the temporal trend in body temperature of patients during the first 5 days after total hip arthroplasty (THA). The medical records of 98 consecutive THAs were reviewed, 88 clinically uncomplicated cases were included. The average maximum temperature reached during the study period was 38.08 degrees C, a 3.7% (P< or =.01) increase from the preoperative base line of 36.64 degrees C. In this study, 62.5% of patients reached a temperature > or =38.0 degrees C; 19.3% > or = 38.5 degrees C; and 3.4% > or = 39.0 degrees C. No patients had a preoperative temperature of > or =38 degrees C recorded. On the first postoperative day, 39 patients had a temperature > or =38 degrees C. The number of febrile patients progressively decreased until by the fifth postoperative day, only 5 patients had a temperature > or =38 degrees C recorded.
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Affiliation(s)
- P C Summersell
- Orthopedic Research Institute, Department of Orthopedic Surgery, St. George Hospital Campus, Sydney, Australia
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Nabavi-Tabrizi A, Turnbull A, Dao Q, Appleyard R. Chondrocyte damage following osteochondral grafting using metal and plastic punches: comparative study in an animal model. J Orthop Surg (Hong Kong) 2002; 10:170-2. [PMID: 12493930 DOI: 10.1177/230949900201000211] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Osteochondral impaction grafting to manage isolated chondral defects in femoral condyles usually uses a metal punch to impact the grafts into predrilled cavities. Damage to the chondrocytes during impaction is a concern, however, and new methods are being sought to minimise the damage. We studied if impaction with a plastic punch instead of a metal punch reduces the extent of chondrocyte damage in an animal model. METHODS 32 osteochondral plugs were prepared from knees of 10 freshly slaughtered sheep knees; the contralateral condyles were then prepared to receive the osteochondral grafts. 20 plugs were impacted into predrilled holes: 10 using a metal punch and 10 using a plastic punch. The 12 remaining plugs were used as controls. The plugs were recovered, incubated for 24 hours in calf serum, and stained with 3-[4,5-dimethylthiazol]-2,5-diphenyltetrazolium to measure the content of viable cells. Digital photographs of the stained cartilage were then analysed on a 0-to-255 grey-scale. RESULTS We found no significant difference in the extent of chondrocyte damage caused by impaction using metal and plastic punches. The content of viable cells in plugs impacted by metal and plastic punches, however, was significantly lower than that in the control plugs, as reflected by higher means of light intensity of 52.9 (p<0.001) and 32.4 (p=0.005), respectively. CONCLUSION Impaction grafting clearly damages chondrocytes of the osteochondral plug. The use of a plastic punch does not reduce the extent of chondrocyte damage during the impaction grafting procedure.
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Oakley SP, Portek I, Szomor Z, Turnbull A, Murrell GAC, Kirkham BW, Lassere MN. Poor accuracy and interobserver reliability of knee arthroscopy measurements are improved by the use of variable angle elongated probes. Ann Rheum Dis 2002; 61:540-3. [PMID: 12006330 PMCID: PMC1754115 DOI: 10.1136/ard.61.6.540] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES (a)To determine the accuracy and reliability of arthroscopic measurements of cartilage lesion diameter in an artificial right knee model; (b) to determine whether the use of a set of variable angle elongated probes improves performance; and (c) to identify other sources of variability. METHODS Ovoid "lesions" were drawn on the five cartilage surfaces of four plastic knees models. Two observers assessed these 20 lesions arthroscopically, measuring two diameters in orientations parallel and orthogonal to the probe. Observer 1 (orthopaedic surgeon) and observer 2 (arthroscopic rheumatologist) made two sets of measurements, firstly with the conventional probe and five months later with the variable angle elongated (VAE) probes. The knees were disarticulated to determine true lesion diameter. RESULTS Observer 1 had negligible bias and good accuracy regardless of orientation or probe type. Observer 2 demonstrated both bias and poor accuracy using the conventional probe. Both improved using VAE probes. Poor interobserver reliability with conventional probes also improved using VAE probes. Major sources of variability could be traced to the probe type, the characteristics of the operator, and the orientation of the lesion in relation to the probe; the lesion location itself did not cause variability. CONCLUSIONS Variation in accuracy and poor interobserver reliability of measurements with conventional methods of cartilage lesion diameter measurement improved when specially designed measurement probes were used. Arthroscopic measurements performed as well as most clinical and radiographic measures. These findings have important implications for the use of arthroscopy as an outcome in multicentre trials where arthroscopists have different levels of experience.
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Affiliation(s)
- S P Oakley
- Department of Rheumatology, St George Hospital, University of New South Wales, Sydney, Australia.
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Gillies RM, Morberg PH, Bruce WJM, Turnbull A, Walsh WR. The influence of design parameters on cortical strain distribution of a cementless titanium femoral stem. Med Eng Phys 2002; 24:109-14. [PMID: 11886829 DOI: 10.1016/s1350-4533(01)00124-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The strain distribution imposed on a femur following a total joint replacement is an important factor, in proximal bone loss due to stress shielding, and long term clinical success. This study investigated how five different design parameters of a cementless titanium femoral prosthesis influenced cortical strains. Test loads were applied and strains were measured with and without an abductor force simulation, using six human cadaveric femora. The cementless design used demonstrated significant calcar loading proximally and a similar strain distribution to the intact femur distally. Implant gross geometry was the major factor in determining the cortical strain distributions under abductor simulation in both axial and torsional loading.
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Affiliation(s)
- R M Gillies
- Orthopaedic Research Laboratories, Dept of Orthopaedics, University of New South Wales, Prince of Wales Hospital, High Street, Edmund Blackett Building, Randwick 2031, NSW, Australia
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