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Chapman A, Bardsley E, Card H, Marshall E, Olsson-Brown A. Evaluation of an established oncology triage hotline in a model of emergency department avoidance: assessing the UKONS triage tool and call outcomes. Support Care Cancer 2023; 32:6. [PMID: 38051438 DOI: 10.1007/s00520-023-08167-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE In response to a demonstrable need for 24/7, specialist oncology advice for patients undergoing systemic anti-cancer therapy, many healthcare institutions have adopted a telephone triage (TT) service. This is true of the Clatterbridge Cancer Centre which uses the UKONS framework to guide its decisions. This study aims to investigate the utilisation and outcomes of this TT service, with a focus on the most unwell call outcomes and factors leading to referrals to accident and emergency departments that could be mitigated with service development and modifications. METHODS A retrospective evaluation study was conducted of calls occurring between 1st September 2021 and 31st August 2022. A descriptive analysis of call UKONS grading, triage outcome and primary complaint was performed. RESULTS The TT hotline received 23,766 calls of which only 9066 were for clinical advice. Of the clinical calls, 45.2% were UKONS red. The majority of red calls 53.3% were directed to AED. The proportion of red calls going to AED changed drastically depending on the timing of call and the corresponding services available at those times, with 38.3% of reds being sent to AED in hours but 72.3% out of hours. The profile of complaints also showed significant differences in hours versus out of hours. CONCLUSION Significant use of the hotline supports a genuine demand for oncology TT services. In order to reduce referrals to AED, this study supports the creation of alternative destinations of emergency care, especially out of hours.
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Affiliation(s)
- A Chapman
- Medical Oncology Department, Clatterbridge Cancer Centre, Liverpool, L7 8YA, UK.
| | - E Bardsley
- Medical Oncology Department, Clatterbridge Cancer Centre, Liverpool, L7 8YA, UK
| | - H Card
- Medical Oncology Department, Clatterbridge Cancer Centre, Liverpool, L7 8YA, UK
| | - E Marshall
- Medical Oncology Department, Clatterbridge Cancer Centre, Liverpool, L7 8YA, UK
| | - A Olsson-Brown
- Medical Oncology Department, Clatterbridge Cancer Centre, Liverpool, L7 8YA, UK
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Burbick CR, Fajt VR, Frey E, Fritz H, Goodman LB, Lorenz C, Lubbers BV, Marshall E, Rankin SC, Silva M. Benefits and challenges of creating veterinary antibiograms for empiric antimicrobial selection in support of antimicrobial stewardship and advancement of one-health goals. Am J Vet Res 2023; 84:ajvr.23.05.0086. [PMID: 37315936 DOI: 10.2460/ajvr.23.05.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023]
Abstract
Antibiograms are important tools for antimicrobial stewardship that are often underutilized in veterinary medicine. Antibiograms summarize cumulative antimicrobial susceptibility testing (AST) data for specific pathogens over a defined time period; in veterinary medicine, they are often stratified by host species and site of infection. They can aid practitioners with empiric therapy choices and assessment of antimicrobial resistance trends within a population in support of one-health goals for antimicrobial stewardship. For optimal application, consideration must be given to the number of isolates used, the timeframe of sample collection, laboratory analytical methodology, and the patient population contributing to the data (eg, treatment history, geographic region, and production type). There are several limitations to veterinary antibiograms, including a lack of breakpoint availability for bacterial species, a lack of standardization of laboratory methodology and technology for culture and AST, and a lack of funding to staff veterinary diagnostic laboratories at a level that supports antibiogram development and education. It is vital that veterinarians who use antibiograms understand how to apply them in practice and receive relevant information pertaining to the data to utilize the most appropriate antibiogram for their patients. This paper explores the benefits and challenges of developing and using veterinary antibiograms and proposes strategies to enhance their applicability and accuracy. Further detail regarding the application of veterinary antibiograms by privately practicing clinicians is addressed in the companion Currents in One Health article by Lorenz et al (JAVMA, September 2023).
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Affiliation(s)
- Claire R Burbick
- Department of Veterinary Microbiology and Pathology, Washington State University, Pullman, WA
| | - Virginia R Fajt
- Department of Veterinary Physiology and Pharmacology, School of Veterinary Medicine, Texas A&M University, College Station, TX
| | - Erin Frey
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC
| | - Heather Fritz
- California Animal Health and Food Safety Laboratory System, University of California, Davis, CA
| | - Laura B Goodman
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY
| | | | - Brian V Lubbers
- Department of Clinical Sciences, Kansas State University, Manhattan, KS
| | - Edith Marshall
- California Department of Food and Agriculture, Sacramento, CA
| | | | - Marissa Silva
- California Department of Food and Agriculture, Sacramento, CA
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Wade S, Marshall E. A pharmacist-led penicillin allergy de-labelling project within a preoperative assessment clinic: the low-hanging fruit is within reach. J Hosp Infect 2023; 139:1-5. [PMID: 37343770 DOI: 10.1016/j.jhin.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 05/24/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Having a false penicillin-allergy label is linked to longer hospital stays and to an increased risk of Clostridioides difficile and meticillin-resistant Staphylococcus aureus infection. AIM To assess a penicillin-allergy de-labelling tool designed for use by the non-allergist. METHODS Patients attending the surgical preoperative assessment clinic (POAC) at a large UK teaching hospital, who reported a penicillin allergy, were directly de-labelled by nursing or pharmacy staff, where appropriate. A penicillin-allergy de-labelling tool designed for use by the non-allergist was adapted and applied; nursing staff were provided with supporting information and education to enable removal of spurious labels. Antimicrobial pharmacists (AMPs) provided follow-up, cross-checked prophylactic antibiotics administered, interrogated clinical notes, and telephoned patients following their surgery, for details of any adverse reactions suffered. FINDINGS A total of 163 patients reporting a penicillin allergy were identified for intervention. Twenty-nine (17.8%) patients reported a penicillin-allergy history appropriate for direct de-labelling, of whom eight (27.6%) declined to consent. The remaining 21 patients (12.8%) were directly de-labelled, with 12 (7.4%) patients consenting during their POAC appointment; the remaining nine (5.5%) patients were consented and de-labelled after their surgery by an AMP. CONCLUSION The POAC was identified as an appropriate location and time-point in the patient pathway to enable the direct removal of spurious penicillin-allergy labels prior to surgery. Results suggest that this could be undertaken by nursing staff, although support from AMPs enabled a greater number of patients to be de-labelled.
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Affiliation(s)
- S Wade
- University Hospitals Bristol & Weston NHS Foundation Trust, Marlborough Street, Bristol, UK.
| | - E Marshall
- University Hospitals Bristol & Weston NHS Foundation Trust, Marlborough Street, Bristol, UK
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Lorenz C, Silva M, Frey E, Fritz H, Marshall E. Antibiograms as one-health tools for antimicrobial stewardship: California's experience with livestock antibiogram development. J Am Vet Med Assoc 2023; 261:1272-1280. [PMID: 37400072 DOI: 10.2460/javma.23.05.0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/11/2023] [Indexed: 07/05/2023]
Abstract
Antibiograms are collections of antimicrobial susceptibility data for a particular bacterial organism and host species. Antibiograms are important tools for antimicrobial stewardship, as they may be used to guide empiric antimicrobial therapy and assess trends in antimicrobial resistance, maximizing treatment success and preserving the efficacy of currently available pharmaceuticals. Targeted use of antimicrobials is critically important to minimize the spread of antimicrobial resistance, which may be conveyed between animals and humans directly but may also be spread through the environment and ecological niches, such as soil, water, and wildlife reservoirs. To effectively utilize antibiograms as part of a comprehensive antimicrobial stewardship plan, veterinarians need to know data characteristics, including the source population, body site (when possible), and number of isolates included, in addition to the animal species and bacterial organisms for which each breakpoint was developed. Although widely used in human health systems, antibiograms are not often available in veterinary medicine. This paper describes antibiogram creation and use, discusses antibiogram development by US veterinary diagnostic laboratories, and shares California's process to create and promote livestock antibiograms. The companion Currents in One Health article by Burbick et al, AJVR, September 2023, addresses the benefits and challenges associated with developing veterinary antibiograms.
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Affiliation(s)
| | - Marissa Silva
- 1California Department of Food and Agriculture, Sacramento, CA
| | - Erin Frey
- 2Department of Clinical Sciences, North Carolina State University, Raleigh, NC
| | - Heather Fritz
- 3California Animal Health and Food Safety Laboratory System, University of California-Davis, Davis, CA
| | - Edith Marshall
- 1California Department of Food and Agriculture, Sacramento, CA
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Ramafikeng MC, Marshall E. Navigating language discordance in public health care in rural South Africa: a qualitative descriptive study of occupational therapists' perspectives. BMC Health Serv Res 2023; 23:867. [PMID: 37582788 PMCID: PMC10428555 DOI: 10.1186/s12913-023-09658-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 06/06/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Language discordance occurs in healthcare when staff and service users do not share proficiency in the same language. It is a global phenomenon impacting on the quality of health services, as person-centred practice requires communication to establish partnerships and rapport. In a country as linguistically diverse as South Africa, effective ways to navigate language discordance in health care are urgently required, yet there is limited research. This study aimed to describe how occupational therapists navigated language discordance when working in the public health sector in KwaZulu-Natal. METHODS A qualitative descriptive design involved using purposive sampling to recruit occupational therapists as participants (n = 8) for 15 semi-structured interviews. Thematic analysis was used to analyse the data, which included reflective journal entries from all participants. RESULTS The four emergent themes were: (1) concurrent use of strategies, (2) I'm doing as much I can, what more can I do? (3) Language definitely impacts that therapy process and lastly, (4) systemic oppression perpetuating language discordance. CONCLUSION Language discordance is a complex context-specific phenomenon, therefore insight into concurrent use of strategies is important to practitioners to enable them to navigate language discordance and ensure provision of quality services. These insights are significant for healthcare professionals and resource allocators as they shed light on the shortcomings of advocating for a single strategy such as providing trained interpreters. Successful navigation is characterised by determination, being kind to oneself, willingness to learn and use of pragmatic and flexible approaches. To prepare to navigate language discordance in a low-resource context, education should extend in time and scope, to include multiple strategies, culture and relevant languages.
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Affiliation(s)
- M C Ramafikeng
- School of Health and Social Care, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK.
| | - E Marshall
- Marshall Occupational Therapy, 3rd Avenue, Kenilworth, 7708, Cape Town, South Africa
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Yu Q, Kwak D, Ungchusri E, Van Ha T, Kumari D, Patel M, Marshall E, Pillai A, Liao A, Zhang M, Hwang G, Ahmed O. Abstract No. 265 Segmental Radioembolization using Yttrium-90 Glass Microspheres Greater than 400 Gray: A Real-World Experience. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.330] [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: 02/27/2023] Open
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Qureshi H, Holt C, Mirvis R, Cross S, Hussain O, Hutchings H, Marshall E, Turner F, Wilson Jones C. Introducing PEEP: The psychiatry early experience programme. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
At Guy's King's and St Thomas’ School of Medicine, a unique initiative is the Psychiatry Early Experience Programme (PEEP), which allows students to shadow psychiatry trainees at work several times a year. The students’ attitudes towards psychiatry and the scheme are regularly assessed and initial results are already available.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Ahmed O, Guajardo S, Funaki B, Marshall E, Sellers E, Leef J, Lu Z. Abstract No. 474 Quantifying radiation dose with hybrid angiography computed tomography compared with cone-beam computed tomography. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.535] [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: 10/25/2022] Open
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9
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Dykens JA, Smith JS, Demment M, Marshall E, Schuh T, Peters K, Irwin T, McIntosh S, Sy A, Dye T. Evaluating the implementation of cervical cancer screening programs in low-resource settings globally: a systematized review. Cancer Causes Control 2020; 31:417-429. [PMID: 32185604 PMCID: PMC7105425 DOI: 10.1007/s10552-020-01290-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/27/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Cervical cancer disproportionately burdens low-resource populations where access to quality screening services is limited. A greater understanding of sustainable approaches to implement cervical cancer screening services is needed. METHODS We conducted a systematized literature review of evaluations from cervical cancer screening programs implemented in resource-limited settings globally that included a formal evaluation and intention of program sustainment over time. We categorized the included studies using the continuum of implementation research framework which categorizes studies progressively from "implementation light" to more implementation intensive. RESULTS Fifty-one of 13,330 initially identified papers were reviewed with most study sites in low-resource settings of middle-income countries (94.1%) ,while 9.8% were in low-income countries. Across all studies, visual inspection of the cervix with acetic acid (58.8%) was the most prevalent screening method followed by cytology testing (39.2%). Demand-side (client and community) considerations were reported in 86.3% of the articles, while 68.6% focused scientific inquiry on the supply side (health service). Eighteen articles (35.3%) were categorized as "Informing Scale-up" along the continuum of implementation research. CONCLUSIONS The number of cervical cancer screening implementation reports is limited globally, especially in low-income countries. The 18 papers we classified as Informing Scale-up provide critical insights for developing programs relevant to implementation outcomes. We recommend that program managers report lessons learnt to build collective implementation knowledge for cervical cancer screening services, globally.
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Affiliation(s)
- J. Andrew Dykens
- University of Illinois at Chicago College of Medicine, Chicago, IL USA
| | - Jennifer S. Smith
- University of North Carolina School of Public Health, Chapel Hill, NC USA
| | - Margaret Demment
- University of Rochester Department of Obstetrics and Gynecology, Rochester, NY USA
| | - E. Marshall
- University of Illinois at Chicago Institute for Health Research and Policy, Chicago, IL USA
| | - Tina Schuh
- University of Illinois at Chicago Institute for Health Research and Policy, Chicago, IL USA
| | - Karen Peters
- University of Illinois at Chicago Institute for Health Research and Policy, Chicago, IL USA
| | - Tracy Irwin
- University of Washington Department of Obstetrics and Gynecology, Seattle, WA USA
| | - Scott McIntosh
- University of Rochester Department of Public Health Sciences, Rochester, NY USA
| | - Angela Sy
- University of Hawaii John A Burns School of Medicine, Honolulu, HI USA
| | - Timothy Dye
- University of Rochester Department of Obstetrics and Gynecology, Rochester, NY USA
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Corrie PG, Marshall A, Nathan PD, Lorigan P, Gore M, Tahir S, Faust G, Kelly CG, Marples M, Danson SJ, Marshall E, Houston SJ, Board RE, Waterston AM, Nobes JP, Harries M, Kumar S, Goodman A, Dalgleish A, Martin-Clavijo A, Westwell S, Casasola R, Chao D, Maraveyas A, Patel PM, Ottensmeier CH, Farrugia D, Humphreys A, Eccles B, Young G, Barker EO, Harman C, Weiss M, Myers KA, Chhabra A, Rodwell SH, Dunn JA, Middleton MR, Nathan P, Lorigan P, Dziewulski P, Holikova S, Panwar U, Tahir S, Faust G, Thomas A, Corrie P, Sirohi B, Kelly C, Middleton M, Marples M, Danson S, Lester J, Marshall E, Ajaz M, Houston S, Board R, Eaton D, Waterston A, Nobes J, Loo S, Gray G, Stubbings H, Gore M, Harries M, Kumar S, Goodman A, Dalgleish A, Martin-Clavijo A, Marsden J, Westwell S, Casasola R, Chao D, Maraveyas A, Marshall E, Patel P, Ottensmeier C, Farrugia D, Humphreys A, Eccles B, Dega R, Herbert C, Price C, Brunt M, Scott-Brown M, Hamilton J, Hayward RL, Smyth J, Woodings P, Nayak N, Burrows L, Wolstenholme V, Wagstaff J, Nicolson M, Wilson A, Barlow C, Scrase C, Podd T, Gonzalez M, Stewart J, Highley M, Wolstenholme V, Grumett S, Goodman A, Talbot T, Nathan K, Coltart R, Gee B, Gore M, Farrugia D, Martin-Clavijo A, Marsden J, Price C, Farrugia D, Nathan K, Coltart R, Nathan K, Coltart R. Adjuvant bevacizumab for melanoma patients at high risk of recurrence: survival analysis of the AVAST-M trial. Ann Oncol 2019; 29:1843-1852. [PMID: 30010756 PMCID: PMC6096737 DOI: 10.1093/annonc/mdy229] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Bevacizumab is a recombinant humanised monoclonal antibody to vascular endothelial growth factor shown to improve survival in advanced solid cancers. We evaluated the role of adjuvant bevacizumab in melanoma patients at high risk of recurrence. Patients and methods Patients with resected AJCC stage IIB, IIC and III cutaneous melanoma were randomised to receive either adjuvant bevacizumab (7.5 mg/kg i.v. 3 weekly for 1 year) or standard observation. The primary end point was detection of an 8% difference in 5-year overall survival (OS) rate; secondary end points included disease-free interval (DFI) and distant metastasis-free interval (DMFI). Tumour and blood were analysed for prognostic and predictive markers. Results Patients (n=1343) recruited between 2007 and 2012 were predominantly stage III (73%), with median age 56 years (range 18–88 years). With 6.4-year median follow-up, 515 (38%) patients had died [254 (38%) bevacizumab; 261 (39%) observation]; 707 (53%) patients had disease recurrence [336 (50%) bevacizumab, 371 (55%) observation]. OS at 5 years was 64% for both groups [hazard ratio (HR) 0.98; 95% confidence interval (CI) 0.82–1.16, P = 0.78). At 5 years, 51% were disease free on bevacizumab versus 45% on observation (HR 0.85; 95% CI 0.74–0.99, P = 0.03), 58% were distant metastasis free on bevacizumab versus 54% on observation (HR 0.91; 95% CI 0.78–1.07, P = 0.25). Forty four percent of 682 melanomas assessed had a BRAFV600 mutation. In the observation arm, BRAF mutant patients had a trend towards poorer OS compared with BRAF wild-type patients (P = 0.06). BRAF mutation positivity trended towards better OS with bevacizumab (P = 0.21). Conclusions Adjuvant bevacizumab after resection of high-risk melanoma improves DFI, but not OS. BRAF mutation status may predict for poorer OS untreated and potential benefit from bevacizumab. Clinical Trial Information ISRCTN 81261306; EudraCT Number: 2006-005505-64
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Affiliation(s)
- P G Corrie
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
| | - A Marshall
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - P D Nathan
- Medical Oncology, Mount Vernon Hospital, Northwood, UK
| | - P Lorigan
- Department of Medical Oncology, Christie Hospital, Manchester, UK
| | - M Gore
- Royal Marsden Hospital NHS Trust, London, UK
| | - S Tahir
- Oncology Research, Broomfield Hospital, Chelmsford, UK
| | - G Faust
- Oncology Department, Leicester Royal Infirmary, Leicester, UK
| | - C G Kelly
- Sir Bobby Robson Cancer Trials Research Centre, Freeman Hospital, Newcastle upon Tyne, UK
| | - M Marples
- Leeds Cancer Centre, St James's University Hospital, Leeds, UK
| | - S J Danson
- Weston Park Hospital, Academic Unit of Clinical Oncology, Sheffield, UK
| | - E Marshall
- Cancer & Palliative Care, St. Helen's Hospital, St. Helens, UK
| | - S J Houston
- Oncology Department, Royal Surrey County Hospital, Guildford, UK
| | - R E Board
- Rosemere Cancer Centre, Royal Preston Hospital, Preston, UK
| | - A M Waterston
- Clinical Trials Unit, Beatson WOS Cancer Centre, Glasgow, UK
| | - J P Nobes
- Department of Clinical Oncology, Norfolk & Norwich University Hospital, Norwich, UK
| | - M Harries
- Guy's & St. Thomas' Hospital, Guy's Cancer Centre, London, UK
| | - S Kumar
- Velindre Cancer Centre, Cardiff, UK
| | - A Goodman
- Exeter Oncology Centre, Royal Devon and Exeter Hospital, Exeter, UK
| | - A Dalgleish
- St George's Hospital, Cancer Centre, London, UK
| | | | - S Westwell
- Sussex Cancer Centre, Royal Sussex County Hospital, Brighton, UK
| | - R Casasola
- Cancer Centre, Ninewells Hospital, Dundee, UK
| | - D Chao
- Royal Free Hospital, London, UK
| | | | - P M Patel
- Academic Unit of Clinical Oncology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - C H Ottensmeier
- CRUK and NIHR Southampton Experimental Cancer Medicine Centre, Southampton University Hospitals NHS Foundation Trust, Southampton, UK
| | - D Farrugia
- Oncology Centre, Cheltenham General Hospital, Cheltenham, UK
| | - A Humphreys
- Oncology Department, James Cook University Hospital, Middlesbrough, UK
| | - B Eccles
- Oncology Department, Poole Hospital, Dorset, UK
| | - G Young
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - E O Barker
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - C Harman
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - M Weiss
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - K A Myers
- Department of Oncology, University of Oxford, Oxford, UK; Experimental Cancer Medicine Centre, Oxford, UK
| | - A Chhabra
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - J A Dunn
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
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Corrie PG, Marshall A, Nathan PD, Lorigan P, Gore M, Tahir S, Faust G, Kelly CG, Marples M, Danson SJ, Marshall E, Houston SJ, Board RE, Waterston AM, Nobes JP, Harries M, Kumar S, Goodman A, Dalgleish A, Martin-Clavijo A, Westwell S, Casasola R, Chao D, Maraveyas A, Patel PM, Ottensmeier CH, Farrugia D, Humphreys A, Eccles B, Young G, Barker EO, Harman C, Weiss M, Myers KA, Chhabra A, Rodwell SH, Dunn JA, Middleton MR. Adjuvant bevacizumab for melanoma patients at high risk of recurrence: survival analysis of the AVAST-M trial. Ann Oncol 2019; 30:2013-2014. [PMID: 31430371 PMCID: PMC6938599 DOI: 10.1093/annonc/mdz237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ng K, Sage A, Marshall E, Enfield K, Lam W. MA04.11 Biological and Prognostic Implications of the Long Non-Coding Transcriptome in Tumour-Infiltrating Immune Cells. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.528] [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: 10/25/2022]
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Vucic E, Marshall E, Ng R, Lam S, Lam W. P2.03-24 Concurrent Aberrations in G2/M-Phase Transcriptional Programs and Genomic Gatekeepers Highlight Lung Cancer Predisposition in COPD Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Khoja L, Atenafu E, Suciu S, Leyvraz S, Sato T, Marshall E, Keilholz U, Zimmer L, Patel S, Piperno-Neumann S, Piulats J, Kivelä T, Pfoehler C, Bhatia S, Huppert P, Van Iersel L, De Vries I, Penel N, Vogl T, Cheng T, Fiorentini G, Mouriaux F, Tarhini A, Patel P, Carvajal R, Joshua A. Meta-analysis in metastatic uveal melanoma to determine progression free and overall survival benchmarks: an international rare cancers initiative (IRCI) ocular melanoma study. Ann Oncol 2019; 30:1370-1380. [DOI: 10.1093/annonc/mdz176] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Urbonas V, Schadendorf D, Zimmer L, Danson S, Marshall E, Corrie P, Wheater M, Plummer E, Mauch C, Scudder C, Goff M, Love SB, Mohammed SB, Middleton MR. Paclitaxel with or without trametinib or pazopanib in advanced wild-type BRAF melanoma (PACMEL): a multicentre, open-label, randomised, controlled phase II trial. Ann Oncol 2019; 30:317-324. [PMID: 30428063 PMCID: PMC6386028 DOI: 10.1093/annonc/mdy500] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Advanced melanoma treatments often rely on immunotherapy or targeting mutations, with few treatment options for wild-type BRAF (BRAF-wt) melanoma. However, the mitogen-activated protein kinase pathway is activated in most melanoma, including BRAF-wt. We assessed whether inhibiting this pathway by adding kinase inhibitors trametinib or pazopanib to paclitaxel chemotherapy improved outcomes in patients with advanced BRAF-wt melanoma in a phase II, randomised and open-label trial. PATIENTS AND METHODS Patients were randomised (1 : 1 : 1) to paclitaxel alone or with trametinib or pazopanib. Paclitaxel was given for a maximum of six cycles, while 2 mg trametinib and 800 mg pazopanib were administered orally once daily until disease progression or unacceptable toxicity. Participants and investigators were unblinded. The primary end point was progression-free survival (PFS). Key secondary end points included overall survival (OS) and objective response rate (ORR). RESULTS Participants were randomised to paclitaxel alone (n = 38), paclitaxel and trametinib (n = 36), or paclitaxel and pazopanib (n = 37). Adding trametinib significantly improved 6-month PFS [time ratio (TR), 1.47; 90% confidence interval (CI) 1.08-2.01, P = 0.04] and ORR (42% versus 13%; P = 0.01) but had no effect on OS (P = 0.25). Adding pazopanib did not benefit 6-month PFS; (TR 1.36; 90% CI 0.96-1.93; P = 0.14), ORR, or OS. Toxicity increased in both combination arms. CONCLUSION In this phase II trial, adding trametinib to paclitaxel chemotherapy for BRAF-wt melanoma improved PFS and substantially increased ORR but did not impact OS.This study was registered with the EU Clinical Trials Register, EudraCT number 2011-002545-35, and with the ISRCTN registry, number 43327231.
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Affiliation(s)
- V Urbonas
- Early Phase Clinical Trials Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; National Cancer Institute, Vilnius, Lithuania
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, West German Cancer Centre, University Duisburg-Essen, Essen, Germany; The German Cancer Consortium, Essen, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, West German Cancer Centre, University Duisburg-Essen, Essen, Germany; The German Cancer Consortium, Essen, Germany
| | - S Danson
- Department of Oncology, Sheffield Experimental Cancer Medicine Centre, Weston Park Hospital, Sheffield, UK
| | - E Marshall
- Department of Oncology, Clatterbridge Cancer Centre, Wirral, UK
| | - P Corrie
- Department of Oncology, Addenbrookes Hospital, Cambridge, UK
| | - M Wheater
- Department of Oncology, Southampton General Hospital, Southampton, UK
| | - E Plummer
- Department of Oncology, Freeman Hospital, Newcastle upon Tyne, UK
| | - C Mauch
- Köln Universitätsklinik, Köln, Germany
| | - C Scudder
- Oncology Clinical Trials Office, University of Oxford, Oxford, UK
| | - M Goff
- Oncology Clinical Trials Office, University of Oxford, Oxford, UK
| | - S B Love
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - S B Mohammed
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - M R Middleton
- Early Phase Clinical Trials Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Department of Oncology, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
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Marshall E. Ambulatory management in low risk neutropenic sepsis - A plea for integrated acute cancer care. Acute Med 2019; 18:6-7. [PMID: 32608386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Neutropenic Sepsis (NS) is a well recognised treatment complication, typically occurring 7-10 days following cancer cytotoxic chemotherapy. Colleagues in acute medicine will be only too familiar with the scenario of cancer patients that present with fever in the absence of localising signs and symptoms and with a very low yield from microbiological cultures. The incidence and mortality of NS are poorly defined and historically, management guidelines have often been developed in relative isolation from the broader subject of infection and sepsis care. Despite the lack of a clear and pragmatic definition, NICE guidance CG151 (2012) identified suspected NS as a medical emergency requiring prompt empirical broad spectrum antibiotics.
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Affiliation(s)
- E Marshall
- Consultant Medical Oncologist, Clatterbridge Cancer Centre, Merseyside
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Sage A, Stewart G, Rowbotham D, Enfield K, Marshall E, Martinez V, Anderson C, Lam W. MA24.07 A Novel cis-Acting lncRNA Controls HMGA1 Expression in Lung Adenocarcinoma. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Minatel B, Martinez V, Sage A, Marshall E, Tokar T, Becker-Santos D, Robinson W, Jurisica I, Lam W. MA21.10 Large-Scale Discovery of Novel Human Oncofetal Transcripts in Lung. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sage A, Ng K, Marshall E, Enfield K, Stewart G, Martin S, Minatel B, Brown C, Abraham N, Lam W. MA24.06 Long Non-Coding Rna Expression Patterns Delineate Infiltrating Immune Cells in the Lung Tumour Microenvironment. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sage A, Stewart G, Enfield K, Marshall E, Martinez V, Lam W. MA 15.14 Long Non-Coding RNA Disruption in Lung Adenocarcinoma Reveals Novel Mechanisms of Metastasis. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.595] [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: 10/18/2022]
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Minatel B, Martinez V, Sage A, Marshall E, Ng K, Anderson C, Becker-Santos D, Robinson W, Jurisica I, Lam W. MA 15.12 Expanding the Lung Small RNA Transcriptome: Discovery of Unannotated microRNAs with Roles in Development and Tumorigenesis. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sage A, Stewart G, Anderson C, Rowbotham D, Enfield K, Marshall E, Martinez V, Lam W. P2.02-022 Alternative Regulation of Cancer-Associated Genes through Modulation of Long Non-Coding RNAs. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1199] [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: 10/18/2022]
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Marshall E, Ng K, Enfield K, Martin S, Milne K, Kung S, Macaulay C, Lam W. MA 10.09 Increased T Follicular Helper Cell Infiltration in Lung Adenocarcinoma Tertiary Lymphoid Organs. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.539] [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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Martinez V, Ng K, Marshall E, Sage A, Minatel B, Jurisica I, Lam W. P1.02-006 Arsenic Promotes Persistent Alterations in the Lung PiRNA Transcriptome to Target Epigenetic Pathways. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.738] [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: 10/18/2022]
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Keenan J, Marshall E, Heidel E. Women over 37 have superior pregnancy rates with frozen compared with fresh embryo transfers - an analysis of 43,5765 cycles from the national art surveillance system (NASS). Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.503] [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: 10/18/2022]
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Fanari Z, Gunasekaran P, Shaukat A, Wiley M, Dawn B, Weintraub W, Tadros P, Marshall E. P1646Paradoxical low flow low gradient severe aortic stenosis with preserved left ventricular ejection fraction. impact of medical, transcatheter and surgical management. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Marshall E, Gibson AM. The effect of an imagery training intervention on self-confidence and anxiety in acrobatic gymnastics. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bernal F, Whiting A, Aguilar F, Marshall E. Disruption of the linear ubiquitin chain assembly complex (LUBAC) with hydrocarbon stapled alpha helices. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nathan P, Cohen V, Coupland S, Curtis K, Damato B, Evans J, Fenwick S, Kirkpatrick L, Li O, Marshall E, McGuirk K, Ottensmeier C, Pearce N, Salvi S, Stedman B, Szlosarek P, Turnbull N. Uveal Melanoma UK National Guidelines. Eur J Cancer 2015; 51:2404-12. [PMID: 26278648 DOI: 10.1016/j.ejca.2015.07.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 07/10/2015] [Indexed: 01/09/2023]
Abstract
The United Kingdom (UK) uveal melanoma guideline development group used an evidence based systematic approach (Scottish Intercollegiate Guidelines Network (SIGN)) to make recommendations in key areas of uncertainty in the field including: the use and effectiveness of new technologies for prognostication, the appropriate pathway for the surveillance of patients following treatment for primary uveal melanoma, the use and effectiveness of new technologies in the treatment of hepatic recurrence and the use of systemic treatments. The guidelines were sent for international peer review and have been accredited by NICE. A summary of key recommendations is presented. The full documents are available on the Melanoma Focus website.
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Affiliation(s)
- P Nathan
- Mount Vernon Cancer Centre, Northwood, Middlesex, UK.
| | - V Cohen
- Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, UK
| | - S Coupland
- Department Molecular and Clinical Cancer Medicine, University of Liverpool, UK
| | | | - B Damato
- Royal Liverpool University Hospital, Liverpool, UK
| | - J Evans
- Royal Liverpool University Hospital, Liverpool, UK
| | - S Fenwick
- University Hospital Aintree, Liverpool, UK
| | | | - O Li
- Moorfields Eye Hospital, London, UK
| | - E Marshall
- The Clatterbridge Cancer Centre, NHS Foundation Trust, Liverpool, UK
| | | | - C Ottensmeier
- Southampton University Hospitals and University of Southampton, UK
| | - N Pearce
- University Hospital Southampton, Southampton, UK
| | - S Salvi
- Royal Hallamshire Hospital, Sheffield, UK
| | - B Stedman
- Southampton University Hospitals, NHS Trust, Southampton, UK
| | - P Szlosarek
- St Bartholomew's Hospital, UK; Barts Cancer Institute, Queen Mary University of London, London, UK
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Escriu C, Wong H, Marshall E. Outcomes Over a Decade in Stage IV Non-Small Cell Lung Cancer (NSCLC): the Clatterbridge Cancer Centre Experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv050.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Qureshi H, Holt C, Cross S, Hutchings H, Marshall E, Mirvis R, Wilson Jones C. The Psychiatry Early Experience Programme: Stigma, Attitudes and Recruitment. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31975-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
During eukaryotic cellular protein synthesis, ribosomal translation is made more efficient through interaction between the two ends of the messenger RNA (mRNA). Ribosomes reaching the 3′ end of the mRNA can thus recycle and begin translation again on the same mRNA, the so-called ‘closed-loop’ model. Using a driven diffusion lattice model of translation, we study the effects of ribosome recycling on the dynamics of ribosome flow and density on the mRNA. We show that ribosome recycling induces a substantial increase in ribosome current. Furthermore, for sufficiently large values of the recycling rate, the lattice does not transition directly from low to high ribosome density, as seen in lattice models without recycling. Instead, a maximal current phase becomes accessible for much lower values of the initiation rate, and multiple phase transitions occur over a wide region of the phase plane. Crucially, we show that in the presence of ribosome recycling, mRNAs can exhibit a peak in protein production at low values of the initiation rate, beyond which translation rate decreases. This has important implications for translation of certain mRNAs, suggesting that there is an optimal concentration of ribosomes at which protein synthesis is maximal, and beyond which translational efficiency is impaired.
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Affiliation(s)
- E Marshall
- Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK SUPA, Institute for Complex Systems and Mathematical Biology, King's College, University of Aberdeen, Aberdeen AB24 3UE, UK
| | - I Stansfield
- Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK
| | - M C Romano
- Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK SUPA, Institute for Complex Systems and Mathematical Biology, King's College, University of Aberdeen, Aberdeen AB24 3UE, UK
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De Boo D, Erskine B, Marshall E, kavnoudias H, Koukounaras J, Thomson K. Evaluation of a radiographer-led PICC insertion service. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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O' Reilly S, Sinclair L, Maynard M, Rajon D, Wayson M, Marshall E, Bolch W. WE-E-BRE-01: An Image-Based Skeletal Dosimetry Model for the ICRP Reference Adult Female - Internal Electron Sources. Med Phys 2014. [DOI: 10.1118/1.4889430] [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: 11/07/2022] Open
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Gomez D, Wetherill C, Cheong J, Jones L, Marshall E, Damato B, Coupland SE, Ghaneh P, Poston GJ, Malik HZ, Fenwick SW. The Liverpool uveal melanoma liver metastases pathway: outcome following liver resection. J Surg Oncol 2014; 109:542-7. [PMID: 24357463 DOI: 10.1002/jso.23535] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 11/27/2013] [Indexed: 01/19/2023]
Abstract
AIM To determine the outcome of patients that underwent liver resection for metastases from uveal melanoma. METHODS Over a 9-year period, patients referred with uveal melanoma metastases were included. Following treatment of primary uveal melanoma, high-risk patients were offered to be enrolled into a 6-monthly non-contrast liver magnetic resonance imaging (MRI) surveillance. Following detection of liver metastases, patients were staged with a contrast-enhanced (Primovist(®)) liver MRI, computer tomography (CT) of the thorax and staging laparoscopy. RESULTS 155 patients were referred with uveal melanoma liver metastases, of which 17 (11.0%) patients had liver resection and one patient was treated with percutaneous radio-frequency ablation. The majority of patients undergoing liver resection were treated with multiple metastectomies (n = 8) and three patients had major liver resections. The overall median survival for patients treated with surgery/ablation was 27 (14-90) months, and this was significantly better compared to patients treated palliatively [median = 8(1-30) months, P < 0.001]. Following surgery, 11 patients had recurrent disease [median = 13(6-36) months]. Patients who had undergone a major liver resection had a significantly poorer disease-free survival (P = 0.037). CONCLUSIONS Patients who can undergo surgical resection for metastatic uveal melanoma have a more favorable survival compared to those who do not.
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Affiliation(s)
- D Gomez
- North Western Hepatobiliary Unit, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
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Costa LM, Marshall E, Tesfaye M, Silverstein KAT, Mori M, Umetsu Y, Otterbach SL, Papareddy R, Dickinson HG, Boutiller K, VandenBosch KA, Ohki S, Gutierrez-Marcos JF. Central Cell-Derived Peptides Regulate Early Embryo Patterning in Flowering Plants. Science 2014; 344:168-72. [DOI: 10.1126/science.1243005] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Leyvraz S, Piperno-Neumann S, Suciu S, Baurain JF, Zdzienicki M, Testori A, Marshall E, Scheulen M, Jouary T, Negrier S, Vermorken JB, Kaempgen E, Durando X, Schadendorf D, Gurunath RK, Keilholz U. Hepatic intra-arterial versus intravenous fotemustine in patients with liver metastases from uveal melanoma (EORTC 18021): a multicentric randomized trial. Ann Oncol 2014; 25:742-746. [PMID: 24510314 PMCID: PMC4433517 DOI: 10.1093/annonc/mdt585] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 11/13/2013] [Accepted: 12/02/2013] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In uveal melanoma (UM) with metastatic disease limited to the liver, the effect of an intrahepatic treatment on survival is unknown. We investigated prospectively the efficacy and toxicity of hepatic intra-arterial (HIA) versus systemic (IV) fotemustine in patients with liver metastases from UM. PATIENTS AND METHODS Patients were randomly assigned to receive either IV or HIA fotemustine at 100 mg/m(2) on days 1, 8, 15 (and 22 in HIA arm only) as induction, and after a 5-week rest period every 3 weeks as maintenance. Primary end point was overall survival (OS). Response rate (RR), progression-free survival (PFS) and safety were secondary end points. RESULTS Accrual was stopped after randomization of 171 patients based on the results of a futility OS analysis. A total of 155 patients died and 16 were still alive [median follow-up 1.6 years (range 0.25-6 years)]. HIA did not improve OS (median 14.6 months) when compared with the IV arm (median 13.8 months), hazard ratio (HR) 1.09; 95% confidence interval (CI) 0.79-1.50, log-rank P = 0.59. However, there was a significant benefit on PFS for HIA compared with IV with a median of 4.5 versus 3.5 months, respectively (HR 0.62; 95% CI 0.45-0.84, log-rank P = 0.002). The 1-year PFS rate was 24% in the HIA arm versus 8% in the IV arm. An improved RR was seen in the HIA (10.5%) compared with IV treatment (2.4%). In the IV arm, the most frequent grade ≥3 toxicity was thrombocytopenia (42.1%) and neutropenia (62.6%), compared with 21.2% and 28.7% in the HIA arm. The main grade ≥3 toxicity related to HIA was catheter complications (12%) and liver toxicity (4.5%) apart from two toxic deaths. CONCLUSION HIA treatment with fotemustine did not translate into an improved OS compared with IV treatment, despite better RR and PFS. Intrahepatic treatment should still be considered as experimental. EUDRACT NUMBER AND CLINICALTRIALSGOV IDENTIFIER 2004-002245-12 and NCT00110123.
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Affiliation(s)
- S Leyvraz
- Oncology Department, University Hospital, Lausanne, Switzerland.
| | | | - S Suciu
- EORTC Headquarters, Brussels
| | - J F Baurain
- Centre du Cancer, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - M Zdzienicki
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - A Testori
- European Institute of Oncology, Milan, Italy
| | - E Marshall
- Clatterbridge Centre for Oncology, Wirral, UK
| | - M Scheulen
- West German Cancer Center, University of Essen Medical School, Essen, Germany
| | - T Jouary
- University Hospital Bordeaux Saint André, Bordeaux
| | - S Negrier
- Léon-Bérard Cancer Centre, Lyon, France
| | | | - E Kaempgen
- Universitätsklinik Erlangen, Erlangen, Germany
| | - X Durando
- Centre Jean Perrin, Clermont-Ferrand, France
| | | | | | - U Keilholz
- Department of Hematology and Medical Oncology, Charité, CBF, Berlin, Germany
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Neville-Webbe HL, Carser JE, Wong H, Andrews J, Poulter T, Smith R, Marshall E. The impact of a new acute oncology service in acute hospitals: experience from the Clatterbridge Cancer Centre and Merseyside and Cheshire Cancer Network. Clin Med (Lond) 2013; 13:565-9. [PMID: 24298102 PMCID: PMC5873657 DOI: 10.7861/clinmedicine.13-6-565] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [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: 11/27/2022]
Abstract
The 2008 National Confidential Enquiry into Patient Outcomes and Death highlighted an urgent need to improve the quality, safety and efficiency of care for cancer patients following emergency presentation to acute general hospitals. A network-wide acute oncology service (AOS) was therefore commissioned and implemented on the basis of recommendations from the National Chemotherapy Advisory Group (NCAG). Through a continuous programme of raising awareness regarding both the role of the AOS and the necessity of early patient referral to acute oncology teams, we have been able to establish an AOS across all acute trusts in our cancer network. The network-wide AOS has improved communication across clinical teams, enabled rapid review of over 3,000 patients by oncology staff, reduced hospital stay, increased understanding of oncology emergencies and their treatment, and enhanced pathways for rapid diagnosis and appropriate referrals for patients presenting with malignancy of undefined origin (MUO). These achievements have been made by developing a network protocol book for managing common oncology emergencies, by introducing local pathways for managing MUO and by collaborating with palliative care teams to introduce local acute oncology (AO) multi-disciplinary team (MDT) meetings.
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Affiliation(s)
- HL Neville-Webbe
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Merseyside, UK
| | - JE Carser
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Merseyside, UK
| | - H Wong
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Merseyside, UK
| | - J Andrews
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Merseyside, UK
| | - T Poulter
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Merseyside, UK
| | - R Smith
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Merseyside, UK
| | - E Marshall
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Merseyside, UK
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Lee S, Upadhyay S, Lewanski C, Falk S, Skailes G, Marshall E, Ngai Y, Rudd R, Hackshaw A, Boshoff C. Topical: Randomized Phase III Trial of Erlotinib Compared with Placebo in Patients with Advanced Non–Small Cell Lung Cancer (NSCLC) Unsuitable for First-Line Chemotherapy: Updated Analysis. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33878-3] [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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Kaurin D, Marshall E, Zaini M, Lavilla M, Sweeney L, Mahendra S. VMAT Couch Attenuation Model Testing for Prostate Plans. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1498] [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: 11/15/2022]
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Martin V, Zhou X, Marshall E, Jia B, Fusheng G, FrancoDixon MA, DeHaan N, Pfeiffer DU, Soares Magalhães RJ, Gilbert M. Risk-based surveillance for avian influenza control along poultry market chains in South China: The value of social network analysis. Prev Vet Med 2011; 102:196-205. [PMID: 21925753 PMCID: PMC7127115 DOI: 10.1016/j.prevetmed.2011.07.007] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Over the past two decades, the poultry sector in China went through a phase of tremendous growth as well as rapid intensification and concentration. Highly pathogenic avian influenza virus (HPAIV) subtype H5N1 was first detected in 1996 in Guangdong province, South China and started spreading throughout Asia in early 2004. Since then, control of the disease in China has relied heavily on wide-scale preventive vaccination combined with movement control, quarantine and stamping out. This strategy has been successful in drastically reducing the number of outbreaks during the past 5years. However, HPAIV H5N1 is still circulating and is regularly isolated in traditional live bird markets (LBMs) where viral infection can persist, which represent a public health hazard for people visiting them. The use of social network analysis in combination with epidemiological surveillance in South China has identified areas where the success of current strategies for HPAI control in the poultry production sector may benefit from better knowledge of poultry trading patterns and the LBM network configuration as well as their capacity for maintaining HPAIV H5N1 infection. We produced a set of LBM network maps and estimated the associated risk of HPAIV H5N1 within LBMs and along poultry market chains, providing new insights into how live poultry trade and infection are intertwined. More specifically, our study provides evidence that several biosecurity factors such as daily cage cleaning, daily cage disinfection or manure processing contribute to a reduction in HPAIV H5N1 presence in LBMs. Of significant importance is that the results of our study also show the association between social network indicators and the presence of HPAIV H5N1 in specific network configurations such as the one represented by the counties of origin of the birds traded in LBMs. This new information could be used to develop more targeted and effective control interventions.
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Affiliation(s)
- Vincent Martin
- Food and Agriculture Organization of the United Nations, Beijing, PR China.
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Azam F, Wong H, Marshall E. 9125 POSTER Role of Chemotherapy in ECOG Performance Status 3 Small Cell Lung Cancer – a Single Centre Study. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72437-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aurangabadkar A, Marshall E. 14. Imaging investigations for carcinoma with unknown primary: diagnoses not to miss. Cancer Imaging 2011. [DOI: 10.1102/1470-7330.2011.9077] [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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Aurangabadkar A, Thind R, Marshall E. 3. Management of carcinoma with unknown primary: what does a radiologist need to know? Cancer Imaging 2011. [DOI: 10.1102/1470-7330.2011.9066] [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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Williams Q, Ochsner M, Marshall E, Kimmel L, Martino C. The impact of a peer-led participatory health and safety training program for Latino day labourers in construction. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.836] [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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