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Lorenzo Polo A, Nix M, Thompson C, O'Hara C, Entwisle J, Murray L, Appelt A, Weistrand O, Svensson S. Improving hybrid image and structure-based deformable image registration for large internal deformations. Phys Med Biol 2024; 69:095011. [PMID: 38518382 DOI: 10.1088/1361-6560/ad3723] [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: 11/08/2023] [Accepted: 03/22/2024] [Indexed: 03/24/2024]
Abstract
Objective.Deformable image registration (DIR) is a widely used technique in radiotherapy. Complex deformations, resulting from large anatomical changes, are a regular challenge. DIR algorithms generally seek a balance between capturing large deformations and preserving a smooth deformation vector field (DVF). We propose a novel structure-based term that can enhance the registration efficacy while ensuring a smooth DVF.Approach.The proposed novel similarity metric for controlling structures was introduced as a new term into a commercially available algorithm. Its performance was compared to the original algorithm using a dataset of 46 patients who received pelvic re-irradiation, many of which exhibited complex deformations.Main results.The mean Dice Similarity Coefficient (DSC) under the improved algorithm was 0.96, 0.94, 0.76, and 0.91 for bladder, rectum, colon, and bone respectively, compared to 0.69, 0.89, 0.62, and 0.88 for the original algorithm. The improvement was more pronounced for complex deformations.Significance.With this work, we have demonstrated that the proposed term is able to improve registration accuracy for complex cases while maintaining realistic deformations.
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Affiliation(s)
| | - M Nix
- Leeds Cancer Centre, Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - C Thompson
- Leeds Cancer Centre, Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - C O'Hara
- Leeds Cancer Centre, Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - J Entwisle
- Leeds Cancer Centre, Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - L Murray
- Leeds Cancer Centre, Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom
| | - A Appelt
- Leeds Cancer Centre, Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom
| | - O Weistrand
- RaySearch Laboratories, SE-104 30 Stockholm, Sweden
| | - S Svensson
- RaySearch Laboratories, SE-104 30 Stockholm, Sweden
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2
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Hudson EM, Slevin F, Biscombe K, Brown SR, Haviland JS, Murray L, Kirby AM, Thomson DJ, Sebag-Montefiore D, Hall E. Hitting the Target: Developing High-quality Evidence for Proton Beam Therapy Through Randomised Controlled Trials. Clin Oncol (R Coll Radiol) 2024; 36:70-79. [PMID: 38042671 DOI: 10.1016/j.clon.2023.11.027] [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: 10/12/2023] [Accepted: 11/03/2023] [Indexed: 12/04/2023]
Abstract
The National Health Service strategy for the delivery of proton beam therapy (PBT) in the UK provides a unique opportunity to deliver high-quality evidence for PBT through randomised controlled trials (RCTs). We present a summary of three UK PBT RCTs in progress, including consideration of their key design characteristics and outcome assessments, to inform and support future PBT trial development. The first three UK multicentre phase III PBT RCTs (TORPEdO, PARABLE and APPROACH), will compare PBT with photon radiotherapy for oropharyngeal squamous cell carcinoma, breast cancer and oligodendroglioma, respectively. All three studies were designed by multidisciplinary teams, which combined expertise from clinicians, clinical trialists and scientists with strong patient advocacy and guidance from national radiotherapy research networks and international collaborators. Consistent across all three studies is a focus on the reduction of long-term radiotherapy-related toxicities and an evaluation of patient-reported outcomes and health-related quality of life, which will address key uncertainties regarding the clinical benefits of PBT. Innovative translational components will provide insights into mechanisms of toxicity and help to frame the key future research questions regarding PBT. The UK radiotherapy research community is developing and delivering an internationally impactful PBT research portfolio. The combination of data from RCTs with prospectively collected data from a national PBT outcomes registry will provide an innovative, high-quality repository for PBT research and the platform to design and deliver future trials of PBT.
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Affiliation(s)
- E M Hudson
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
| | - F Slevin
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - K Biscombe
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - S R Brown
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - J S Haviland
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK; Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - L Murray
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - A M Kirby
- The Royal Marsden NHS Foundation Trust & The Institute of Cancer Research, Sutton, UK
| | - D J Thomson
- The Christie NHS Foundation Trust, Manchester, UK
| | - D Sebag-Montefiore
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - E Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
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Anthony J, Smith J, Murray L, Kirsten GF, Gericke G, Kara Y, Davies V, Pearce D, Van Toorn R, Lippert MM, Lotz JW, Andronikou S, Alheit B, Van Wyk L, Ebrahim AS, Schifrin BS. Commentary on the published position statement regarding the pathogenesis of fetal basal ganglia- thalamic hypoxic-ischaemic injury. S Afr Med J 2023; 114:6-10. [PMID: 38525619 DOI: 10.7196/samj.2024.v114i1.1584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/06/2023] [Indexed: 03/26/2024] Open
Affiliation(s)
- J Anthony
- Retired associate professor and Head of Unit: Maternal and Fetal Medicine, Groote Schuur Hospital.
| | - J Smith
- Emeritus Professor of Neonatology, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
| | - L Murray
- Private Practice in Obstetrics and Gynecology, Cape Town, South Africa.
| | - G F Kirsten
- Emeritus Professor of Neonatology, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
| | - G Gericke
- Extraordinary Professor in Human Genetics, Faculty of Health Sciences, University of Pretoria, South Africa.
| | - Y Kara
- Paediatrician, Umhlanga Hospital and St Augustines Hospital, Durban, South Africa.
| | - V Davies
- Paediatrician and neonatologist, visiting associate professor, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - D Pearce
- Paediatric neurology consultant, University of the Witwatersrand, Donald Gordon Medical Centre Johannesburg, South Africa.
| | - R Van Toorn
- Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
| | - M M Lippert
- Certified paediatric neurology, private practice in Paediatric Neurology, Unitas Hospital, Pretoria, South Africa.
| | - J W Lotz
- Emeritus Professor of Radiology, Division of Radiodiagnosis, Stellenbosch University, Cape Town, South Africa.
| | - S Andronikou
- Pediatric neuroradiologist and paediatric radiologist at the Children's Hospital of Philadelphia, USA; professor of radiology at the Perelman School of Medicine, University of Pennsylvania, USA.
| | | | - L Van Wyk
- Neonatologist, Department of Paediatrics and Child Health Child Health, Stellenbosch University, Cape Town, South Africa.
| | - A S Ebrahim
- Obstetrician and gynaecologist, St Augustine's Hospital, Durban, South Africa.
| | - B S Schifrin
- Formerly professor of obstetrics and gynecology (maternal-fetal medicine), Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
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Ballarotto G, Murray L, Bozicevic L, Marzilli E, Cerniglia L, Cimino S, Tambelli R. Parental sensitivity to toddler's need for autonomy: An empirical study on mother-toddler and father-toddler interactions during feeding and play. Infant Behav Dev 2023; 73:101892. [PMID: 37839158 DOI: 10.1016/j.infbeh.2023.101892] [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: 07/14/2022] [Revised: 08/11/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
During the second year of life, children's need for autonomy grows, and their behaviors become increasingly complex. Parental sensitivity to children's different cues is important in supporting adaptive psycho-emotional development. The present study assumes that mothers and fathers may respond with varying levels of sensitivity to the child's different cues, with particular attention to requests for greater autonomy. The study also examines the possible role played by interactive contexts (ie., play and feeding) and children's and parents' individual factors. The sample comprised N = 91 families with children aged between 12 and 24 months. Mother-toddler and father-toddler interactions were assessed during feeding and play. Parents completed questionnaires assessing children's temperament, psychopathological risk, and parenting stress. RESULTS: showed that toddlers' demands for autonomy were the most frequent cues in both play and feeding contexts, both with mothers and fathers. Furthermore, parents were more sensitive to toddlers' requests for cooperation than their requests for autonomy, in both interactive contexts. Moreover, mothers and fathers showed higher sensitivity to toddlers' demands for greater autonomy in the play context rather than in the feeding context. Mothers were more sensitive than fathers to toddlers' cues of resistance to parents' actions and to toddlers' requests for cooperation. Results showed differences and specificities in mother-toddler and father-toddler interactions in the two interactive contexts, showing associations between child negative emotionality, parental psychopathological risk and parenting stress, and maternal and paternal sensitivity to toddlers' demands for greater autonomy during play and feeding, respectively. These results confirm the initial hypotheses regarding parental sensitivity and its differential expression according to child cues. Implications are discussed.
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Affiliation(s)
- G Ballarotto
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy.
| | - L Murray
- School of Psychology and Clinical Language Sciences, Earley Gate, University of Reading, United Kingdom
| | - L Bozicevic
- Institute of Population Health, Department of Primary Care & Mental Health, Faculty of Health and Life Sciences, University of Liverpool, United Kingdom
| | - E Marzilli
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy
| | - L Cerniglia
- Department of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - S Cimino
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy
| | - R Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza - University of Rome, Rome, Italy
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Sclafani V, De Pascalis L, Bozicevic L, Sepe A, Ferrari PF, Murray L. Similarities and differences in the functional architecture of mother- infant communication in rhesus macaque and British mother-infant dyads. Sci Rep 2023; 13:13164. [PMID: 37574499 PMCID: PMC10423724 DOI: 10.1038/s41598-023-39623-3] [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: 03/09/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023] Open
Abstract
Similarly to humans, rhesus macaques engage in mother-infant face-to-face interactions. However, no previous studies have described the naturally occurring structure and development of mother-infant interactions in this population and used a comparative-developmental perspective to directly compare them to the ones reported in humans. Here, we investigate the development of infant communication, and maternal responsiveness in the two groups. We video-recorded mother-infant interactions in both groups in naturalistic settings and analysed them with the same micro-analytic coding scheme. Results show that infant social expressiveness and maternal responsiveness are similarly structured in humans and macaques. Both human and macaque mothers use specific mirroring responses to specific infant social behaviours (modified mirroring to communicative signals, enriched mirroring to affiliative gestures). However, important differences were identified in the development of infant social expressiveness, and in forms of maternal responsiveness, with vocal responses and marking behaviours being predominantly human. Results indicate a common functional architecture of mother-infant communication in humans and monkeys, and contribute to theories concerning the evolution of specific traits of human behaviour.
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Affiliation(s)
- V Sclafani
- Winnicott Research Unit, Department of Psychology, University of Reading, Reading, UK.
- College of Social Sciences, School of Psychology, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, UK.
| | - L De Pascalis
- Winnicott Research Unit, Department of Psychology, University of Reading, Reading, UK.
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK.
- Department of Psychology, University of Bologna, Bologna, Italy.
| | - L Bozicevic
- Winnicott Research Unit, Department of Psychology, University of Reading, Reading, UK
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, Merseyside, UK
| | - A Sepe
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Laboratory of Neuro- and Psychophysiology, Department of Neurosciences, KU Leuven Medical School, Leuven, Belgium
| | - P F Ferrari
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Institut des Sciences Cognitives 'Marc Jeannerod', CNRS, Bron, and Université Claude Bernard Lyon 1, Lyon, France
| | - L Murray
- Winnicott Research Unit, Department of Psychology, University of Reading, Reading, UK
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6
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Murray L, McGinty G. Use of Physical Activity Measures in Rehabilitation Interventions Following Lower Extremity Amputation. Curr Phys Med Rehabil Rep 2023. [DOI: 10.1007/s40141-023-00383-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Abstract
Purpose of Review
This systematic review aims to evaluate physical performance outcome tools that are used most frequently to assess rehabilitation interventions. The scope of this paper focused on outcomes used with established lower limb amputees when assessing interventions such as exercise programs or changes in prescription published in the last 5 years.
Recent Findings
The most recorded outcome measures used across all the papers were timed walk tests and the Activity Balance Confidence Scale. Many outcomes did not produce statistically significant results with established amputee cohorts. Understanding the minimal important clinical difference is key.
Summary
The use of outcome measures is essential. Training and education are likely to increase the use of outcome measures. Quality of life measures are important in conjunction with physical outcomes. Simple timed walk tests are commonly used. These are in general easy to administer requiring a small space, limited equipment, and a short time frame.
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Fatania K, Fernandez S, Shaw GC, Salvatore D, Teh I, Schneider JE, Murray L, Scarsbrook AF, Short SC, Currie S. P15.04.B Serial18F-fluciclovine PET-CT and multiparametric MRI during chemoradiation for glioblastoma - an exploratory clinical study with pre-clinical correlation. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.294] [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: 11/12/2022] Open
Abstract
Abstract
Background
Positron emission tomography (PET) using anti-1-amino-3-18fluorine-fluorocyclobutane-1-carboxylic acid (18F-fluciclovine) shows preferential glioma cell uptake with low activity in normal brain. Dynamic contrast-enhanced (DCE) MRI may also be used to investigate regions of glioma that do not show gadolinium-enhancement on post-contrast T1-weighted MR sequences (Gd-T1) and may reflect tumour infiltration beyond the Gd-T1 enhancing margin. There is a paucity of data on how 18F-fluciclovine uptake correlates with Gd-T1 and DCE-MRI activity, how it correlates with tumour biology and whether significant changes in uptake occur during treatment. The aims of this pilot study were: 1 To compare 18F-fluciclovine PET, DCE-MRI and Gd-T1 in patients undergoing chemoradiotherapy for glioblastoma (GBM) 2 To investigate correlation between 18F-fluciclovine uptake, MRI findings, and tumour biology in a pre-clinical glioma model.
Material and Methods
18F-fluciclovine-PET-CT and MRI including DCE-MRI were acquired before, during and after adjuvant chemoradiotherapy (60 Gy in 30 fractions with temozolomide) in GBM patients. DCE-MRI and Gd-T1 volumes were manually contoured, and PET volumes defined using semi-automatic thresholding. Gd-T1 was subtracted from PET and DCE-MRI volumes to identify areas beyond the Gd-T1 volume boundary and similarity of the PET and DCE-MRI volumes outside the Gd-T1 volume boundary were measured using the Dice similarity coefficient (DSC). CT-2A tumour cells were stereotactically injected into the right striatum of 8 to 10-week-old C57BL6J mice and they underwent MRI and 18F-fluciclovine PET-CT. Post-mortem mice brains underwent immunohistochemistry staining for ASCT2 (amino acid transporter), nestin (stemness) and Ki-67 (proliferation) to assess for biologically active tumour.
Results
6 patients were recruited (GBM 1-6). For GBM 1-3: PET volumes were greater than DCE-MRI, in turn greater than Gd-T1. For GBM 4-6, Gd-T1 volumes were similar to DCE-MRI and both were greater than PET volumes. GBM 1-3 had lower overall survival than GBM 4-6: median 249 vs. 903 days. 18F-fluciclovine uptake and Gd uptake (on DCE-MRI) was seen beyond the margins of the standard Gd-T1 volume. Comparing these regions beyond the Gd-T1 margins, the PET and DCE-MRI had low DSC, suggesting distinct areas of fluciclovine and DCE-MRI uptake. Pre-clinical PET-CT demonstrated tumour-specific 18F-fluciclovine uptake which corresponded to biologically active tumour based on immunostaining for Ki-67, nestin and ASCT2.
Conclusion
Results from this joint pre-clinical and clinical pilot study suggest volumes of 18F-fluciclovine-PET activity beyond that depicted by MRI-DCE and Gd-T1 are associated with a poorer prognosis in patients undergoing chemoradiotherapy for GBM. The pre-clinical model confirmed 18F-fluciclovine uptake reflected biologically active tumour.
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Affiliation(s)
- K Fatania
- Department of Radiology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
| | - S Fernandez
- Department of Clinical Oncology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
| | - G C Shaw
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
| | - D Salvatore
- Department of Pathophysiology and Transplantation, University of Milan , Segrate , Italy
| | - I Teh
- Biomedical Imaging Science Department, and Discovery & Translational Science Department , Leeds , United Kingdom
| | - J E Schneider
- Biomedical Imaging Science Department, and Discovery & Translational Science Department , Leeds , United Kingdom
| | - L Murray
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
- Department of Clinical Oncology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
| | - A F Scarsbrook
- Department of Radiology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
| | - S C Short
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
- Department of Clinical Oncology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
| | - S Currie
- Department of Radiology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
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Boele FW, Butler S, Nicklin E, Pointon L, Short SC, Murray L. P08.05.B Communication in the context of glioblastoma treatment: what matters most to patients and caregivers. Neuro Oncol 2022. [PMCID: PMC9443239 DOI: 10.1093/neuonc/noac174.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Given the poor prognosis of glioblastoma, with short survival times regardless of treatment, it is critical that the benefits and risks of treatments are clearly discussed with patients and family caregivers. The respective value of quantity versus quality of life varies for each individual. Yet, effective communication can be complicated by emotional responses following diagnosis, patients’ neurocognitive deficits, and sometimes, lower health literacy. We aimed to investigate patient and caregiver experiences and preferences around glioblastoma treatment communication.
Material and Methods
Semi-structured qualitative interviews were conducted with adult glioblastoma patients and their caregivers, interviewed as dyads or individuals. Purposive sampling was used to capture views across the entire disease trajectory. Interviews were recorded, transcribed verbatim, and analysed for common themes. Analysis is ongoing and will be completed by June 2022, with preliminary findings described below.
Results
In total, 15 glioblastoma patients and 13 caregivers took part, 8 as dyads. Five main themes were found. 1) Communication experiences. A rush to get treatment underway can limit adequate communication. Patients and caregivers described that risks of treatment were clearly explained, but perceived it as ‘the only option’. 2) Communication preferences. Balanced and sensitive communication of prognostic information was desired, with uncertainty providing hope as well as being a burden. Patients and caregivers can have different information and support needs, requiring separate and proactive communication. 3) What matters most. Participants valued feeling involved, having clear and reliable information and support from the treatment team, and developing a personable relationship. In terms of treatment goals, they valued extending life with good quality of life. 4) Decision-making. Participants emphasised the importance of being involved in decisions, involving caregivers, and following treatment team advice. While faced with extremely limited treatment options, they valued having a sense of control over declining, pausing or stopping treatment. 5) Impact of Covid-19. In general, patients described limited impact of the measures taken during the pandemic (e.g., masks, telephone consultations), whilst caregivers highlighted specific issues around not being able to support patients in emergencies, expressing/reading nonverbal cues, or fully participating in telephone consultations.
Conclusion
Glioblastoma patients and caregivers value sensitive, comprehensive and comprehensible communication around treatment risks and benefits, and supportive care. Involving and supporting caregivers is critical.
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Affiliation(s)
- F W Boele
- University of Leeds , Leeds , United Kingdom
| | - S Butler
- University of Leeds , Leeds , United Kingdom
| | - E Nicklin
- University of Leeds , Leeds , United Kingdom
| | - L Pointon
- University of Leeds , Leeds , United Kingdom
| | - S C Short
- University of Leeds , Leeds , United Kingdom
| | - L Murray
- University of Leeds , Leeds , United Kingdom
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Frances S, Murray L, Wright J, Velikova G, Boele F. P08.08.B Long-term survival and health-related quality of life in meningioma patients: a mixed-methods systematic review. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.152] [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: 11/14/2022] Open
Abstract
Abstract
Background
Meningiomas account for approximately 36% of all primary brain tumours. These tumours have a relatively favourable prognosis with approximately 92% of meningioma patients surviving >5 years after diagnosis. Yet, patients report high disease burden and survivorship issues even years after treatment, including cognitive issues and anxiety/depression affecting health-related quality of life (HRQOL). We aimed to systematically review the literature and synthesise evidence on HRQOL in meningioma patients across long-term survival, defined as >2 years post diagnosis.
Material and Methods
Systematic literature searches were carried out using Medline, EMBASE, CINAHL, PsycINFO, and Web of Science Core Collection up to November 2021. Two independent assessors carried out screening. Any published, peer reviewed article with primary quantitative or qualitative data covering the physical, mental, and/or social aspects of HRQOL were included. Quality was assessed using the Mixed Methods Appraisal Tool, before a data-based convergent synthesis design was used to interpret findings.
Results
The search returned 2252 articles. Following screening 12 papers were included in the review. The majority of studies used quantitative methods, with only one study reporting mixed-methodology. Two of these were articles from the same study. Most used cross-sectional assessments (n =10) with two reporting longitudinal assessments (n = 2). Included meningioma patient samples (n=2990 in total) represented a wide range of survival lengths (range: 24 months - 10 years). HRQOL was impacted predominantly through physical and mental issues, including persevering symptoms (e.g. headaches, fatigue, vision problems) and emotional difficulties (e.g. poorer mental and general health perceptions). Returning to work proved difficult for patients due to cognitive and social deficits (e.g. issues with concentration, procrastination and isolation). Factors including age and comorbidities, but also treatment type appears to affect patients’ satisfaction with their HRQOL.
Conclusion
While overall prognosis following a meningioma diagnosis is good, meningioma patients’ HRQOL appears affected throughout long-term survivorship. Findings from this review could be beneficial in addressing the HRQOL and supportive-care needs of patients across long-term survivorship.
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Affiliation(s)
- S Frances
- University of Leeds , Leeds , United Kingdom
| | - L Murray
- University of Leeds , Leeds , United Kingdom
| | - J Wright
- University of Leeds , Leeds , United Kingdom
| | - G Velikova
- University of Leeds , Leeds , United Kingdom
| | - F Boele
- University of Leeds , Leeds , United Kingdom
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10
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Murray L. SP-0846 Twists and turns of brain reirradiation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)04040-3] [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: 10/18/2022]
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11
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Diez P, Hanna GG, Aitken KL, van As N, Carver A, Colaco RJ, Conibear J, Dunne EM, Eaton DJ, Franks KN, Good JS, Harrow S, Hatfield P, Hawkins MA, Jain S, McDonald F, Patel R, Rackley T, Sanghera P, Tree A, Murray L. UK 2022 Consensus on Normal Tissue Dose-Volume Constraints for Oligometastatic, Primary Lung and Hepatocellular Carcinoma Stereotactic Ablative Radiotherapy. Clin Oncol (R Coll Radiol) 2022; 34:288-300. [PMID: 35272913 DOI: 10.1016/j.clon.2022.02.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [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: 12/17/2021] [Revised: 01/21/2022] [Accepted: 02/14/2022] [Indexed: 12/25/2022]
Abstract
The use of stereotactic ablative radiotherapy (SABR) in the UK has expanded over the past decade, in part as the result of several UK clinical trials and a recent NHS England Commissioning through Evaluation programme. A UK SABR Consortium consensus for normal tissue constraints for SABR was published in 2017, based on the existing literature at the time. The published literature regarding SABR has increased in volume over the past 5 years and multiple UK centres are currently working to develop new SABR services. A review and update of the previous consensus is therefore appropriate and timely. It is hoped that this document will provide a useful resource to facilitate safe and consistent SABR practice.
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Affiliation(s)
- P Diez
- Radiotherapy Physics, National Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, Northwood, UK
| | - G G Hanna
- Belfast Health and Social Care Trust, Belfast, UK; Queen's University Belfast, Belfast, UK
| | - K L Aitken
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK; Institute of Cancer Research, London, UK
| | - N van As
- Institute of Cancer Research, London, UK; Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Chelsea, London, UK
| | - A Carver
- Department of Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Medical Centre, Edgbaston, Birmingham, UK
| | - R J Colaco
- Department of Clinical Oncology, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - J Conibear
- Radiotherapy Department, Barts Cancer Centre, London, UK
| | - E M Dunne
- Department of Clinical Oncology, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - D J Eaton
- Radiotherapy Physics, National Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, Northwood, UK; Department of Medical Physics, Guys and St Thomas' NHS Foundation Trust, London, UK; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - K N Franks
- Department of Clinical Oncology, Leeds Cancer Centre, St James's University Hospitals, Leeds, UK
| | - J S Good
- Department of Clinical Oncology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK
| | - S Harrow
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - P Hatfield
- Department of Clinical Oncology, Leeds Cancer Centre, St James's University Hospitals, Leeds, UK
| | - M A Hawkins
- Department of Medical Physics and Biomechanical Engineering, University College London, London, UK; Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - S Jain
- Belfast Health and Social Care Trust, Belfast, UK; Queen's University Belfast, Belfast, UK
| | - F McDonald
- Institute of Cancer Research, London, UK; Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Chelsea, London, UK
| | - R Patel
- Radiotherapy Physics, National Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, Northwood, UK
| | - T Rackley
- Department of Clinical Oncology, Velindre Cancer Centre, Cardiff, UK
| | - P Sanghera
- Department of Clinical Oncology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK
| | - A Tree
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK; Institute of Cancer Research, London, UK
| | - L Murray
- Department of Clinical Oncology, Leeds Cancer Centre, St James's University Hospitals, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
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12
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Chuter R, Glassborow E, Speight R, Clarke M, Murray L, Radhakrishna G, Lavin V, Aspin L, Aldred M, Gregory S, Richardson J, Handley J. A treatment planning comparison of photon stereotactic ablative radiotherapy and proton beam therapy for the re-irradiation of pelvic cancer recurrence. Phys Imaging Radiat Oncol 2022; 21:78-83. [PMID: 35243036 PMCID: PMC8881531 DOI: 10.1016/j.phro.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Patients who experience a pelvic cancer recurrence in or near a region that received initial radiotherapy, typically have few options for treatment. Organs at risk (OAR) have often reached their dose constraint limits leaving minimal dose remaining for standard re-irradiation (reRT). However, photon based stereotactic ablative radiotherapy (SABR) has been utilised for reRT with promising initial results although meeting OAR constraints can be challenging. Proton beam therapy (PBT) could offer an advantage. MATERIALS AND METHODS SABR plans used for treatment for ten pelvic reRT patients were dosimetrically compared to PBT plans retrospectively planned using the same CT and contour data. PBT plans were created to match the CTV dose coverage of SABR treatment plans with V100% ≥95%. An 'as low as reasonably achievable' approach was taken to OAR tolerances with consideration of OAR dose from the initial radiation (using equivalent dose in 2 Gy fractions). RESULTS Dosimetric comparison of relevant OAR statistics showed a decrease in OAR dose using PBT over SABR in all patients, with equivalent target coverage. The largest statistically significant reduction was seen for the colon D0.5 cm3 with a median reduction from 13.1 Gy to 5.9 Gy. There were statistically significant dose reductions in the median dose to small bowel, sacral plexus and cauda equina. CONCLUSION PBT has the potential for significant dose reductions for OARs in the pelvic reRT setting compared to SABR. However, it remains unclear if the magnitude of these OAR dose reductions will translate into clinical benefit.
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Affiliation(s)
- R. Chuter
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
- Division of Cancer Sciences, Faculty of Biology, Medicine and Heath, University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - E. Glassborow
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - R. Speight
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M. Clarke
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - L. Murray
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - G. Radhakrishna
- Clinical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - V. Lavin
- Clinical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - L. Aspin
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M Aldred
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S Gregory
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J. Richardson
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
- Division of Cancer Sciences, Faculty of Biology, Medicine and Heath, University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - J. Handley
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
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13
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Farmery AK, Alexander K, Anderson K, Blanchard JL, Carter CG, Evans K, Fischer M, Fleming A, Frusher S, Fulton EA, Haas B, MacLeod CK, Murray L, Nash KL, Pecl GT, Rousseau Y, Trebilco R, van Putten IE, Mauli S, Dutra L, Greeno D, Kaltavara J, Watson R, Nowak B. Food for all: designing sustainable and secure future seafood systems. Rev Fish Biol Fish 2022; 32:101-121. [PMID: 34092936 PMCID: PMC8164055 DOI: 10.1007/s11160-021-09663-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/21/2021] [Indexed: 05/19/2023]
Abstract
UNLABELLED Food from the sea can make a larger contribution to healthy and sustainable diets, and to addressing hunger and malnutrition, through improvements in production, distribution and equitable access to wild harvest and mariculture resources and products. The supply and consumption of seafood is influenced by a range of 'drivers' including ecosystem change and ocean regulation, the influence of corporations and evolving consumer demand, as well as the growing focus on the importance of seafood for meeting nutritional needs. These drivers need to be examined in a holistic way to develop an informed understanding of the needs, potential impacts and solutions that align seafood production and consumption with relevant 2030 Sustainable Development Goals (SDGs). This paper uses an evidence-based narrative approach to examine how the anticipated global trends for seafood might be experienced by people in different social, geographical and economic situations over the next ten years. Key drivers influencing seafood within the global food system are identified and used to construct a future scenario based on our current trajectory (Business-as-usual 2030). Descriptive pathways and actions are then presented for a more sustainable future scenario that strives towards achieving the SDGs as far as technically possible (More sustainable 2030). Prioritising actions that not only sustainably produce more seafood, but consider aspects of access and utilisation, particularly for people affected by food insecurity and malnutrition, is an essential part of designing sustainable and secure future seafood systems. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11160-021-09663-x.
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Affiliation(s)
- A. K. Farmery
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
| | - K. Alexander
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - K. Anderson
- Institute for Marine and Antarctic Studies, University of Tasmania, Newnham, TAS Australia
| | - J. L. Blanchard
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - C. G. Carter
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - K. Evans
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - M. Fischer
- CSIRO Oceans and Atmosphere, St Lucia, QLD Australia
| | - A. Fleming
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Land and Water, Hobart, TAS Australia
| | - S. Frusher
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - E. A. Fulton
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - B. Haas
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - C. K. MacLeod
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - L. Murray
- College of Health, Massey University, Massey, New Zealand
| | - K. L. Nash
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - G. T. Pecl
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - Y. Rousseau
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - R. Trebilco
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - I. E. van Putten
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - S. Mauli
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
| | - L. Dutra
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, St Lucia, QLD Australia
| | - D. Greeno
- College of Arts, Law and Education, University of Tasmania, Hobart, TAS Australia
| | - J. Kaltavara
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
| | - R. Watson
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - B. Nowak
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Newnham, TAS Australia
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14
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Farmery AK, Alexander K, Anderson K, Blanchard JL, Carter CG, Evans K, Fischer M, Fleming A, Frusher S, Fulton EA, Haas B, MacLeod CK, Murray L, Nash KL, Pecl GT, Rousseau Y, Trebilco R, van Putten IE, Mauli S, Dutra L, Greeno D, Kaltavara J, Watson R, Nowak B. Food for all: designing sustainable and secure future seafood systems. Rev Fish Biol Fish 2022; 32:101-121. [PMID: 34092936 DOI: 10.22541/au.160322471.16891119/v1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/21/2021] [Indexed: 05/23/2023]
Abstract
UNLABELLED Food from the sea can make a larger contribution to healthy and sustainable diets, and to addressing hunger and malnutrition, through improvements in production, distribution and equitable access to wild harvest and mariculture resources and products. The supply and consumption of seafood is influenced by a range of 'drivers' including ecosystem change and ocean regulation, the influence of corporations and evolving consumer demand, as well as the growing focus on the importance of seafood for meeting nutritional needs. These drivers need to be examined in a holistic way to develop an informed understanding of the needs, potential impacts and solutions that align seafood production and consumption with relevant 2030 Sustainable Development Goals (SDGs). This paper uses an evidence-based narrative approach to examine how the anticipated global trends for seafood might be experienced by people in different social, geographical and economic situations over the next ten years. Key drivers influencing seafood within the global food system are identified and used to construct a future scenario based on our current trajectory (Business-as-usual 2030). Descriptive pathways and actions are then presented for a more sustainable future scenario that strives towards achieving the SDGs as far as technically possible (More sustainable 2030). Prioritising actions that not only sustainably produce more seafood, but consider aspects of access and utilisation, particularly for people affected by food insecurity and malnutrition, is an essential part of designing sustainable and secure future seafood systems. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11160-021-09663-x.
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Affiliation(s)
- A K Farmery
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
| | - K Alexander
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - K Anderson
- Institute for Marine and Antarctic Studies, University of Tasmania, Newnham, TAS Australia
| | - J L Blanchard
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - C G Carter
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - K Evans
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - M Fischer
- CSIRO Oceans and Atmosphere, St Lucia, QLD Australia
| | - A Fleming
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Land and Water, Hobart, TAS Australia
| | - S Frusher
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - E A Fulton
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - B Haas
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - C K MacLeod
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - L Murray
- College of Health, Massey University, Massey, New Zealand
| | - K L Nash
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - G T Pecl
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - Y Rousseau
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - R Trebilco
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - I E van Putten
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, Hobart, TAS Australia
| | - S Mauli
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
| | - L Dutra
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- CSIRO Oceans and Atmosphere, St Lucia, QLD Australia
| | - D Greeno
- College of Arts, Law and Education, University of Tasmania, Hobart, TAS Australia
| | - J Kaltavara
- Australian National Centre for Ocean Resource and Security, University of Wollongong, Wollongong, NSW Australia
| | - R Watson
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS Australia
| | - B Nowak
- Centre for Marine Socioecology, University of Tasmania, Hobart, TAS Australia
- Institute for Marine and Antarctic Studies, University of Tasmania, Newnham, TAS Australia
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15
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Brown S, Beasley M, Aznar MC, Belderbos J, Chuter R, Cobben D, Faivre-Finn C, Franks K, Henry A, Murray L, Price G, van Herk M. The Impact of Intra-thoracic Anatomical Changes upon the Delivery of Lung Stereotactic Ablative Radiotherapy. Clin Oncol (R Coll Radiol) 2021; 33:e413-e421. [PMID: 34001380 DOI: 10.1016/j.clon.2021.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/23/2021] [Revised: 03/29/2021] [Accepted: 04/21/2021] [Indexed: 12/25/2022]
Abstract
AIMS So far, the impact of intra-thoracic anatomical changes (ITACs) on patients treated with stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer is unknown. Studying these is important, as ITACs have the potential to impact the workflow and reduce treatment quality. The aim of this study was to assess and categorise ITACs, as detected on cone beam computed tomography scans (CBCT), and their subsequent impact upon treatment in lung cancer patients treated with SABR. MATERIALS AND METHODS CBCTs from 100 patients treated with SABR for early non-small cell lung cancer were retrospectively reviewed. The presence of the following ITACs was assessed: atelectasis, infiltrative change, pleural effusion, baseline shift and gross tumour volume (GTV) increase and decrease. ITACs were graded using a traffic light protocol. This was adapted from a tool previously developed to assesses potential target undercoverage or organ at risk overdose. The frequency of physics or clinician review was noted. A linear mixed effects model was used to assess the relationship between ITAC grade and set-up time (time from first CBCT to beam delivery). RESULTS ITACs were observed in 22% of patients. Twenty-one per cent of these were categorised as 'red', implying a risk of underdosage to the GTV. Most were 'yellow' (51%), indicating little impact upon planning target volume coverage of the GTV. Physics or clinician review was required in 10% of all treatment fractions overall. Three patients needed their treatment replanned. The mixed effect model analysis showed that ITACs cause a significant prolongation of set-up time (Χ2(3) = 9.22, P = 0.02). CONCLUSION Most ITACs were minor, but associated with unplanned physics or clinician review, representing a potentially significant resource burden. ITACs also had a significant impact upon set-up time, with consequences for the wider workflow and intra-fraction motion. Detailed guidance on the management of ITACs is needed to provide support for therapeutic radiographers delivering lung SABR.
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Affiliation(s)
- S Brown
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Gloucestershire Oncology Centre, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK.
| | - M Beasley
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M C Aznar
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - J Belderbos
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - R Chuter
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - D Cobben
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - C Faivre-Finn
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - K Franks
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Henry
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - L Murray
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - G Price
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - M van Herk
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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16
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Frances S, Velikova G, Klein M, Short S, Murray L, Wright J, Boele F. P11.02 Long-term impact of primary brain tumour diagnosis on health-related quality of life: a systematic review. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.098] [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: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
A primary brain tumour (PrBT) diagnosis can be devastating, and results in a wide range of symptoms. Relatively little is known about the long-term challenges these symptoms pose on HRQOL. The aim of this review is to identify the long-term HRQOL issues reported at least two years following diagnosis of a PrBT.
MATERIAL AND METHODS
Systematic literature searches were carried out using Medline, EMBASE, CINAHL, PsycINFO and Web of Science Core Collection. Searches were designed to identify a range of reported HRQOL aspects defined as physical, mental or social issues, in adult WHO grade II or III patients. To capture the full extent of patients’ experience, studies of any design reporting on primary data where patients had at least two years follow-up from diagnosis were included. WHO grade I and grade IV tumours were excluded due to their different prognoses and the expected nature of their disease trajectories. Quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). Narrative synthesis was used to collate findings.
RESULTS
The search returned 8438 articles. 477 titles remained after title and abstract screening, with eighteen full text articles included in the final analysis. The majority of studies used quantitative methods, with only two articles reporting qualitative or mixed methodology. Articles were predominantly cross-sectional studies (n = 10), along with cohort studies (n = 3), clinical trials (n = 3) and pilot studies (n = 2). Results indicated that patients reported a variety of issues influencing their HRQOL, with emotional/psychological/cognitive changes being the most commonly reported. Physical complaints included problems with fatigue, seizures and maintaining daily activity. Social challenges included strained social relationships and issues managing finances. Patient coping strategies were found to significantly influence wellbeing and subsequent HRQOL.
CONCLUSION
PrBT patients’ long-term HRQOL and daily functioning can be impacted by their physical, mental and social wellbeing. Findings from this review lay the groundwork for efforts to improve patient HRQOL in long-term survivorship.
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Affiliation(s)
- S Frances
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, United Kingdom
| | - G Velikova
- University of Leeds, St James Institute of Oncology, Leeds, United Kingdom
| | - M Klein
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - S Short
- University of Leeds, St James Institute of Oncology, Leeds, United Kingdom
| | - L Murray
- Leeds Institute of Molecular Research, University of Leeds, Leeds, United Kingdom
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, United Kingdom
| | - J Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - F Boele
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, United Kingdom
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17
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Wakeham K, Murray L, Muirhead R, Hawkins MA, Sebag-Montefiore D, Brown S, Murphy L, Thomas G, Bell S, Whibley M, Morgan C, Sleigh K, Gilbert DC. Multicentre Investigation of Prognostic Factors Incorporating p16 and Tumour Infiltrating Lymphocytes for Anal Cancer After Chemoradiotherapy. Clin Oncol (R Coll Radiol) 2021; 33:638-649. [PMID: 34024700 DOI: 10.1016/j.clon.2021.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/09/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
Abstract
AIMS Anal squamous cell carcinomas (ASCC) are strongly associated with human papillomaviruses. Standard of care is chemoradiotherapy at uniform doses with no treatment stratification. Immunohistochemical staining for p16INK4A (p16), a surrogate for human papillomaviruses, is prognostic for outcomes. We investigated this alongside clinical-pathological factors, including tumour infiltrating lymphocyte (TIL) scores. MATERIALS AND METHODS Using an independent, multicentre cohort of 257 ASCC treated with chemoradiotherapy, pretreatment biopsies were stained and scored for p16 and TIL. Kaplan-Meier curves were derived for outcomes (disease-free survival [DFS], overall survival and cancer-specific survival), by stage, p16 and TIL scores and Log-rank tests were carried out to investigate prognostic effect. A multivariate analysis was carried out using Cox regression. RESULTS Stage, sex, p16 and TILs were independently prognostic. Hazard ratios for death (overall survival) were 2.51 (95% confidence interval 1.36-4.63) for p16 negative versus p16 positive, 2.17 (1.34-3.5) for T3/4 versus T1/2, 2.42 (1.52-3.8) for males versus females and 3.30 (1.52-7.14) for TIL1 versus TIL3 (all P < 0.05). CONCLUSIONS We have refined prognostic factors in ASCC. p16 adds to stratification by stage with respect to DFS in early disease and overall survival/DFS in locally advanced cancers. Our data support the role of the host immune response in mediating outcomes. These factors will be prospectively evaluated in PLATO (ISRCTN88455282).
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Affiliation(s)
- K Wakeham
- Sussex Cancer Centre, Royal Sussex County Hospital, Brighton, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - L Murray
- Leeds Institute of Medical Research, University of Leeds, Leeds Cancer Centre, Leeds, UK
| | - R Muirhead
- Oxford University Hospitals NHS Trust, Department of Oncology, Churchill Hospital, Oxford, UK
| | - M A Hawkins
- University College London, Medical Physics and Biomedical Engineering, London, UK
| | - D Sebag-Montefiore
- Leeds Institute of Medical Research, University of Leeds, Leeds Cancer Centre, Leeds, UK
| | - S Brown
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - L Murphy
- MRC Clinical Trials Unit at UCL, London, UK
| | - G Thomas
- Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Cancer Sciences Unit, University of Southampton, Southampton, UK
| | - S Bell
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - M Whibley
- Sussex Cancer Centre, Royal Sussex County Hospital, Brighton, UK
| | - C Morgan
- Sussex Cancer Centre, Royal Sussex County Hospital, Brighton, UK
| | - K Sleigh
- Sussex Cancer Centre, Royal Sussex County Hospital, Brighton, UK
| | - D C Gilbert
- MRC Clinical Trials Unit at UCL, London, UK.
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18
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Zamparini J, Murray L, Saggers RT, Wise AJ, Lombaard H. Considerations for COVID-19 vaccination in pregnancy. S Afr Med J 2021; 111:544-549. [PMID: 34382563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 06/13/2023] Open
Abstract
Pregnant women are at greater risk of severe COVID-19 than non-pregnant women. Despite limited safety data on use of COVID-19 vaccines in pregnancy, many international societies have recommended their use when pregnant women are at particularly high risk of acquiring COVID-19, or have suggested that vaccines should not be withheld from pregnant women where no other contraindications to COVID-19 vaccination exist. A number of vaccines, including those against influenza, tetanus and pertussis, have been shown to reduce both maternal and infant morbidity and mortality when used antenatally. We explore the role of COVID-19 vaccination in the setting of pregnancy, discuss the limited data available, and summarise current international guidelines.
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Affiliation(s)
- J Zamparini
- Division of Infectious Diseases, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Slevin F, Beasley M, Speight R, Lilley J, Murray L, Hawkins M, Radhakrishna G, Henry A. Evaluation of Clinician Contouring for Pancreatic Stereotactic Ablative Radiotherapy During a Contouring Workshop Organised by the Royal College of Radiologists. Clin Oncol (R Coll Radiol) 2021; 33:e196-e197. [PMID: 33129654 DOI: 10.1016/j.clon.2020.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/19/2020] [Indexed: 11/22/2022]
Affiliation(s)
| | - M Beasley
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - R Speight
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Lilley
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - M Hawkins
- Medical Physics and Biochemical Engineering, University College London, London, UK
| | | | - A Henry
- University of Leeds, Leeds, UK
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20
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Fernandez S, Beasley M, Lilley J, Murray L, Short SC. Establishing a Link Between Commonly Reported Toxicities and Tumour Location in Brain Tumour Patients Treated With Volumetric-modulated Arc Radiotherapy. Clin Oncol (R Coll Radiol) 2021; 33:e97-e98. [PMID: 33020010 DOI: 10.1016/j.clon.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/18/2020] [Indexed: 11/28/2022]
Affiliation(s)
- S Fernandez
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M Beasley
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Lilley
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - L Murray
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S C Short
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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21
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Bishop-Royse J, Lange-Maia B, Murray L, Shah RC, DeMaio F. Structural racism, socio-economic marginalization, and infant mortality. Public Health 2020; 190:55-61. [PMID: 33348089 DOI: 10.1016/j.puhe.2020.10.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 10/02/2020] [Accepted: 10/29/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES We examine associations between infant mortality rates (IMRs) and measures of structural racism and socio-economic marginalization in Chicago, Illinois. Our purpose was to determine whether the Index of Concentration at the Extremes (ICE) was significantly related to community-level IMRs. STUDY DESIGN We use a cross-sectional ecological public health design to examine community-level factors related to IMRs in Chicago neighborhoods. METHODS We use data from the Chicago Department of Public Health and the American Community Survey to examine IMR inequities during the period 2012-2016. Calculations of the ICE for race and income were undertaken. In addition, we calculated racialized socio-economic status, which is the concentration of affluent Whites relative to poor Blacks in a community area. We present these ICE measures, as well as hardship, percent of births with inadequate prenatal care (PNC), and the percent of single-parent households as quintiles so that we can compare neighborhoods with the most disadvantage with neighborhoods with the least. Negative binomial regression was used to determine whether the ICE measures were independently related to community IMRs, net of hardship scores, PNC, and single-parent households. RESULTS Spearman correlation results indicate significant associations in Chicago communities between measures of racial segregation and economic marginalization and IMRs. Community areas with the lowest ICERace scores (those with the largest concentrations of Black residents, compared with White) had IMRs that were 3.63 times higher than those communities with the largest concentrations of White residents. Most associations between community IMRS and measures of structural racism and socioeconomic marginalization are accounted for in fully adjusted negative binomial regression models. Only ICERace remained significantly related to IMRs. CONCLUSIONS We show that structural racism as represented by the ICE is independently related to IMRs in Chicago; community areas with the largest concentrations of Blacks residents compared with Whites are those with the highest IMRs. This relationship persists even after controlling for socio-economic marginalization, hardship, household composition/family support, and healthcare access. Interventions to improve birth outcomes must address structural determinants of health inequities.
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Affiliation(s)
- J Bishop-Royse
- Faculty Scholarship Collaborative, DePaul University, Chicago, IL 60614, USA; Center for Community Health Equity, Chicago, IL, USA.
| | - B Lange-Maia
- Department of Preventative Medicine, Rush University Medical Center, Chicago, IL 60612, USA; Center for Community Health Equity, Chicago, IL, USA.
| | - L Murray
- Center for Community Health Equity, Chicago, IL, USA.
| | - R C Shah
- Center for Community Health Equity, Chicago, IL, USA; Department of Family Medicine, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
| | - F DeMaio
- Center for Community Health Equity, Chicago, IL, USA; Center for Health Equity, American Medical Association, Chicago, IL 60611, USA; Department of Sociology, DePaul University, Chicago, IL 60614, USA.
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22
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Cerniglia L, Dentale F, Tambelli R, Murray L, Cooper P, Cimino S. The stable component of maternal depressive symptoms predicts offspring emotional and behavioral symptoms: a 9-years longitudinal study. BMC Psychol 2020; 8:126. [PMID: 33261655 PMCID: PMC7709270 DOI: 10.1186/s40359-020-00496-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/27/2020] [Indexed: 11/19/2022] Open
Abstract
Background Maternal sub-threshold and non-clinical depression and its possible outcomes on offspring internalizing/externalizing symptoms has received growing attention in recent years because of its significant worldwide prevalence. Methods Through a Latent State-Trait Analysis approach (LST), this longitudinal study aimed to identify a stable component of non-clinical maternal depression across a temporal interval of 6 years (measured through the Symptom Check-List-90/R) and to determine the effect of this component on children’s emotional and behavioral functioning (measured through the Child Behaviour Check-List) at age 12 years. Results LST analysis showed that maternal depressive symptoms tended to remain stable within individuals across 6 years of observation strongly contributing to children’s internalizing/externalizing and dysregulation symptoms. Conclusions The current longitudinal analysis of maternal and child data revealed that a stable component of maternal depressive symptoms reliably predicted a wide range of child emotional and behavioral symptoms at 12 years of age.
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Affiliation(s)
- L Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - F Dentale
- Department of Clinical and Dynamic Psychology, Sapienza, University of Rome, Via dei Marsi, 78, 00186, Rome, Italy
| | - R Tambelli
- Department of Clinical and Dynamic Psychology, Sapienza, University of Rome, Via dei Marsi, 78, 00186, Rome, Italy
| | - L Murray
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - P Cooper
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - S Cimino
- Department of Clinical and Dynamic Psychology, Sapienza, University of Rome, Via dei Marsi, 78, 00186, Rome, Italy.
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23
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Glassborow E, Richardson J, Clarke M, Murray L, Speight R, Aspin L, Gregory S, Handley J, Chuter R. PD-0305: SABR re-irradiation of pelvic cancer recurrences: photon vs proton beam therapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00329-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Tyyger M, Nix M, Murray L, Currie S, Nallathambi C, Speight R, Al-Qaisieh B. PO-0897: Dosimetric Consequence of Transient Post-Surgical Anatomical Effects for Glioblastoma. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00914-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Nix M, Bird D, Tyyger M, Appelt A, Murray L, McCallum H, Al-Qaisieh B, Gooya A. PH-0606: AutoConfidence: Per-patient validation for clinical confidence in deep learning for radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00628-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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26
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Jamieson A, Murray L, Buis A. The Use of Physical Activity Outcomes in Rehabilitation Interventions for Lower Limb Amputees: a Systematic Review. Can Prosthet Orthot J 2020; 3:33931. [PMID: 37614661 PMCID: PMC10443482 DOI: 10.33137/cpoj.v3i1.33931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/11/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Interventions which have focused on improving the physical activity of individuals with lower limb amputation can be mostly categorized into behavioural-based and prosthetic-based interventions. The aim of this review was to assess the quality of these interventions, and to identify the key gaps in research in this field. METHODOLOGY The databases of Scopus, Pubmed, Embase, Medline and Web of Science were searched between September and December of 2019 for articles relating to physical activity, amputees and interventions. Articles were assessed quantitively based on internal validity, external validity and intervention intensity. FINDINGS Sixteen articles (5 behavioural, 11 prosthetic) were assessed. Both approaches had comparable methodological quality and mixed efficacy for producing a significant change in physical activity outcomes. Almost all interventions used a simplistic measurement of activity as their outcome. CONCLUSIONS There is an insufficient amount of studies to assess the overall efficacy of behavioural interventions in regard to how they impact on physical activity behaviour. However, the increase of quality of the methodology in the more recent studies could indicate that future interventions will retain similar levels of quality. Prosthetic interventions have shown no major improvement in efficacy compared to similar reviews and may need to utilise more advanced prosthetic components to attain significant changes in physical activity. Activity outcomes should expand into more complex activity measurements to properly understand the physical activity profile of people with lower limb amputation.
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Affiliation(s)
- A.G. Jamieson
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, Scotland, UK
| | - L Murray
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, Scotland, UK
| | - A Buis
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, Scotland, UK
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27
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Sun F, Franks K, Murray L, Lilley J, Wheller B, Banfill K, McWilliam A, Abravan A, Van Herk M, Faivre-Finn C, Cubbon R. Cardiovascular mortality and morbidity following radical radiotherapy for lung cancer: Is cardiovascular death under-reported? Lung Cancer 2020; 146:1-5. [PMID: 32460218 DOI: 10.1016/j.lungcan.2020.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/18/2020] [Accepted: 05/04/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lung cancer is the most common malignancy worldwide. Radical radiotherapy is an essential treatment in the management of early and locally advanced lung cancer. Cardiac events are known to occur following radical radiotherapy for lung cancer. This study examines the burden of cardiac events post radiotherapy, and estimates the accuracy of death certification in patients who received radical radiotherapy for lung cancer. METHODS We conducted a retrospective observational cohort study for all patients receiving radical radiotherapy for non-small cell lung cancer (NSCLC) at a large cancer centre between 01/01/2010 to 31/12/2016. Baseline cardiovascular disease and cancer status and treatment data were collected, along with hospital admission data and documented cause of death from the national registry for a median follow-up period of 34 months. RESULTS Of 1224 patients included in the analysis, 378 (30.9%) patients had cardiovascular disease at baseline, including 140 (11.4%) with prior myocardial infarction. In the 846 patients without known cardiovascular disease, 451 (53.3%) had a QRISK2 predicted 10-year cardiovascular risk >20% over 10 years. During follow-up, 215 hospitalisations occurred (Incidence rate 6.2 per hundred patient years) which were classified as primarily cardiac, and 622 patients died (18 per 100 patient-years). However, death certificates stated a primary cardiac cause of death in only 33 cases (5.3% of deaths). Notably, 29% of patients dying out of hospital and certified as cancer death did not have documented cancer relapse prior to death, and 61% had no community palliative care input prior to death, implying these events may have been sudden and unexpected. CONCLUSION There is a high prevalence of baseline cardiovascular disease in people undergoing radiotherapy for NSCLC, accompanied by significant rates of post-radiotherapy cardiovascular hospitalisation. However, only a small proportion of deaths are attributed to cardiovascular disease, together with the large amount of sudden deaths observed, this suggests that cardiovascular death is greatly under-reported in official statistics.
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Affiliation(s)
- F Sun
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
| | - K Franks
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
| | - L Murray
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
| | - J Lilley
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
| | - B Wheller
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
| | - K Banfill
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
| | - A McWilliam
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
| | - A Abravan
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
| | - M Van Herk
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
| | | | - R Cubbon
- Leeds Cancer Centre, Beckett Street, Leeds, UK.
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28
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Sethna V, Murray L, Psychogiou L, Ramchandani P. The Impact of Paternal Depression in Infancy: A Mechanism for the Intergenerational Transmission of Risk. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(09)70469-9] [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: 11/28/2022] Open
Abstract
The adverse influence of parental psychopathology on child development has been the focus of intense research in recent years, yet we are only beginning to understand the factors that explain this intergenerational transmission. Depressive symptoms in fathers have received relatively little attention when compared to research on the impact of maternal depression on children's emotional and behavioural problems. Recent evidence suggests that paternal depressive symptoms in the postnatal period are associated with an increased risk of toddler behaviour problems, which persist in clinical significance into childhood. This research examines a model of ‘social-environmental transmission’ of paternal psychopathology. We compared patterns of parent-infant interactions among families with depressed and non-depressed fathers to address the following question: Are the early interactions of depressed fathers characterised by maladaptive affect, behaviour and cognitions? This study is part of an on-going longitudinal investigation, The Oxford Fathers Project (OFP) of families who are followed when infants are 3 months to 2 years of age. Paternal behaviours, including verbal comments and interactive behaviour were examined during free-play with their 3-month old infants. Father's behaviour was coded from Fiori-Cowley and Murray's (1996) Global Rating Scale and verbal transcripts were examined for cognitive and mentalizing statements.Preliminary results suggest a higher proportion of infant directed negativity, in the verbal content of depressed fathers. Further analysis will be conducted and presented at the meeting. Discussion emphasises the importance of dysfunctional communication patterns in father-infant interactions that provide important clinical hypotheses as well as targets for identification and early intervention.
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30
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Murray L, Mugwagwa A, Horsfall M, Tam P, Teh J, Gordon D, Bennetts J, Joseph M. 504 Infective Endocarditis at a Tertiary Hospital in Adelaide, Australia. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.511] [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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31
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aharchi J, Aldridge I, Arling V, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Rucker C, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 996.14 Assurance® Polyclonal Enzyme Immunoassay for Detection of Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Assurance®Listeria Polyclonal Enzyme Immunoassay (EIA) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 23 collaborators, representing government agencies, as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 550 test portions and controls was analyzed and confirmed, of which 207 were positive and 336 were negative by both methods. Six test portions were positive by culture, but negative by the EIA. Three test portions were negative by culture, but positive by the EIA. Two test portions were negative by EIA and by culture, but confirmed positive when EIA enrichment broths were subcultured to selective agars. The data reported here indicate that the Assurance®Listeria EIA method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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32
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Silbernagel K, Jechorek R, Carver C, Barbour WM, Mrozinski P, Albert A, Andaloro B, Anderson G, Beacorn F, Brooks R, Carson M, Crossfield D, Eliasberg S, Farmer D, Frantzeskakis C, Gasses T, Gatesy T, Hall G, Hanson P, Heddaeus K, Hermann K, Hutchins J, Jenkins J, Johnson F, Johnson J, Kawalek M, Kelly L, Koschmann C, Lannon P, Lester D, Manner K, Martin J, Maselli M, McGovern B, Mohnke F, Moon B, Murray L, Pace R, Richards J, Robeson S, Rodgers D, Rosario G, Saunders C, Shaw C, Dana Shell J, Sloan E, Thompson S, Vialpando M, Voermans R, Watts K, Wieczorek K, Wilson K, Yeh H, Zamora D. Evaluation of the BAX® System for Detection of Salmonella in Selected Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.6.1149] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A multilaboratory study was conducted to compare the automated BAX® System to the standard cultural methods for detection of Salmonella in selected foods. Five food types—frankfurters, raw ground beef, mozzarella cheese, raw frozen tilapia fish, and orange juice—at 3 inoculation levels, were analyzed by each method. A sixth food type, raw ground chicken, was tested using 3 naturally contaminated lots. A total of 16 laboratories representing government and industry participated. In this study, 1386 samples were analyzed, of which 1188 were paired samples and 198 were unpaired samples. Of the 1188 paired samples, 461 were positive by both methods and 404 were negative by both methods. Thirty-seven samples were positive by the BAX System but negative by the standard reference method, and 11 samples were positive by standard cultural method and negative by the BAX System. Of the 198 unpaired samples, 106 were positive by the BAX System and 60 were positive by the standard cultural method. A Chi square analysis of each of the 6 food types, at the 3 inoculation levels tested, was performed. For all foods, the BAX System demonstrated results comparable to those of the standard reference methods based on the Chi square results.
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Affiliation(s)
| | | | - Charles Carver
- rtech laboratories, PO Box 64101, St. Paul, MN 55164-0101
| | - W Mark Barbour
- DuPont Qualicon, 3531 Silverside Rd, Bedford Building, Wilmington, DE 19810
| | - Peter Mrozinski
- DuPont Qualicon, 3531 Silverside Rd, Bedford Building, Wilmington, DE 19810
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33
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aguilar G, Aharchi J, Aldridge I, Arling V, Bitner B, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Dombroski P, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, Martensen D, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Robertson M, Rogers P, Rucker C, Sacca J, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, Vess R, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 997.03 Visual Immunoprecipitate Assay (VIP®) for Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Visual Immunoprecipitate assay (VIP®) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 27 laboratories, representing government agencies as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 615 test portions and controls was analyzed and confirmed, of which 227 were positive and 378 were negative by both methods. Nine test portions were positive by culture, but negative by the VIP. Five test portions were negative by culture, but positive by the VIP. Four test portions were negative by VIP and by culture, but confirmed positive when VIP enrichment broths were subcultured to selective agars. The data reported here indicate that the VIP method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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34
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Powell JR, Murray L, Burnet NG, Fernandez S, Lingard Z, McParland L, O'Hara DJ, Whitfield GA, Short SC. Patient Involvement in the Design of a Randomised Trial of Proton Beam Radiotherapy Versus Standard Radiotherapy for Good Prognosis Glioma. Clin Oncol (R Coll Radiol) 2019; 32:89-92. [PMID: 31607613 DOI: 10.1016/j.clon.2019.09.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/02/2019] [Accepted: 08/14/2019] [Indexed: 11/12/2022]
Affiliation(s)
- J R Powell
- Department of Oncology, Velindre University NHS Trust, Cardiff, UK.
| | - L Murray
- St James's Hospital and Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - N G Burnet
- Division of Cancer Sciences, Manchester Cancer Research Centre, University of Manchester, Manchester, UK; Department of Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - S Fernandez
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Z Lingard
- Division of Cancer Sciences, Manchester Cancer Research Centre, University of Manchester, Manchester, UK
| | - L McParland
- Department of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - D J O'Hara
- Clinical and Health Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - G A Whitfield
- Division of Cancer Sciences, Manchester Cancer Research Centre, University of Manchester, Manchester, UK; Department of Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - S C Short
- St James's Hospital and Leeds Institute of Medical Research, University of Leeds, Leeds, UK
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Sun F, Murray L, Lilley J, Banfill K, Wheller B, Mcwilliam A, Abravan A, Van Herk M, Faivre-Finn C, Franks K. P1.17-22 Do Statins Improve Outcomes After Radical Radiotherapy for Lung Cancer? An In-Depth Analysis of Over 1100 Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1296] [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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Salvatore D, Shaw G, Wright J, Teh I, Koch-Paszkowski J, Murray L, Scarsbrook A, Schneider J, Ottobrini L, Short S. P11.13 Radiotherapy combined with a multimodal imaging approach in a glioblastoma preclinical model. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Glioblastoma multiforme (GBM) carries a poor prognosis, partly due to biological and anatomical heterogeneity. Although radiotherapy (RT) is effective, high doses damage surrounding healthy tissues. Multimodal imaging with Magnetic Resonance (MRI) and Positron Emission Tomography (PET) may represent a useful approach for identifying GBM heterogeneity and visualising metabolic tumour properties. PET radiotracer [18F]-fluciclovine is preferentially accumulated in gliomas compared to healthy brain tissue via the cellular transport systems, LAT1 and ASCT2. In this study the effect of fractionated RT using multimodal imaging including [18F]-fluciclovine uptake and immunohistochemistry (IHC) in a GBM preclinical model will be validated.
MATERIAL AND METHODS
Two C57BL/6J mice cohorts were injected intracranially (i.c.) with murine CT2A-luc cells and subsequently submitted to multiparametric MRI and [18F]-fluciclovine PET imaging during hemi-brain RT (3Gy on 2 days/each week) for maximum 25 days after i.c. injection. Brains were collected for IHC characterization including LAT1 and ASCT2 staining.
RESULTS
Preliminary data showed that both MRI and PET were effective modalities to track tumour growth in this model. PET data revealed up to greater than 3-fold increase in SUVmax from regions of interest around the tumour site compared to healthy brain tissue. Time activity curves showed a steady increase in tumour uptake over 90 minutes. MRI showed a 25% increase in T2 values in tumours relative to unaffected contralateral regions. Confirmation of treatment response through matched imaging and IHC are ongoing, from which changes in glioma cell biology as well as amino acid transporter protein levels will be analysed.
CONCLUSION
These preliminary results show that multimodal imaging presents novel data in the assessment of treatment response in this model and will permit parallel IHC analyses to better define GBM tumour heterogeneity aligned with imaging changes. These data will also inform an on-going clinical study using the same imaging modalities.
Work at authors’ labs are supported by an Investigator initiated project from Blue Earth Diagnostics (AS, SCS) and a University of Leeds Biswas studentship (SCS, DS). Daniela Salvatore is also supported by a Scholarship provided by Molecular and Translational Medicine Doctorate School of University of Milan (Italy).
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Affiliation(s)
- D Salvatore
- Leeds Institute of Medical Research (LIMR), Leeds Teaching Hospitals Trust, University of Leeds, Leeds, United Kingdom
- Department of Pathophysiology and Transplantation, University of Milan, Segrate, Milan, Italy
| | - G Shaw
- Leeds Institute of Medical Research (LIMR), Leeds Teaching Hospitals Trust, University of Leeds, Leeds, United Kingdom
| | - J Wright
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), School of Medicine, University of Leeds, Leeds, United Kingdom
| | - I Teh
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), School of Medicine, University of Leeds, Leeds, United Kingdom
| | - J Koch-Paszkowski
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), School of Medicine, University of Leeds, Leeds, United Kingdom
| | - L Murray
- Leeds Institute of Medical Research (LIMR), Leeds Teaching Hospitals Trust, University of Leeds, Leeds, United Kingdom
| | - A Scarsbrook
- Leeds Institute of Medical Research (LIMR), Leeds Teaching Hospitals Trust, University of Leeds, Leeds, United Kingdom
| | - J Schneider
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), School of Medicine, University of Leeds, Leeds, United Kingdom
| | - L Ottobrini
- Department of Pathophysiology and Transplantation, University of Milan, Segrate- Molecular Bioimaging and Physiology (IBFM), CNR, Segrate, Milan, Italy
| | - S Short
- Leeds Institute of Medical Research (LIMR), Leeds Teaching Hospitals Trust, University of Leeds, Leeds, United Kingdom
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Moulton CD, Murray L, Winkley K, Amiel SA, Ismail K, Patel A. Depression and change in occupational functioning in type 2 diabetes. Occup Med (Lond) 2019; 69:322-328. [PMID: 31087077 DOI: 10.1093/occmed/kqz072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The effect of depression on both employment and productivity in type 2 diabetes (T2D) is poorly understood. AIMS We tested whether depressive symptoms at diagnosis of T2D are associated with change in employment status and productivity over 2-year follow-up. METHODS In a prospective analysis of working-age (18-63 years) people with newly diagnosed T2D recruited from primary care, we tested the association between depressive symptoms at diagnosis of T2D (baseline) and employment rates over 2 years. Using the Patient Health Questionnaire-9, depressive symptoms were measured categorically (depression caseness score ≥10) and continuously. In those employed, we measured changes in presenteeism and absenteeism using the World Health Organization (WHO) Health and Work Performance Questionnaire in univariate and multivariate models, respectively, including and excluding part-time workers. RESULTS Of 1202 people aged 18-63 at baseline, 982 (82%) provided employment information; the mean age was 50.3 (SD 8.1) years, 44% were female, 59% of non-white ethnicity and 16% had depression. After adjustment for age, sex, ethnicity, socio-economic status, diabetes control and depression treatment, depression caseness was associated with worsening unemployment over 2 years only in full-time workers (odds ratio 0.43 (95% CI 0.20, 0.96), P < 0.05). In those employed full-time or part-time, total depressive symptoms were associated with worsening presenteeism over 2 years after full adjustment (β = -2.63 (95% CI -4.81, -0.45), P < 0.05), despite no association with worsening absenteeism. CONCLUSIONS In newly diagnosed T2D, depressive symptoms demonstrate an association with worsening employment rate and decline in work productivity over 2-year follow-up.
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Affiliation(s)
- C D Moulton
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - L Murray
- Warrington Public Health Team, Buttermarket Street, Warrington, UK
| | - K Winkley
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - S A Amiel
- Diabetes Research Group, School of Life Course Sciences, King's College London, London, UK
| | - K Ismail
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Patel
- Anita Patel Health Economics Consulting Ltd, London, UK
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Devereux G, Bourke S, Daines C, Doe S, Dougherty R, Franco R, Innes A, Kopp B, Lascano J, Layish D, McGregor G, Murray L, Peckham D, Smith T, Lucidi V, Volpi S, Lovie E, Robertson J, Fraser-Pitt D, O'Neil D. WS12-6 Evaluating appropriate PROMs in CARE-CF-1 trial: Lynovex® (cysteamine) an oral adjunct to SOC interventions in cystic fibrosis infectious exacebations. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30191-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Haroz EE, Bolton P, Nguyen AJ, Lee C, Bogdanov S, Bass J, Singh NS, Doty SB, Murray L. Measuring implementation in global mental health: validation of a pragmatic implementation science measure in eastern Ukraine using an experimental vignette design. BMC Health Serv Res 2019; 19:262. [PMID: 31036002 PMCID: PMC6489318 DOI: 10.1186/s12913-019-4097-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 12/18/2018] [Accepted: 04/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is mounting evidence supporting the effectiveness of task-shifted mental health interventions in low- and middle-income countries (LMIC). However, there has been limited systematic scale-up or sustainability of these programs, indicating a need to study implementation. One barrier to progress is a lack of locally relevant and valid implementation measures. We adapted an existing brief dissemination and implementation (D&I) measure which includes scales for acceptability, appropriateness, feasibility and accessibility for local use and studied its validity and reliability among a sample of consumers in Ukraine. METHODS Local qualitative data informed adaptation of the measure and development of vignettes to test the reliability and validity. Participants were veterans and internally displaced persons (IDPs) recruited as part of a separate validity study of adapted mental health instruments. We examined internal consistency reliability, test-retest reliability, and construct and criterion validity for each scale on the measure. We randomly assigned half the participants to respond to a vignette depicting existing local psychiatric services which we knew were not well regarded, while the other half was randomized to a vignette describing a potentially more well-implemented mental health service. Criterion validity was assessed by comparing scores on each scale by vignette and by overall summary ratings of the programs described in the vignettes. RESULTS N = 169 participated in the qualitative study and N = 153 participated in the validity study. Qualitative findings suggested the addition of several items to the measure and indicated the importance of addressing professionalism/competency of providers in both the scales and the vignettes. Internal consistency reliabilities ranged from α = 0.85 for feasibility to α = 0.91 for appropriateness. Test-rest reliabilities were acceptable to good for all scales (rho: 0.61-0.79). All scales demonstrated substantial and significant differences in average scores by vignette assignment (ORs: 2.21-5.6) and overall ratings (ORs: 5.1-14.47), supporting criterion validity. CONCLUSIONS This study represents an innovative mixed-methods approach to testing an implementation science measure in contexts outside the United States. Results support the reliability and validity of most scales for consumers in Ukraine. Challenges included large amounts of missing data due to participants' difficulties responding to questions about a hypothetical program.
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Affiliation(s)
- E E Haroz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway 8th fl, Baltimore, MD, 21205, USA.
| | - P Bolton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway 8th fl, Baltimore, MD, 21205, USA.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - A J Nguyen
- University of Virginia Curry School of Education, Virginia, USA
| | - C Lee
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - S Bogdanov
- Center for Mental Health and Psychosocial Support National University of Kyiv-Mohyla, Kyiv-Mohyla, Ukraine
| | - J Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway 8th fl, Baltimore, MD, 21205, USA
| | - N S Singh
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - S B Doty
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway 8th fl, Baltimore, MD, 21205, USA
| | - L Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway 8th fl, Baltimore, MD, 21205, USA
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Nix M, Gregory S, Aldred M, Aspin L, Al-Qaisieh B, Lilley J, Appelt A, Dickinson P, Murray L. PO-1001 Combined image-based and biomechanical deformable image registration of extreme anatomical changes. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sun F, Banfill K, Lilley J, Wheller B, Murray L, McWilliam A, Van Herk M, Abravan A, Faivre-Finn C, Franks K. Multi-centre analysis of cardiac events following radical radiotherapy for lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz064.004] [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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Murray L, Gregory S, Nix M, Aldred M, Aspin L, Uzan J, Lilley J, Al-Qaisieh B, Appelt A. PV-0427 Improving cumulative dose evaluation for reirradiation: first results from the STRIDeR project. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30847-3] [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: 11/30/2022]
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Rodda S, Murray L, Bottomley D, Bownes P, Wilkinson C, Adiotomre E, Al-Qaisieh B, Dugdale E, Hulson O, Mason J, Smith J, Henry A. PO-1054 LDR versus HDR brachytherapy boost in prostate cancer patients - a retrospective analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31474-4] [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: 10/26/2022]
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Waldram R, Taylor A, Prestwich R, Whittam S, Murray L, Al-Qaisieh B, Cardale K, Ramasamy S, Murray P, Dyker K, Sen M. PO-073 Outcomes and patterns of failure of oral squamous cell carcinomas treated post-operatively with IMRT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Murray L. Coronary Artery Aneurysms Following Bioresorbable Vascular Scaffolds. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.600] [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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Brown S, Beasley M, Chuter R, Faivre-Finn C, Franks K, Henry A, Murray L, Van-Herk M. The impact of intra-thoracic anatomical changes upon the delivery of lung stereotactic ablative radiotherapy. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30224-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Jenkins C, Ngan T, Ngoc N, Phuong T, Lohfeld L, Donnelly M, Minh H, Murray L. Strengthening Screening and Detection Services for Breast Cancer in Vietnam. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.39100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The incidence of breast cancer has increased consistently in Vietnam over the past two decades. Data from 2012 indicates an increase from an age-standardized rate of 16.2 per 100,000 in 2002, to 23.0 per 100,000 in 2012. Despite this, and consistent studies indicating late diagnosis, there has been a lack of empirical studies on what breast cancer services exist and how they function across different levels of the Vietnamese health system. Aim: Our project sought to examine the accessibility, affordability, and appropriateness of breast cancer services in Vietnam with the objective of making recommendations to strengthen service delivery. Methods: The project used a mixed-methods approach, collecting data through self-administered questionnaires (n=69) and in-depth interviews (n=23) with health professionals working at facilities across all four levels of the Vietnamese health system (national, provincial, district, & commune). We completed in-depth interviews with women (n=12) diagnosed with breast cancer, focusing on their experiences of accessing and using services. Our study was located across three provinces, representing the northern, central, and southern regions of the country. Results: Our results show that screening activities for breast cancer in the community are not systematically organized or provided. There are no stand-alone screening campaigns for breast cancer and facility-based opportunistic screening is limited. There is scope for strengthening the primary and secondary levels of the Vietnamese health system to detect, diagnose and treat breast cancer. Increased autonomy and support for commune-level health stations to conduct screening activities, the systematic incorporation of opportunistic screening, and the extension of breast cancer-specific training for commune and district level health care staff are potential areas for strengthening. Conclusion: Our study suggests that there should be concerted efforts to implement the Ministry of Health's strategic objectives to decentralise and strengthen commune and district levels of the health system in relation to detection, diagnosis and treatment of breast cancer. No studies have been conducted that pilot interventions to provide systematic and comprehensive breast cancer services at the lower levels of the health system. Specific attention should be given to increasing autonomy and support for commune level health stations to conduct screening activities; for the systematic incorporation of opportunistic screening; and the extension of breast cancer-specific training for commune and district level health care staff.
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Affiliation(s)
- C. Jenkins
- Queen's University Belfast, Centre for Public Health, Belfast, United Kingdom
| | - T.T. Ngan
- Queen's University Belfast, Centre for Public Health, Belfast, United Kingdom
| | - N.B. Ngoc
- Queen's University Belfast, Centre for Public Health, Belfast, United Kingdom
| | - T.B. Phuong
- Queen's University Belfast, Centre for Public Health, Belfast, United Kingdom
| | - L. Lohfeld
- Queen's University Belfast, Centre for Public Health, Belfast, United Kingdom
| | - M. Donnelly
- Queen's University Belfast, Centre for Public Health, Belfast, United Kingdom
| | - H.V. Minh
- Queen's University Belfast, Centre for Public Health, Belfast, United Kingdom
| | - L. Murray
- Queen's University Belfast, Centre for Public Health, Belfast, United Kingdom
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Parikh S, Murray L, Kenning L, Bottomley D, Din O, Dixit S, Ferguson C, Handforth C, Joseph L, Mokhtar D, White L, Wright G, Henry A. Real-world Outcomes and Factors Predicting Survival and Completion of Radium 223 in Metastatic Castrate-resistant Prostate Cancer. Clin Oncol (R Coll Radiol) 2018; 30:548-555. [DOI: 10.1016/j.clon.2018.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/16/2018] [Accepted: 05/20/2018] [Indexed: 01/04/2023]
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Martin A, Murray L, Sethugavalar B, Buchan C, Williams GF, Sen M, Prestwich RJD. Changes in Patient-reported Swallow Function in the Long Term After Chemoradiotherapy for Oropharyngeal Carcinoma. Clin Oncol (R Coll Radiol) 2018; 30:756-763. [PMID: 30025978 DOI: 10.1016/j.clon.2018.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/07/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022]
Abstract
AIMS To assess long-term patient-reported swallow function after chemoradiotherapy for oropharyngeal carcinoma and to evaluate the frequency of deterioration/improvement over years. MATERIALS AND METHODS Fifty-nine patients with oropharyngeal carcinoma treated with parotid-sparing intensity-modulated radiotherapy and concurrent chemotherapy between 2010 and 2012 had previously completed the MD Anderson Dysphagia Inventory (MDADI) at a median of 34 months (range 24-59) after treatment. An MDADI was posted to 55 alive and disease-free patients after a 30 month interval; 52/55 replies were received, a median of 64 months (range 52-88) after treatment; 27/52 (52%) had been managed with a prophylactic gastrostomy. A 10 point or greater change in the MDADI scores was defined as clinically significant. RESULTS Overall, in the whole cohort, patient-reported swallow function showed a small absolute improvement in MDADI composite score on the second MDADI questionnaire (>5 years after treatment) compared with the first MDADI (>2 years after treatment); mean 68.0 (standard deviation 19.3) versus 64.0 (standard deviation 16.3), P = 0.021. Using the composite score, swallow function was stable over time in 29/52 (56%) patients; a clinically significant improvement in swallow function over time was noted in 17/52 (33%) patients; conversely 6/52 (12%) patients experienced a clinically significant deterioration with time. Abnormality of pre-treatment diet and a prophylactic gastrostomy correlated with an inferior MDADI composite score on the later questionnaire (P = 0.029 and P = 0.044, respectively). CONCLUSIONS Long-term dysphagia is prevalent >5 years after treatment. Although long-term swallow function is stable in most patients, it is not static in a minority. On MDADI composite summary scores, 33% of patients experienced an improvement, whereas 12% deteriorated with time. Further investigation is needed to determine underlying mechanisms behind these divergent outcomes.
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Affiliation(s)
- A Martin
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - L Murray
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - B Sethugavalar
- Department of Radiotherapy, The James Cook University Hospital, Middlesbrough, UK
| | - C Buchan
- Department of Radiotherapy, Leeds Cancer Centre, Leeds, UK
| | - G F Williams
- Dietetic Department, Leeds Cancer Centre, Leeds, UK
| | - M Sen
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - R J D Prestwich
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK.
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Molina-Montes E, Gomez-Rubio P, Márquez M, Rava M, Löhr M, Michalski CW, Molero X, Farré A, Perea J, Greenhalf W, Ilzarbe L, O'Rorke M, Tardón A, Gress T, Barberà VM, Crnogorac-Jurcevic T, Domínguez-Muñoz E, Muñoz-Bellvís L, Balsells J, Costello E, Huang J, Iglesias M, Kleeff J, Kong B, Mora J, Murray L, O'Driscoll D, Poves I, Scarpa A, Ye W, Hidalgo M, Sharp L, Carrato A, Real FX, Malats N. Risk of pancreatic cancer associated with family history of cancer and other medical conditions by accounting for smoking among relatives. Int J Epidemiol 2018; 47:473-483. [PMID: 29329392 DOI: 10.1093/ije/dyx269] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2018] [Indexed: 12/16/2022] Open
Abstract
Background Family history (FH) of pancreatic cancer (PC) has been associated with an increased risk of PC, but little is known regarding the role of inherited/environmental factors or that of FH of other comorbidities in PC risk. We aimed to address these issues using multiple methodological approaches. Methods Case-control study including 1431 PC cases and 1090 controls and a reconstructed-cohort study (N = 16 747) made up of their first-degree relatives (FDR). Logistic regression was used to evaluate PC risk associated with FH of cancer, diabetes, allergies, asthma, cystic fibrosis and chronic pancreatitis by relative type and number of affected relatives, by smoking status and other potential effect modifiers, and by tumour stage and location. Familial aggregation of cancer was assessed within the cohort using Cox proportional hazard regression. Results FH of PC was associated with an increased PC risk [odds ratio (OR) = 2.68; 95% confidence interval (CI): 2.27-4.06] when compared with cancer-free FH, the risk being greater when ≥ 2 FDRs suffered PC (OR = 3.88; 95% CI: 2.96-9.73) and among current smokers (OR = 3.16; 95% CI: 2.56-5.78, interaction FHPC*smoking P-value = 0.04). PC cumulative risk by age 75 was 2.2% among FDRs of cases and 0.7% in those of controls [hazard ratio (HR) = 2.42; 95% CI: 2.16-2.71]. PC risk was significantly associated with FH of cancer (OR = 1.30; 95% CI: 1.13-1.54) and diabetes (OR = 1.24; 95% CI: 1.01-1.52), but not with FH of other diseases. Conclusions The concordant findings using both approaches strengthen the notion that FH of cancer, PC or diabetes confers a higher PC risk. Smoking notably increases PC risk associated with FH of PC. Further evaluation of these associations should be undertaken to guide PC prevention strategies.
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Affiliation(s)
- E Molina-Montes
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
| | - P Gomez-Rubio
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
| | - M Márquez
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
| | - M Rava
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
| | - M Löhr
- Karolinska Institutet and University Hospital, Gastrocentrum, Stockholm, Sweden
| | - C W Michalski
- Technical University of Munich, Department of Surgery, Munich, Germany
- University of Heidelberg, Department of Surgery, Heidelberg, Germany
| | - X Molero
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, and CIBEREHD, Spain
| | - A Farré
- Hospital de la Santa Creu i Sant Pau, Department of Gastroenterology, Barcelona, Spain
| | - J Perea
- University Hospital 12 de Octubre, Department of Surgery, Madrid, Spain
| | - W Greenhalf
- Royal Liverpool University Hospital, Department of Molecular and Clinical Cancer Medicine, Liverpool, UK
| | - L Ilzarbe
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - M O'Rorke
- Queen's University Belfast, Centre for Public Health, Belfast, UK
| | - A Tardón
- Instituto Universitario de Oncología del Principado de Asturias, Department of Medicine, Oviedo, and CIBERESP, Spain
| | - T Gress
- University Hospital of Giessen and Marburg, Department of Gastroenterology, Marburg, Germany
| | - V M Barberà
- General University Hospital of Elche, Molecular Genetics Laboratory, Elche, Spain
| | - T Crnogorac-Jurcevic
- Barts Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, London, UK
| | - E Domínguez-Muñoz
- University Clinical Hospital of Santiago de Compostela, Department of Gastroenterology, Santiago de Compostela, Spain
| | - L Muñoz-Bellvís
- Salamanca University Hospital, General and Digestive Surgery Department, Salamanca, Spain
| | - J Balsells
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, and CIBEREHD, Spain
| | - E Costello
- Royal Liverpool University Hospital, Department of Molecular and Clinical Cancer Medicine, Liverpool, UK
| | - J Huang
- Karolinska Institutet and University Hospital, Gastrocentrum, Stockholm, Sweden
| | - M Iglesias
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - J Kleeff
- Technical University of Munich, Department of Surgery, Munich, Germany
- Martin-Luther-University Halle-Wittenberg, Department of Visceral, Vascular and Endocrine Surgery, Halle (Saale), Germany
| | - Bo Kong
- Technical University of Munich, Department of Surgery, Munich, Germany
| | - J Mora
- Hospital de la Santa Creu i Sant Pau, Department of Gastroenterology, Barcelona, Spain
| | - L Murray
- Queen's University Belfast, Centre for Public Health, Belfast, UK
| | - D O'Driscoll
- National Cancer Registry Ireland and HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - I Poves
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - A Scarpa
- ARC-Net Centre for Applied Research on Cancer and Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - W Ye
- Karolinska Institutet and University Hospital, Gastrocentrum, Stockholm, Sweden
| | - M Hidalgo
- Madrid-Norte-Sanchinarro Hospital, Madrid, Spain
| | - L Sharp
- National Cancer Registry Ireland and HRB Clinical Research Facility, University College Cork, Cork, Ireland
- Newcastle University, Institute of Health and Society, Newcastle upon Tyne, UK
| | - A Carrato
- Ramón y Cajal University Hospital, Department of Oncology, IRYCIS, Alcala University, Madrid, and CIBERONC, Spain
| | - F X Real
- Spanish National Cancer Research Centre (CNIO), Epithelial Carcinogenesis Group, Madrid, Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut, Barcelona, and CIBERONC, Spain
| | - N Malats
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
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