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Wright AS, Guthrie-Dixon N, Tulloch-Reid MK, Chang SM, Walker SP. Maternal feeding styles in infancy predict child body mass index z-scores at 72 months: findings from a cohort of Jamaican children. Front Public Health 2023; 11:1161808. [PMID: 37457271 PMCID: PMC10349535 DOI: 10.3389/fpubh.2023.1161808] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Objective To explore whether maternal feeding styles at 12 months predict child Body Mass Index (BMI) z-scores at 72 months and evaluate whether BMI z-scores at 18 months mediates the association. Methods Data from 239 mother-child pairs participating in a parenting intervention were analyzed. Feeding information was ascertained at 12 months by questionnaire with feeding styles identified using factor analysis. Children's weight and length/height were measured at 18 and 72 months and BMI z-scores computed. Maternal sociodemographic data, depressive symptoms and language skills were obtained by questionnaire. Multilevel linear regression analysis was used to examine whether feeding styles predicted 72 month BMI z-scores. Complete case analysis was conducted and multiple imputation used to treat missing values of explanatory and outcome variables at 18 and 72 months. Mediational analysis was performed to assess the indirect effects of feeding styles on 72 month BMI z-scores via 18 month BMI z-scores. Results Restrictive feeding at age 12 months predicted higher 72 month BMI z-scores in both complete case analysis [β (95%CI): 0.19 (0.02, 0.37)] and multiple imputation [β (95%CI): 0.20 (0.02, 0.39)]. Uninvolved, forceful, indulgent and responsive feeding styles were not significant predictors of 72 month BMI z-scores. A significant indirect effect was observed between restrictive feeding and child BMI z-scores at 72 months via 18 month BMI z-scores [β (95% CI) 0.12 (0.03, 0.22)]. Conclusion Restrictive feeding at 12 months was associated with higher BMI z-scores at 72 months and appeared to be mediated by BMI z-scores at 18 months.
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Dawkins YM, Rowe-Gardener S, Guthrie-Dixon N, Thompson R, Thompson T, Lee MG, Cunningham-Myrie C. H. pylori predictors and outcomes among adults undergoing upper endoscopy at a Jamaican teaching hospital: A cross-sectional study. Helicobacter 2023; 28:e12968. [PMID: 37025012 DOI: 10.1111/hel.12968] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Recent data on the prevalence of H. pylori infection in Jamaica are lacking. It is postulated that there has been a decline in the prevalence of H. pylori infection and its associated complications. We determined sociodemographic characteristics, prevalence of H. pylori infection and clinical outcomes among adults undergoing esophagogastroduodenoscopy (EGD) and histology at the University Hospital of the West Indies (UHWI) between May 2018 and December 2020. MATERIALS AND METHODS A cross-sectional study of patients (≥18 years old), who underwent EGD and histological evaluation for H. pylori infection, was conducted. Associations of H. pylori positivity and gastric cancer with sociodemographic/clinical variables and endoscopic findings were determined by stepwise logistic regression using backward selection. Unadjusted and adjusted odds ratios with related 95% confidence intervals (Cis) were calculated for H. pylori positivity and gastric cancer status. RESULTS There were 323 participants (mean age 58.6 ± 17.8 years, 54.2% females). H. pylori prevalence was 22.2% (n = 70 of 315), 5.6% had gastric neoplasia (GN), 15.5% gastric atrophy, 11.4% intestinal metaplasia and 3.7% dysplasia on histology. Mucositis (64.5%), gastric ulcer (14.9%), and duodenal ulcer (13.9%) were the most common endoscopic findings. Participants with peptic ulcer disease (PUD) (unOR = 4.0; p = .017), gastric cancer (unOR = 9.5; p = .003), gastric atrophy (unOR = 12.8; p < .001), and intestinal metaplasia (unOR = 5.0; p < .001) had a significantly higher odds of being H. pylori positive, but after multivariable analyses only gastric atrophy remained significant (aOR = 27.3; p < .001). Participants with mucositis had a significantly lower odds of gastric cancer (unOR 0.1; p = .035) while participants with dysplasia had significantly higher odds (unOR 8.0; p = .042), but these were no longer significant after multivariable analyses (aOR = 0.2; p = .156 and aOR = 18.9; p = .070, respectively). CONCLUSIONS Histology based prevalence of H. pylori infection is lower than previously reported in Jamaica. Gastric atrophy is a significant predictor of H. pylori positivity.
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Affiliation(s)
- Y M Dawkins
- Department of Medicine, University of the West Indies, Mona, Jamaica
| | - S Rowe-Gardener
- Department of Medicine, University of the West Indies, Mona, Jamaica
| | - N Guthrie-Dixon
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - R Thompson
- Department of Pathology, University of the West Indies, Mona, Jamaica
| | - T Thompson
- Department of Medicine, University of the West Indies, Mona, Jamaica
| | - M G Lee
- Department of Medicine, University of the West Indies, Mona, Jamaica
| | - C Cunningham-Myrie
- Department of Community Health & Psychiatry, University of the West Indies, Mona, Jamaica
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Wayas FA, Smith JA, Lambert EV, Guthrie-Dixon N, Wasnyo Y, West S, Oni T, Foley L. Association of Perceived Neighbourhood Walkability with Self-Reported Physical Activity and Body Mass Index in South African Adolescents. Int J Environ Res Public Health 2023; 20:2449. [PMID: 36767815 PMCID: PMC9916213 DOI: 10.3390/ijerph20032449] [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] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Adolescence is a life stage critical to the establishment of healthy behaviours, including physical activity (PA). Factors associated with the built environment have been shown to impact PA across the life course. We examined the sociodemographic differences in, and associations between, perceived neighbourhood walkability, PA, and body mass index (BMI) in South African adolescents. We recruited a convenience sample (n = 143; 13-18 years; 65% female) of students from three high schools (middle/high and low-income areas). Participants completed a PA questionnaire and the Neighbourhood Environment Walkability Scale (NEWS)-Africa and anthropometry measurements. Multivariable linear regression was used to examine various relationships. We found that, compared with adolescents living in middle/high income neighbourhoods, those living in low-income neighbourhoods had lower perceived walkability and PA with higher BMI percentiles. The associations between neighbourhood walkability and PA were inconsistent. In the adjusted models, land use diversity and personal safety were associated with club sports participation, street connectivity was positively associated with school sports PA, and more favourable perceived walkability was negatively associated with active transport. Overall, our findings suggest that the perceived walkability of lower income neighbourhoods is worse in comparison with higher income neighbourhoods, though the association with PA and BMI is unclear.
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Affiliation(s)
- Feyisayo A. Wayas
- Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS), Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Joanne A. Smith
- Caribbean Institute for Health Research, Epidemiology Research Unit, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Estelle V. Lambert
- Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS), Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Natalie Guthrie-Dixon
- Caribbean Institute for Health Research, Epidemiology Research Unit, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Yves Wasnyo
- Health of Populations in Transition (HoPiT), Research Group, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé P.O. Box 8046, Cameroon
| | - Sacha West
- Department of Sport Management, Cape Peninsula University of Technology, Cape Town 7705, South Africa
| | - Tolu Oni
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
- Research Initiative for Cities Health and Equity (RICHE), School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Louise Foley
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
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Cunningham-Myrie C, Theall KP, Younger-Coleman N, Wiggan J, McFarlane S, Francis D, Bennett N, Tulloch-Reid M, Ferguson TS, Davidson T, Govia I, Guthrie-Dixon N, Aiken W, Grant A, Webster-Kerr K, Wilks R. Who moves in vulnerable Caribbean neighborhoods? Positive deviance for physical activity: Findings from the Jamaica health and Lifestyle Survey 2017 (JHLS III). Prev Med Rep 2022; 30:101998. [PMID: 36189127 PMCID: PMC9519374 DOI: 10.1016/j.pmedr.2022.101998] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022] Open
Abstract
Decreased physical activity (PA) has been associated with residents living in neighborhoods perceived as being disordered or having high crime levels. What is unknown are the characteristics of individuals who engage in moderate to vigorous levels of PA (MVPA) despite living in these vulnerable neighborhoods, or who may be referred to as positive deviants (PD). We examined the factors associated with PD for PA among Jamaicans. Between 2016 and 2017 the Jamaica Health and Lifestyle Survey, a cross-sectional nationally representative survey (n = 2807), was conducted on individuals aged 15 years and older. Regression analyses were performed to identify associations with PD, defined using engagement in MVPA among persons living in vulnerable neighborhoods (N = 1710). Being female (odds ratio [OR]a = 0.64 (0.48, 0.86); p = 0.003), obese while living in an urban area (ORa = 0.39; 95 % CI = 0.26, 0.59; p < 0.0001), unemployed (ORa = 0.53; 95 % CI = 0.39, 0.73; p < 0.0001), or a student (ORa = 0.62; 95 % CI = 0.39, 0.98); p = 0.041) was associated with a significantly lower likelihood of PD, while having a personal medical history of at least one chronic disease significantly increased likelihood (ORa = 1.43; 95 % CI = 1.08, 1.90; p = 0.014). Taking a PD approach may be one angle to consider in trying to determine what is working and for whom, so that this may be harnessed in policy, prevention and intervention programming to increase PA.
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Affiliation(s)
- C Cunningham-Myrie
- Department of Community Health & Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - K P Theall
- Departments of Social, Behavioral, and Population Sciences and Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - N Younger-Coleman
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - J Wiggan
- Ministry of Health & Wellness, Jamaica
| | - S McFarlane
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - D Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, USA
| | - N Bennett
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - M Tulloch-Reid
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - T S Ferguson
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - I Govia
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - N Guthrie-Dixon
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - W Aiken
- Department of Surgery, Radiology, Anaesthesia & Intensive Care, University of the West Indies, Mona, Kingston, Jamaica
| | - A Grant
- Ministry of Health & Wellness, Jamaica
| | | | - R Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
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Williamson GA, Rodrigo S, Guthrie-Dixon N, Blackman E, Beck JR, Hambleton I, Bailey A, Paul T, Ragin CC, Tulloch-Reid MK. A cross-sectional analysis of investigator needs for non-communicable disease research at the University of the West Indies, Mona. Rev Panam Salud Publica 2021; 45:e35. [PMID: 33833787 PMCID: PMC8021206 DOI: 10.26633/rpsp.2021.35] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the needs of academic staff conducting non-communicable disease (NCD) research at the University of the West Indies, Mona Campus in Jamaica. METHODS Utilizing a cross-sectional design an online survey was created using the research electronic data capture application (REDCap); it was disseminated via email to 708 academic staff members in the Faculties of Medical Sciences and Science & Technology between September and November 2018. Participants were asked to indicate their level of access to expertise, training and equipment for conducting research. Descriptive analysis was conducted using STATA version 14. RESULTS Most respondents were women (74.2%), predominantly scientists (33.1%) or specialist physicians (22.6%). Less than 2/3 of respondents reported publishing research findings in peer reviewed journals, with a quarter not disseminating their research findings in any medium. Resources for field research/data collection, epidemiological methods and principles, and data management/data analysis were generally available. However, there was limited access to training, expertise and equipment in emerging techniques for NCD research such as metabolomics, bioinformatics/analysis of large-scale data sets and health economics. Additional challenges included limited access to financing for research, inadequate workspace and poor administrative support for conducting research. CONCLUSIONS There is a need for more local research seed funding, stronger administrative support for researchers, and opportunities for training in cutting edge NCD research techniques. Jamaican researchers could benefit from being part of a regional research centre of excellence with critical research skills and equipment that builds research networks and strengthens the NCD research response.
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Affiliation(s)
- Georgia A Williamson
- Caribbean Institute for Health Research at The University of the West Indies (UWI)MonaJamaicaCaribbean Institute for Health Research at The University of the West Indies (UWI), Mona, Jamaica
| | - Shelly Rodrigo
- Caribbean Public Health AgencyTrinidad and TobagoCaribbean Public Health Agency, Trinidad and Tobago
| | - Natalie Guthrie-Dixon
- Caribbean Institute for Health Research at The University of the West Indies (UWI)MonaJamaicaCaribbean Institute for Health Research at The University of the West Indies (UWI), Mona, Jamaica
| | - Elizabeth Blackman
- Fox Chase Cancer CenterPhiladelphiaUnited States of AmericaFox Chase Cancer Center, Philadelphia, United States of America
| | - J Robert Beck
- Fox Chase Cancer CenterPhiladelphiaUnited States of AmericaFox Chase Cancer Center, Philadelphia, United States of America
| | - Ian Hambleton
- Caribbean Institute for Health Research at UWICave HillBarbadosCaribbean Institute for Health Research at UWI, Cave Hill, Barbados
| | - Althea Bailey
- Department of Community Health and Psychiatry at UWIMonaJamaicaDepartment of Community Health and Psychiatry at UWI, Mona, Jamaica
| | - Tomlin Paul
- Faculty of Medical Sciences at UWIMonaJamaicaFaculty of Medical Sciences at UWI, Mona, Jamaica
| | - Camille C Ragin
- Fox Chase Cancer CenterPhiladelphiaUnited States of AmericaFox Chase Cancer Center, Philadelphia, United States of America
| | - Marshall K Tulloch-Reid
- Caribbean Institute for Health Research at The University of the West Indies (UWI)MonaJamaicaCaribbean Institute for Health Research at The University of the West Indies (UWI), Mona, Jamaica
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Blake A, Guthrie-Dixon N, Grindley M, Barton-Gooden A, Knight-Madden J, Asnani M. Level of agreement between adolescents' self-assessment and parent proxy report of health-related quality of life in adolescents with sickle cell disease. Pediatr Blood Cancer 2020; 67:e28198. [PMID: 32020725 DOI: 10.1002/pbc.28198] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/08/2020] [Accepted: 01/12/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND We aim to assess the levels of agreement between parents, as proxies, and Jamaican adolescents living with sickle cell disease (SCD) in the reporting of the adolescent's quality of life. PROCEDURES This cross-sectional study assessed 102 patient/proxy pairs on quality of life of adolescents with SCD using the PedsQL-SCD module. The level of agreement among pairs was assessed starting with broad group-level approaches (the Wilcoxon signed-rank test augmented by exploring percentage agreement) tapering to individual-level approaches (intraclass correlation coefficients [ICCs] supplemented with Bland-Altman plots). RESULTS Most patients (76.5%) had homozygous SS disease (45.1% females; mean age 15.2 ± 1.5 years). Median total pediatric quality of life (PedsQL) scores were 79.1 (adolescent report) and 80.2 (parental report) (P = .60). There were 11.8% underestimation and 12.7% overestimation of overall health-related quality of life (HRQOL) by parents. The highest perfect agreement existed on the "pain and hurt" domain for both male and female adolescents (85.7% and 84.4%, respectively). Overestimation was highest on the "social communication" domain for both male and female adolescents (19.6% and 34.8%, respectively). Parents exhibited good agreement on total PedsQL scores in male adolescents (ICC = 0.70), but moderate agreement (ICC = 0.43) in female adolescents. Generally, parents underestimated their male child's functioning and overestimated the female child's functioning on the various domains. CONCLUSIONS Parents and adolescents exhibit fair agreement in assessment of the adolescent's overall HRQOL but differ on subjective domains. Agreement varies by sex of the affected teen where girls' HRQOL is generally overestimated by the parental proxy. Interventions to improve parents' understanding of their children's psychosocial needs are needed.
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Affiliation(s)
- Alphanso Blake
- Caribbean Institute for Health Research-Sickle Cell Unit, The University of the West Indies, Kingston 7, Jamaica
| | - Natalie Guthrie-Dixon
- Caribbean Institute for Health Research-Epidemiology Research Unit, The University of the West Indies, Kingston 7, Jamaica
| | - Marlyn Grindley
- Caribbean Institute for Health Research-Sickle Cell Unit, The University of the West Indies, Kingston 7, Jamaica
| | | | - Jennifer Knight-Madden
- Caribbean Institute for Health Research-Sickle Cell Unit, The University of the West Indies, Kingston 7, Jamaica
| | - Monika Asnani
- Caribbean Institute for Health Research-Sickle Cell Unit, The University of the West Indies, Kingston 7, Jamaica
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Blackman E, Ashing KT, Ragin C, Tulloch-Reid M, Beck JR, Bailey A, Hambilton I, Guthrie-Dixon N, Williamson G, Forman A, Roberts R. Abstract 4185: Establishing sustainable research collaborations in the Caribbean through the utilization of multiple technology platforms. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-4185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: International research collaborations are a critical strategy in tackling immigrant and global prevention and control challenges. Available communications and data technology facilitates collaborations to address global cancer inequities. The purpose of the African Caribbean Cancer Consortium (AC3) is to develop and sustain partnerships to investigate and respond to the increasing cancer vulnerability among African descended peoples worldwide. In the Caribbean, cancer incidence and mortality are rising in persons of African ancestry. We will present preliminary outcomes from our NCI-P20 award.
Methods: Our goal is to establish a Caribbean Regional Center of Research Excellence (CRCRE). The project started in Jamaica in partnership with the University of the West Indies-Mona. The CRCRE is building a sustainable research center at the Mona campus that will spread to other campuses throughout the University system. Using ZOOM, WhatsApp, YouTube, GoogleDocs, and REDCap, we will develop a sustainable research infrastructure in the Caribbean.
Results:
Regional Needs Assessment- Using REDCap, we were able to conduct a research needs assessment across the Caribbean. A survey was developed by the research team and administered within the Mona campus and Caribbean-wide through the AC3 member listserv. We had over 150 respondents representing key stakeholders who identified top priorities to develop sustainable research in the region.
The REDCap database for the CRCRE will also house training webinars readily available for users.
Mentor-Mentee Program was implemented to match junior faculty in the Caribbean to senior faculty within the AC3 network. Among Caribbean researchers, we are building capacity for basic, translational, clinical and behavioral research. Mentors and mentees will utilize ZOOM, e-mail, Googledocs, WhatsApp and YouTube to facilitate training, mentoring and study processes.
Genetic Counseling Training was conducted between genetic counselors at Fox Chase Cancer Center (FCCC) and 3 Caribbean nurses based at Princess Margaret Hospital, Nassau, Bahamas. Nurses received virtual training via NCCN and ZOOM lectures. Nurses then shadowed FCCC genetic counselors. They will utilize ZOOM, WhatsApp and YouTube to facilitate ongoing training, mentoring, and supervision.
Discussion: Using communication and data technologies are effective and cost effective platforms for developing and sustaining international cancer prevention and control research in low and middle-income countries including the Caribbean. Caribbeans account for 10% of all immigrants and 50% of all immigrant Blacks. Therefore, attending to and addressing cancer biologic, genetic, environmental and behavioral risk and disparate outcomes among Caribbeans will benefit the Region as well as inform strategies to reduce cancer disparities within U.S. Black population.
Citation Format: Elizabeth Blackman, Kimlin Tam Ashing, Camille Ragin, Marshall Tulloch-Reid, J. Robert Beck, Althea Bailey, Ian Hambilton, Natalie Guthrie-Dixon, Georgia Williamson, Andrea Forman, Robin Roberts. Establishing sustainable research collaborations in the Caribbean through the utilization of multiple technology platforms [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4185.
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Affiliation(s)
| | | | | | | | | | - Althea Bailey
- 3University of the West Indies-Mona Campus, Kingston, Jamaica
| | | | | | | | | | - Robin Roberts
- 5University of the West Indies- School of Clinical Medicine and Research, Nassau, Bahamas
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