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Castillo B, Marulanda J, Thomson P. Experimental Evaluation of Pedestrian-Induced Multiaxial Gait Loads on Footbridges: Effects of the Structure-to-Human Interaction by Lateral Vibrating Platforms. Sensors (Basel) 2024; 24:2517. [PMID: 38676134 DOI: 10.3390/s24082517] [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: 01/19/2024] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 04/28/2024]
Abstract
The introduction of resistant and lightweight materials in the construction industry has led to civil structures being vulnerable to excessive vibrations, particularly in footbridges exposed to human-induced gait loads. This interaction, known as Human-Structure Interaction (HSI), involves a complex interplay between structural vibrations and gait loads. Despite extensive research on HSI, the simultaneous effects of lateral structural vibrations with fundamental frequencies close to human gait frequency (around 1.0 Hz) and wide amplitudes (over 30.0 mm) remain inadequately understood, posing a contemporary structural challenge highlighted by incidents in iconic bridges like the Millennium Bridge in London, Solferino Bridge in Paris, and Premier Bridge in Cali, Colombia. This paper focuses on the experimental exploration of Structure-to-Human Interaction (S2HI) effects using the Human-Structure Interaction Multi-Axial Test Framework (HSI-MTF). The framework enables the simultaneous measurement of vertical and lateral loads induced by human gait on surfaces with diverse frequency ranges and wide-amplitude lateral harmonic motions. The study involved seven test subjects, evaluating gait loads on rigid and harmonic lateral surfaces with displacements ranging from 5.0 to 50.0 mm and frequency content from 0.70 to 1.30 Hz. A low-cost vision-based motion capture system with smartphones analyzed the support (Tsu) and swing (Tsw) periods of human gait. Results indicated substantial differences in Tsu and Tsw on lateral harmonic protocols, reaching up to 96.53% and 58.15%, respectively, compared to rigid surfaces. Normalized lateral loads (LL) relative to the subject's weight (W0) exhibited a linear growth proportional to lateral excitation frequency, with increased proportionality constants linked to higher vibration amplitudes. Linear regressions yielded an average R2 of 0.815. Regarding normalized vertical load (LV) with respect to W0, a consistent behavior was observed for amplitudes up to 30.0 mm, beyond which a linear increase, directly proportional to frequency, resulted in a 28.3% increment compared to rigid surfaces. Correlation analyses using Pearson linear coefficients determined relationships between structural surface vibration and pedestrian lateral motion, providing valuable insights into Structure-to-Human Interaction dynamics.
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Affiliation(s)
- Bryan Castillo
- School of Civil and Geomatic Engineering, University of Valley, Cali 760001, Colombia
| | - Johannio Marulanda
- School of Civil and Geomatic Engineering, University of Valley, Cali 760001, Colombia
| | - Peter Thomson
- School of Civil and Geomatic Engineering, University of Valley, Cali 760001, Colombia
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Kingsmore D, Edgar B, Stevenson K, Greenlaw N, Aitken E, Jackson A, Thomson P. A practical review of barriers and challenges to a definitive randomised trial of grafts versus fistula. J Vasc Access 2024:11297298241234610. [PMID: 38436199 DOI: 10.1177/11297298241234610] [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] [Indexed: 03/05/2024] Open
Abstract
A definitive randomised controlled trial of arteriovenous fistula (AVF) versus arteriovenous grafts (AVG) has been advocated for more than a decade, but as yet, none has been completed. The aim of this article is to summarise the theoretical barriers, review the difficulties in trial design and practicalities that have thus far prevented this from occurring.
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Affiliation(s)
- David Kingsmore
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Department of Vascular Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Ben Edgar
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Karen Stevenson
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Nicola Greenlaw
- Glasgow Clinical Trials Unit, Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Emma Aitken
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Andrew Jackson
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Peter Thomson
- Department of Renal Medicine, Queen Elizabeth University Hospital, Glasgow, UK
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Ryder D, Stone D, Minardi D, Riley A, Avant J, Cross L, Soeffker M, Davidson D, Newman A, Thomson P, Darby C, van Aerle R. De novo assembly and annotation of the Patagonian toothfish (Dissostichus eleginoides) genome. BMC Genomics 2024; 25:233. [PMID: 38438840 PMCID: PMC10910785 DOI: 10.1186/s12864-024-10141-4] [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: 11/13/2023] [Accepted: 02/19/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Patagonian toothfish (Dissostichus eleginoides) is an economically and ecologically important fish species in the family Nototheniidae. Juveniles occupy progressively deeper waters as they mature and grow, and adults have been caught as deep as 2500 m, living on or in just above the southern shelves and slopes around the sub-Antarctic islands of the Southern Ocean. As apex predators, they are a key part of the food web, feeding on a variety of prey, including krill, squid, and other fish. Despite its importance, genomic sequence data, which could be used for more accurate dating of the divergence between Patagonian and Antarctic toothfish, or establish whether it shares adaptations to temperature with fish living in more polar or equatorial climes, has so far been limited. RESULTS A high-quality D. eleginoides genome was generated using a combination of Illumina, PacBio and Omni-C sequencing technologies. To aid the genome annotation, the transcriptome derived from a variety of toothfish tissues was also generated using both short and long read sequencing methods. The final genome assembly was 797.8 Mb with a N50 scaffold length of 3.5 Mb. Approximately 31.7% of the genome consisted of repetitive elements. A total of 35,543 putative protein-coding regions were identified, of which 50% have been functionally annotated. Transcriptomics analysis showed that approximately 64% of the predicted genes (22,617 genes) were found to be expressed in the tissues sampled. Comparative genomics analysis revealed that the anti-freeze glycoprotein (AFGP) locus of D. eleginoides does not contain any AFGP proteins compared to the same locus in the Antarctic toothfish (Dissostichus mawsoni). This is in agreement with previously published results looking at hybridization signals and confirms that Patagonian toothfish do not possess AFGP coding sequences in their genome. CONCLUSIONS We have assembled and annotated the Patagonian toothfish genome, which will provide a valuable genetic resource for ecological and evolutionary studies on this and other closely related species.
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Affiliation(s)
- David Ryder
- Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, Suffolk, UK.
| | - David Stone
- Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, Suffolk, UK
| | - Diana Minardi
- Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, Suffolk, UK
| | - Ainsley Riley
- Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, Suffolk, UK
| | - Justin Avant
- Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, Suffolk, UK
| | - Lisa Cross
- Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, Suffolk, UK
| | - Marta Soeffker
- Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, Suffolk, UK
- Collaborative Centre for Sustainable Use of the Seas, University of East Anglia, Norwich, UK
| | | | | | | | - Chris Darby
- Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, Suffolk, UK
| | - Ronny van Aerle
- Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, Suffolk, UK
- Centre for Sustainable Aquaculture Futures , University of Exeter, Exeter, UK
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Meiklem R, Bouamrane MM, Kingsmore D, Stevenson K, Dunlop M, Thomson P. Patient-Centred, Technology-Based Interventions for High Treatment Burden: An Overview of the State of the Art. Stud Health Technol Inform 2024; 310:529-533. [PMID: 38269865 DOI: 10.3233/shti231021] [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] [Indexed: 01/26/2024]
Abstract
This study provides an overview of recent efforts to develop technology-based interventions for patients with high treatment burden. Adoption of a technological intervention for high treatment burden will depend on a range of factors, including: the reliability and accessibility of the technology, patient factors including age, socio-economic factors, technology literacy, overall health status and personal priorities - as well as the perceived benefits provided by the technology intervention, from the perspectives of both patients and clinicians.
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Affiliation(s)
- Ramsay Meiklem
- Computer and Information Sciences, University of Strathclyde, Scotland
| | | | | | | | - Mark Dunlop
- Computer and Information Sciences, University of Strathclyde, Scotland
| | - Peter Thomson
- Queen Elizabeth University Hospital, Glasgow, Scotland
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Edgar B, Jones C, Aitken E, Stevenson K, Jackson A, Gaianu L, Thomson P, Kasthuri R, Stove C, Kingsmore D. What are the observed procedural costs of vascular access surgery? Protocol for a systematic review. BMJ Open 2024; 14:e079773. [PMID: 38272545 PMCID: PMC10824010 DOI: 10.1136/bmjopen-2023-079773] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION A central component in the introduction of a novel surgical procedure or technique is an evaluation of its cost efficiency when compared with a benchmark standard of care. Accurate assessment of costs is thus essential in ensuring appropriate allocation of resources within a healthcare system. The treatment of kidney failure requires a significant volume of resources, and vascular access provision is the main modifiable cost. The costs of providing this service are obscured by generic NHS reference costs, which lack adequate granularity to allow meaningful comparisons between treatments. The aim of this systematic review will be to assess the reporting of procedural costs in all published economic analyses of vascular access surgery and perform a comparison of the reported procedural costs involved in arteriovenous fistula (AVF) and arteriovenous graft (AVG) creation. This will provide an estimate as to the accuracy of the NHS reference costs in this field. METHODS AND ANALYSIS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be followed. A systematic search will be performed of the MEDLINE, Embase and Cochrane databases to identify full-text economic analyses of vascular access for haemodialysis in which the procedural cost of AVF or AVG creation is reported. Publications in English from 1 January 2000 to 30 August 2023, will be eligible for inclusion. Studies will be selected by title and abstract review, followed by a full-text review using inclusion and exclusion criteria. Studies not reporting the procedural costs of surgery will be excluded. Data collected will pertain to procedural costs of AVF and AVG creation. Costs will be adjusted to a common currency using a gross domestic product (GDP) deflator index and conversion rates based on purchasing power parities for GDP. Comparison with NHS reference costs will indicate their reliability for use in future economic analyses in this field. ETHICS AND DISSEMINATION Ethical approval is not required for this systematic review. Findings will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42023458779.
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Affiliation(s)
- Ben Edgar
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Catrin Jones
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Emma Aitken
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Karen Stevenson
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Andrew Jackson
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Lucian Gaianu
- Independent Health Economist, Healthonomics UK Ltd, Reading, UK
| | - Peter Thomson
- Department of Renal Medicine, Queen Elizabeth University Hospital, Glasgow, UK
| | - Ram Kasthuri
- Department of Interventional Radiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Callum Stove
- Department of Interventional Radiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - David Kingsmore
- Renal Transplant and Vascular Access Surgery, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Vascular Surgery, Queen Elizabeth University Hospital, Glasgow, UK
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Kingsmore D, Meiklem R, Stevenson K, Thomson P, Bouamrane M, Dunlop M. A national co-design workshop of a mobile-based application for vascular access as a patient decision aid. J Vasc Access 2024; 25:187-192. [PMID: 35686488 DOI: 10.1177/11297298221091140] [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] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Increasing options for vascular access have increased the need for more effective communication to optimize patient engagement and ensure effective consent. An advanced prototype of the mobile application (VA App) was developed over 3 years as a patient decision aid. For the first time, entry to the 2021 UK Kidney Week was opened to all professions and patients and was held online. The VA App was presented in an inter-active session. This report summarizes the findings. METHODS A 30-min interactive session was allocated with the session delivered in four sections: (1) demographic data was collected; (2) an overall opinion was obtained about current patient information sources and satisfaction with these; (3) the participants were asked a series of eight questions regarding the main problem areas previously identified; (4) following a 6-min demonstration video, the participants were then re-asked the same questions to determine if the VA App would improve/worsen these areas. RESULTS Completed data from 30 participants showed great variation in all demographics. The most cited source was verbal and rated the best, whilst all other sources were felt to be poor by 90%. All eight aspects of current information sources rated poorly. There was a unanimous agreement that the VA App could make this better. Interestingly, when the eight aspects were ranked by order of the worst to best, this matched the order of the benefits of the VA App. DISCUSSION This is the first report of an on-line, multi-professional co-design workshop. With a unanimous view that current systems are very limited and that better patient information systems are required, the VA App was found to be a potential solution as a patient decision aid. Interestingly, paper leaflets were widely viewed as the least used and the least effective mechanism for communicating information to patients. Funding for a commercially produced mobile application has been secured and will be further tested in the near future.
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Affiliation(s)
- David Kingsmore
- Department of Vascular Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
- Renal Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Ramsay Meiklem
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, Scotland, UK
| | - Karen Stevenson
- Renal Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - Peter Thomson
- Department of Nephrology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - Matt Bouamrane
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Mark Dunlop
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, Scotland, UK
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Ramamurthy P, Sharma D, Adeoye J, Choi SW, Thomson P. Bayesian Disease Mapping to Identify High-Risk Population for Oral Cancer: A Retrospective Spatiotemporal Analysis. Int J Dent 2023; 2023:3243373. [PMID: 37954499 PMCID: PMC10635753 DOI: 10.1155/2023/3243373] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/05/2023] [Accepted: 09/13/2023] [Indexed: 11/14/2023] Open
Abstract
Objectives Bayesian mapping is an effective spatiotemporal approach to identify high-risk geographic areas for diseases and has not been used to identify oral cancer hotspots in Australia previously. This retrospective disease mapping study was undertaken to identify the oral cancer trends and patterns within the Queensland state in Australia. Methods This study included data obtained from Queensland state Cancer Registry from 1982 to 2018. Domains mapped included the oral cancer incidence and mortality in Queensland (QLD). Local government areas (LGAs) and suburbs were utilized as geographical units for the estimation using Bayesian mapping approach. Results Of the 78 LGAs, 21 showed high-oral cancer incidence as measured using higher median smoothed incidence risk (SIR), above the state average. Specifically, nine LGAs within predominantly rural areas had SIR above 100% of the state average. Of these, only one LGA (Mount Isa City) had a median smoothed SIR and 95% CI of 2.61 (2.14-3.15) which was constantly above 100% of the state average. Furthermore, mortality risk estimated using smoothed mortality risk (SMR), were significantly higher than the state average in 31 LGAs. Seventeen LGAs had a median SMR above 100% of the state average while three LGAs had the highest overall, 3- and 5-year mortality risks. Considering the 95% credible interval which is indicative of the uncertainty around the estimates, three LGAs had the highest overall mortality risks-Yarrabah Aboriginal Shire (3.80 (2.16-6.39)), Cook Shire (3.37 (2.21-5.06)), and Mount Isa City (3.04 (2.40-3.80)). Conclusion Bayesian disease mapping approach identified multiple incidence and mortality hotspots within regional areas of the Queensland. Findings from our study can aid in designing targeted public health screening and interventions for primary prevention of oral cancer in regional and remote communities.
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Affiliation(s)
- Poornima Ramamurthy
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland 4878, Australia
| | - Dileep Sharma
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Ourimbah, NSW 2258, Australia
| | - John Adeoye
- Faculty of Dentistry, Oral and Maxillofacial Surgery, University of Hong Kong, Hong Kong
| | - Siu-Wai Choi
- Faculty of Dentistry, Oral and Maxillofacial Surgery, University of Hong Kong, Hong Kong
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland 4878, Australia
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Kingsmore DB, Thomson P, Stevenson K. Screening and surveillance of venous stenosis in AVG: Is it time to rethink our assumptions? J Vasc Access 2023; 24:873-878. [PMID: 34763539 DOI: 10.1177/11297298211055611] [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] [Indexed: 11/16/2022] Open
Abstract
Guidelines make no firm recommendations about surveillance of arteriovenous grafts as several randomised trials (RCT) have not shown a clear benefit in patency. However a more thorough review of these RCT based on epidemiological principles reveals significant limitations. In particular a key weakness of these older studies is the interventions performed for venous stenosis detected that was largely angioplasty. However, the observational data of modern stent-grafts shows a clear benefit over angioplasty, and thus seems to suggest that a modern well considered RCT is now mandated.
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Affiliation(s)
- David B Kingsmore
- Hon Prof of Surgery, Univeristy of Glasgow, UK
- Department of Vascular Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Peter Thomson
- Department of Nephrology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Karen Stevenson
- Department of Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
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Edgar B, Kingsmore DB, Aitken E, Calder F, Franchin M, Geddes C, Inston N, Jackson A, Jones RG, Karydis N, Kasthuri R, Mestres G, Papadakis G, Sivaprakasam R, Stephens M, Stevenson K, Stove C, Szabo L, Thomson P, Tozzi M, White RD. Quality assurance in surgical trials of arteriovenous grafts for haemodialysis: protocol for a systematic review. BMJ Open 2023; 13:e071646. [PMID: 37419647 PMCID: PMC10335504 DOI: 10.1136/bmjopen-2023-071646] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/11/2023] [Indexed: 07/09/2023] Open
Abstract
INTRODUCTION Decisions regarding the optimal vascular access for haemodialysis patients are becoming increasingly complex, and the provision of vascular access is open to variations in systems of care as well as surgical experience and practice. Two main surgical options are recognised: arteriovenous fistula and arteriovenous graft (AVG). All recommendations regarding AVG are based on a limited number of randomised controlled trials (RCTs). It is essential that when considering an RCT of a surgical procedure, an appropriate definition of quality assurance (QA) is made for both the new approach and the comparator, otherwise replication of results or implementation into clinical practice may differ from published results. The aim of this systematic review will be to assess the methodological quality of RCT involving AVG, and the QA measures implemented in delivering interventions in these trials. METHODS AND ANALYSIS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be followed. A systematic search will be performed of the MEDLINE, Embase and Cochrane databases to identify relevant literature. Studies will be selected by title and abstract review, followed by a full-text review using inclusion and exclusion criteria. Data collected will pertain to generic measures of QA, credentialing of investigators, procedural standardisation and performance monitoring. Trial methodology will be compared against a standardised template developed by a multinational, multispecialty review body with experience in vascular access. A narrative approach will be taken to synthesise and report data. ETHICS AND DISSEMINATION Ethical approval is not required as it is a protocol for a systematic review. Findings will be disseminated through peer-reviewed publications and conference presentations, with the ultimate aim of providing recommendations for future RCT of AVG design.
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Affiliation(s)
- Ben Edgar
- Department of Renal Surgery and Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - David B Kingsmore
- Department of Renal Surgery and Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Department of Vascular Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Emma Aitken
- Department of Renal Surgery and Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Francis Calder
- Renal & Transplant Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Marco Franchin
- Department of Vascular Surgery, University of Insubria, Varese, Italy
| | - Colin Geddes
- Department of Nephrology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Nick Inston
- Renal and Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Andrew Jackson
- Department of Renal Surgery and Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
| | - Rob G Jones
- Interventional Radiology, Queen Elizabeth Hospital, Birmingham, UK
| | - Nikolaos Karydis
- Department of General and Transplant Surgery, University of Patras, Patra, Greece
| | - Ram Kasthuri
- Department of Interventional Radiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Gaspar Mestres
- Department of Vascular Surgery, University of Barcelona, Barcelona, Spain
| | - Georgios Papadakis
- Renal & Transplant Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Mike Stephens
- Dialysis Access Team, University Hospital of Wales, Cardiff, UK
| | - Karen Stevenson
- Department of Renal Surgery and Transplantation, Queen Elizabeth University Hospital, Glasgow, UK
| | - Callum Stove
- Department of Interventional Radiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Lazslo Szabo
- Dialysis Access Team, University Hospital of Wales, Cardiff, UK
| | - Peter Thomson
- Department of Nephrology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Matteo Tozzi
- Department of Vascular Surgery, University of Insubria, Varese, Italy
| | - Richard D White
- Department of Interventional Radiology, University Hospital of Wales, Cardiff, UK
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Alkandari AS, Ho JCY, Choi SW, Thomson P. Oral cavity and oropharyngeal carcinoma disparities in age and survival in Indigenous and non-Indigenous populations of Queensland. BMC Cancer 2023; 23:503. [PMID: 37270559 DOI: 10.1186/s12885-023-11002-1] [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: 02/22/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVES To investigate the risk and prognosis of oral squamous cell carcinoma (SCC) between Indigenous and non-Indigenous populations of Queensland. MATERIALS AND METHODS Retrospective analysis of data from the Queensland Cancer Registry (QCR) between the years 1982-2018. Main outcome measures were age at diagnosis and cumulative survival to compare the risk and prognosis of oral SCC between the populations. RESULTS 9424 patients with self-declared ethnicity were identified with oral SCC from the QCR, with a male to female ratio of 2.56:1. Of these patients, 9132 were non-Indigenous (96.9%) and 292 Indigenous (3.1%). Indigenous people were significantly younger at diagnosis (mean (SD) age 54.3 (10.1) years), compared to 62.0 (12.1) years in non-Indigenous people. Mean survival in the full cohort was 4.3 years (SD: 5.6), with Indigenous people presenting a significant shorter mean survival of 2.0 years (SD: 3.5) when compared with 4.4 years (SD: 5.7) in non-Indigenous people (p < 0.001). CONCLUSIONS Indigenous Australians are diagnosed at a significantly younger age and present with worse survival and poorer prognosis. Due to missing variables in the Queensland Cancer Registry, it is not possible in the current study to ascertain the scientific or social reasons behind these disparities. CLINICAL RELEVANCE Results from this study can inform public policy and raise awareness in Queensland regarding disparity in oral cancer prognosis.
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Affiliation(s)
| | - Jemmi Ching Ying Ho
- Department of Anaesthesiology, Faculty of Medicine, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Siu Wai Choi
- Department of Orthopaedics & Traumatology, Faculty of Medicine, University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Peter Thomson
- College of Medicine & Dentistry, James Cook University, Douglas, Australia
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Wang W, Zhang Q, Thomson P, Sharma D, Ramamurthy P, Choi SW. Predicting oral cancer survival-Development and validation of an Asia-Pacific nomogram. J Oral Pathol Med 2023. [PMID: 37247328 DOI: 10.1111/jop.13454] [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: 04/13/2023] [Accepted: 05/13/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Nomograms are graphical calculating devices that predict response to treatment during cancer management. Oral squamous cell carcinoma (OSCC) is a lethal and deforming disease of rising incidence and global significance. The aim of this study was to develop a nomogram to predict individualized OSCC survival using a population-based dataset obtained from Queensland, Australia and externally validated using a cohort of OSCC patients treated in Hong Kong. METHODS Clinico-pathological data for newly diagnosed OSCC patients, including age, sex, tumour site and grading, were accessed retrospectively from the Queensland Cancer Registry (QCR) in Australia and the Clinical Data Analysis and Reporting System (CDARS) in Hong Kong. Multivariate Cox proportional hazard regression was used to construct overall survival (OS) and cancer-specific survival (CSS) prediction models. Nomograms were internally validated using 10-fold cross validation, and externally validated against the Hong Kong dataset. RESULTS Data from 9885 OSCC patients in Queensland and 465 patients from Hong Kong were analysed. All clinico-pathological variables significantly influenced survival outcomes. Nomogram calibration curves demonstrated excellent agreement between predicted and actual probability for Queensland patients. External validation in the Hong Kong population demonstrated slightly poorer nomogram performance, but predictive power remained strong. CONCLUSION Based upon readily available data documenting patient demographic and clinico-pathological variables, predictive nomograms offer pragmatic aid to clinicians in individualized treatment planning and prognosis assessment in contemporary OSCC management.
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Affiliation(s)
- Weilan Wang
- School of Data Science, The City University of Hong Kong, Hong Kong, China
| | - Qingpeng Zhang
- School of Data Science, The City University of Hong Kong, Hong Kong, China
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Dileep Sharma
- Oral Health, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Poornima Ramamurthy
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Siu-Wai Choi
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
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12
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Goyal N, Hennessy M, Lehman E, Lin W, Agudo A, Ahrens W, Boccia S, Brennan P, Brenner H, Cadoni G, Canova C, Chen C, Conway D, Curado MP, Dal Maso L, Daudt AW, Edefonti V, Fabianova E, Fernandez L, Franceschi S, Garavello W, Gillison M, Hayes RB, Healy C, Herrero R, Holcatova I, Kanda JL, Kelsey K, Hansen BT, Koifman R, Lagiou P, La Vecchia C, Levi F, Li G, Lissowska J, Mendoza López R, Luce D, Macfarlane G, Mates D, Matsuo K, McClean M, Menezes A, Menvielle G, Morgenstern H, Moysich K, Negri E, Olshan AF, Pandics T, Polesel J, Purdue M, Radoi L, Ramroth H, Richiardi L, Schantz S, Schwartz SM, Serraino D, Shangina O, Smith E, Sturgis EM, Świątkowska B, Thomson P, Vaughan TL, Vilensky M, Winn DM, Wunsch-Filho V, Yu GP, Zevallos JP, Zhang ZF, Zheng T, Znaor A, Boffetta P, Hashibe M, Lee YCA, Muscat JE. Risk factors for head and neck cancer in more and less developed countries: Analysis from the INHANCE consortium. Oral Dis 2023; 29:1565-1578. [PMID: 35322907 DOI: 10.1111/odi.14196] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 09/10/2021] [Revised: 02/24/2022] [Accepted: 03/03/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE We analyzed the pooled case-control data from the International Head and Neck Cancer Epidemiology (INHANCE) consortium to compare cigarette smoking and alcohol consumption risk factors for head and neck cancer between less developed and more developed countries. SUBJECTS AND METHODS The location of each study was categorized as either a less developed or more developed country. We compared the risk of overall head and neck cancer and cancer of specific anatomic subsites associated with cigarette smoking and alcohol consumption. Additionally, age and sex distribution between categories was compared. RESULTS The odds ratios for head and neck cancer sites associated with smoking duration differed between less developed and more developed countries. Smoking greater than 20 years conferred a higher risk for oral cavity and laryngeal cancer in more developed countries, whereas the risk was greater for oropharynx and hypopharynx cancer in less developed countries. Alcohol consumed for more than 20 years conferred a higher risk for oropharynx, hypopharynx, and larynx cancer in less developed countries. The proportion of cases that were young (<45 years) or female differed by country type for some HNC subsites. CONCLUSION These findings suggest the degree of industrialization and economic development affects the relationship between smoking and alcohol with head and neck cancer.
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Affiliation(s)
- Neerav Goyal
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Max Hennessy
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Erik Lehman
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Wenxue Lin
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
| | | | - Wolfgang Ahrens
- Faculty of Mathematics and Computer Science, Institute of Statistics, Leibniz Institute for Prevention Research and Epidemiology, BIPS, and University of Bremen, Bremen, Germany
| | - Stefania Boccia
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Paul Brennan
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Gabriella Cadoni
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Dipartimento Patologia Testa Collo e Organi di Senso, Facoltà Medicina e, Chirurgia Università Cattolica Sacro Cuore, Roma, Italy
| | | | - Chu Chen
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - David Conway
- Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO) Aviano, IRCCS, Aviano, PN, Italy
| | | | - Valeria Edefonti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Eleonora Fabianova
- Regional Authority of Public Health in Banska Bystrica, Banska Bystrica, Slovakia
| | | | - Silvia Franceschi
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Maura Gillison
- Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Richard B Hayes
- Division of Epidemiology, New York University School of Medicine, New York, New York, USA
| | - Claire Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | - Rolando Herrero
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, Prague, Czech Republic
| | - Jossy L Kanda
- Faculdade de Medicina do ABC, Hospital de Ensino, São Bernardo do Campo, SP, Brazil
| | - Karl Kelsey
- Brown University, Providence, Rhode Island, USA
| | | | - Rosalina Koifman
- Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Pagona Lagiou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Fabio Levi
- Institut Universitaire de Medecine Sociale et Preventive (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Guojun Li
- UT-M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Rossana Mendoza López
- Faculdade de Medicina da, Universidade de São Paulo, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | - Danièle Luce
- Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, France
| | | | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | - Keitaro Matsuo
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michael McClean
- Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ana Menezes
- Universidade Federal de Pelotas, Pelotas, Brazil
| | - Gwenn Menvielle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Paris, France
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Andrew F Olshan
- University of North Carolina School of Public Health, Chapel Hill, North Carolina, USA
| | | | - Jerry Polesel
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO) Aviano, IRCCS, Aviano, PN, Italy
| | - Mark Purdue
- New York Eye and Ear Infirmary, New York, New York, USA
| | - Loredana Radoi
- INSERM UMR 1018, Centre for Research in Epidemiology and Population Health (CESP), Cancer Epidemiology, Genes and Environment Team, Villejuif, France
| | - Heribert Ramroth
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | | | | | | | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO) Aviano, IRCCS, Aviano, PN, Italy
| | | | - Elaine Smith
- College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Erich M Sturgis
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | | | | | - Thomas L Vaughan
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Marta Vilensky
- Institute of Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires, Argentina
| | | | | | - Guo-Pei Yu
- Department of Otolaryngology, School of Medicine, New York Medical College, Valhalla, New York, USA
| | - Jose P Zevallos
- Division of Head and Neck Surgical Oncology, Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Zuo-Feng Zhang
- UCLA School of Public Health, Los Angeles, California, USA
| | - Tongzhang Zheng
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Ariana Znaor
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Yuan-Chin A Lee
- Division of Public Health, Department of Family & Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Joshua E Muscat
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
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13
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Kingsmore D, White RD, Mestres G, Stephens M, Calder F, Papadakis G, Aitken E, Jackson A, Inston N, Jones RG, Geddes C, Stevenson K, Szabo L, Thomson P, Stove C, Kasthuri R, Edgar B, Tozzi M, Franchin M, Sivaprakasam R, Karydis N. Recruitment into randomised trials of arteriovenous grafts: A systematic review. J Vasc Access 2023:11297298231158413. [PMID: 36905207 DOI: 10.1177/11297298231158413] [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] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Although randomised controlled trials (RCT) are considered the optimal form of evidence, there are relatively few in surgery. Surgical RCT are particularly likely to be discontinued with poor recruitment cited as a leading reason. Surgical RCT present challenges over and above those seen in drug trials as the treatment under study may vary between procedures, between surgeons in one unit, and between units in multi-centred RCT. The most contentious and debated area of vascular access remains the role of arteriovenous grafts, and thus the quality of the data that is used to support opinions, guidelines and recommendations is critical. The aim of this review was to determine the extent of variation in the planning and recruitment in all RCT involving AVG. The findings of this are stark: there have been only 31 RCT performed in 31 years, the vast majority of which exhibited major limitations severe enough to undermine the results. This underlines the need for better quality RCT and data, and further inform the design of future studies. Perhaps most fundamental is the planning for a RCT that accounts for the intended population, the uptake of a RCT and the attrition for the significant co-morbidity in this population.
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Affiliation(s)
- David Kingsmore
- Vascular Surgery, Queen Elizabeth University Hospital, Glasgow, UK.,Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Richard D White
- Department of Interventional Radiology, University Hospital of Wales, Cardiff, UK
| | - Gaspar Mestres
- Department of Vascular Surgery, University of Barcelona, Spain
| | - Mike Stephens
- Dialysis Access Team, University Hospital of Wales, Cardiff, UK
| | - Francis Calder
- Renal & Transplant Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Georgios Papadakis
- Renal & Transplant Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Emma Aitken
- Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Andrew Jackson
- Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Nick Inston
- Renal and Transplant Surgery, University Hospital Birmingham, UK
| | - Rob G Jones
- Interventional Radiology, Queen Elizabeth Hospital Birmingham, UK
| | - Colin Geddes
- Department of Nephrology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Karen Stevenson
- Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Laszlo Szabo
- Dialysis Access Team, University Hospital of Wales, Cardiff, UK
| | - Peter Thomson
- Department of Nephrology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Callum Stove
- Department of Interventional Radiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Ram Kasthuri
- Department of Vascular Surgery, University of Insubria, Varesi, Italy
| | - Ben Edgar
- Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Matteo Tozzi
- Department of Vascular Surgery, University of Insubria, Varesi, Italy
| | - Marco Franchin
- Department of Vascular Surgery, University of Insubria, Varesi, Italy
| | | | - Nikolaos Karydis
- Department of Renal and Transplant Surgery, University Hospital of Patras, Greece
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14
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Sun A, Sharma D, Choi SW, Ramamurthy P, Thomson P. Oral cancer in Australia: Rising incidence and worsening mortality. J Oral Pathol Med 2023; 52:328-334. [PMID: 36852511 DOI: 10.1111/jop.13421] [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: 12/24/2022] [Accepted: 02/24/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Oral cancer, predominantly squamous cell carcinoma (SCC), is a lethal and deforming disease of rising incidence. Although largely preventable by eliminating harmful tobacco and alcohol risk factor behaviour, 5-year survival rates remain around 50%, primarily due to late presentation of advanced stage disease. Whilst low socio-economic status, regional and remote location and indigenous status are associated with head and neck cancer in general, detailed incidence and demographic data for oral SCC in Australia are limited. This study aimed to characterise the Queensland population at risk of oral SCC development. METHODS Following ethical approval, the Queensland Cancer Register (QCR) dataset was analysed to determine patterns of incidence, anonymised patient demographics, clinical presentation and outcome data for oral SCC cases diagnosed between 1982 and 2018. RESULTS Data from 9887 patients were obtained. Mean age at diagnosis was 64.55 years, with a male-to-female ratio of 2.51:1; males were diagnosed at a younger age (p < 0.001). At study census date, 59% of patients had died, with females demonstrating longer mean survival (p < 0.001). Clinicopathological data confirmed that SCC most commonly arose from tongue sites (49%) and, whilst tumours were predominantly moderately differentiated in nature (63%), patients with poorly differentiated carcinomas exhibited shortest survival times (p < 0.05). Over the 36-year study period, the number of diagnoses increased 4.49-fold, whilst the number of deaths increased 19.14-fold. CONCLUSION Oral SCC poses a significant and growing healthcare problem in Queensland. In the absence of national screening, characterising the high-risk oral SCC population facilitates pragmatic opportunities to raise disease awareness, to deliver targeted screening and effective primary prevention strategies, and to provide early interventional treatment intervention to reduce disease mortality and morbidity.
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Affiliation(s)
- Aria Sun
- Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Dileep Sharma
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.,Oral Health, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Siu-Wai Choi
- Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Poornima Ramamurthy
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
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15
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Sayal L, Hamadah O, Almasri A, Idrees M, Thomson P, Kujan O. Saliva-based cell-free DNA and cell-free mitochondrial DNA in head and neck cancers have promising screening and early detection role. J Oral Pathol Med 2023; 52:29-36. [PMID: 36459078 PMCID: PMC10108294 DOI: 10.1111/jop.13392] [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: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Cell-free DNA (cfDNA) and cell-free mitochondrial DNA (cf-mtDNA) have been postulated as potential diagnostic and prognostic biomarkers for different human malignancies. Early detection of head and neck malignancies is fundamental for optimal patient management. This study, therefore, aimed to assess the utility of saliva-based liquid biopsy as a noninvasive source of cfDNA and cf-mtDNA for detecting head and neck cancer (HNSCC). METHODS One hundred thirty-three patients diagnosed with either oral leukoplakia (OLK) or HNSCC were compared with 137 healthy volunteers. An unstimulated whole saliva sample was collected from each participant. The absolute copy numbers of salivary cf-mtDNA and cfDNA were quantified using Multiplex Quantitative PCR. Two diagnostic indices based on the investigated molecules were assessed for their ability to differentiate between different diagnostic categories. RESULTS The median scores of cfDNA and cf-mtDNA were statistically significantly higher among HNSCC patients (p < 0.05), revealing area under the curve values of 0.758 and 0.826, respectively. The associated accuracy for this test in discriminating HNSCC from other diagnostic categories was 77.37% for the cfDNA-based index and 80.5% for the cf-mtDNA-based index. The median score of cfDNA was statistically significantly higher for patients with severe epithelial dysplasia (OED) compared to those with epithelial keratosis with no OED and mild OED. However, there was no significant difference between controls and OLK individuals. CONCLUSION cfDNA and cf-mtDNA showed potential for use as precision medicine tools to detect HNSCC. Further multi-centre prospective studies are warranted to assess the prognostic utility of these molecules.
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Affiliation(s)
- Lana Sayal
- Department of Oral Medicine, The Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Omar Hamadah
- Department of Oral Medicine and Pathology, The Faculty of Dental Medicine, Al-Sham Private University, Damascus, Syria
| | - Aroub Almasri
- Biomedical Department, National Commission of Biotechnology, Damascus, Syria
| | - Majdy Idrees
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
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16
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Adeoye J, Zheng LW, Thomson P, Choi SW, Su YX. Explainable ensemble learning model improves identification of candidates for oral cancer screening. Oral Oncol 2023; 136:106278. [PMID: 36525782 DOI: 10.1016/j.oraloncology.2022.106278] [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: 11/04/2022] [Revised: 11/26/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Artificial intelligence could enhance the use of disparate risk factors (crude method) for better stratification of patients to be screened for oral cancer. This study aims to construct a meta-classifier that considers diverse risk factors to identify patients at risk of oral cancer and other suspicious oral diseases for targeted screening. MATERIALS AND METHODS A retrospective dataset from a community oral cancer screening program was used to construct and train the novel voting meta-classifier. Comprehensive risk factor information from this dataset was used as input features for eleven supervised learning algorithms which served as base learners and provided predicted probabilities that are weighted and aggregated by the meta-classifier. Training dataset was augmented using SMOTE-ENN. Additionally, Shapley additive explanations (SHAP) values were generated to implement the explainability of the model and display the important risk factors. RESULTS Our meta-classifier had an internal validation recall, specificity, and AUROC of 0.83, 0.86, and 0.85 for identifying the risk of oral cancer and 0.92, 0.60, and 0.76 for identifying suspicious oral mucosal disease respectively. Upon external validation, the meta-classifier had a significantly higher AUROC than the crude/current method used for identifying the risk of oral cancer (0.78 vs 0.46; p = 0.001) Also, the meta-classifier had better recall than the crude method for predicting the risk of suspicious oral mucosal diseases (0.78 vs 0.47). CONCLUSION Overall, these findings showcase that our approach optimizes the use of risk factors in identifying patients for oral screening which suggests potential clinical application.
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Affiliation(s)
- John Adeoye
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Li-Wu Zheng
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Siu-Wai Choi
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Yu-Xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
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17
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Adeoye J, Akinshipo A, Koohi-Moghadam M, Thomson P, Su YX. Construction of machine learning-based models for cancer outcomes in low and lower-middle income countries: A scoping review. Front Oncol 2022; 12:976168. [DOI: 10.3389/fonc.2022.976168] [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] [Received: 06/23/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BackgroundThe impact and utility of machine learning (ML)-based prediction tools for cancer outcomes including assistive diagnosis, risk stratification, and adjunctive decision-making have been largely described and realized in the high income and upper-middle-income countries. However, statistical projections have estimated higher cancer incidence and mortality risks in low and lower-middle-income countries (LLMICs). Therefore, this review aimed to evaluate the utilization, model construction methods, and degree of implementation of ML-based models for cancer outcomes in LLMICs.MethodsPubMed/Medline, Scopus, and Web of Science databases were searched and articles describing the use of ML-based models for cancer among local populations in LLMICs between 2002 and 2022 were included. A total of 140 articles from 22,516 citations that met the eligibility criteria were included in this study.ResultsML-based models from LLMICs were often based on traditional ML algorithms than deep or deep hybrid learning. We found that the construction of ML-based models was skewed to particular LLMICs such as India, Iran, Pakistan, and Egypt with a paucity of applications in sub-Saharan Africa. Moreover, models for breast, head and neck, and brain cancer outcomes were frequently explored. Many models were deemed suboptimal according to the Prediction model Risk of Bias Assessment tool (PROBAST) due to sample size constraints and technical flaws in ML modeling even though their performance accuracy ranged from 0.65 to 1.00. While the development and internal validation were described for all models included (n=137), only 4.4% (6/137) have been validated in independent cohorts and 0.7% (1/137) have been assessed for clinical impact and efficacy.ConclusionOverall, the application of ML for modeling cancer outcomes in LLMICs is increasing. However, model development is largely unsatisfactory. We recommend model retraining using larger sample sizes, intensified external validation practices, and increased impact assessment studies using randomized controlled trial designsSystematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=308345, identifier CRD42022308345.
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18
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Ferreira e Costa R, Leão MLB, Sant’Ana MSP, Mesquita RA, Gomez RS, Santos‑Silva AR, Khurram SA, Tailor A, Schouwstra C, Robinson L, van Heerden WFP, Tomasi RA, Gorrino R, de Prato RSF, Taylor AM, Urizar JMA, de Mendoza ILI, Radhakrishnan R, Chandrashekar C, Choi S, Thomson P, Pontes HAR, Fonseca FP. Author Correction: Oral Squamous Cell Carcinoma Frequency in Young Patients from Referral Centers Around the World. Head Neck Pathol 2022; 16:1263. [PMID: 36239868 PMCID: PMC9729644 DOI: 10.1007/s12105-022-01503-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Rafael Ferreira e Costa
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG Brazil
| | - Marina Luiza Baião Leão
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG Brazil
| | - Maria Sissa Pereira Sant’Ana
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG Brazil
| | - Alan Roger Santos‑Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Syed Ali Khurram
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Artysha Tailor
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Ciska‑Mari Schouwstra
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Willie F. P. van Heerden
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Romina Gorrino
- Department of Pathology, Dental School, National University of Córdoba, Córdoba, Argentina
| | | | | | | | | | - Raghu Radhakrishnan
- Department of Oral Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Chetana Chandrashekar
- Department of Oral Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Siu‑Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG Brazil ,Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil ,Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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19
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Ferreira E Costa R, Leão MLB, Sant'Ana MSP, Mesquita RA, Gomez RS, Santos-Silva AR, Khurram SA, Tailor A, Schouwstra CM, Robinson L, van Heerden WFP, Tomasi RA, Gorrino R, de Prato RSF, Taylor AM, Urizar JMA, de Mendoza ILI, Radhakrishnan R, Chandrashekar C, Choi SW, Thomson P, Pontes HAR, Fonseca FP. Oral Squamous Cell Carcinoma Frequency in Young Patients from Referral Centers Around the World. Head Neck Pathol 2022; 16:755-762. [PMID: 35316511 PMCID: PMC9424469 DOI: 10.1007/s12105-022-01441-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/27/2022] [Indexed: 12/24/2022]
Abstract
Oral squamous cell carcinoma (OSCC) commonly affects older patients; however, several studies have documented an increase in its incidence among younger patients. Therefore, it is important to investigate if this trend is also found in different geographic regions. The pathology files of diagnostic and therapeutic institutions from different parts of the globe were searched for OSCC cases diagnosed from 1998 to 2018. Data regarding the sex, age, and tumor location of all cases, as well as the histologic grade and history of exposure to risk habits of cases diagnosed as OSCC in young patients (≤ 40 years of age) were obtained. The Chi-square test was used to determine any increasing trend. A total of 10,727 OSCC cases were identified, of which 626 cases affected young patients (5.8%). Manipal institution (India) showed the highest number of young patients (13.2%). Males were the most affected in both age groups, with the tongue and floor of the mouth being the most affected subsites. OSCC in young individuals were usually graded as well or moderately differentiated. Only 0.9% of the cases occurred in young patients without a reported risk habit. There was no increasing trend in the institutions and the period investigated (p > 0.05), but a decreasing trend was observed in Hong Kong and the sample as a whole (p < 0.001). In conclusion there was no increase of OSCC in young patients in the institutions investigated and young white females not exposed to any known risk factor represented a rare group of patients affected by OSCC.
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Affiliation(s)
- Rafael Ferreira E Costa
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Marina Luiza Baião Leão
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Maria Sissa Pereira Sant'Ana
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Syed Ali Khurram
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Artysha Tailor
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Ciska-Mari Schouwstra
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Willie F P van Heerden
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Romina Gorrino
- Department of Pathology, Dental School, National University of Córdoba, Córdoba, Argentina
| | | | | | | | | | - Raghu Radhakrishnan
- Department of Oral Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Chetana Chandrashekar
- Department of Oral Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil.
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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20
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Meiklem R, Stevenson K, Richarz S, Kingsmore D, Bouamrane MM, Dunlop M, Thomson P. Patients' and Clinicians' Perspectives on the Acceptability of Completing Digital Quality of Life Questionnaires During Routine Haemodialysis Clinics: A Mixed-Methods Study. Stud Health Technol Inform 2022; 290:752-756. [PMID: 35673118 DOI: 10.3233/shti220179] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Advanced chronic kidney disease is a serious and common medical condition with significant treatment choices incurring varying high treatment burdens. Better understanding on how to best collect quality of life (QoL) in this unique situation may help guide critical decisions. This study investigates the acceptability of digital QoL questionnaires completed during routine haemodialysis sessions. Qualitative data was collected from patient (n=23) and clinical researcher (n=2) interviews alongside analysis of data from questionnaires completed by patients (n=101) during a 6-week validation study. Interviews refined the content and format of digital QoL questionnaires and provided novel insights regarding how patients assessed and completed QoL questions. This study suggests collecting QoL data using digital tablet technology during routine haemodialysis clinics is both feasible and acceptable to patients and has provided novel insights that are not routinely available with traditional methods.
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Affiliation(s)
- Ramsay Meiklem
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, Scotland
| | | | | | | | | | - Mark Dunlop
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, Scotland
| | - Peter Thomson
- Queen Elizabeth University Hospital, Glasgow, Scotland
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21
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Marlatt VL, Bayen S, Castaneda-Cortès D, Delbès G, Grigorova P, Langlois VS, Martyniuk CJ, Metcalfe CD, Parent L, Rwigemera A, Thomson P, Van Der Kraak G. Impacts of endocrine disrupting chemicals on reproduction in wildlife and humans. Environ Res 2022; 208:112584. [PMID: 34951986 DOI: 10.1016/j.envres.2021.112584] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
Endocrine disrupting chemicals (EDCs) are ubiquitous in aquatic and terrestrial environments. The main objective of this review was to summarize the current knowledge of the impacts of EDCs on reproductive success in wildlife and humans. The examples selected often include a retrospective assessment of the knowledge of reproductive impacts over time to discern how the effects of EDCs have changed over the last several decades. Collectively, the evidence summarized here within reinforce the concept that reproduction in wildlife and humans is negatively impacted by anthropogenic chemicals, with several altering endocrine system function. These observations of chemicals interfering with different aspects of the reproductive endocrine axis are particularly pronounced for aquatic species and are often corroborated by laboratory-based experiments (i.e. fish, amphibians, birds). Noteworthy, many of these same indicators are also observed in epidemiological studies in mammalian wildlife and humans. Given the vast array of reproductive strategies used by animals, it is perhaps not surprising that no single disrupted target is predictive of reproductive effects. Nevertheless, there are some general features of the endocrine control of reproduction, and in particular, the critical role that steroid hormones play in these processes that confer a high degree of susceptibility to environmental chemicals. New research is needed on the implications of chemical exposures during development and the potential for long-term reproductive effects. Future emphasis on field-based observations that can form the basis of more deliberate, extensive, and long-term population level studies to monitor contaminant effects, including adverse effects on the endocrine system, are key to addressing these knowledge gaps.
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Affiliation(s)
- V L Marlatt
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
| | - S Bayen
- Department of Food Science and Agricultural Chemistry, McGill University, Montreal, QC, Canada
| | - D Castaneda-Cortès
- Centre Eau Terre Environnement, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - G Delbès
- Centre Armand Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - P Grigorova
- Département Science et Technologie, Université TELUQ, Montréal, QC, Canada
| | - V S Langlois
- Centre Eau Terre Environnement, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - C J Martyniuk
- Center for Environmental and Human Toxicology, Department of Physiological Sciences, University of Florida, Gainesville, FL, United States
| | - C D Metcalfe
- School of Environment, Trent University, Trent, Canada
| | - L Parent
- Département Science et Technologie, Université TELUQ, Montréal, QC, Canada
| | - A Rwigemera
- Centre Armand Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - P Thomson
- Centre Eau Terre Environnement, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - G Van Der Kraak
- Department of Integrative Biology, University of Guelph, Guelph, ON, Canada
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22
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Van Rhijn P, Mark P, Thomson P, Mangion K, Stoumpos S. MO981: DE Novo Heart Failure After Kidney Transplantation: Epidemiology, Risk Factors and Outcomes. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac087.039] [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 AND AIMS
Although the risk for congestive heart failure (CHF) decreases after kidney transplantation (KT) compared with dialysis, it remains a significant clinical concern associated with a higher risk of mortality, cardiovascular events and kidney graft loss. Available epidemiological data on CHF after KT are limited, outdated and have mostly focused on traditional risk factors. We aim to describe the risk, predictors and outcomes associated with de novo CHF after KT.
METHOD
We used electronic patient records from the West of Scotland renal database to retrospectively investigate de novo CHF in adult kidney transplant recipients between 1 January 2010 and 31 March 2020. Heart failure was ascertained using a combination of physician-reported diagnosis, echocardiographic criteria, radiological evidence of heart failure and elevation of NT-proBNP levels. Participants were followed up until 15 April 2021. Multivariable regression analysis was used to identify independent correlates of post-transplantation de novo CHF (odds ratio [OR] and 95% confidence interval [CI]) and examine de novo CHF as a predictor of death and graft loss after transplantation.
RESULTS
One hundred and four (8.9%) of 1172 transplant recipients had de novo CHF [mean age, 50 ± 13 years; 470 (40%) women]. The cumulative incidences of de novo CHF were 3.8% (95% CI: 2.9–5.1), 5.2% (95% CI: 4.1–6.7) and 7.1% (95% CI: 5.6–8.9) at 1, 3 and 5 years, respectively. Risk factors for de novo CHF included older recipient age (OR: 1.04; 95% CI: 1.02–1.06; P < 0.001), pre-transplantation diabetes mellitus (OR: 1.9; 95% CI: 1.1–3.2; P = 0.014), pre-transplantation vascular disease (OR: 2.2; 95% CI: 1.3–3.7; P = 0.003), pre-emptive kidney transplant (OR: 0.4; 95% CI: 0.2–0.9; P = 0.024) and the presence of a functional fistula at time of transplantation (OR: 2.3; 95% CI: 1.1–4.9; P = 0.025). In separate analyses, de novo CHF predicted death (OR: 3.3; 95% CI: 1.5–7; P = 0.002) and death-censored graft failure (OR: 5.1; 95% CI: 2.8–9.3; P < 0.001).
CONCLUSION
Congestive heart failure is a common complication after kidney transplantation associated with markedly increased risk for death and graft loss. Identification and optimization of pretransplantation risk factors for CHF and pre-emptive transplantation, suggests targets for improving outcomes.
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Affiliation(s)
- Peter Van Rhijn
- Queen Elizabeth University Hospital, Renal and Transplant Unit, Glasgow, UK
| | - Patrick Mark
- Queen Elizabeth University Hospital, Renal and Transplant Unit, Glasgow, UK
- University of Glasgow, Institute of Cardiovascular and medical sciences, Glasgow, UK
| | - Peter Thomson
- Queen Elizabeth University Hospital, Renal and Transplant Unit, Glasgow, UK
| | - Kenneth Mangion
- University of Glasgow, Institute of Cardiovascular and medical sciences, Glasgow, UK
| | - Sokratis Stoumpos
- Queen Elizabeth University Hospital, Renal and Transplant Unit, Glasgow, UK
- University of Glasgow, Institute of Cardiovascular and medical sciences, Glasgow, UK
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23
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Stevens K, Delles C, Mark P, Thomson P, Gill J, Gray S, Ho F, Rutherford E, Lees J. MO468: Moving More Associates With Reduced Risk of Cardiovascular Disease and Death Across All Stages of Chronic Kidney Disease: A UK Biobank Study. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac070.082] [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 AND AIMS
Physical activity (PA) is widely recommended for the prevention of chronic conditions including cardiovascular (CV) disease. In chronic kidney disease (CKD), it is unclear whether PA confers a similar benefit. We examined whether the duration and intensity of PA are associated with the risk of CV disease and mortality and whether the relationship differs in CKD.
METHOD
Participants were from UK Biobank: a prospective cohort study with over 500 000 participants. The estimated glomerular filtration rate was calculated using cystatin C (eGFRcys). CKD was defined according to the KDIGO guidelines and participants were categorized as no CKD (eGFRcys > 90mL/min/1.73m2), CKD G1-2 (eGFRcys 60–89mL/min/1.73m2) or CKD G3-5 (eGFRcys < 60mL/min/1.73m2). Exercise duration and intensity were self-reported using the international physical activity questionnaire (IPAQ) and participants were categorized into four groups: inactive (reference), low, moderate and vigorous PA, according to World Health Organisation (WHO) weekly PA recommendations. Cox proportional hazards models tested associations between PA category and a composite endpoint of CV disease (myocardial infarction or stroke) or all-cause mortality across CKD categories. Models were adjusted for other known risk factors for CV disease and death including age, smoking status, blood pressure, eGFRcys and albuminuria.
RESULTS
Of 502 460 participants in UK Biobank, 123 167 were excluded because of missing biochemistry or IPAQ data and a further 21 084 were excluded because of pre-existing CV disease: 358 209 participants were included in the analyses. Of these 182 457 (51.0%) were classed as no CKD, 162 621 (45.4%) as CKD G1-2 and 13 131 (3.7%) as CKD G3-5. A total of 48 369 (13.5%) of participants were classed as inactive and 211 591 (16.5%) as undertaking vigorous PA. In participants without CKD, any PA above inactivity was associated with a reduced risk of reaching the combined endpoint by approximately 20% (low: hazard ratio, HR 0.77, 95% confidence interval, CI 0.67–0.89; moderate: HR 0.80, 95%CI 0.70–0.91; vigorous: HR 0.81, 95%CI 0.73–0.90, P < 0.001). This relationship is maintained in CKD G1-2, but in CKD G3-5, moderate (HR 0.75, 95%CI 0.61–0.93) and vigorous (HR 0.77, CI 0.66–0.89, P < 0.001) activity are associated with reduced risk of the combined endpoint (Table 1). Interestingly across all categories of CKD, the majority of participants considered that they undertook more than the WHO minimum recommended PA per week.
CONCLUSION
Achieving the minimum weekly targets for PA set by WHO is associated with a significantly reduced risk of a combined endpoint of CV disease and death. This relationship is preserved in those with CKD G1-2, even when adjusted for other recognized risk factors. The benefit is seen in CKD G3-5 with increased intensity of PA, above the WHO minimum. PA data is self-reported which limits the accuracy and association does not prove causality. However, patients with CKD have a much higher risk of CVD and death and PA is a simple, low-cost intervention that warrants further study to improve CV morbidity and all-cause mortality amongst people with CKD.
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Affiliation(s)
| | | | | | | | - Jason Gill
- University of Glasgow, ICAMS, Glasgow, UK
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24
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Adeoye J, Sakeen Alkandari A, Tan JY, Wang W, Zhu WY, Thomson P, Zheng LW, Choi SW, Su YX. Performance of a simplified scoring system for risk stratification in oral cancer and oral potentially malignant disorders screening. J Oral Pathol Med 2022; 51:464-473. [PMID: 35312123 DOI: 10.1111/jop.13293] [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: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Impact and efficiency of oral cancer and oral potentially malignant disorders screening are most realized in "at-risk" individuals. However, tools that can provide essential knowledge on individuals' risks are not applied in risk-based screening. This study aims to optimize a simplified risk scoring system for risk stratification in organized oral cancer and oral potentially malignant disorders screening. METHODS Participants were invited to attend a community-based oral cancer and oral potentially malignant disorders screening program in Hong Kong. Visual oral examination was performed for all attendees and information on sociodemographic characteristics as well as habitual, lifestyle, familial, and comorbidity risk factors were obtained. Individuals' status of those found to have suspicious lesions following biopsy and histopathology were classified as positive/negative and this outcome was used in a multiple logistic regression analysis with variables collected during screening. Odds ratio weightings were then used to develop a simplified risk scoring system which was validated in an external cohort. RESULTS Of 979 participants, 4.5% had positive status following confirmatory diagnosis. A 12-variable simplified risk scoring system with weightings was generated with an AUC, sensitivity, and specificity of 0.82, 0.71, and 0.78 for delineating high-risk cases. Further optimization on the validation cohort of 491 participants yielded a sensitivity and specificity of 0.75 and 0.87 respectively. CONCLUSIONS The simplified risk scoring system was able to stratify oral cancer and oral potentially malignant disorders risk with satisfactory sensitivity and specificity and can be applied in risk-based disease screening.
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Affiliation(s)
- John Adeoye
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR, China
| | - Abdulrahman Sakeen Alkandari
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR, China
| | - Jia Yan Tan
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR, China
| | - Weilan Wang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR, China
| | - Wang-Yong Zhu
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR, China
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Li-Wu Zheng
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR, China
| | - Siu-Wai Choi
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR, China
| | - Yu-Xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR, China
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25
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Adeoye J, Akinshipo A, Thomson P, Su YX. Artificial intelligence-based prediction for cancer-related outcomes in Africa: Status and potential refinements. J Glob Health 2022; 12:03017. [PMID: 35493779 PMCID: PMC9022723 DOI: 10.7189/jogh.12.03017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- John Adeoye
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Oral Cancer Research Theme, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Abdulwarith Akinshipo
- Department of Oral and Maxillofacial Pathology and Biology, Faculty of Dentistry, University of Lagos, Lagos, Nigeria
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Yu-Xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Oral Cancer Research Theme, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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26
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Adeoye J, Chu CS, Choi SW, Thomson P. Oral Cancer Awareness and Individuals' Inclination to Its Screening and Risk Prediction in Hong Kong. J Cancer Educ 2022; 37:439-448. [PMID: 32705524 DOI: 10.1007/s13187-020-01834-x] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Assessing the baseline knowledge status and expectations of the target population of any health promotion and secondary prevention program is essential to the success of such intervention. To obtain this information about the Hong Kong population a priori to implementing these preventive strategies for oral cancer in addition to determining the willingness of potential screening participants to take risk-profiling assessments, a cross-sectional survey was conducted between November 2019 and March 2020. A total of 964 residents between the ages 18 and 86 years were invited to participate in this study across the three geographical areas in Hong Kong. Most participants self-reported being aware of oral cancer (86.3%), although the proportion of those with substantial knowledge on salient risk factors and early identifiable signs were very low (2.9%). Age and level of education were the only demographic characteristics associated with the knowledge status. The proportion of participants willing to attend community screening and partake in risk profiling assessment was high (83.9% and 80.9% respectively). Willingness to attend community screening was directly associated with respondents' self-reported oral cancer awareness status (OR: 1.9, 95% CI: 1.22-2.96). Also, we observed that those participants who were willing to attend screening are more inclined to take risk prediction assessments that those not willing to attend. These findings have showcased the need to intensify health promotion via personal skills development to encourage early disease presentation and will assist in the planning of these programs accordingly in the Hong Kong population.
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Affiliation(s)
- John Adeoye
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR, China.
| | - Chui Shan Chu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR, China
| | - Siu-Wai Choi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR, China
| | - Peter Thomson
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR, China
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27
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Gulati SK, Thomson P, Ha W, Lee W, Lee J, Choi J, Ko K, Park S, Cox G, Scott TW. Transfer rates of Docosahexaenoic (DHA) and Eicosapentaenoic (EPA) Acids Into Cow's Milk in Pasture Based and Feed‐Lot Management Systems. EUR J LIPID SCI TECH 2022. [DOI: 10.1002/ejlt.202100106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Suresh Kumar Gulati
- School of Veterinary Science Faculty of Science University of Sydney Sydney NSW 2006 Australia
- Naturale Ringarooma Tasmania Australia
| | - Peter Thomson
- School of Veterinary Science Institute of Agriculture University of Sydney Camden NSW 2570 Australia
| | | | - Won‐Jae Lee
- Department of Animal Bioscience (Institute of Agriculture and Life Science) Gyeongsang National University Jinju Korea
| | - Ji‐Hong Lee
- Department of Animal Bioscience (Institute of Agriculture and Life Science) Gyeongsang National University Jinju Korea
| | - Jae‐Heung Choi
- Busan Gyungnam Dairy Cooperative 362 Beon‐gil, 24, Uam‐ro Nam‐gu Busan Korea
| | - Ki‐Han Ko
- Busan Gyungnam Dairy Cooperative 362 Beon‐gil, 24, Uam‐ro Nam‐gu Busan Korea
| | - Sang‐Ik Park
- Busan Gyungnam Dairy Cooperative 362 Beon‐gil, 24, Uam‐ro Nam‐gu Busan Korea
| | - Geoff Cox
- Naturale Ringarooma Tasmania Australia
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28
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Bell S, Campbell J, Lambourg E, Watters C, O'Neil M, Almond A, Buck K, Carr E, Clark L, Cousland Z, Findlay M, Joss N, Metcalfe W, Petrie M, Spalding E, Traynor J, Sanu V, Thomson P, Methven S, Mark P. The Impact of Vaccination on Incidence and Outcomes of SARS-CoV-2 Infection in Patients with Kidney Failure in Scotland. J Am Soc Nephrol 2022; 33:677-686. [PMID: 35110363 PMCID: PMC8970454 DOI: 10.1681/asn.2022010046] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 12/15/2022] Open
Abstract
Background: Patients with kidney failure requiring kidney replacement therapy (KRT) are at high risk of complications and death following SARS-CoV-2 infection with variable antibody responses to vaccination reported. We investigated the effects of COVID-19 vaccination on incidence of infection, hospitalization and death of COVID-19 infection. Methods: Study design was an observational data linkage cohort study. Multiple healthcare datasets were linked to ascertain all SARS-CoV-2 testing, vaccination, hospitalization, and mortality data for all patients treated with KRT in Scotland, from the start of the pandemic over a period of 20 months. Descriptive statistics, survival analyses, and vaccine effectiveness were calculated. Results: As of 19th September 2021, 93% (n=5281) of the established KRT population in Scotland had received two doses of an approved SARS-CoV-2 vaccine. Over the study period, there were 814 cases of SARS-CoV-2 infection (15.1% of the KRT population). Vaccine effectiveness against infection and hospitalization was 33% (95% CI 0-52) and 38% (95% CI 0-57) respectively. 9.2% of fully vaccinated individuals died within 28 days of a SARS-CoV-2 positive PCR test (7% dialysis patients and 10% kidney transplant recipients). This compares to <0.1% of the vaccinated Scottish population being admitted to hospital or dying death due to COVID19 during that period. Conclusions: These data demonstrate a primary vaccine course of two doses has limited impact on COVID-19 infection and its complications in patients treated with KRT. Adjunctive strategies to reduce risk of both COVID-19 infection and its complications in this population are urgently required.
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Affiliation(s)
- Samira Bell
- S Bell, Division of Population Health and Genomics, University of Dundee School of Medicine, Dundee, United Kingdom of Great Britain and Northern Ireland
| | - Jacqueline Campbell
- J Campbell, The Scottish Renal Registry, Scottish Health Audits, Public Health Scotland Glasgow Office, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Emilie Lambourg
- E Lambourg, Division of Population Health and Genomics, University of Dundee School of Medicine, Dundee, United Kingdom of Great Britain and Northern Ireland
| | - Chrissie Watters
- C Watters, The Scottish Renal Registry, Scottish Health Audits, Public Health Scotland Glasgow Office, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Martin O'Neil
- M O'Neil, The Scottish Renal Registry, Scottish Health Audits, Public Health Scotland Glasgow Office, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Alison Almond
- A Almond, Renal Unit, Mountainhall Treatment Centre, Dumfries, United Kingdom of Great Britain and Northern Ireland
| | - Katharine Buck
- K Buck, Renal Unit, Victoria Hospital, Kirkcaldy, United Kingdom of Great Britain and Northern Ireland
| | - Edward Carr
- E Carr, Cell Biology of Infection Laboratory, The Francis Crick Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Laura Clark
- L Clark, Department of Renal Medicine, Aberdeen Royal Infirmary, Aberdeen, United Kingdom of Great Britain and Northern Ireland
| | - Zoe Cousland
- Z Cousland, Renal Unit, Monklands Hospital, Airdrie, United Kingdom of Great Britain and Northern Ireland
| | - Mark Findlay
- M Findlay, Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Nicola Joss
- N Joss, Renal Unit, Raigmore Hospital, Inverness, United Kingdom of Great Britain and Northern Ireland
| | - Wendy Metcalfe
- W Metcalfe, Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Michaela Petrie
- M Petrie, Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Elaine Spalding
- E Spalding, Renal Unit, University Hospital Crosshouse, Kilmarnock, United Kingdom of Great Britain and Northern Ireland
| | - Jamie Traynor
- J Traynor, Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Vinod Sanu
- V Sanu, Renal Unit, Ninewells Hospital and Medical School, Dundee, United Kingdom of Great Britain and Northern Ireland
| | - Peter Thomson
- P Thomson, Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Shona Methven
- S Methven, Department of Renal Medicine, Aberdeen Royal Infirmary, Aberdeen, United Kingdom of Great Britain and Northern Ireland
| | - Patrick Mark
- P Mark, Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital Campus, Glasgow, United Kingdom of Great Britain and Northern Ireland
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Adeoye J, Koohi-Moghadam M, Lo AWI, Tsang RKY, Chow VLY, Zheng LW, Choi SW, Thomson P, Su YX. Deep Learning Predicts the Malignant-Transformation-Free Survival of Oral Potentially Malignant Disorders. Cancers (Basel) 2021; 13:cancers13236054. [PMID: 34885164 PMCID: PMC8657223 DOI: 10.3390/cancers13236054] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/26/2021] [Accepted: 11/26/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Mouth cancer is the most common malignancy in the head-and-neck region. Usually, these tumors develop from white lesions in the mouth that appear long before cancer diagnosis. However, platforms that can estimate the time-factored risk of cancer occurring from these diseases and guide treatment and monitoring approaches are elusive. To this end, our study presents time-to-event models that are based on machine learning for prediction of the risk of malignancy from oral white lesions following pathological diagnosis as a function of time. These models displayed very satisfactory discrimination and calibration after multiple tests. To facilitate their preliminary use in clinical practice and further validation, we created a website supporting the use of these models to aid decision making. Abstract Machine-intelligence platforms for the prediction of the probability of malignant transformation of oral potentially malignant disorders are required as adjunctive decision-making platforms in contemporary clinical practice. This study utilized time-to-event learning models to predict malignant transformation in oral leukoplakia and oral lichenoid lesions. A total of 1098 patients with oral white lesions from two institutions were included in this study. In all, 26 features available from electronic health records were used to train four learning algorithms—Cox-Time, DeepHit, DeepSurv, random survival forest (RSF)—and one standard statistical method—Cox proportional hazards model. Discriminatory performance, calibration of survival estimates, and model stability were assessed using a concordance index (c-index), integrated Brier score (IBS), and standard deviation of the averaged c-index and IBS following training cross-validation. This study found that DeepSurv (c-index: 0.95, IBS: 0.04) and RSF (c-index: 0.91, IBS: 0.03) were the two outperforming models based on discrimination and calibration following internal validation. However, DeepSurv was more stable than RSF upon cross-validation. External validation confirmed the utility of DeepSurv for discrimination (c-index—0.82 vs. 0.73) and RSF for individual survival estimates (0.18 vs. 0.03). We deployed the DeepSurv model to encourage incipient application in clinical practice. Overall, time-to-event models are successful in predicting the malignant transformation of oral leukoplakia and oral lichenoid lesions.
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Affiliation(s)
- John Adeoye
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China; (J.A.); (L.-W.Z.); (S.-W.C.)
| | - Mohamad Koohi-Moghadam
- Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China;
| | | | - Raymond King-Yin Tsang
- Division of Otorhinolaryngology, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China;
| | - Velda Ling Yu Chow
- Division of Head and Neck Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China;
| | - Li-Wu Zheng
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China; (J.A.); (L.-W.Z.); (S.-W.C.)
| | - Siu-Wai Choi
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China; (J.A.); (L.-W.Z.); (S.-W.C.)
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Cairns, QLD 4870, Australia
- Correspondence: (P.T.); (Y.-X.S.)
| | - Yu-Xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China; (J.A.); (L.-W.Z.); (S.-W.C.)
- Correspondence: (P.T.); (Y.-X.S.)
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Adeoye J, Hui L, Koohi-Moghadam M, Tan JY, Choi SW, Thomson P. Comparison of time-to-event machine learning models in predicting oral cavity cancer prognosis. Int J Med Inform 2021; 157:104635. [PMID: 34800847 DOI: 10.1016/j.ijmedinf.2021.104635] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 03/29/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Applying machine learning to predicting oral cavity cancer prognosis is important in selecting candidates for aggressive treatment following diagnosis. However, models proposed so far have only considered cancer survival as discrete rather than dynamic outcomes. OBJECTIVES To compare the model performance of different machine learning-based algorithms that incorporate time-to-event data. These algorithms included DeepSurv, DeepHit, neural net-extended time-dependent cox model (Cox-Time), and random survival forest (RSF). MATERIALS AND METHODS Retrospective cohort of 313 oral cavity cancer patients were obtained from electronic health records. Models were trained on patient data following preprocessing. Predictors were based on demographic, clinicopathologic, and treatment information of the cases. Outcomes were the disease-specific and overall survival. Multivariable analyses were conducted to select significant prognostic features associated with tumor prognosis. Two models were generated per algorithm based on all-prognostic features and significant-prognostic features following statistical analysis. Concordance index (c-index) and integrated Brier scores were used as performance evaluators and model stability was assessed using intraclass correlation coefficients (ICC) calculated from these measures obtained from the cross-validation folds. RESULTS While all models were satisfactory, better discriminatory performance and calibration was observed for disease-specific than overall survival (mean c-index: 0.85 vs 0.74; mean integrated Brier score: 0.12 vs 0.17). DeepSurv performed best in terms of discrimination for both outcomes (c-indices: 0.76 -0.89) while RSF produced better calibrated survival estimates (integrated Brier score: 0.06 -0.09). Model stability of the algorithms varied with the outcomes as Cox-Time had the best intraclass correlation coefficient (mean ICC: 1.00) for disease-specific survival while DeepSurv was most stable for overall survival prediction (mean ICC: 0.99). CONCLUSIONS Machine learning algorithms based on time-to-event outcomes are successful in predicting oral cavity cancer prognosis with DeepSurv and RSF producing the best discriminative performance and calibration.
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Affiliation(s)
- John Adeoye
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China; Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
| | - Liuling Hui
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Mohamad Koohi-Moghadam
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Jia Yan Tan
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China; Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China; Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China; Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong, China; College of Medicine and Dentistry, James Cook University, Queensland, Australia.
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Islam MA, Lomax S, Doughty A, Islam MR, Jay O, Thomson P, Clark C. Automated Monitoring of Cattle Heat Stress and Its Mitigation. Front Anim Sci 2021. [DOI: 10.3389/fanim.2021.737213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Climate change related global warming is likely to continue, despite all mitigation measures taken by humans, due to the lag effect of long-term anthropogenic activities. Warming of the atmosphere can impact worldwide cattle production directly by compromising health, welfare and productivity, and indirectly by reducing the quality and quantity of animal feed. Under warm thermal conditions, cattle adjust their physiological and behavioural responses as an integral part of thermoregulation to maintain internal body temperature within a safe range. However, a greater intensity and duration of heat exposure can exceed thermoregulatory capacity leading to an increase in internal body temperature beyond the normal limit that ultimately evokes different animal responses to heat. In cattle, response to heat stress can be visually observed as elevated respiration rate or panting, but continuous visual monitoring is labour intensive, time consuming and subjective. Therefore, different weather-based indices have been developed such as the temperature humidity index (THI) and heat load index (HLI) which are commonly used weather-based indices for monitoring cattle heat stress at commercial level. However, the thermal comfort level of cattle based on weather-based indices has limited use at a microclimatic and individual animal level. Varying sensor-based approaches have shown promise to shift the focus of heat stress management to the individual level. Monitoring individual animal response and mitigation strategies for isolated heat-susceptible cattle could save on heat management costs whilst improving animal welfare and productivity. Here we review the technologies that enable automatic, continuous, and real-time cattle heat stress monitoring and mitigation under commercial conditions. Future platforms for autonomous monitoring and mitigation of heat stress in cattle are likely to be based on minimally-invasive smart technologies either singly, or in an integrated system, enabling real-time solutions to animal responses under various production systems and environmental conditions.
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Curtin J, Wong G, Wang W, Thomson P, Lam AK, Choi SW. A comparison of two methods for the detection of circulating tumour cells in patients with oral cavity cancer. J Oral Pathol Med 2021; 51:249-255. [PMID: 34586677 DOI: 10.1111/jop.13240] [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: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Circulating tumour cells (CTCs) detected in patient blood samples are relevant as diagnostic and prognostic markers offering insights into tumour behaviour and guiding treatment of cancer at an individualised level. The aim of this study was to ascertain the feasibility of detecting CTCs in oral squamous cell carcinoma (OSCC) using two different methods so as to determine the optimal method for the study of this cancer. METHODS Comparison of the numbers of CTCs, circulating tumour micro-emboli (CTMs) and circulating tumour endothelial cells (CTECs), was undertaken in forty clinical samples of oral squamous cell carcinoma (OSCC) determined by filtration (ISET® ) and in situ fluorescent immunostaining (i-FISH, Cytelligen® ) immunostaining and in situ hybridisation. RESULTS i-FISH detected CTCs in 80% of samples compared with 40% of samples analysed by microfiltration. i-FISH detected CTCs in a further 40% of samples in which microfiltration did not detect CTCs. No CTC clusters were detected by microfiltration while i-FISH detected CTM in 12.5% of samples. i-FISH analysis detected CTECs in 20/40 samples. CONCLUSION These results highlight significant differences in detection of CTCs, CTM and CTECs between i-FISH and microfiltration when applied to OSCC samples, suggesting that technologies capable of detecting circulating aneuploid cells more accurately detect CTCs. i-FISH also detected CTM and CTEC not detected using ISET® . With proven prognostic relevance in adenocarcinomas, accurate enumeration of CTCs, CTMs and CTECs may be a clinically useful tool in the management of OSCC and may aid in the reduction of false-negative diagnoses.
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Affiliation(s)
- Justin Curtin
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Gordon Wong
- Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Hong Kong
| | - Weilan Wang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Peter Thomson
- College of Medicine and Dentistry, James Cook University, Brisbane, QLD, Australia
| | - Alfred K Lam
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Siu-Wai Choi
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
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Ramamurthy P, Sharma D, Thomson P. Oral cancer awareness in patients attending university dental clinics: A scoping review of Australian studies. Aust Dent J 2021; 67:5-11. [PMID: 34555206 DOI: 10.1111/adj.12877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 01/22/2023]
Abstract
This scoping review was carried out to evaluate the important role Australian university-based dental teaching clinics and dental students might have in promoting oral cancer awareness in their patients. Four Online database (PubMed, OVID, Scopus and Emcare) were searched for studies that assessed oral cancer awareness amongst patients attending Australian university-associated (teaching) clinics. A total of five articles were retrieved for full-text analysis. All studies showed significant variation in patient awareness and understanding regarding the principal risk factors associated with oral cancer development. Smoking was predominantly identified as a significant risk factor, but alcohol consumption was less frequently recognized as relevant. Non-healing ulceration was most commonly identified as a symptom of concern, whilst red and/or white mucosal patches were infrequently recognized as potentially malignant conditions. Our review confirms that a significant lack of patient awareness regarding oral cancer risk and the signs /symptoms of early malignancy or potentially malignant disease exist in patients attending dental teaching clinics. Important opportunities exist to involve dental students proactively in raising oral cancer awareness, delivering smoking cessation interventions and safe alcohol consumption advice to their patients. Incorporation of established health educational models might deliver effective support for such student-delivered patient education.
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Affiliation(s)
- P Ramamurthy
- College of Medicine and Dentistry, James Cook University, Smithfield, Queensland, Australia
| | - D Sharma
- College of Medicine and Dentistry, James Cook University, Smithfield, Queensland, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, Queensland, Australia
| | - P Thomson
- College of Medicine and Dentistry, James Cook University, Smithfield, Queensland, Australia
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Adeoye J, Tan JY, Choi SW, Thomson P. Prediction models applying machine learning to oral cavity cancer outcomes: A systematic review. Int J Med Inform 2021; 154:104557. [PMID: 34455119 DOI: 10.1016/j.ijmedinf.2021.104557] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 04/25/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Machine learning platforms are now being introduced into modern oncological practice for classification and prediction of patient outcomes. To determine the current status of the application of these learning models as adjunctive decision-making tools in oral cavity cancer management, this systematic review aims to summarize the accuracy of machine-learning based models for disease outcomes. METHODS Electronic databases including PubMed, Scopus, EMBASE, Cochrane Library, LILACS, SciELO, PsychINFO, and Web of Science were searched up until December 21, 2020. Pertinent articles detailing the development and accuracy of machine learning prediction models for oral cavity cancer outcomes were selected in a two-stage process. Quality assessment was conducted using the Quality in Prognosis Studies (QUIPS) tool and results of base studies were qualitatively synthesized by all authors. Outcomes of interest were malignant transformation of precancer lesions, cervical lymph node metastasis, as well as treatment response, and prognosis of oral cavity cancer. RESULTS Twenty-seven articles out of 950 citations identified from electronic and manual searching were included in this study. Five studies had low bias concerns on the QUIPS tool. Prediction of malignant transformation, cervical lymph node metastasis, treatment response, and prognosis were reported in three, six, eight, and eleven articles respectively. Accuracy of these learning models on the internal or external validation sets ranged from 0.85 to 0.97 for malignant transformation prediction, 0.78-0.91 for cervical lymph node metastasis prediction, 0.64-1.00 for treatment response prediction, and 0.71-0.99 for prognosis prediction. In general, most trained algorithms predicting these outcomes performed better than alternate methods of prediction. We also found that models including molecular markers in training data had better accuracy estimates for malignant transformation, treatment response, and prognosis prediction. CONCLUSION Machine learning algorithms have a satisfactory to excellent accuracy for predicting three of four oral cavity cancer outcomes i.e., malignant transformation, nodal metastasis, and prognosis. However, considering the training approach of many available classifiers, these models may not be streamlined enough for clinical application currently.
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Affiliation(s)
- John Adeoye
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jia Yan Tan
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
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Sathasivam HP, Kist R, Sloan P, Thomson P, Nugent M, Alexander J, Haider S, Robinson M. Predicting the clinical outcome of oral potentially malignant disorders using transcriptomic-based molecular pathology. Br J Cancer 2021; 125:413-421. [PMID: 33972745 PMCID: PMC8329212 DOI: 10.1038/s41416-021-01411-z] [Citation(s) in RCA: 6] [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: 11/18/2020] [Revised: 04/06/2021] [Accepted: 04/16/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND This study was undertaken to develop and validate a gene expression signature that characterises oral potentially malignant disorders (OPMD) with a high risk of undergoing malignant transformation. METHODS Patients with oral epithelial dysplasia at one hospital were selected as the 'training set' (n = 56) whilst those at another hospital were selected for the 'test set' (n = 66). RNA was extracted from formalin-fixed paraffin-embedded (FFPE) diagnostic biopsies and analysed using the NanoString nCounter platform. A targeted panel of 42 genes selected on their association with oral carcinogenesis was used to develop a prognostic gene signature. Following data normalisation, uni- and multivariable analysis, as well as prognostic modelling, were employed to develop and validate the gene signature. RESULTS A prognostic classifier composed of 11 genes was developed using the training set. The multivariable prognostic model was used to predict patient risk scores in the test set. The prognostic gene signature was an independent predictor of malignant transformation when assessed in the test set, with the high-risk group showing worse prognosis [Hazard ratio = 12.65, p = 0.0003]. CONCLUSIONS This study demonstrates proof of principle that RNA extracted from FFPE diagnostic biopsies of OPMD, when analysed on the NanoString nCounter platform, can be used to generate a molecular classifier that stratifies the risk of malignant transformation with promising clinical utility.
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Affiliation(s)
- Hans Prakash Sathasivam
- grid.1006.70000 0001 0462 7212School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK ,Cancer Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Ralf Kist
- grid.1006.70000 0001 0462 7212School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK ,grid.1006.70000 0001 0462 7212Newcastle University Biosciences Institute, Newcastle University Centre for Cancer, Newcastle upon Tyne, UK
| | - Philip Sloan
- grid.1006.70000 0001 0462 7212School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK ,grid.420004.20000 0004 0444 2244Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Peter Thomson
- grid.194645.b0000000121742757Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Michael Nugent
- grid.416726.00000 0004 0399 9059Oral and Maxillofacial Surgery, Sunderland Royal Hospital, Sunderland, UK
| | - John Alexander
- grid.18886.3f0000 0001 1271 4623The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Syed Haider
- grid.18886.3f0000 0001 1271 4623The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Max Robinson
- grid.1006.70000 0001 0462 7212School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK ,grid.420004.20000 0004 0444 2244Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Conway DI, Hovanec J, Ahrens W, Ross A, Holcatova I, Lagiou P, Serraino D, Canova C, Richiardi L, Healy C, Kjaerheim K, Macfarlane GJ, Thomson P, Agudo A, Znaor A, Brennan P, Luce D, Menvielle G, Stucker I, Benhamou S, Ramroth H, Boffetta P, Vilensky M, Fernandez L, Curado MP, Menezes A, Daudt A, Koifman R, Wunsch-Filho V, Yuan-Chin AL, Hashibe M, Behrens T, McMahon AD. Occupational socioeconomic risk associations for head and neck cancer in Europe and South America: individual participant data analysis of pooled case-control studies within the INHANCE Consortium. J Epidemiol Community Health 2021; 75:779-787. [PMID: 33622804 PMCID: PMC8292575 DOI: 10.1136/jech-2020-214913] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/22/2020] [Accepted: 01/04/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The association between socioeconomic disadvantage (low education and/or income) and head and neck cancer is well established, with smoking and alcohol consumption explaining up to three-quarters of the risk. We aimed to investigate the nature of and explanations for head and neck cancer risk associated with occupational socioeconomic prestige (a perceptual measure of psychosocial status), occupational socioeconomic position and manual-work experience, and to assess the potential explanatory role of occupational exposures. METHODS Pooled analysis included 5818 patients with head and neck cancer (and 7326 control participants) from five studies in Europe and South America. Lifetime job histories were coded to: (1) occupational social prestige-Treiman's Standard International Occupational Prestige Scale (SIOPS); (2) occupational socioeconomic position-International Socio-Economic Index (ISEI); and (3) manual/non-manual jobs. RESULTS For the longest held job, adjusting for smoking, alcohol and nature of occupation, increased head and neck cancer risk estimates were observed for low SIOPS OR=1.88 (95% CI: 1.64 to 2.17), low ISEI OR=1.74 (95% CI: 1.51 to 1.99) and manual occupations OR=1.49 (95% CI: 1.35 to 1.64). Following mutual adjustment by socioeconomic exposures, risk associated with low SIOPS remained OR=1.59 (95% CI: 1.30 to 1.94). CONCLUSIONS These findings indicate that low occupational socioeconomic prestige, position and manual work are associated with head and neck cancer, and such risks are only partly explained by smoking, alcohol and occupational exposures. Perceptual occupational psychosocial status (SIOPS) appears to be the strongest socioeconomic factor, relative to socioeconomic position and manual/non-manual work.
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Affiliation(s)
- David I Conway
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Jan Hovanec
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Alastair Ross
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, Charles University First Faculty of Medicine, Praha, Czech Republic
| | - Pagona Lagiou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Diego Serraino
- Oncology Reference Center, Aviano, Friuli-Venezia Giulia, Italy
| | - Cristina Canova
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padova, Veneto, Italy
| | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, Torino, Piemonte, Italy
| | - Claire Healy
- School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | | | | | - Peter Thomson
- Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Hospitalet de Llobregat, Catalunya, Spain
| | - Ariana Znaor
- International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Danièle Luce
- University of Rennes 1-Health Sciences Campus Villejean, Rennes, Bretagne, France
- Institute for Research in Health, Environment and Work, National Institute of Health and Medical Research, Rennes, Bretagne, France
- School of Advanced Studies in Public Health, Rennes, Bretagne, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Isabelle Stucker
- Paris-Sud University, Saint-Aubin, Île-de-France, France
- Environmental Epidemiology of Cancer, Centre for Research in Epidemiology and Population Health, National Institute of Health and Medical Research, Villejuif, Île-de-France, France
| | | | - Heribert Ramroth
- Institute of Public Health, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Paolo Boffetta
- The Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Marta Vilensky
- Institute of Oncology Angel H Roffo, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Maria Paula Curado
- Epidemiology, AC Camargo Cancer Center International Research Center, Sao Paulo, Brazil
| | - Ana Menezes
- Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Alexander Daudt
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rosalina Koifman
- Fundacao Oswaldo Cruz, National School of Public Health, Rio de Janeiro, Brazil
| | | | - Amy Lee Yuan-Chin
- Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Alex D McMahon
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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Adeoye J, Tan JY, Ip CM, Choi SW, Thomson P. "Fact or fiction?": Oral cavity cancer in nonsmoking, nonalcohol drinking patients as a distinct entity-Scoping review. Head Neck 2021; 43:3662-3680. [PMID: 34313348 DOI: 10.1002/hed.26824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/11/2021] [Accepted: 07/19/2021] [Indexed: 12/20/2022] Open
Abstract
Oral cavity cancer is often described as a lifestyle-related malignancy due to its strong associations with habitual factors, including tobacco use, heavy alcohol consumption, and betel nut chewing. However, patients with no genetically predisposing conditions who do not indulge in these risk habits are still being encountered, albeit less commonly. The aim of this review is to summarize contemporaneous reports on these nonsmoking, nonalcohol drinking (NSND) patients. We performed database searching to identify relevant studies from January 1, 2000 to March 31, 2021. Twenty-six articles from 20 studies were included in this study. We found that these individuals were mostly females in their eighth decade with tumors involving the tongue and gingivobuccal mucosa. This review also observed that these patients were likely diagnosed with early stage tumors with overexpression of programmed death-ligand 1 (PD-L1) and increased intensity of tumor infiltrating lymphocytes. Treatment response and disease-specific prognosis were largely comparable between NSND and smoking/drinking patients.
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Affiliation(s)
- John Adeoye
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Jia Yan Tan
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Cheuk Man Ip
- Department of Anesthesia, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Thomson P, Núñez P, Quera R, Bay C. Gastrointestinal microbiome, what is behind faecal microbiota transplantation? New Microbes New Infect 2021; 42:100898. [PMID: 34168881 PMCID: PMC8207221 DOI: 10.1016/j.nmni.2021.100898] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/19/2022] Open
Abstract
The intestinal microbiota is made up of billions of microorganisms that coexist in an organised ecosystem, where strict and facultative anaerobic bacteria predominate. The alteration or imbalance of these microorganisms, known as dysbiosis, can be associated with both gastrointestinal and extraintestinal diseases. Based on a review of the literature, the intestinal microbiota is described in its state of health, the changes associated with some gastrointestinal diseases and the potential role that faecal microbiota transplantation has in the reestablishment of an altered ecosystem. Undoubtedly, the information revealed makes us reflect on the indication of faecal microbiota transplantation in various pathologies of intestinal origin. However, to ensure the efficacy and safety of this therapy, more studies are needed to obtain more evidence.
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Affiliation(s)
- P. Thomson
- Veterinarian School of Medicine, Faculty of Life Science, Andrés Bello University, Avenida República 440, Santiago, Chile
| | - P. Núñez
- Department of Gastroenterology, Hospital San Juan De Dios – University of Chile, Huérfanos 3255, Santiago, Chile
- Gastroenterology Department, Clínica Universidad de los Andes, Avda. Plaza 2501, Chile
| | - R. Quera
- Gastroenterology Department, Clínica Universidad de los Andes, Avda. Plaza 2501, Chile
| | - C. Bay
- Department of Pediatrics, Medicine School, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile
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Richarz S, Stevenson K, White B, Thomson P, Jackson A, Isaak A, Kingsmore D. Early-cannulation arteriovenous grafts are safe and effective in avoiding recurrent tunneled central catheter infection. Br J Surg 2021. [DOI: 10.1093/bjs/znab202.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objective
Tunneled central venous catheter infection (TCVCi) is a common complication that often necessitates removal of the TCVC and a further TCVC. Theoeretically, insertion of an early-cannualtion graft (ecAVG) early after TCVC infection is possible but not widely practiced with concerns over safety and infection in the ecAVG. With 8 years of ecAVG experience, the aim of this study was to compare the outcomes following TCVC infection, comparing replacement with TCVC (TCVCr) versus immediate ecAVG (ecAVGr).
Methods
Retrospective comparison of two cohorts, who underwent replacement of an infected TCVC either by an early cannulation graft (n = 18) or by a further central catheter (n = 39).
Data were abstracted from a prospectively completed electronic patient record and collected on patient demographics, TCVC insertion, duration and infection, including culture proven bacteriaemia and subsequent access interventions.
Results
18/299 patients identified from 2012-2020 had an ecAVG implanted as treatment for a TCVCi. In a one-year time-period (1/1/2015 -31/12/2015) out of 222 TCVC inserted, 39 were as a replacement following a TCVCi. No patient with an ecAVGr developed an immediate infection, nor complication from the procedure. The rate of subsequent vascular access infection was significantly more frequent for those with TCVCr than with an ecAVGr (0.6 vs. 0.1/patient/ 1000 HD days, p < 0.000). The number of further TCVC required was significantly higher in the TCVCr group (7.1 vs. 0.4/patient/ 1000 HD days, p = 0.000).
Conclusion
An ecAVG early following a TCVC infection is safe, reduces the incidence of subsequent infectious complications and reduces the number of TCVC required, with a better functional patency.
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Affiliation(s)
- S Richarz
- Department of Vascular Surgery, University Hospital Basel, Basel, Switzerland
- Department of Renal and Transplant Surgery, Queen Elizabeth University Hospital Glasgow, Glasgow, United Kingdom
| | - K Stevenson
- Department of Renal and Transplant Surgery, Queen Elizabeth University Hospital Glasgow, Glasgow, United Kingdom
| | - B White
- Department of Infectious Diseases and Microbiology, Queen Elizabeth University Hospital Glasgow, Glasgow, United Kingdom
| | - P Thomson
- Department of Nephrology, Queen Elizabeth University Hospital Glasgow, Glasgow, United Kingdom
| | - A Jackson
- Department of Renal and Transplant Surgery, Queen Elizabeth University Hospital Glasgow, Glasgow, United Kingdom
| | - A Isaak
- Department of Vascular Surgery, Cantonal Hospital Aarau, Aarau, Switzerland
| | - D Kingsmore
- Department of Vascular and Endovascular Surgery, Queen Elizabeth University Hospital Glasgow, Glasgow, United Kingdom
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Adeoye J, Hui L, Tan JY, Koohi-Moghadam M, Choi SW, Thomson P. Prognostic value of non-smoking, non-alcohol drinking status in oral cavity cancer. Clin Oral Investig 2021; 25:6909-6918. [PMID: 33991259 DOI: 10.1007/s00784-021-03981-x] [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: 03/19/2021] [Accepted: 05/10/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To compare the treatment response and prognosis of oral cavity cancer between non-smoking and non-alcohol-drinking (NSND) patients and smoking and alcohol-drinking (SD) patients. METHODS A total of 313 consecutively treated patients from 2000 to 2019 were included. Demographic, clinicopathologic, treatment, and prognosis information were obtained. Relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were compared between NSND and SD groups using Kaplan-Meier plots, log-rank test, and multivariate Cox regression analysis. RESULTS Sample prevalence of NSND patients was 54.6%. These patients were predominantly females in their eighth decade with lower prevalence of floor of the mouth cancers compared to SD patients (1.8% vs 14.8%). No difference in the RFS and DSS between both groups was found following multivariable analysis; however, NSND patients had better OS (HR (95% CI) - 0.47 (0.29-0.75); p = 0.002). Extracapsular extension was associated with significantly poorer OS, DSS, and RFS in this oral cavity cancer cohort. CONCLUSION Treatment response and disease-specific prognosis are comparable between NSND and SD patients with oral cavity cancer. However, NSND patients have better OS. CLINICAL RELEVANCE This study shows that oral cavity cancer in NSND is not less or more aggressive compared to SD patients. Although better survival is expected for NSND than SD patients, this is likely due to the reduced incidence of other chronic diseases in the NSND group.
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Affiliation(s)
- John Adeoye
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China. .,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.
| | - Liuling Hui
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Jia Yan Tan
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Mohamad Koohi-Moghadam
- Applied Oral Sciences and Community Dental Care, University of Hong Kong, Hong Kong SAR, China
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
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Wang W, Adeoye J, Thomson P, Choi SW. Multiple tumour recurrence in oral, head and neck cancer: Characterising the patient journey. J Oral Pathol Med 2021; 50:979-984. [PMID: 33811374 DOI: 10.1111/jop.13182] [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: 03/10/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) is the 15th most common cause of cancer-related mortality worldwide and approximately one oral cancer-related death occurs for every two new diagnoses. Death-due-to-disease is usually ascribed to inoperable primary tumours, treatment complications, second primary tumours arising due to field cancerization, or locoregional recurrence and distant metastases. METHODS A retrospective review of OSCC patients treated over a 19-year period, betweenOctober 1st , 2000 and October 1st , 2019. Patient demographic records were collected from consecutively treated adult patients with clinical subtypes corresponding to ICD-10 C00-C06, C09 and C10 were retrieved from the database. Patients who had suffered three or more recurrences after diagnosis of the primary tumour are defined as multiple-recurrent patients. RESULTS A total of 467 OSCC patients were treated during the study period. One hundred and fifty-five patients developed recurrent OSCC, amongst which 22 were designated as multiple cases. The time between initial OSCC diagnosis and first tumour recurrence varied from 3 to 276 months. Nine of the 22 multiple patients (41%) were diagnosed with buccal mucosal SCC as the primary tumour, which is significantly higher than the average prevalence (or 4.4, 95% CI (1.8, 10.8), p < 0.001) for buccal tumours within the cohort. All patients were treated initially by surgical tumour excision. There were no demonstrable differences in adjuvant chemo-radiotherapy regimes in any of the study groups. CONCLUSION Multiple OSCC development may occur either synchronously or metachronously during the course of oral cancer disease and poses an important management problem in contemporary oncology practice.
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Kingsmore D, Stevenson K, Jackson A, Richarz S, Isaak A, White B, Thomson P. Application and implications of a standardised reporting system for arteriovenous access graft infection. J Vasc Access 2021; 23:353-359. [PMID: 33567938 DOI: 10.1177/1129729820987382] [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] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The perception that arteriovenous graft infection (AVGi) is frequent and severe is not based on contemporary data from large units using modern AVG. Furthermore, older reports compounded misperceptions by using non-standardised reporting that prevents easy comparison against the alternative modalities. The aim of this article is to use a recently published reporting scheme to analyse the frequency, management and outcome of AVGi in a large series of sequential early-cannulation AVG with long-term follow-up. METHODS A single-center series analysis was performed of 277 early-cannulation AVG with minimum 1-year follow-up (total 120,082 days). Infections relating to the AVG were classified, root-cause analysed and the outcomes presented. RESULTS Sixteen percent of all AVG implanted (51 episodes) developed infection related to the AVG. Primary AVGi (related to the insertion procedure or within 28 days) occurred in 9 (3%); secondary AVGi (related to AVG in use) occurred 33 times (rate 0.27/1000 haemodialysis days), at a mean of 382 days, and tertiary AVGi (in AVG no longer in use) occurred nine times. Only 1/3 of all AVGi led to bacteraemia, and ½ did not lead to loss of functional access. SUMMARY AVG infection is not common, caused a systemic infection in only one-third, did not lead to metastatic infection, and importantly, was treatable without loss of access in one-half of all cases. Using an objective system that discriminates between aetiology and outcome allows a more complete objective understanding of relative infection risks and outcomes for AVG that can inform discussions with patients requiring vascular access for haemodialysis.
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Affiliation(s)
- David Kingsmore
- Department of Vascular Surgery, Queen Elizabeth University Hospital, Glasgow, UK.,Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Karen Stevenson
- Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Andrew Jackson
- Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Sabine Richarz
- Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK.,Department of Vascular Surgery, University Hospital Basel, Basel, Switzerland
| | - Andrej Isaak
- Renal and Transplant Surgery, Queen Elizabeth University Hospital, Glasgow, UK.,Department of Vascular Surgery, University Hospital Basel, Basel, Switzerland
| | - Beth White
- Department of Infectious Disease and Microbiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Peter Thomson
- Department of Nephrology, Queen Elizabeth University Hospital, Glasgow, UK
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Adeoye J, Thomson P. A call for an established oral cancer classification by etiology and revision of related terminology. Oral Dis 2021; 28:840-842. [PMID: 33512047 DOI: 10.1111/odi.13784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 01/24/2021] [Indexed: 12/28/2022]
Affiliation(s)
- John Adeoye
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
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Adeoye J, Alade AA, Zhu WY, Wang W, Choi SW, Thomson P. Efficacy of hypermethylated DNA biomarkers in saliva and oral swabs for oral cancer diagnosis: Systematic review and meta-analysis. Oral Dis 2021; 28:541-558. [PMID: 33423350 DOI: 10.1111/odi.13773] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/18/2020] [Accepted: 01/05/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES This study aims to determine the diagnostic test accuracy (DTA) of hypermethylated DNA biomarkers in saliva and oral swabs for oral squamous cell carcinoma (OSCC) detection from the prevalidation studies available. MATERIALS AND METHODS Electronic database searching of PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and LILACS was conducted to identify relevant articles that were published between January 1, 2000, and August 1, 2020. RESULTS Meta-analysis was conducted based on 11 of 20 studies selected for review. Included studies had high bias concerns on the QUADAS-2 study assessment tool. We found that salivary and oral swab hypermethylation markers had better specificity than sensitivity for oral cancer detection. Summary sensitivity and specificity (95% CI) of hypermethylation panels were 86.2% (60-96.2) and 90.6% (85.9-93.9) while for individual markers, summary sensitivity and specificity (95% CI) were 70% (56.9-80.5) and 91.9% (80.3-96.9), respectively. Respective positive and negative likelihood ratios for combined markers were 9.2 (5.89-14.36) and 0.15 (0.05-0.5), and 8.61 (3.39-21.87) and 0.33 (0.22-0.49) for single-application biomarkers. CONCLUSION DNA hypermethylation biomarkers especially in combination have acceptable DTA that warrants further optimization with rigorous biomarker evaluation methods for conclusive determination of their efficacy.
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Affiliation(s)
- John Adeoye
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Azeez Arisekola Alade
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Wang-Yong Zhu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Weilan Wang
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Siu-Wai Choi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Coulthard P, Thomson P, Dave M, Coulthard FP, Seoudi N, Hill M. The COVID-19 pandemic and dentistry: the clinical, legal and economic consequences - part 1: clinical. Br Dent J 2020; 229:743-747. [PMID: 33311687 PMCID: PMC7729702 DOI: 10.1038/s41415-020-2404-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/02/2020] [Indexed: 01/16/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus which causes COVID-19, is highly contagious. Dentistry is a high-risk profession for occupational virus transmission because of the close proximity of the operator to the patient during treatment and the procedural generation of aerosols.The impact on the provision of dental care has been profound, with routine care restricted or paused for a period around the world. There have been adverse consequences for dental education and clinical research. Emergency and urgent care provisions have generally proceeded. However, even when a patient's condition is deemed urgent, access to the appropriate care may not have been possible due to lack of the recommended personal protective equipment. The common dental diseases of caries and periodontitis usually present with signs and symptoms after some advancement, hence the recommended regular dental examination so that these may be diagnosed early by a professional with suitable lighting, instruments and radiography. Conditions such as oral cancer similarly present in their early stages without symptoms. Many countries introduced telephone and video consultations for patients with symptoms but much disease has gone undiagnosed and without management.It is difficult to ascertain the full effect of the disruption to dental services, education and research but it is likely to be substantial. The immediate future will focus on return to routine care provision with likely longer-term permanent changes.
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Affiliation(s)
- Paul Coulthard
- Professor of Oral and Maxillofacial Surgery, Dean and Director for Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Peter Thomson
- Clinical Professor in Oral & Maxillofacial Surgery, Associate Dean (Clinical Affairs), Director, Prince Philip Dental Hospital, Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - Manas Dave
- NIHR Academic Clinical Fellow in Oral and Maxillofacial Pathology, The University of Manchester, UK.
| | | | - Noha Seoudi
- Senior Clinical Lecturer in Oral Microbiology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Mike Hill
- Barrister, Parklane Plowden Chambers, UK
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46
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Adeoye J, Wan CCJ, Thomson P. An appraisal of pivotal evaluation designs in validating noninvasive biomarkers for head and neck cancer detection. Acta Oncol 2020; 59:1500-1502. [PMID: 32924723 DOI: 10.1080/0284186x.2020.1820077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- John Adeoye
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Oral Cancer Research Group, The University of Hong Kong, Hong Kong SAR, China
| | - Chi Ching Joan Wan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Oral Cancer Research Group, The University of Hong Kong, Hong Kong SAR, China
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47
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Adeoye J, Wan CCJ, Thomson P. Mock clinical testing in the validation of fluid-phase biomarkers for head and neck carcinoma diagnosis: Scoping review. Head Neck 2020; 43:691-704. [PMID: 33151603 DOI: 10.1002/hed.26526] [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: 08/25/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 12/24/2022] Open
Abstract
This review sought to determine the range and nature of prospective-sampling and blinding methods for validating nonviral biofluid markers diagnostic of head and neck carcinomas. Electronic database searching was conducted to identify studies published in English from January 1, 2009 to August 1, 2020. Sixteen studies from 17 articles published between 2011 and 2020 were included in this review. We found that about 3 out of 100 studies utilized at least one of the mock testing approaches for biomarker validation. Protein, mRNA, and metabolomic markers also represented the only groups whose validation has been attempted using these methods. Furthermore, studies that utilized both methods were found to have lower bias concerns on the quality assessment of diagnostic accuracy studies (QUADAS-2) tool. Overall, there is a need to include these protocols in research endeavours verifying diagnostic biomarkers for head and neck carcinomas following the preliminary establishment of their classification accuracy.
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Affiliation(s)
- John Adeoye
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Chi Ching Joan Wan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Di Credico G, Polesel J, Dal Maso L, Pauli F, Torelli N, Luce D, Radoï L, Matsuo K, Serraino D, Brennan P, Holcatova I, Ahrens W, Lagiou P, Canova C, Richiardi L, Healy CM, Kjaerheim K, Conway DI, Macfarlane GJ, Thomson P, Agudo A, Znaor A, Franceschi S, Herrero R, Toporcov TN, Moyses RA, Muscat J, Negri E, Vilensky M, Fernandez L, Curado MP, Menezes A, Daudt AW, Koifman R, Wunsch-Filho V, Olshan AF, Zevallos JP, Sturgis EM, Li G, Levi F, Zhang ZF, Morgenstern H, Smith E, Lazarus P, La Vecchia C, Garavello W, Chen C, Schwartz SM, Zheng T, Vaughan TL, Kelsey K, McClean M, Benhamou S, Hayes RB, Purdue MP, Gillison M, Schantz S, Yu GP, Chuang SC, Boffetta P, Hashibe M, Yuan-Chin AL, Edefonti V. Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration. Br J Cancer 2020; 123:1456-1463. [PMID: 32830199 PMCID: PMC7592048 DOI: 10.1038/s41416-020-01031-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Alcohol is a well-established risk factor for head and neck cancer (HNC). This study aims to explore the effect of alcohol intensity and duration, as joint continuous exposures, on HNC risk. METHODS Data from 26 case-control studies in the INHANCE Consortium were used, including never and current drinkers who drunk ≤10 drinks/day for ≤54 years (24234 controls, 4085 oral cavity, 3359 oropharyngeal, 983 hypopharyngeal and 3340 laryngeal cancers). The dose-response relationship between the risk and the joint exposure to drinking intensity and duration was investigated through bivariate regression spline models, adjusting for potential confounders, including tobacco smoking. RESULTS For all subsites, cancer risk steeply increased with increasing drinks/day, with no appreciable threshold effect at lower intensities. For each intensity level, the risk of oral cavity, hypopharyngeal and laryngeal cancers did not vary according to years of drinking, suggesting no effect of duration. For oropharyngeal cancer, the risk increased with durations up to 28 years, flattening thereafter. The risk peaked at the higher levels of intensity and duration for all subsites (odds ratio = 7.95 for oral cavity, 12.86 for oropharynx, 24.96 for hypopharynx and 6.60 for larynx). CONCLUSIONS Present results further encourage the reduction of alcohol intensity to mitigate HNC risk.
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Affiliation(s)
- Gioia Di Credico
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy
| | - Jerry Polesel
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
| | - Francesco Pauli
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy
| | - Nicola Torelli
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy
| | - Daniele Luce
- Université de Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Pointe-à-Pitre, France
| | - Loredana Radoï
- INSERM UMR 1018, Centre for Research in Epidemiology and Population Health (CESP), Cancer Epidemiology, Genes and Environment Team, Villejuif, France
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Ivana Holcatova
- Institute of Hygiene & Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
- University of Bremen, Faculty of Mathematics and Computer Science, Bremen, Germany
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Claire M Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | | | - David I Conway
- School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, UK
| | - Gary J Macfarlane
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | | | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
| | - Ariana Znaor
- International Agency for Research on Cancer, Lyon, France
| | - Silvia Franceschi
- Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - Tatiana N Toporcov
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Raquel A Moyses
- Head and Neck Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Marta Vilensky
- Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Ana Menezes
- Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Rosalina Koifman
- Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Victor Wunsch-Filho
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Jose P Zevallos
- Division of Head and Neck Surgical Oncology in the Department of Otolaryngology/Head and Neck Surgery at Washington University School of Medicine, St Louis, MO, USA
| | - Erich M Sturgis
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Guojun Li
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Fabio Levi
- Institut Universitaire de Médecine Sociale et Préventive (IUMSP), Unisanté, University of Lausanne, Lausanne, Switzerland
| | | | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Elaine Smith
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Carlo La Vecchia
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Chu Chen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Stephen M Schwartz
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tongzhang Zheng
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Thomas L Vaughan
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Karl Kelsey
- Brown University, Providence, Rhode Island, RI, USA
| | | | - Simone Benhamou
- National Institute of Health and Medical Research, INSERM U1018, Villejuif, France
| | - Richard B Hayes
- Division of Epidemiology, New York University School Of Medicine, New York, NY, USA
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Maura Gillison
- "Thoracic/Head and Neck Medical Oncology", The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Beijing, China
| | - Shu-Chun Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Amy Lee Yuan-Chin
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Valeria Edefonti
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
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Wang W, Adeoye J, Thomson P, Choi S. Statistical profiling of oral cancer and the prediction of outcome. J Oral Pathol Med 2020; 50:39-46. [DOI: 10.1111/jop.13110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Weilan Wang
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Pokfulam Hong Kong
| | - John Adeoye
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Pokfulam Hong Kong
| | - Peter Thomson
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Pokfulam Hong Kong
| | - Siu‐Wai Choi
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Pokfulam Hong Kong
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50
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Sathasivam HP, Casement J, Bates T, Sloan P, Thomson P, Robinson M, Kist R. Gene expression changes associated with malignant transformation of oral potentially malignant disorders. J Oral Pathol Med 2020; 50:60-67. [PMID: 32740996 DOI: 10.1111/jop.13090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/13/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND A large number of oral squamous cell carcinomas (OSCCs) are believed to be preceded by oral potentially malignant disorders (OPMD) that have an increased likelihood of malignant transformation compared to clinically normal mucosa. This study was performed to identify differentially expressed genes between OPMDs that underwent malignant transformation (MT) and those that did not, termed "non-transforming" (NT) cases. METHODS Total RNA was extracted from formalin-fixed paraffin-embedded tissue biopsies of 20 OPMD cases with known clinical outcomes (10 MT vs. 10 NT). Samples were assessed for quantity, quality and integrity of RNA prior to sequencing. Analysis for differential gene expression between MT and NT was performed using statistical packages in R. Genes were considered to be significantly differentially expressed if the False Discovery Rate corrected P-value was < 0.05. RESULTS RNA yield was variable but RNA purity was good (A260/A280 > 1.90). Analysis of RNA-Sequencing outputs revealed 41 genes (34 protein-coding; 7 non-coding) that were significantly differentially expressed between MT and NT cases. The log2 fold change for the statistically significant differentially expressed genes ranged from -2.63 to 2.48, with 23 protein-coding genes being downregulated and 11 protein-coding genes being upregulated in MT cases compared to NT cases. CONCLUSION Several candidate genes that may play a role in malignant transformation of OPMD have been identified. Experiments to validate these candidates are underway. It is anticipated that this work will contribute to better understanding of the etiopathogenesis of OPMD and development of novel biomarkers.
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Affiliation(s)
- Hans P Sathasivam
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cancer Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Malaysia
| | - John Casement
- Bioinformatics Support Unit, Newcastle University, Newcastle upon Tyne, UK
| | | | - Philip Sloan
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Max Robinson
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ralf Kist
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Biosciences Institute, Newcastle University Centre for Cancer, Newcastle upon Tyne, UK
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