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Alexander J, Schipper K, Nash S, Brough R, Kemp H, Iacovacci J, Isacke C, Natrajan R, Sawyer E, Lord CJ, Haider S. Pathway-based signatures predict patient outcome, chemotherapy benefit and synthetic lethal dependencies in invasive lobular breast cancer. Br J Cancer 2024:10.1038/s41416-024-02679-7. [PMID: 38600325 DOI: 10.1038/s41416-024-02679-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Invasive Lobular Carcinoma (ILC) is a morphologically distinct breast cancer subtype that represents up to 15% of all breast cancers. Compared to Invasive Breast Carcinoma of No Special Type (IBC-NST), ILCs exhibit poorer long-term outcome and a unique pattern of metastasis. Despite these differences, the systematic discovery of robust prognostic biomarkers and therapeutically actionable molecular pathways in ILC remains limited. METHODS Pathway-centric multivariable models using statistical machine learning were developed and tested in seven retrospective clinico-genomic cohorts (n = 996). Further external validation was performed using a new RNA-Seq clinical cohort of aggressive ILCs (n = 48). RESULTS AND CONCLUSIONS mRNA dysregulation scores of 25 pathways were strongly prognostic in ILC (FDR-adjusted P < 0.05). Of these, three pathways including Cell-cell communication, Innate immune system and Smooth muscle contraction were also independent predictors of chemotherapy response. To aggregate these findings, a multivariable machine learning predictor called PSILC was developed and successfully validated for predicting overall and metastasis-free survival in ILC. Integration of PSILC with CRISPR-Cas9 screening data from breast cancer cell lines revealed 16 candidate therapeutic targets that were synthetic lethal with high-risk ILCs. This study provides interpretable prognostic and predictive biomarkers of ILC which could serve as the starting points for targeted drug discovery for this disease.
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Affiliation(s)
- John Alexander
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Koen Schipper
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Sarah Nash
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
- Breast Cancer Genetics, King's College London, London, SE1 9RT, UK
| | - Rachel Brough
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Harriet Kemp
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Jacopo Iacovacci
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Clare Isacke
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Rachael Natrajan
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Elinor Sawyer
- Breast Cancer Genetics, King's College London, London, SE1 9RT, UK
| | - Christopher J Lord
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Syed Haider
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, SW3 6JB, UK.
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Lee SE, Amin N, Mannent LP, Bachert C, Gross G, Cho SH, Praestgaard A, Siddiqui S, Nash S, Kamat S, Khan AH, Jacob Nara JA. The relationship of sinus opacification, olfaction and dupilumab efficacy in patients with CRSwNP. Rhinology 2023; 61:531-540. [PMID: 37453138 DOI: 10.4193/rhin22.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Loss of sense of smell is one of the most burdensome symptoms of chronic rhinosinusitis with nasal polyps (CRSwNP) but its relationship to sinus disease on imaging is unclear. Dupilumab improves sense of smell and radiographic severity of sinus disease in patients with CRSwNP. We investigated the relationship of sinus opacification severity and loci to olfactory impairment and dupilumab efficacy in patients with CRSwNP from the SINUS-24/SINUS-52 (NCT02912468/NCT02898454) studies. METHODS Sinus opacification was evaluated using the Lund-Mackay computed tomography (LMK-CT) score and sense of smell using patient-reported loss of smell (LoS) score, University of Pennsylvania Smell Identification Test (UPSIT) score and the 22-item Sino-Nasal Outcome Test (SNOT-22) smell/taste item. RESULTS At baseline, 95% of patients (688/724) had impaired sense of smell and opacification was extensive across all sinuses. Greater olfactory impairment was associated with greater opacification, especially in the ethmoid, sphenoid and frontal sinuses. At Week 24, reductions in LMK-CT total score and ethmoid and sphenoid sinus scores with dupilumab were weakly correlated with improvements in sense of smell assessed by LoS, UPSIT and SNOT-22 smell/taste item. More dupilumab than placebo patients achieved clinically meaningful improvement in LMK-CT total score at Week 24 and Week 52. CONCLUSION Radiographic disease severity on imaging was associated with smell outcomes in this cohort. Opacification of the ethmoid, sphenoid and frontal sinuses was associated with severe smell loss. These data suggest that dupilumab effects on smell may be partly mediated through reduced sinus inflammation.
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Affiliation(s)
- S E Lee
- Division of Otolaryngology - Head and Neck Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - N Amin
- Clinical Sciences Global Development, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - L P Mannent
- Global Clinical Development, Sanofi, Chilly-Mazarin, France
| | - C Bachert
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Münster, Münster, Germany, and International Airway Research Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, and Upper Airways Research Laboratory and Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - G Gross
- Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
| | - S H Cho
- Division of Allergy-Immunology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - A Praestgaard
- Department of Biostatistics, Sanofi, Cambridge, MA, USA
| | - S Siddiqui
- Medical Affairs, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - S Nash
- Medical Affairs, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - S Kamat
- Medical Affairs, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - A H Khan
- Global Medical Affairs, Sanofi, Chilly-Mazarin, France
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Wahlen MM, Lizarraga IM, Kahl AR, Zahnd WE, Eberth JM, Overholser L, Askelson N, Hirschey R, Yeager K, Nash S, Engelbart JM, Charlton ME. Effect of rurality and travel distance on contralateral prophylactic mastectomy for unilateral breast cancer. Cancer Causes Control 2023; 34:171-186. [PMID: 37095280 PMCID: PMC10689552 DOI: 10.1007/s10552-023-01689-9] [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: 11/04/2022] [Accepted: 03/29/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE Despite lack of survival benefit, demand for contralateral prophylactic mastectomy (CPM) to treat unilateral breast cancer remains high. High uptake of CPM has been demonstrated in Midwestern rural women. Greater travel distance for surgical treatment is associated with CPM. Our objective was to examine the relationship between rurality and travel distance to surgery with CPM. METHODS Women diagnosed with stages I-III unilateral breast cancer between 2007 and 2017 were identified using the National Cancer Database. Logistic regression was used to model likelihood of CPM based on rurality, proximity to metropolitan centers, and travel distance. A multinomial logistic regression model compared factors associated with CPM with reconstruction versus other surgical options. RESULTS Both rurality (OR 1.10, 95% CI 1.06-1.15 for non-metro/rural vs. metro) and travel distance (OR 1.37, 95% CI 1.33-1.41 for those who traveled 50 + miles vs. < 30 miles) were independently associated with CPM. For women who traveled 30 + miles, odds of receiving CPM were highest for non-metro/rural women (OR 1.33 for 30-49 miles, OR 1.57 for 50 + miles; reference: metro women traveling < 30 miles). Non-metro/rural women who received reconstruction were more likely to undergo CPM regardless of travel distance (ORs 1.11-1.21). Both metro and metro-adjacent women who received reconstruction were more likely to undergo CPM only if they traveled 30 + miles (ORs 1.24-1.30). CONCLUSION The impact of travel distance on likelihood of CPM varies by patient rurality and receipt of reconstruction. Further research is needed to understand how patient residence, travel burden, and geographic access to comprehensive cancer care services, including reconstruction, influence patient decisions regarding surgery.
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Affiliation(s)
- Madison M Wahlen
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Ingrid M Lizarraga
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
| | | | - Whitney E Zahnd
- Department of Health Management and Policy, University of Iowa, Iowa City, IA, USA
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
- Department of Health Management and Policy, Drexel University, Philadelphia, PA, USA
| | - Linda Overholser
- Department of Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Natoshia Askelson
- Department of Community and Behavioral Health, University of Iowa, Iowa City, IA, USA
| | - Rachel Hirschey
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
| | - Katherine Yeager
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Sarah Nash
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
- Iowa Cancer Registry, Iowa City, IA, USA
| | - Jacklyn M Engelbart
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Mary E Charlton
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
- Iowa Cancer Registry, Iowa City, IA, USA
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Adsul P, Islam J, Chebli P, Kranick J, Nash S, Arem H, Wheeler S, Lopez-Pentecost M, Foster V, Sharma RK, Felder T, Risendal B, Chavarria EA, Kwon S, Hirschey R, Trinh-Shevrin C. Identifying research practices toward achieving health equity principles within the Cancer Prevention and Control Research Network. Cancer Causes Control 2023; 34:15-21. [PMID: 36826623 PMCID: PMC9950692 DOI: 10.1007/s10552-023-01674-2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Although there is national recognition for health equity-oriented research, there is limited guidance for researchers to engage partnerships that promote health equity in cancer research. The Cancer Prevention and Control Research Network's (CPCRN) Health Equity Work Group developed a toolkit to guide researchers in equitable collaborations. METHODS The CPCRN's Health Equity Work Group collectively outlined health and racial equity principles guiding research collaborations with partners that include communities, community-based organizations, implementing partners in the clinical setting including providers and health care organizations, and policy makers. Using a network-wide survey to crowdsource information around ongoing practices, we leveraged and integrated the network's experience and collaborations. RESULTS Data from the survey formed the preliminary basis for the toolkit, with a focus on sharing fiscal resources with partners, training and capacity building, collaborative decision-making, community-driven research agenda setting, and sustainability. The final toolkit provides reflection considerations for researchers and collated exemplary resources, supported by the contemporary research. CONCLUSIONS The toolkit provides a guide to researchers at all experience levels wanting to engage in equitable research collaborations. Future efforts are underway to evaluate whether and how researchers within and outside CPCRN are able to incorporate these principles in research collaborations.
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Affiliation(s)
- Prajakta Adsul
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
- Cancer Control and Populations Sciences Research Program, Cancer Research Facility (CRF), University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.
| | | | - Perla Chebli
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
| | - Julie Kranick
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
| | - Sarah Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Hannah Arem
- MedStar Health Research Institute, Washington, DC, USA
| | - Stephanie Wheeler
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Victoria Foster
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
| | - Rashmi K Sharma
- Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Betsy Risendal
- Colorado School of Public Health, University of Colorado Cancer Center, Aurora, CO, USA
| | - Enmanuel A Chavarria
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Rollins School of Public Health, Atlanta, GA, USA
| | - Simona Kwon
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
| | - Rachel Hirschey
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, NYU Grossman School of Medicine, Section for Health Equity, New York, NY, USA
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Henriques A, Nash S, Barofsky D, Bollen G, Lapierre A, Schwarz S, Sumithrarachchi C, Zhao Q, Villari ACC. Quantification and purification of isotopic contamination at the ReAccelerator of the Facility for Rare Isotope Beams. Rev Sci Instrum 2023; 94:103306. [PMID: 37815423 DOI: 10.1063/5.0165850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023]
Abstract
At the ReAccelerator within the Facility for Rare Isotope Beams, a combination of an interchangeable aluminum foil and a silicon detector was developed to quantify isobaric contamination in rare isotope beams. The device is simple to operate and is now used routinely. In this article, we describe the system and show an application of the device to determine the level of contamination of an Si-32 rare isotope beam by stable S-32. In addition, we describe how the new diagnostic device helped confirm an enhancement of the beam purity prior to beam delivery to experiments.
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Affiliation(s)
- A Henriques
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Nash
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Barofsky
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - G Bollen
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Lapierre
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Schwarz
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Sumithrarachchi
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - Q Zhao
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - A C C Villari
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
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6
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Nash S, Weeks K, Kahl AR, Del Vecchio NJ, Gao X, Guyton K, Charlton M. Diagnosing Provider, Referral Patterns, Facility Type, and Patient Satisfaction Among Iowa Rectal Cancer Patients. J Gastrointest Cancer 2023:10.1007/s12029-023-00963-y. [PMID: 37646879 DOI: 10.1007/s12029-023-00963-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Rectal cancer treatment at high-volume centers is associated with higher likelihood of guideline-concordant care and improved outcomes. Whether rectal cancer patients are referred for treatment at high-volume hospitals may depend on diagnosing provider specialty. We aimed to determine associations of diagnosing provider specialty with treating provider specialty and characteristics of the treating facility for rectal cancer patients in Iowa. METHODS Rectal cancer patients identified using the Iowa Cancer Registry completed a mailed survey on their treatment experience and decision-making process. Provider type was defined by provider specialty and whether the provider referred patients elsewhere for surgery. Multivariable-adjusted logistic regression models were used to examine predictors of being diagnosed by a general surgeon who also performed the subsequent surgery. RESULTS Of 417 patients contacted, 381 (76%) completed the survey; our final analytical sample size was 267. Half of respondents were diagnosed by a gastroenterologist who referred them elsewhere; 30% were diagnosed by a general surgeon who referred them elsewhere, and 20% were diagnosed by a general surgeon who performed the surgery. Respondents who were ≥ 65 years old, had less than a college education, and who made < $50,000 per year were more likely to be diagnosed by a general surgeon who performed surgery. In multivariable-adjusted models, respondents diagnosed and treated by the same general surgeon were more likely to have surgery at hospitals with low annual colorectal cancer surgery volume and less likely to be satisfied with their care. CONCLUSIONS Among rectal cancer patients in Iowa, respondents who were diagnosed and treated by the same provider were less likely to get treatment at a high-volume facility. This study informs the importance of provider referral in centralization of rectal cancer care.
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Affiliation(s)
- Sarah Nash
- Department of Epidemiology, College of Public Health, University of Iowa, 145 N Riverside Dr., IA, 52242, Iowa City, USA
- State Health Registry of Iowa, College of Public Health, University of Iowa, 145 N Riverside Dr., IA, 52242, Iowa City, USA
| | - Kristin Weeks
- Department of Internal Medicine, The Ohio State University Medical Center, 410 W Tenth Ave, Columbus, OH, 43210, USA
| | - Amanda R Kahl
- State Health Registry of Iowa, College of Public Health, University of Iowa, 145 N Riverside Dr., IA, 52242, Iowa City, USA
| | - Natalie J Del Vecchio
- Division of Public Health Science, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
| | - Xiang Gao
- Department of Surgery, University of Iowa Carver College of Medicine, 200 Hawkins Dr., IA, 52242, Iowa City, USA
| | - Kristina Guyton
- Department of Surgery, University of Iowa Carver College of Medicine, 200 Hawkins Dr., IA, 52242, Iowa City, USA
| | - Mary Charlton
- Department of Epidemiology, College of Public Health, University of Iowa, 145 N Riverside Dr., IA, 52242, Iowa City, USA.
- State Health Registry of Iowa, College of Public Health, University of Iowa, 145 N Riverside Dr., IA, 52242, Iowa City, USA.
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Bland P, Saville H, Wai PT, Curnow L, Muirhead G, Nieminuszczy J, Ravindran N, John MB, Hedayat S, Barker HE, Wright J, Yu L, Mavrommati I, Read A, Peck B, Allen M, Gazinska P, Pemberton HN, Gulati A, Nash S, Noor F, Guppy N, Roxanis I, Pratt G, Oldreive C, Stankovic T, Barlow S, Kalirai H, Coupland SE, Broderick R, Alsafadi S, Houy A, Stern MH, Pettit S, Choudhary JS, Haider S, Niedzwiedz W, Lord CJ, Natrajan R. SF3B1 hotspot mutations confer sensitivity to PARP inhibition by eliciting a defective replication stress response. Nat Genet 2023; 55:1311-1323. [PMID: 37524790 PMCID: PMC10412459 DOI: 10.1038/s41588-023-01460-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/26/2023] [Indexed: 08/02/2023]
Abstract
SF3B1 hotspot mutations are associated with a poor prognosis in several tumor types and lead to global disruption of canonical splicing. Through synthetic lethal drug screens, we identify that SF3B1 mutant (SF3B1MUT) cells are selectively sensitive to poly (ADP-ribose) polymerase inhibitors (PARPi), independent of hotspot mutation and tumor site. SF3B1MUT cells display a defective response to PARPi-induced replication stress that occurs via downregulation of the cyclin-dependent kinase 2 interacting protein (CINP), leading to increased replication fork origin firing and loss of phosphorylated CHK1 (pCHK1; S317) induction. This results in subsequent failure to resolve DNA replication intermediates and G2/M cell cycle arrest. These defects are rescued through CINP overexpression, or further targeted by a combination of ataxia-telangiectasia mutated and PARP inhibition. In vivo, PARPi produce profound antitumor effects in multiple SF3B1MUT cancer models and eliminate distant metastases. These data provide the rationale for testing the clinical efficacy of PARPi in a biomarker-driven, homologous recombination proficient, patient population.
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Affiliation(s)
- Philip Bland
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Harry Saville
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Patty T Wai
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Lucinda Curnow
- Division of Cancer Biology, The Institute of Cancer Research, London, UK
| | - Gareth Muirhead
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | | | - Nivedita Ravindran
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Marie Beatrix John
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Somaieh Hedayat
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Holly E Barker
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
- Stem Cells and Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - James Wright
- Division of Cancer Biology, The Institute of Cancer Research, London, UK
| | - Lu Yu
- Division of Cancer Biology, The Institute of Cancer Research, London, UK
| | - Ioanna Mavrommati
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Abigail Read
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Barrie Peck
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
- Translational Cancer Metabolism Team, Centre for Tumour Biology, Barts Cancer Institute, Cancer Research UK Centre of Excellence, Queen Mary University of London, Charterhouse Square, London, UK
| | - Mark Allen
- Biological Services Unit, The Institute of Cancer Research, London, UK
| | - Patrycja Gazinska
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Helen N Pemberton
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
- The Cancer Research UK Gene Function Laboratory, The Institute of Cancer Research, London, UK
| | - Aditi Gulati
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
- The Cancer Research UK Gene Function Laboratory, The Institute of Cancer Research, London, UK
| | - Sarah Nash
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Farzana Noor
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Naomi Guppy
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Ioannis Roxanis
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Guy Pratt
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ceri Oldreive
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Tatjana Stankovic
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Samantha Barlow
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Helen Kalirai
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Sarah E Coupland
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Ronan Broderick
- Division of Cancer Biology, The Institute of Cancer Research, London, UK
| | - Samar Alsafadi
- Inserm U830, PSL University, Institut Curie, Paris, France
| | - Alexandre Houy
- Inserm U830, PSL University, Institut Curie, Paris, France
| | | | - Stephen Pettit
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
- The Cancer Research UK Gene Function Laboratory, The Institute of Cancer Research, London, UK
| | - Jyoti S Choudhary
- Division of Cancer Biology, The Institute of Cancer Research, London, UK
| | - Syed Haider
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | | | - Christopher J Lord
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
- The Cancer Research UK Gene Function Laboratory, The Institute of Cancer Research, London, UK
| | - Rachael Natrajan
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK.
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Kung CP, Skiba MB, Crosby EJ, Gorzelitz J, Kennedy MA, Kerr BA, Li YR, Nash S, Potiaumpai M, Kleckner AS, James DL, Coleman MF, Fairman CM, Galván GC, Garcia DO, Gordon MJ, His M, Hornbuckle LM, Kim SY, Kim TH, Kumar A, Mahé M, McDonnell KK, Moore J, Oh S, Sun X, Irwin ML. Key takeaways for knowledge expansion of early-career scientists conducting Transdisciplinary Research in Energetics and Cancer (TREC): a report from the TREC Training Workshop 2022. J Natl Cancer Inst Monogr 2023; 2023:149-157. [PMID: 37139978 PMCID: PMC10157760 DOI: 10.1093/jncimonographs/lgad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 05/05/2023] Open
Abstract
The overall goal of the annual Transdisciplinary Research in Energetics and Cancer (TREC) Training Workshop is to provide transdisciplinary training for scientists in energetics and cancer and clinical care. The 2022 Workshop included 27 early-to-mid career investigators (trainees) pursuing diverse TREC research areas in basic, clinical, and population sciences. The 2022 trainees participated in a gallery walk, an interactive qualitative program evaluation method, to summarize key takeaways related to program objectives. Writing groups were formed and collaborated on this summary of the 5 key takeaways from the TREC Workshop. The 2022 TREC Workshop provided a targeted and unique networking opportunity that facilitated meaningful collaborative work addressing research and clinical needs in energetics and cancer. This report summarizes the 2022 TREC Workshop's key takeaways and future directions for innovative transdisciplinary energetics and cancer research.
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Affiliation(s)
- Che-Pei Kung
- Division of Molecular Oncology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Meghan B Skiba
- Division of Biobehavioral Health Science, College of Nursing, University of Arizona, Tucson, AZ, USA
| | | | - Jessica Gorzelitz
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Mary A Kennedy
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Bethany A Kerr
- Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, NC, USA
- Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, NC, USA
| | - Yun Rose Li
- Departments of Radiation Oncology and Cancer Genetics and Epigenetics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
- Division of Quantitative Medicine and Systems Biology, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Sarah Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Melanie Potiaumpai
- Milton S. Hershey College of Medicine, Public Health Sciences, Pennsylvania State University, Hershey, PA, USA
| | - Amber S Kleckner
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Dara L James
- Community Mental Health Nursing Department, College of Nursing, University of South Alabama, Mobile, AL, USA
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Michael F Coleman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ciaran M Fairman
- Exercise Science Department, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Gloria C Galván
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - David O Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Max J Gordon
- Department of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mathilde His
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, Lyon, France
| | - Lyndsey M Hornbuckle
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, USA
| | - So-Youn Kim
- Olson Center for Women’s Health, Department of Obstetrics and Gynecology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tae-Hyung Kim
- Department of Pathology, School of Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Amanika Kumar
- Department of Obstetrics and Gynecology and Oncology, Mayo Clinic, Rochester, MN, USA
| | - Mélanie Mahé
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Karen K McDonnell
- Cancer Survivorship Research Center, College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Jade Moore
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA, USA
| | - Sangphil Oh
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Xinghui Sun
- Department of Biochemistry, University of Nebraska—Lincoln, Lincoln, NE, USA
| | - Melinda L Irwin
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
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9
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Kratzer TB, Jemal A, Miller KD, Nash S, Wiggins C, Redwood D, Smith R, Siegel RL. Cancer statistics for American Indian and Alaska Native individuals, 2022: Including increasing disparities in early onset colorectal cancer. CA Cancer J Clin 2023; 73:120-146. [PMID: 36346402 DOI: 10.3322/caac.21757] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [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: 07/12/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022] Open
Abstract
American Indian and Alaska Native (AIAN) individuals are diverse culturally and geographically but share a high prevalence of chronic illness, largely because of obstacles to high-quality health care. The authors comprehensively examined cancer incidence and mortality among non-Hispanic AIAN individuals, compared with non-Hispanic White individuals for context, using population-based data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries. Overall cancer rates among AIAN individuals were 2% higher than among White individuals for incidence (2014 through 2018, confined to Purchased/Referred Care Delivery Area counties to reduce racial misclassification) but 18% higher for mortality (2015 through 2019). However, disparities varied widely by cancer type and geographic region. For example, breast and prostate cancer mortality rates are 8% and 31% higher, respectively, in AIAN individuals than in White individuals despite lower incidence and the availability of early detection tests for these cancers. The burden among AIAN individuals is highest for infection-related cancers (liver, stomach, and cervix), for kidney cancer, and for colorectal cancer among indigenous Alaskans (91.3 vs. 35.5 cases per 100,000 for White Alaskans), who have the highest rates in the world. Steep increases for early onset colorectal cancer, from 18.8 cases per 100,000 Native Alaskans aged 20-49 years during 1998 through 2002 to 34.8 cases per 100,000 during 2014 through 2018, exacerbated this disparity. Death rates for infection-related cancers (liver, stomach, and cervix), as well as kidney cancer, were approximately two-fold higher among AIAN individuals compared with White individuals. These findings highlight the need for more effective strategies to reduce the prevalence of chronic oncogenic infections and improve access to high-quality cancer screening and treatment for AIAN individuals. Mitigating the disparate burden will require expanded financial support of tribal health care as well as increased collaboration and engagement with this marginalized population.
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Affiliation(s)
- Tyler B Kratzer
- Surveillance and Health Services Research, American Cancer Society, Kennesaw, Georgia, USA
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Kennesaw, Georgia, USA
| | - Kimberly D Miller
- Surveillance and Health Services Research, American Cancer Society, Kennesaw, Georgia, USA
| | - Sarah Nash
- University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Charles Wiggins
- University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA
| | - Diana Redwood
- Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Robert Smith
- Early Cancer Detection Science, American Cancer Society, Kennesaw, Georgia, USA
| | - Rebecca L Siegel
- Surveillance and Health Services Research, American Cancer Society, Kennesaw, Georgia, USA
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10
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Bland P, Saville H, Read A, Wai P, Muirhead G, Curnow L, Nieminuszczy J, Ravindran N, John M, Hedayat S, Barker H, Wright J, Yu L, Mavrommati I, Peck B, Allen M, Gazinska P, Pemberton H, Gulati A, Nash S, Noor F, Guppy N, Roxanis I, Barlow S, Kalirai H, Coupland S, Broderick R, Alsafadi S, Houy A, Stern MH, Pettit S, Choudhary J, Haider S, Niedzwiedz W, Lord C, Natrajan R. Abstract P6-10-05: Mutations in the RNA Splicing Factor SF3B1 drive endocrine therapy resistance and confer a targetable replication stress response defect through PARP inhibition. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p6-10-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: Heterozygous hotspot mutations in the RNA splicing factor SF3B1, occur in 3% of unselected breast cancers and are associated with oestrogen receptor (ER+) breast cancer (BC) where they are enriched in metastatic disease and are associated with a poor clinical outcome. SF3B1 mutations drive distinct signatures of alternative splicing through cryptic 3’ splice site selection leading to global transcriptomic and proteomic changes. The functional consequences of the mis-splicing events and resultant genetic vulnerabilities are poorly understood and precision medicine approaches that exploit these characteristics are not clinically available (Table 1).
Methods: To understand the role of SF3B1 mutations in ER+ BC, we generated a series of SF3B1 mutant (SF3B1MUT) isogenic cell lines which were characterised using RNA-sequencing and high content mass-spectrometry proteomic profiling. SF3B1 interactome analysis was also performed using immunoprecipitation of SF3B1 followed by mass-spectrometry. The molecular consequences of aberrant splicing were investigated using a targeted screening approach of 280 genes predicted to be alternatively spliced in SF3B1MUT BC, while high-throughput drug screens were used to identify novel therapeutic options for patients with SF3B1MUT breast cancer using isogenic cells. Hits were validated in vitro and in vivo using cell line and patient derived xenografts.
Results: Transcriptomic and proteomic profiling of SF3B1MUT cells identified global alternative 3’ splice site selection and subsequent proteomic changes induced by the mutations. Investigation of the SF3B1K700E interactome identified an enrichment of SF3B1K700E binding with ER, aberrant splicing of ER target genes, global rewiring of ER chromatin binding and resistance to endocrine therapy. Silencing of the aberrantly spliced candidate genes PPIH, TRIM37, HIGD1A, BRD9, and PHKG2 significantly enhanced the growth of the SF3B1 mutant cells, suggestive of a dose dependent tumour suppressive effect.
Through synthetic-lethal drug screens we found that SF3B1MUT cells are selectively sensitive to PARP inhibitors. SF3B1MUT cells display a defective response to PARPi induced replication stress. Mechanistically, this occurs via defective ATR signalling in SF3B1MUT cells, which upon PARPi exposure leads to increased replication origin firing and loss of pChk1 (S317) induction. The resultant replication stress leads to failure to resolve DNA replication intermediates via the endonuclease MUS81 and cell cycle stalling at the G2/M checkpoint. These defects can be further targeted by ATM, CDK7 or FACT inhibition, when used in combination with PARPi treatment. This SF3B1MUT selective PARPi sensitivity is preserved across multiple cell lines and patient derived tumour models. In vivo, PARPi produce profound anti-tumour effects in multiple SF3B1MUT cancer models and eliminate distant metastases.
Conclusions: Our integrative analysis reveals mechanistic insight into the role of SF3B1 mutations in endocrine therapy response in ER+ breast cancers, where altered SF3B1 induces ER-transcriptional re-programming. We further identified a robust synthetic-lethal relationship of mutant SF3B1 with PARP inhibition that is caused by a defective response to PARPi induced replication stress. Furthermore, we identified several potential selective combination strategies together with PARPi that are selective for SF3B1MUT cells. Together, these data provide the pre-clinical and mechanistic rationale for assessing already-approved PARPi in a biomarker-defined subset of advanced ER+ BC.
Table 1. Identified potential therapies for SF3B1 mutant cancers from this study and the literature
Citation Format: Phil Bland, Harry Saville, Abigail Read, Patty Wai, Gareth Muirhead, Lucinda Curnow, Jadwiga Nieminuszczy, Nivedita Ravindran, Marie John, Somaieh Hedayat, Holly Barker, James Wright, Lu Yu, Ioanna Mavrommati, Barrie Peck, Mark Allen, Patrycja Gazinska, Helen Pemberton, Aditi Gulati, Sarah Nash, Farzana Noor, Naomi Guppy, Ioannis Roxanis, Samantha Barlow, Helen Kalirai, Sarah Coupland, Ronan Broderick, Samar Alsafadi, Alexandre Houy, Marc-Henri Stern, Stephen Pettit, Jyoti Choudhary, Syed Haider, Wojciech Niedzwiedz, Christopher Lord, Rachael Natrajan. Mutations in the RNA Splicing Factor SF3B1 drive endocrine therapy resistance and confer a targetable replication stress response defect through PARP inhibition. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-10-05.
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Affiliation(s)
- Phil Bland
- 1The Institute of Cancer Research, London, United Kingdom
| | - Harry Saville
- 2The Institute of Cancer Research, London,, United Kingdom
| | - Abigail Read
- 3The Institute of Cancer Research, London, United Kingdom
| | - Patty Wai
- 4The Institute of Cancer Research, London, United Kingdom
| | | | - Lucinda Curnow
- 6The Institute of Cancer Research, London, United Kingdom
| | | | | | - Marie John
- 9The Institute of Cancer Research, United Kingdom
| | | | - Holly Barker
- 11The Institute of Cancer Research, London, Australia
| | - James Wright
- 12The Institute of Cancer Research, London, United Kingdom
| | - Lu Yu
- 13The Institute of Cancer Research, London, United Kingdom
| | | | - Barrie Peck
- 15Barts Cancer Institute, Queen Mary University of London, United Kingdom
| | - Mark Allen
- 16The Institute of Cancer Research, London, United Kingdom
| | | | | | - Aditi Gulati
- 19The Institute of Cancer Research, London, United Kingdom
| | - Sarah Nash
- 20The Institute of Cancer Research, London, United Kingdom
| | - Farzana Noor
- 21The Institute of Cancer Research, London, United Kingdom
| | - Naomi Guppy
- 22The Institute of Cancer Research, London, United Kingdom
| | - Ioannis Roxanis
- 23Breast Cancer Now Toby Robinsons Research Centre, The Institute of Cancer Research, London
| | - Samantha Barlow
- 24Department of Molecular and Clinical Cancer Medicine, University of Liverpool, United Kingdom
| | - Helen Kalirai
- 25Department of Molecular and Clinical Cancer Medicine, United Kingdom
| | - Sarah Coupland
- 26Department of Molecular and Clinical Cancer Medicine, United Kingdom
| | | | | | - Alexandre Houy
- 29Inserm U830, PSL University, Institut Curie, United Kingdom
| | | | - Stephen Pettit
- 31The Institute of Cancer Research, London, United Kingdom
| | | | - Syed Haider
- 33Breast Cancer Now Toby Robinsons Research Centre, The Institute of Cancer Research, London
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Bachert C, Khan A, Lee S, Peters A, Nash S, Radwan A, Jacob-Nara J. DUPILUMAB IMPROVES CHRONIC RHINOSINUSITIS WITH NASAL POLYPS DISEASE OUTCOMES IRRESPECTIVE OF TYPE 2 SIGNATURE DEFINITION. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Soler Z, Lane A, Patel Z, Mattos J, Xia C, Khan A, Nash S. ASSOCIATION BETWEEN SMELL LOSS, DISEASE BURDEN, AND DUPILUMAB EFFICACY IN CHRONIC RHINOSINUSITIS WITH NASAL POLYPS. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ulmer KK, Greteman B, McDonald M, Gonzalez Bosquet J, Charlton ME, Nash S. Association of Distance to Gynecologic Oncologist and Survival in a Rural Midwestern State. Women's Health Reports 2022; 3:678-685. [PMID: 36147832 PMCID: PMC9436260 DOI: 10.1089/whr.2022.0016] [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] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Keely K. Ulmer
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Breanna Greteman
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Megan McDonald
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Jesus Gonzalez Bosquet
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Mary E. Charlton
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Sarah Nash
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
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Khalique S, Nash S, Natrajan R. Definitive study shows no association between ARID1A mutation status and clinical outcome in endometriosis related ovarian cancers. J Pathol 2022; 258:1-3. [PMID: 35647895 PMCID: PMC9540905 DOI: 10.1002/path.5973] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/23/2022]
Abstract
The ARID1A tumour suppressor protein is a component of the SWI/SNF chromatin remodelling complex, which is mutated in approximately 20% of all human cancers. ARID1A mutational status is considered to hold prognostic significance in a range of solid malignancies, yet in endometriosis‐related ovarian carcinomas there has been a lack of clarity of its prognostic role. Moreover, the relationship between ARID1A status and immune infiltrate is also poorly understood. In a recent issue of The Journal of Pathology, a large comprehensive study by Heinze, Nazeran et al addressed these areas by reviewing 1,623 endometriosis‐associated ovarian carcinomas and correlating ARID1A status using standardised immunohistochemistry to infer mutation status, with comprehensive clinicopathological features, mismatch repair status and CD8+ tumour infiltrating lymphocytes. The study definitively showed that ARID1A status does not provide any independent prognostic value in endometriosis‐associated ovarian carcinomas. ARID1A loss was, however, shown to be associated with mismatch repair deficiency and increased CD8+ tumour infiltrating lymphocytes in endometrioid ovarian carcinoma, which may be relevant for future studies. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Saira Khalique
- The Breast Cancer Now Toby Robins Research Centre, Division of Breast Cancer, The Institute of Cancer Research, London, UK
| | - Sarah Nash
- The Breast Cancer Now Toby Robins Research Centre, Division of Breast Cancer, The Institute of Cancer Research, London, UK
| | - Rachael Natrajan
- The Breast Cancer Now Toby Robins Research Centre, Division of Breast Cancer, The Institute of Cancer Research, London, UK
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15
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Phillips R, Jones B, Nash S. M379A Mutant Tyrosine Phenol-lyase from Citrobacter freundii Has Altered Conformational Dynamics. Chembiochem 2022; 23:e202200028. [PMID: 35577764 PMCID: PMC9262865 DOI: 10.1002/cbic.202200028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/12/2022] [Indexed: 12/03/2022]
Abstract
The M379A mutant of Citrobacter freundii tyrosine phenol‐lyase (TPL) has been prepared. M379A TPL is a robust catalyst to prepare a number of tyrosines substituted at the 3‐position with bulky groups that cannot be made with wild type TPL. The three dimensional structures of M379A TPL complexed with L‐methionine and 3‐bromo‐dl‐phenylalanine have been determined by X‐ray crystallography. Methionine is bound as a quinonoid complex in a closed active site in 3 of 4 chains of homotetrameric M379A TPL. M379A TPL reacts with l‐methionine about 8‐fold slower than wild type TPL. The temperature dependence shows that the slower reaction is due to less positive activation entropy. The structure of the M379A TPL complex of 3‐bromo‐DL‐phenylalanine has a quinonoid complex in two subunits, with an open active site conformation. The effects of the M379A mutation on TPL suggest that the mutant enzyme has altered the conformational dynamics of the active site.
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Affiliation(s)
- Robert Phillips
- University of Georgia Franklin College of Arts and Sciences, Chemistry, UNITED STATES
| | - Benjamin Jones
- University of Georgia, Biological Engineering, UNITED STATES
| | - Sarah Nash
- University of Georgia Franklin College of Arts and Sciences, Biology, UNITED STATES
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16
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Khalique S, Nash S, Mansfield D, Wampfler J, Attygale A, Vroobel K, Kemp H, Buus R, Cottom H, Roxanis I, Jones T, von Loga K, Begum D, Guppy N, Ramagiri P, Fenwick K, Matthews N, Hubank MJF, Lord CJ, Haider S, Melcher A, Banerjee S, Natrajan R. Quantitative Assessment and Prognostic Associations of the Immune Landscape in Ovarian Clear Cell Carcinoma. Cancers (Basel) 2021; 13:3854. [PMID: 34359755 PMCID: PMC8345766 DOI: 10.3390/cancers13153854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/22/2021] [Accepted: 07/27/2021] [Indexed: 12/13/2022] Open
Abstract
Ovarian clear cell carcinoma (OCCC) is a rare subtype of epithelial ovarian cancer characterised by a high frequency of loss-of-function ARID1A mutations and a poor response to chemotherapy. Despite their generally low mutational burden, an intratumoural T cell response has been reported in a subset of OCCC, with ARID1A purported to be a biomarker for the response to the immune checkpoint blockade independent of micro-satellite instability (MSI). However, assessment of the different immune cell types and spatial distribution specifically within OCCC patients has not been described to date. Here, we characterised the immune landscape of OCCC by profiling a cohort of 33 microsatellite stable OCCCs at the genomic, gene expression and histological level using targeted sequencing, gene expression profiling using the NanoString targeted immune panel, and multiplex immunofluorescence to assess the spatial distribution and abundance of immune cell populations at the protein level. Analysis of these tumours and subsequent independent validation identified an immune-related gene expression signature associated with risk of recurrence of OCCC. Whilst histological quantification of tumour-infiltrating lymphocytes (TIL, Salgado scoring) showed no association with the risk of recurrence or ARID1A mutational status, the characterisation of TILs via multiplexed immunofluorescence identified spatial differences in immunosuppressive cell populations in OCCC. Tumour-associated macrophages (TAM) and regulatory T cells were excluded from the vicinity of tumour cells in low-risk patients, suggesting that high-risk patients have a more immunosuppressive microenvironment. We also found that TAMs and cytotoxic T cells were also excluded from the vicinity of tumour cells in ARID1A-mutated OCCCs compared to ARID1A wild-type tumours, suggesting that the exclusion of these immune effectors could determine the host response of ARID1A-mutant OCCCs to therapy. Overall, our study has provided new insights into the immune landscape and prognostic associations in OCCC and suggest that tailored immunotherapeutic approaches may be warranted for different subgroups of OCCC patients.
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Affiliation(s)
- Saira Khalique
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
| | - Sarah Nash
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
| | - David Mansfield
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SW3 6JB, UK; (D.M.); (A.M.)
| | - Julian Wampfler
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (J.W.); (A.A.); (K.V.)
| | - Ayoma Attygale
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (J.W.); (A.A.); (K.V.)
- Department of Histopathology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Katherine Vroobel
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (J.W.); (A.A.); (K.V.)
- Department of Histopathology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Harriet Kemp
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
| | - Richard Buus
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
| | - Hannah Cottom
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
| | - Ioannis Roxanis
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
| | - Thomas Jones
- Division of Molecular Pathology, The Institute of Cancer Research, London SM2 5NG, UK; (T.J.); (M.J.F.H.)
| | - Katharina von Loga
- Biomedical Research Centre, The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK; (K.v.L.); (D.B.)
| | - Dipa Begum
- Biomedical Research Centre, The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK; (K.v.L.); (D.B.)
| | - Naomi Guppy
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
| | - Pradeep Ramagiri
- Tumour Profiling Unit, The Institute of Cancer Research, London SW3 6JB, UK; (P.R.); (K.F.); (N.M.)
| | - Kerry Fenwick
- Tumour Profiling Unit, The Institute of Cancer Research, London SW3 6JB, UK; (P.R.); (K.F.); (N.M.)
| | - Nik Matthews
- Tumour Profiling Unit, The Institute of Cancer Research, London SW3 6JB, UK; (P.R.); (K.F.); (N.M.)
| | - Michael J. F. Hubank
- Division of Molecular Pathology, The Institute of Cancer Research, London SM2 5NG, UK; (T.J.); (M.J.F.H.)
| | - Christopher J. Lord
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
- The CRUK Gene Function Laboratory, The Institute of Cancer Research, London SW3 6JB, UK
| | - Syed Haider
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
| | - Alan Melcher
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SW3 6JB, UK; (D.M.); (A.M.)
| | - Susana Banerjee
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (J.W.); (A.A.); (K.V.)
- Division of Clinical Studies, The Institute of Cancer Research, London SM2 5NG, UK
| | - Rachael Natrajan
- Division of Brest Cancer, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK; (S.K.); (S.N.); (H.K.); (R.B.); (H.C.); (I.R.); (N.G.); (C.J.L.); (S.H.)
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Nolen LD, Bressler S, Vindigni SM, Miller K, Nash S. Gastric Cancer in Alaska Native and American Indian People Living in Alaska, 1990-2017. Clin Transl Gastroenterol 2021; 12:e00374. [PMID: 34158461 PMCID: PMC8221803 DOI: 10.14309/ctg.0000000000000374] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/20/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Alaska Native (AN) people experience a high burden of gastric cancer compared with other US Native and non-Native populations. Previous reports have suggested that gastric cancer in AN people occurs at a younger age and is a more aggressive pathologic type. We evaluated all cases of gastric cancer in AN people from 1990 to 2017 and compared the epidemiologic and pathologic characteristics with the gastric cancers that occurred in the same time in the US white (USW) population. METHODS Cancer data were collected by the Alaska Native Tumor Registry and National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Comparisons were performed looking at the age and sex distribution of the affected AN and USW people, as well as the cancer characteristics, including the location, stage, and pathology. RESULTS The age distribution was significantly different between AN and USW patients (P < 0.001), with a greater proportion of AN people diagnosed younger than 40 years (11% vs 3%, P < 0.0001) and 40-59 years (37% vs 20%, P < 0.0001). In addition, a greater proportion of AN people were diagnosed with distant stage cancer (AN: 48% and USW: 35%, P < 0.0001). The age-adjusted rate of gastric cancer in the AN population was significantly higher than the USW population (20.8 vs 6.7 per 100,000 persons, P < 0.0001). Although there has been a significant decrease in the gastric cancer incidence rate in the USW population, no significant change in incidence was seen in the AN population. DISCUSSION This study highlights the disproportionate burden of gastric cancer in the AN population. Further work is needed to address and understand this disparity.
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Affiliation(s)
- Leisha D. Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Sara Bressler
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Stephen M. Vindigni
- Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
- University of Washington, Seattle, Washington, USA
| | - Keri Miller
- Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Sarah Nash
- Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
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Singh U, Castle J, Greenhalgh S, Hussain U, Descamps T, Nash S, Wilson M, Hunt R, Kirwan CC. O44: WOUND HEALING INFLAMMATORY MARKERS PREDICT PROGNOSIS AND SURVIVAL IN EARLY BREAST CANCER. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.044] [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]
Abstract
Abstract
Introduction
Cancer is likened to a non-healing wound. There is limited evidence on the expression of wound healing tissue inflammatory markers, CD68(pan-macrophage marker), HO-1(tumour cell marker) and FAP(cancer-associated fibroblast marker) in human breast cancer.
Method
In 201 invasive breast cancer and 58 DCIS patients, CD68+TAM expression, tumour HO-1 and fibroblast FAP expression, quantified by immunohistochemistry(dichotomised: high/present vs low/absent), was correlated with tumour factors (grade, proliferation(Ki67), ER, HER2); demographic factors, behavioural factors (smoking, alcohol) and survival status(DFS, OS)
Result
High CD68+macrophage expression was increased in invasive breast cancer, compared to DCIS, and normal tissue distant from the tumour(59%,41%and 6% respectively; p<0.001).In invasive cancer,CD68+TAM expression increased with increasing tumour grade(Grade 1:42%, Grade 2:58%, Grade 3:72%; p=0.006), high Ki67(71%vs.47%; p=0.004), ER negativity(79.4%vs.55.4%; p=0.01) and HER2(HER2 positive 81.8% vs. HER2 negative 56.3%; p=0.03). CD68+TAM expression was higher in high compared to low/intermediate grade DCIS(44% % vs. 31% p=0.52). CD68+TAM expression was increased in patients who self-reported alcohol intake(non-drinker 43% vs. drinker 62%; p=0.01). HO-1 was associated with shorter DFS(HR:3.22,p=0.027) and OS(HR:2.86,p=0.029).FAP fibroblast expression correlated with longer DFS (HR:0.296,p=0.029) and OS (HR:0.271,p=0.008).
Conclusion
Tumour inflammation as assessed by CD68+TAM expression shows utility in identifying aggressive breast cancer sub-types. The association reported between CD68+TAM density and alcohol intake suggests a possible mechanism for alcohol as a risk factor for breast cancer. The prognostic value of HO-1 and FAP expression demonstrated here suggests a functional role of these wound healing markers in breast cancer. HO-1:Heme-oxygenase-1; FAP:Fibroblast activation protein; TAM:Tumour associated macrophage; DCIS: Ductal carcinoma in situ
Take-home message
Wound healing pathways of inflammation may be implicated in early breast cancer development
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Affiliation(s)
- U Singh
- Division of Cancer Sciences, The University of Manchester
| | - J Castle
- Division of Cancer Sciences, The University of Manchester
| | | | - U Hussain
- Manchester University NHS Foundation Trust
| | | | - S Nash
- Manchester University NHS Foundation Trust
| | - M Wilson
- Manchester University NHS Foundation Trust
| | - R Hunt
- Manchester University NHS Foundation Trust
| | - CC Kirwan
- Division of Cancer Sciences, The University of Manchester
- Manchester University NHS Foundation Trust
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Singh U, Castle J, Shaker H, Greenhalgh S, Hussain U, Descamps T, Nash S, Wilson M, Hunt R, Kirwan C. PO-75 The relationship between the coagulation and inflammatory phases of wound healing in early breast cancer. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00248-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nash S, Dietrich J, Ssemata AS, Herrera C, O'Hagan K, Else L, Chiodi F, Kelly C, Shattock R, Chirenje M, Lebina L, Khoo S, Bekker LG, Weiss HA, Gray C, Stranix-Chibanda L, Kaleebu P, Seeley J, Martinson N, Fox J. Combined HIV Adolescent Prevention Study (CHAPS): comparison of HIV pre-exposure prophylaxis regimens for adolescents in sub-Saharan Africa-study protocol for a mixed-methods study including a randomised controlled trial. Trials 2020; 21:900. [PMID: 33121503 PMCID: PMC7596950 DOI: 10.1186/s13063-020-04760-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 05/20/2020] [Accepted: 09/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV remains a major public health issue, especially in Eastern and Southern Africa. Pre-exposure prophylaxis is highly effective when adhered to, but its effectiveness is limited by cost, user acceptability and uptake. The cost of a non-inferiority phase III trial is likely to be prohibitive, and thus, it is essential to select the best possible drug, dose and schedule in advance. The aim of this study, the Combined HIV Adolescent PrEP and Prevention Study (CHAPS), is to investigate the drug, dose and schedule of pre-exposure prophylaxis (PrEP) required for the protection against HIV and the acceptability of PrEP amongst young people in sub-Saharan Africa, and hence to inform the choice of intervention for future phase III PrEP studies and to improve strategies for PrEP implementation. METHODS We propose a mixed-methods study amongst young people aged 13-24 years. The first component consists of qualitative research to identify the barriers and motivators towards the uptake of PrEP amongst young people in South Africa, Uganda and Zimbabwe. The second component is a randomised clinical trial (ClinicalTrials.gov NCT03986970, June 2019) using a novel ex vivo HIV challenge method to investigate the optimal PrEP treatment (FTC-TDF vs FTC-TAF), dose and schedule. We will recruit 144 amongst HIV-negative uncircumcised men aged 13-24 years from voluntary male medical circumcision clinics in two sites (South Africa and Uganda) and randomise them into one of nine arms. One group will receive no PrEP prior to surgery; the other arms will receive either FTC-TDF or FTC-TAF, over 1 or 2 days, and with the final dose given either 6 or 20 h prior to surgery. We will conduct an ex vivo HIV challenge on their resected foreskin tissue. DISCUSSION This study will provide both qualitative and quantitative results to help decide the optimum drug, dose and schedule for a future phase III trial of PrEP. The study will also provide crucial information on successful strategies for providing PrEP to young people in sub-Saharan Africa. TRIAL REGISTRATION ClinicalTrials.gov NCT03986970 . Registered on 14 June 2019.
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Affiliation(s)
- S Nash
- London School of Hygiene and Tropical Medicine, London, UK
| | - J Dietrich
- University of the Witwatersrand Perinatal HIV Research Unit, Johannesburg, South Africa
| | - A S Ssemata
- MRC/UVRI Uganda Research Unit On Aids, Entebbe, Uganda
| | | | - K O'Hagan
- University of Cape Town, Cape Town, South Africa
| | - L Else
- University of Liverpool, Liverpool, UK
| | - F Chiodi
- Karolinska Institutet, Solna, Sweden
| | - C Kelly
- King's College London, London, UK
| | | | - M Chirenje
- University of Zimbabwe, Harare, Zimbabwe
| | - L Lebina
- University of the Witwatersrand Perinatal HIV Research Unit, Johannesburg, South Africa
| | - S Khoo
- University of Liverpool, Liverpool, UK
| | - L-G Bekker
- Desmond Tutu HIV Foundation, Cape Town, South Africa
| | - H A Weiss
- London School of Hygiene and Tropical Medicine, London, UK
| | - C Gray
- University of Cape Town, Cape Town, South Africa
| | | | - P Kaleebu
- MRC/UVRI Uganda Research Unit On Aids, Entebbe, Uganda
| | - J Seeley
- London School of Hygiene, London, UK
| | - N Martinson
- University of the Witwatersrand Perinatal HIV Research Unit, Johannesburg, South Africa
| | - J Fox
- King's College London, London, UK.
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Kirwan PD, Hibbert M, Kall M, Nambiar K, Ross M, Croxford S, Nash S, Webb L, Wolton A, Delpech VC. HIV prevalence and HIV clinical outcomes of transgender and gender-diverse people in England. HIV Med 2020; 22:131-139. [PMID: 33103840 DOI: 10.1111/hiv.12987] [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: 03/03/2020] [Revised: 08/07/2020] [Accepted: 09/23/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We provide the first estimate of HIV prevalence among trans and gender-diverse people living in England and compare outcomes of people living with HIV according to gender identity. METHODS We analysed a comprehensive national HIV cohort and a nationally representative self-reported survey of people accessing HIV care in England (Positive Voices). Gender identity was recorded using a two-step question co-designed with community members and civil society. Responses were validated by clinic follow-up and/or self-report. Population estimates were obtained from national government offices. RESULTS In 2017, HIV prevalence among trans and gender-diverse people was estimated at 0.46-4.78 per 1000, compared with 1.7 (95% credible interval: 1.6-1.7) in the general population. Of 94 885 people living with diagnosed HIV in England, 178 (0.19%) identified as trans or gender-diverse. Compared with cisgender people, trans and gender-diverse people were more likely to be London residents (57% vs. 43%), younger (median age 42 vs. 46 years), of white ethnicity (61% vs. 52%), under psychiatric care (11% vs. 4%), to report problems with self-care (37% vs. 13%), and to have been refused or delayed healthcare (23% vs. 11%). Antiretroviral uptake and viral suppression were high in both groups. CONCLUSIONS HIV prevalence among trans and gender-diverse people living in England is relatively low compared with international estimates. Furthermore, no inequalities were observed with regard to HIV care. Nevertheless, trans and gender-diverse people with HIV report poorer mental health and higher levels of discrimination compared with cisgender people.
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Affiliation(s)
- P D Kirwan
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK.,Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - M Hibbert
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
| | - M Kall
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
| | - K Nambiar
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | | | - S Croxford
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
| | - S Nash
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
| | - L Webb
- LGBT Foundation, Manchester, UK
| | - A Wolton
- Chelsea and Westminster Hospital NHS Trust, London, UK
| | - V C Delpech
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, Public Health England, London, UK
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Singh U, Castle J, Greenhalgh S, Hussain U, Descamps T, Nash S, Wilson M, Hunt R, Kirwan CC. Abstract P5-04-27: The relationship between tumour associated macrophage markers and tumour, demographic & behavioural factors in breast cancer. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-04-27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Tumour associated macrophages (TAMs) are prognostic markers in breast cancer, however the influence of patient demographic and behavioural factors on these inflammatory markers has not been fully appreciated.
METHODS: In 201 invasive breast cancer and 58 ductal carcinoma in-situ (DCIS) patients, TAM density (percentage % CD68 [IHC-immunohistochemistry] positive cells) was correlated with tumour factors (grade, proliferation (Ki67), ER, HER2); demographic factors (age, menopausal status, breast density, BMI, diabetes) and behavioural factors (smoking, alcohol).
RESULTS: TAM density was increased in invasive breast cancer, compared to DCIS, and normal tissue distant from the tumour (59%, 41% and 6% respectively; p<0.001). In invasive cancer, TAM density increased with increasing tumour grade (Grade 1: 42%, Grade 2: 58%, Grade 3: 72%; p=0.006), high Ki67 (71% vs. 47%; p=0.004), ER negativity (70% vs. 51%; p=0.02) and HER2 (HER2 positive 77% vs. HER2 negative 55%; p=0.055). TAM density was higher in high compared to low/intermediate DCIS (44% % vs 31% respectively).
In terms of demographic factors, TAM density did not correlate with age, menopausal status, breast density (BIRADs), BMI or history of diabetes. TAM density was not increased in patients who smoked; however, it was increased in patients who self-reported alcohol intake (non-drinker 43% vs. drinker 62%; p=0.01).
CONCLUSION: TAM density shows utility in identifying aggressive breast cancer sub-types. The association reported between TAM density and alcohol intake suggests a possible mechanism for alcohol as a risk factor for breast cancer.
Citation Format: Urvashi Singh, John Castle, Sophie Greenhalgh, Umar Hussain, Tine Descamps, Sarah Nash, Mary Wilson, Roger Hunt, Cliona C Kirwan. The relationship between tumour associated macrophage markers and tumour, demographic & behavioural factors in breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-04-27.
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Affiliation(s)
- Urvashi Singh
- 1University of Manchester, Manchester, United Kingdom
| | - John Castle
- 1University of Manchester, Manchester, United Kingdom
| | - Sophie Greenhalgh
- 2Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Umar Hussain
- 2Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Tine Descamps
- 3Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Sarah Nash
- 2Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Mary Wilson
- 2Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Roger Hunt
- 2Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Nash S, Rahman MS. Short‐term heat stress impairs testicular functions in the American oyster,Crassostrea virginica: Molecular mechanisms and induction of oxidative stress and apoptosis in spermatogenic cells. Mol Reprod Dev 2019; 86:1444-1458. [DOI: 10.1002/mrd.23268] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/28/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Sarah Nash
- School of Earth, Environmental, and Marine SciencesUniversity of Texas Rio Grande Valley Brownsville Texas
| | - Md Saydur Rahman
- School of Earth, Environmental, and Marine SciencesUniversity of Texas Rio Grande Valley Brownsville Texas
- Department of BiologyUniversity of Texas Rio Grande Valley Brownsville Texas
- Division of Biochemistry and Molecular BiologyUniversity of Texas Rio Grande Valley Brownsville Texas
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Nash S, Johnstone J, Rahman MS. Elevated temperature attenuates ovarian functions and induces apoptosis and oxidative stress in the American oyster, Crassostrea virginica: potential mechanisms and signaling pathways. Cell Stress Chaperones 2019; 24:957-967. [PMID: 31363994 PMCID: PMC6717220 DOI: 10.1007/s12192-019-01023-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 05/16/2019] [Revised: 07/11/2019] [Accepted: 07/17/2019] [Indexed: 12/12/2022] Open
Abstract
Global climate change is predicted to intensify thermal stress in marine and coastal organisms, affecting their development, growth, and reproductive functions. In this study, we performed histological observations on ovarian development, immunohistochemical analyses of ovarian heat shock protein-70 (HSP70), nitrotyrosine protein (NTP, an indicator of reactive nitrogen species (RNS)), and dinitrophenyl protein (DNP, an indicator of protein oxidation) expressions, in situ TUNEL assay for cellular apoptosis, biochemical analyses of ovarian caspase-3/7 activity and protein carbonyl (PC, a measure of reactive oxygen species (ROS)) contents, nitrate/nitrite (NOx) levels, and extrapallial fluid (EPF, an important body fluid) pH in the American oyster, Crassostrea virginica. Oysters were exposed to medium (28 °C) and high (32 °C) temperatures under controlled laboratory conditions for 1 week. Oysters exposed to higher temperatures significantly decreased the number and diameter of eggs, and EPF protein concentrations compared with controls (24 °C). In contrast, EPF pH, ovarian HSP70 mRNA levels, and protein expression were increased after heat exposure, consistent with increased ovarian apoptosis. The enhanced apoptosis in ovaries was associated with increased ovarian caspase-3/7 activity, PC contents, NOx levels, and NTP and DNP expressions in heat-exposed oysters. Collectively, these results suggest that higher temperatures drastically increase RNS and ROS levels, increasing incidence of apoptosis and subsequently reducing ovarian functions in oysters.
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Affiliation(s)
- Sarah Nash
- School of Earth, Environmental and Marine Sciences, University of Texas Rio Grande Valley, Brownsville, Texas, 78520, USA
| | - Jackson Johnstone
- School of Earth, Environmental and Marine Sciences, University of Texas Rio Grande Valley, Brownsville, Texas, 78520, USA
| | - Md Saydur Rahman
- School of Earth, Environmental and Marine Sciences, University of Texas Rio Grande Valley, Brownsville, Texas, 78520, USA.
- Department of Biology, University of Texas Rio Grande Valley, Brownsville, Texas, 78520, USA.
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Johnstone J, Nash S, Hernandez E, Rahman MS. Effects of elevated temperature on gonadal functions, cellular apoptosis, and oxidative stress in Atlantic sea urchin Arbacia punculata. Mar Environ Res 2019; 149:40-49. [PMID: 31150926 DOI: 10.1016/j.marenvres.2019.05.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 04/01/2019] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 06/09/2023]
Abstract
Increasing seawater temperature affects growth, reproduction and development in marine organisms. In this study, we examined the effects of elevated temperatures on reproductive functions, heat shock protein 70 (HSP70) and nitrotyrosine protein (NTP, an indicator of reactive nitrogen species) expressions, protein carbonyl (PC, an indicator of oxidative stress) contents, cellular apoptosis, and coelomic fluid (CF) conditions in Atlantic sea urchin. Sea urchins were housed in six aquaria with control (24 °C) and elevated temperatures (28 °C and 32 °C) for a 7-day period. After exposure, sea urchins exhibited decreased percentages of gametes (eggs/sperm), as well as increased HSP70 and NTP expressions in eggs and spermatogenic cells, increased gonadal apoptosis, and decreased CF pH compared to controls. PC contents were also significantly increased in gonadal tissues at higher temperatures. These results suggest that elevated temperature acidifies CF, increases oxidative stress and gonadal apoptosis, and results in impairment of reproductive functions in sea urchins.
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Affiliation(s)
- Jackson Johnstone
- School of Earth, Environmental and Marine Sciences, University of Texas Rio Grande Valley, Brownsville, TX, 78520, USA
| | - Sarah Nash
- School of Earth, Environmental and Marine Sciences, University of Texas Rio Grande Valley, Brownsville, TX, 78520, USA
| | - Eleazar Hernandez
- School of Earth, Environmental and Marine Sciences, University of Texas Rio Grande Valley, Brownsville, TX, 78520, USA
| | - Md Saydur Rahman
- School of Earth, Environmental and Marine Sciences, University of Texas Rio Grande Valley, Brownsville, TX, 78520, USA; Department of Biology, University of Texas Rio Grande Valley, Brownsville, TX, 78520, USA.
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Trotry C, Rode G, Nash S. Descriptive study of post-minor stroke cognitive defects (modified ranking scale ≤ 2), impact on quality of life and return to work. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Brown AE, Nash S, Connor N, Kirwan PD, Ogaz D, Croxford S, Angelis DD, Delpech VC. Towards elimination of HIV transmission, AIDS and HIV-related deaths in the UK. HIV Med 2018; 19:505-512. [PMID: 29923668 DOI: 10.1111/hiv.12617] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Our objective was to present recent trends in the UK HIV epidemic (2007-2016) and the public health response. METHODS HIV diagnoses and clinical markers were extracted from the HIV and AIDS Reporting System; HIV testing data in sexual health services (SHS) were taken from GUMCAD STI Surveillance System. HIV data were modelled to estimate the incidence in men who have sex with men (MSM) and post-migration HIV acquisition in heterosexuals. Office for National Statistics (ONS) data enabled mortality rates to be calculated. RESULTS New HIV diagnoses have declined in heterosexuals as a result of decreasing numbers of migrants from high HIV prevalence countries entering the UK. Among MSM, the number of HIV diagnoses fell from 3570 in 2015 to 2810 in 2016 (and from 1554 to 1096 in London). Preceding the decline in HIV diagnoses, modelled estimates indicate that transmission began to fall in 2012, from 2800 [credible interval (CrI) 2300-3200] to 1700 (CrI 900-2700) in 2016. The crude mortality rate among people promptly diagnosed with HIV infection was comparable to that in the general population (1.22 vs. 1.39 per 1000 aged 15-59 years, respectively). The number of MSM tested for HIV at SHS increased annually; 28% of MSM who were tested in 2016 had been tested in the preceding year. In 2016, 76% of people started antiretroviral therapy within 90 days of diagnosis (33% in 2007). CONCLUSIONS The dual successes of the HIV transmission decline in MSM and reduced mortality are attributable to frequent HIV testing and prompt treatment (combination prevention). Progress towards the elimination of HIV transmission, AIDS and HIV-related deaths could be achieved if combination prevention, including pre-exposure prophylaxis, is replicated for all populations.
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Affiliation(s)
- A E Brown
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - S Nash
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - N Connor
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - P D Kirwan
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - D Ogaz
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | - S Croxford
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
| | | | - V C Delpech
- HIV and STI Department, National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, UK
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Olnes MJ, Pihl E, Minder M, Parrish JC, Holck P, Tiesinga J, Stillwater B, Zimpelman G, Nash S, Martinson H. Nasopharyngeal cancer in Alaska Native people: A cancer health disparity. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.1574] [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: 11/20/2022] Open
Affiliation(s)
| | - Erik Pihl
- University of Washington School of Medicine, Anchorage, AK
| | - Mariah Minder
- University of Washington School of Medicine, Anchorage, AK
| | | | | | - Jim Tiesinga
- Alaska Native Tribal Health Consortium, Anchorage, AK
| | | | | | - Sarah Nash
- Alaska Native Tribal Health Consortium, Anchorage, AK
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Wykes T, Csipke E, Williams P, Koeser L, Nash S, Rose D, Craig T, McCrone P. Improving patient experiences of mental health inpatient care: a randomised controlled trial. Psychol Med 2018; 48:488-497. [PMID: 28726599 PMCID: PMC5757411 DOI: 10.1017/s003329171700188x] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 06/13/2017] [Accepted: 06/14/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Poorer patient views of mental health inpatient treatment predict both further admissions and, for those admitted involuntarily, longer admissions. As advocated in the UK Francis report, we investigated the hypothesis that improving staff training improves patients' views of ward care. METHOD Cluster randomised trial with stepped wedge design in 16 acute mental health wards randomised (using the ralloc procedure in Stata) by an independent statistician in three waves to staff training. A psychologist trained ward staff on evidence-based group interventions and then supported their introduction to each ward. The main outcome was blind self-report of perceptions of care (VOICE) before or up to 2 years after staff training between November 2008 and January 2013. RESULTS In total, 1108 inpatients took part (616 admitted involuntarily under the English Mental Health Act). On average 51.6 staff training sessions were provided per ward. Involuntary patient's perceptions of, and satisfaction with, mental health wards improved after staff training (N582, standardised effect -0·35, 95% CI -0·57 to -0·12, p = 0·002; interaction p value 0·006) but no benefit to those admitted voluntarily (N469, -0.01, 95% CI -0.23 to 0.22, p = 0.955) and no strong evidence of an overall effect (N1058, standardised effect -0.18 s.d., 95% CI -0.38 to 0.01, p = 0.062). The training costs around £10 per patient per week. Resource allocation changed towards patient perceived meaningful contacts by an average of £12 (95% CI -£76 to £98, p = 0.774). CONCLUSION Staff training improved the perceptions of the therapeutic environment in those least likely to want an inpatient admission, those formally detained. This change might enhance future engagement with all mental health services and prevent the more costly admissions.
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Affiliation(s)
- T. Wykes
- Institute of Psychiatry, Psychology and
Neuroscience, King's College London, London,
UK
- South London and Maudsley NHS Trust,
London, UK
| | - E. Csipke
- Division of Psychiatry,
University College London, London,
UK
| | - P. Williams
- Institute of Psychiatry, Psychology and
Neuroscience, Kings College London, London,
UK
| | - L. Koeser
- Institute of Psychiatry, Psychology and
Neuroscience, Kings College London, London,
UK
| | - S. Nash
- London School of Hygiene and Tropical
Medicine, Keppel Street, London,
UK
| | - D. Rose
- Service User Research Enterprise, Institute of
Psychiatry, Psychology and Neuroscience, King's College London,
London, UK
| | - T. Craig
- Health Services and Population Research
Department, Institute of Psychiatry, Psychology and Neuroscience, King's College
London, London, UK
| | - P. McCrone
- Health Economics, Health Services and Population
Research, Institute of Psychiatry, Psychology and Neuroscience, King's College
London, London, UK
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Lally J, Watkins R, Nash S, Shetty H, Gardner-Sood P, Smith S, Murray RM, Gaughran F. The Representativeness of Participants With Severe Mental Illness in a Psychosocial Clinical Trial. Front Psychiatry 2018; 9:654. [PMID: 30564154 PMCID: PMC6288469 DOI: 10.3389/fpsyt.2018.00654] [Citation(s) in RCA: 16] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/16/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction: Cardiovascular morbidity and mortality are increased in severe mental illnesses (SMI). Trials of psychosocial health interventions to improve physical health in SMI, including in treatment-resistant schizophrenia, have shown some benefit. However, the representativeness of participants in such trials has not been determined. Method: We utilized an anonymised case register to determine if participants in a randomized controlled trial (RCT) of a novel psychosocial health intervention aiming to improve physical health in SMI had similar severity of illness to eligible non-participants. A retrospective database analysis was performed, using Health of the Nation Outcome Scale (HoNOS) data from the sample of patients participating in the IMPaCT (Improving Physical health and reducing substance use in Psychosis) RCT (n = 293) compared to all eligible participants with a psychotic illness (n = 774). Results: The mean total HoNOS score in the eligible comparator population (Mean = 9.09, SD = 5.8, range = 0-30) was significantly greater than that of the IMPaCT RCT participants (Mean = 7.16, SD = 4.7, range = 0-26), (t = 3.810, p = 0.006), as was the degree of overall illness severity and functional impairment, as measured by HoNOS. Conclusion: This study shows for the first time that the patient population participating in an RCT of a lifestyle intervention for those with SMI had a better mental health status at entry to the trial, than the total eligible population, although there was no difference in physical health needs. This has relevance to the applicability of RCTs of lifestyle interventions in service planning and suggests that when people are more unwell, greater effort may be needed to include them in psychosocial interventions. A more careful and focused recruitment approach should be followed to improve the participation of the more severely ill patients in psychosocial interventions in order to enhance the external validity of such studies.
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Affiliation(s)
- John Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.,Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.,St Vincent's Hospital Fairview, Dublin, Ireland
| | - Rochelle Watkins
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sarah Nash
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Hitesh Shetty
- Biomedical Research Centre (BRC) Case Register, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Poonam Gardner-Sood
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Shubulade Smith
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom.,Forensic Intensive Care Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Psychiatry, Experimental Biomedicine and Clinical Neuroscience (BIONEC), University of Palermo, Palermo, Italy
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, Experimental Biomedicine and Clinical Neuroscience (BIONEC), University of Palermo, Palermo, Italy
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King J, Palmer DH, Johnson P, Ross P, Hubner RA, Sumpter K, Darby S, Braconi C, Iwuji C, Swinson D, Collins P, Patel K, Nobes J, Muazzam I, Blesing C, Kirkwood A, Nash S, Meyer T. Sorafenib for the Treatment of Advanced Hepatocellular Cancer - a UK Audit. Clin Oncol (R Coll Radiol) 2017; 29:256-262. [PMID: 27964898 DOI: 10.1016/j.clon.2016.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 09/11/2016] [Revised: 10/28/2016] [Accepted: 11/01/2016] [Indexed: 01/08/2023]
Abstract
AIMS Sorafenib is the current standard treatment for advanced hepatocellular carcinoma. We carried out a national audit of UK patients treated with sorafenib as standard-of-care and those treated with systemic therapy in first-line trials. MATERIALS AND METHODS Sorafenib-treated and trial-treated patients were identified via the Cancer Drugs Fund and local databases. Data were collected retrospectively from medical records according to a standard case report form. The primary outcome measure was overall survival, estimated by the Kaplan-Meier method. RESULTS Data were obtained for 448 sorafenib-treated patients from 15 hospitals. The median age was 68 years (range 17-89) and 75% had performance status ≤ 1. At baseline, 77% were Child-Pugh A and 16.1% Child-Pugh B; 38% were albumin-bilirubin grade 1 (ALBI-1) and 48% ALBI-2; 23% were Barcelona Clinic Liver Classification B (BCLC-B) and 72% BCLC-C. The median time on sorafenib was 3.6 months, with a mean daily dose of 590 mg. The median overall survival for 448 evaluable sorafenib-treated patients was 8.5 months. There were significant differences in overall survival comparing Child-Pugh A versus Child-Pugh B (9.5 versus 4.6 months), ALBI-1 versus ALBI-2 (12.9 versus 5.9 months) and BCLC-B versus BCLC-C (13.0 versus 8.3 months). For trial-treated patients (n=109), the median overall survival was 8.1 months and this was not significantly different from the sorafenib-treated patients. CONCLUSION For Child-Pugh A patients with good performance status, survival outcomes were similar to those reported in global randomised controlled trials. Patients with ALBI grade > 1, Child-Pugh B or poor performance status seem to derive limited benefit from sorafenib treatment.
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Affiliation(s)
- J King
- Department of Oncology, Royal Free London NHS Foundation Trust, London, UK
| | - D H Palmer
- University of Birmingham, Birmingham, UK; University of Liverpool, Liverpool, UK; Clatterbridge Cancer Centre, Wirral, UK
| | - P Johnson
- University of Birmingham, Birmingham, UK; University of Liverpool, Liverpool, UK; Clatterbridge Cancer Centre, Wirral, UK
| | - P Ross
- King's College Hospital, London, UK
| | - R A Hubner
- The Christie NHS Foundation Trust, Manchester, UK
| | - K Sumpter
- The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - S Darby
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - C Braconi
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - C Iwuji
- Leicester Royal Infirmary, Leicester, UK
| | - D Swinson
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - P Collins
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - K Patel
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - J Nobes
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - I Muazzam
- Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - C Blesing
- Great Western Hospital NHS Trust, Swindon, UK
| | - A Kirkwood
- Cancer Research UK & UCL Cancer Trials Centre, London, UK
| | - S Nash
- Cancer Research UK & UCL Cancer Trials Centre, London, UK
| | - T Meyer
- Department of Oncology, Royal Free London NHS Foundation Trust, London, UK; UCL Cancer Institute, London, UK.
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32
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Nash S, Rees DAS. The Effect of Microstructure on Models for the Flow of a Bingham Fluid in Porous Media: One-Dimensional Flows. Transp Porous Media 2017. [DOI: 10.1007/s11242-016-0813-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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33
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Bailey GP, Rehman B, Wind K, Wood DM, Thanacoody R, Nash S, Archer J, Eddleston M, Thompson JP, Vale JA, Thomas S, Dargan PI. Taking stock: UK national antidote availability increasing, but further improvements are required. Eur J Hosp Pharm 2015; 23:145-150. [PMID: 31156836 DOI: 10.1136/ejhpharm-2015-000802] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 10/02/2015] [Accepted: 10/05/2015] [Indexed: 11/04/2022] Open
Abstract
Background A 2010/2011 audit of the Royal College of Emergency Medicine (RCEM) National Poisons Information Service (NPIS) UK guidelines on antidote availability demonstrated variable stocking of antidotes for the management of poisoned patients; the guidelines were updated and republished in 2013. Aim To assess if antidote stocking has improved since the 2010/2011 audit and introduction of the 2013 guidelines. Methods Questionnaires were sent to Chief Pharmacists at all 215 acute hospitals in England, Wales and Northern Ireland in October 2014. Data were collected on the timing of availability (category A antidotes should be available immediately, category B within 1 h and category C can be held supraregionally) and stock levels. Results 169 (78.6%) responses were received. Atropine, calcium gluconate and flumazenil (category A) were the only antidotes available in all hospitals within the recommended time and stock levels. Forty-one (24.3%) hospitals held every category A antidote; this increased to 81 (47.9%) for those holding at least one cyanide antidote and all other category A antidotes. The proportion of hospitals stocking category A/B antidotes within the recommended time increased for 20 (90.9%) category A/B antidotes. Fomepizole (category B) availability increased to 62.1% of hospitals from 11.4% in 2010/2011. Other than penicillamine (63.3% hospitals), there was poor availability (2.4%-36.1%) of category C antidotes. Conclusions Availability of category A and B antidotes has improved since the 2010/2011 audit and 2013 guidelines. However, there remains significant variability particularly for category C antidotes. More work is required to ensure that those treating poisoned patients have timely access to antidotes focusing particularly on category C antidotes.
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Affiliation(s)
- G P Bailey
- Department of Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Emergency Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - B Rehman
- London Medicines Information Service, London Northwest Healthcare NHS Trust, London, UK
| | - K Wind
- Pharmacy Department, Southend Hospital NHS Trust, Southend, UK
| | - D M Wood
- Department of Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - R Thanacoody
- National Poisons Information Service (Newcastle Unit), Newcastle Hospitals NHS Trust, Newcastle, UK.,Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - S Nash
- Department of Emergency Medicine, Princess Royal University Hospital, London, UK
| | - Jrh Archer
- Department of Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Eddleston
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, Edinburgh, UK
| | - J P Thompson
- National Poisons Information Service (Cardiff Unit), University Hospital Llandough, Cardiff, UK
| | - J A Vale
- National Poisons Information Service (Birmingham Unit), City Hospital, Birmingham, UK
| | - Shl Thomas
- National Poisons Information Service (Newcastle Unit), Newcastle Hospitals NHS Trust, Newcastle, UK.,Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - P I Dargan
- Department of Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Faculty of Life Sciences and Medicine, King's College London, London, UK
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34
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Grenader T, Nash S, Adams R, Kaplan R, Fisher D, Maughan T, Bridgewater J. 2104 Derived neutrophil to lymphocyte ratio is not predictive for use of a continuous or intermittent first-line oxaliplatin/fluoropyrimidine combination in patients with advanced colorectal cancer: A post-hoc analysis of the MRC COIN study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31026-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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35
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Nash S, Rode G, Charnallet A. Global/local integration and corpus callosum: Anatomical and behavioural study of case of Allgrove syndrome (triple-A syndrome). Ann Phys Rehabil Med 2015. [DOI: 10.1016/j.rehab.2015.07.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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36
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Grenader T, Nash S, Plotkin Y, Furuse J, Mizuno N, Okusaka T, Wasan H, Valle J, Bridgewater J. Derived neutrophil lymphocyte ratio may predict benefit from cisplatin in the advanced biliary cancer: the ABC-02 and BT-22 studies. Ann Oncol 2015; 26:1910-1916. [DOI: 10.1093/annonc/mdv253] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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37
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Grenader T, Nash S, Adams R, Kaplan R, Fisher D, Maugham T, Bridgewater J. 2105 Derived neutrophil to lymphocyte ratio as prognostic factor in patients with advanced colorectal cancer according RAS and BRAF mutations status: A post-hoc analysis of the MRC COIN study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31027-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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38
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Nash S, Till C, Song X, Platz E, Schenk J. Serum Carotenoid Concentrations and Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.406.2] [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)
- Sarah Nash
- Cancer Prevention Fellowship Program National Cancer InstituteBethesdaMDUnited States
| | - Cathee Till
- Cancer Prevention Program Fred Hutchinson Cancer Research CenterSeattleWAUnited States
| | - Xiaoling Song
- Cancer Prevention Program Fred Hutchinson Cancer Research CenterSeattleWAUnited States
| | - Elizabeth Platz
- Department of Epidemiology Johns Hopkins Bloomberg School of Public HealthStillwaterOKUnited States
| | - Jeannette Schenk
- Cancer Prevention Program Fred Hutchinson Cancer Research CenterSeattleWAUnited States
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39
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Jaeger M, Deiana G, Nash S, Bar JY, Cotton F, Dailler F, Fischer C, Rode G, Boisson D, Luauté J. Prognostic factors of long-term outcome in cases of severe traumatic brain injury. Ann Phys Rehabil Med 2014; 57:436-51. [DOI: 10.1016/j.rehab.2014.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 11/25/2022]
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40
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Schwitzer C, Mittermeier RA, Johnson SE, Donati G, Irwin M, Peacock H, Ratsimbazafy J, Razafindramanana J, Louis EE, Chikhi L, Colquhoun IC, Tinsman J, Dolch R, LaFleur M, Nash S, Patel E, Randrianambinina B, Rasolofoharivelo T, Wright PC. Conservation. Averting lemur extinctions amid Madagascar's political crisis. Science 2014; 343:842-3. [PMID: 24558147 DOI: 10.1126/science.1245783] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- C Schwitzer
- Bristol Zoological Society, Bristol BS8 3HA, UK
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Choy K, Nash S, Orr E, Hopkins S, O'Brien D. Seasonal and annual variation in intake of traditional marine foods by a Yup'ik Eskimo population: a sequential dietary record from hair stable isotope analysis. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.lb347] [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)
- Kyungcheol Choy
- Institute for Arctic BiologyUniversity of Alaska FairbanksFairbanksAK
| | - Sarah Nash
- Institute for Arctic BiologyUniversity of Alaska FairbanksFairbanksAK
- Department of Biology and WildlifeUniversity of Alaska FairbanksFairbanksAK
| | - Eliza Orr
- Institute for Arctic BiologyUniversity of Alaska FairbanksFairbanksAK
| | - Scarlett Hopkins
- Institute for Arctic BiologyUniversity of Alaska FairbanksFairbanksAK
| | - Diane O'Brien
- Institute for Arctic BiologyUniversity of Alaska FairbanksFairbanksAK
- Department of Biology and WildlifeUniversity of Alaska FairbanksFairbanksAK
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42
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OˈBrien DM, Choy K, Nash S. The carbon isotope ratio of RBC alanine is a biomarker of sugar‐sweetened beverage (SSB) intake. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.131.2] [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)
- Diane Marie OˈBrien
- Center for Alaska Native Health ResearchUniversity of Alaska FairbanksFairbanksAK
| | - Kyungcheol Choy
- Center for Alaska Native Health ResearchUniversity of Alaska FairbanksFairbanksAK
| | - Sarah Nash
- Center for Alaska Native Health ResearchUniversity of Alaska FairbanksFairbanksAK
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43
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Nash S. A cooperative participative inquiry into the effectiveness of a bereavement drop-in service. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000105.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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44
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Pearce S, Nash S. Knowing yourself - understanding others - how an awareness of personality type can help with change. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000105.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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45
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Bersamin A, Herron J, Nash S, Maier J, Luick B. Characterizing beverage patterns among Alaska Natives living in rural, remote communities: the CANHR study. FASEB J 2011. [DOI: 10.1096/fasebj.25.1_supplement.991.11] [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)
- Andrea Bersamin
- Center for Alaska Native Health ResearchUniversity of Alaska FairbanksFairbanksAK
| | - Johanna Herron
- Center for Alaska Native Health ResearchUniversity of Alaska FairbanksFairbanksAK
| | - Sarah Nash
- Center for Alaska Native Health ResearchUniversity of Alaska FairbanksFairbanksAK
| | - Janne Maier
- Center for Alaska Native Health ResearchUniversity of Alaska FairbanksFairbanksAK
| | - Bret Luick
- Center for Alaska Native Health ResearchUniversity of Alaska FairbanksFairbanksAK
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Couto CG, Lorentzen L, Beall MJ, Shields J, Bertolone N, Couto JI, Couto KM, Nash S, Slack J, Kvitko H, Westendorf N, Marin L, Iazbik MC, Vicario FC, Sanz P, Ruano R. Serological Study of Selected Vector-Borne Diseases in Shelter Dogs in Central Spain Using Point-of-Care Assays. Vector Borne Zoonotic Dis 2010; 10:885-8. [DOI: 10.1089/vbz.2009.0063] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C. Guillermo Couto
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
- The Veterinary Teaching Hospital, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
- The OSU Comprehensive Cancer Center, The Ohio State University; Columbus, Ohio
| | | | | | | | - Nicolette Bertolone
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - Jason I. Couto
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - Kristen M. Couto
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - Sarah Nash
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - Jessica Slack
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - Heather Kvitko
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - Nicole Westendorf
- The Veterinary Teaching Hospital, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Liliana Marin
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - M. Christina Iazbik
- The Veterinary Teaching Hospital, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | | | - Pilar Sanz
- Studio Veterinario Bisio-Sangiorgio-Tagliabue, Genoa, Italy
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Badell M, Lathrop E, Goedken P, Nash S, Nguyen M, Cwiak C. Reproductive healthcare needs of HIV-positive women. Contraception 2010. [DOI: 10.1016/j.contraception.2010.04.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sorenson EJ, Windbank AJ, Mandrekar JN, Bamlet WR, Appel SH, Armon C, Barkhaus PE, Bosch P, Boylan K, David WS, Feldman E, Glass J, Gutmann L, Katz J, King W, Luciano CA, McCluskey LF, Nash S, Newman DS, Pascuzzi RM, Pioro E, Sams LJ, Scelsa S, Simpson EP, Subramony SH, Tiryaki E, Thornton CA. Subcutaneous IGF-1 is not beneficial in 2-year ALS trial. Neurology 2008; 71:1770-5. [PMID: 19029516 PMCID: PMC2617770 DOI: 10.1212/01.wnl.0000335970.78664.36] [Citation(s) in RCA: 180] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Previous human clinical trials of insulin-like growth factor type I (IGF-1) in amyotrophic lateral sclerosis (ALS) have been inconsistent. This phase III, randomized, double-blind, placebo-controlled study was undertaken to address whether IGF-1 benefited patients with ALS. METHODS A total of 330 patients from 20 medical centers were randomized to receive 0.05 mg/kg body weight of human recombinant IGF-1 given subcutaneously twice daily or placebo for 2 years. The primary outcome measure was change in their manual muscle testing score. Secondary outcome measures included tracheostomy-free survival and rate of change in the revised ALS functional rating scale. Intention to treat analysis was used. RESULTS There was no difference between treatment groups in the primary or secondary outcome measures after the 2-year treatment period. CONCLUSIONS Insulin-like growth factor type I does not provide benefit for patients with amyotrophic lateral sclerosis.
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Affiliation(s)
- E J Sorenson
- Department of Neurology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA.
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Pocock B, Nash S, Klein L, El-Tamer M, Schnabel FR, Joseph KA. Disparities in time to definitive surgical treatment between black and white women diagnosed with ductal carcinoma in situ. Am J Surg 2007; 194:521-3. [PMID: 17826071 DOI: 10.1016/j.amjsurg.2007.06.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Revised: 06/27/2007] [Accepted: 06/28/2007] [Indexed: 01/02/2023]
Abstract
BACKGROUND Although black women develop invasive breast cancer at a lower incidence than white women, the cancers they develop tend to be of a higher grade and are more likely estrogen receptor negative. There is very little information with regard to black women and ductal carcinoma in situ (DCIS). In addition, although various reasons have been proposed for the delay to screening for black women, a delay after diagnosis has also been recognized. PURPOSE The purpose of this study was to investigate disparities in time to treatment between black women and white women once DCIS has been diagnosed. METHODS A retrospective analysis of 37 black women and 37 matched white women treated for DCIS was performed. Matches were made based on the date of birth, date of diagnosis, date and type of surgery, and age at diagnosis. The time from the date of diagnosis to the date of surgery was ascertained. RESULTS Black women were 64% more likely to undergo a delay to surgery (>50 days) compared with white women (21% versus 13%, P < .05). CONCLUSION Black women are more likely not to reach surgery within 50 days of diagnosis, which is concerning, and further studies to investigate the cause of these delays are warranted.
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Affiliation(s)
- Benjamin Pocock
- Comprehensive Breast Center, Department of Surgery, Columbia University Medical Center/New York Presbyterian Hospital, New York, NY 10032, USA.
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Nicholas B, Rudrasingham V, Nash S, Kirov G, Owen MJ, Wimpory DC. Association of Per1 and Npas2 with autistic disorder: support for the clock genes/social timing hypothesis. Mol Psychiatry 2007; 12:581-92. [PMID: 17264841 DOI: 10.1038/sj.mp.4001953] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Clock gene anomalies have been suggested as causative factors in autism. We screened eleven clock/clock-related genes in a predominantly high-functioning Autism Genetic Resource Exchange sample of strictly diagnosed autistic disorder progeny and their parents (110 trios) for association of clock gene variants with autistic disorder. We found significant association (P<0.05) for two single-nucleotide polymorphisms in per1 and two in npas2. Analysis of all possible combinations of two-marker haplotypes for each gene showed that in npas2 40 out of the 136 possible two-marker combinations were significant at the P<0.05 level, with the best result between markers rs1811399 and rs2117714, P=0.001. Haplotype analysis within per1 gave a single significant result: a global P=0.027 for the markers rs2253820-rs885747. No two-marker haplotype was significant in any of the other genes, despite the large number of tests performed. Our findings support the hypothesis that these epistatic clock genes may be involved in the etiology of autistic disorder. Problems in sleep, memory and timing are all characteristics of autistic disorder and aspects of sleep, memory and timing are each clock-gene-regulated in other species. We identify how our findings may be relevant to theories of autism that focus on the amygdala, cerebellum, memory and temporal deficits. We outline possible implications of these findings for developmental models of autism involving temporal synchrony/social timing.
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Affiliation(s)
- B Nicholas
- North West Cancer Research Fund Institute, University of Wales, Bangor, UK
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