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Metzler J, Saw T, Nono D, Kadondi A, Zhang Y, Leu CS, Gabriel A, Savage K, Landers C. Improving adolescent mental health and protection in humanitarian settings: longitudinal findings from a multi-arm randomized controlled trial of child-friendly spaces among South Sudanese refugees in Uganda. J Child Psychol Psychiatry 2023; 64:907-917. [PMID: 36593181 DOI: 10.1111/jcpp.13746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The effects of conflict and displacement on adolescent mental health and protection are profound and can have lasting consequences. We aimed to investigate the effectiveness of two group-based psychosocial interventions on mental health and protection of South Sudanese refugee adolescents. METHODS A randomized controlled trial was done in four villages within the Omugo extension of Rhino Camp refugee settlement in the West Nile region of Uganda. Male and female adolescents (aged 9-14 years) were randomly assigned to attend 12 weeks of either a Standard psychosocial intervention delivered in a child-friendly space (CFS) or a more structured sequential delivery of psychosocial sessions guided by a newly developed Toolkit for Child-Friendly Spaces in Humanitarian Settings. The primary outcomes were psychological distress and resilience 12 months after baseline assessment. The trial is registered with ClinicalTrials.gov, NCT03897894. RESULTS Between May 28, 2019, and February 20, 2020, 1,280 eligible adolescents were recruited. With 70.2% retention at follow-up, 214 assigned to the Standard, 211 assigned to the Toolkit, and 370 assigned to the waitlist control were included in the intention-to-treat and as-treated analysis. Both the Toolkit and Standard approaches were more effective in reducing psychological distress and perceived protection risks reported by adolescents compared to no intervention. Differential intervention impacts are indicated in subgroup analyses. CONCLUSIONS The trial found that both psychosocial interventions when implemented in a CFS are well suited as a first-line mental health and violence prevention intervention for adolescent populations exposed to conflict and forced displacement. Where feasible, CFS should be implemented as a primary response strategy soon after displacement to improve psychological health and reduce the risk environment for adolescents.
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Affiliation(s)
- Janna Metzler
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Terry Saw
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Denis Nono
- AfriChild Center for the Study of the African Child, Makerere University, New York, NY, USA
| | | | - Yuan Zhang
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Cheng-Shiun Leu
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | | | - Cassie Landers
- Columbia University Mailman School of Public Health, New York, NY, USA
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2
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Macken WL, Falabella M, McKittrick C, Pizzamiglio C, Ellmers R, Eggleton K, Woodward CE, Patel Y, Labrum R, Phadke R, Reilly MM, DeVile C, Sarkozy A, Footitt E, Davison J, Rahman S, Houlden H, Bugiardini E, Quinlivan R, Hanna MG, Vandrovcova J, Pitceathly RDS, Hubbard TJP, Jackson R, Jones LJ, Kasperaviciute D, Kayikci M, Kousathanas A, Lahnstein L, Lakey A, Leigh SEA, Leong IUS, Lopez FJ, Maleady-Crowe F, McEntagart M, Minneci F, Mitchell J, Moutsianas L, Mueller M, Murugaesu N, Need AC, O’Donovan P, Odhams CA, Patch C, Perez-Gil D, Pereira MB, Pullinger J, Rahim T, Rendon A, Rogers T, Savage K, Sawant K, Scott RH, Siddiq A, Sieghart A, Smith SC, Sosinsky A, Stuckey A, Tanguy M, Taylor Tavares AL, Thomas ERA, Thompson SR, Tucci A, Welland MJ, Williams E, Witkowska K, Wood SM, Zarowiecki M, Phadke R, Reilly MM, DeVile C, Sarkozy A, Footitt E, Davison J, Rahman S, Houlden H, Bugiardini E, Quinlivan R, Hanna MG, Vandrovcova J, Pitceathly RDS. Specialist multidisciplinary input maximises rare disease diagnoses from whole genome sequencing. Nat Commun 2022; 13:6324. [PMID: 36344503 PMCID: PMC9640711 DOI: 10.1038/s41467-022-32908-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022] Open
Abstract
Diagnostic whole genome sequencing (WGS) is increasingly used in rare diseases. However, standard, semi-automated WGS analysis may overlook diagnoses in complex disorders. Here, we show that specialist multidisciplinary analysis of WGS, following an initial 'no primary findings' (NPF) report, improves diagnostic rates and alters management. We undertook WGS in 102 adults with diagnostically challenging primary mitochondrial disease phenotypes. NPF cases were reviewed by a genomic medicine team, thus enabling bespoke informatic approaches, co-ordinated phenotypic validation, and functional work. We enhanced the diagnostic rate from 16.7% to 31.4%, with management implications for all new diagnoses, and detected strong candidate disease-causing variants in a further 3.9% of patients. This approach presents a standardised model of care that supports mainstream clinicians and enhances diagnostic equity for complex disorders, thereby facilitating access to the potential benefits of genomic healthcare. This research was made possible through access to the data and findings generated by the 100,000 Genomes Project: http://www.genomicsengland.co.uk .
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Affiliation(s)
- William L. Macken
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Micol Falabella
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Caroline McKittrick
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Chiara Pizzamiglio
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Rebecca Ellmers
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Kelly Eggleton
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Cathy E. Woodward
- grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Yogen Patel
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Robyn Labrum
- grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | | | - Rahul Phadke
- grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Mary M. Reilly
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Catherine DeVile
- grid.424537.30000 0004 5902 9895Department of Neurosciences, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna Sarkozy
- grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Emma Footitt
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - James Davison
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,grid.420468.cNational Institute for Health and Care Research Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Shamima Rahman
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,grid.83440.3b0000000121901201Mitochondrial Research Group, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Henry Houlden
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Enrico Bugiardini
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Rosaline Quinlivan
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Michael G. Hanna
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Jana Vandrovcova
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Robert D. S. Pitceathly
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
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Shoemark A, Griffin H, Wheway G, Hogg C, Lucas JS, Camps C, Taylor J, Carroll M, Loebinger MR, Chalmers JD, Morris-Rosendahl D, Mitchison HM, De Soyza A, Brown D, Ambrose JC, Arumugam P, Bevers R, Bleda M, Boardman-Pretty F, Boustred CR, Brittain H, Caulfield MJ, Chan GC, Fowler T, Giess A, Hamblin A, Henderson S, Hubbard TJP, Jackson R, Jones LJ, Kasperaviciute D, Kayikci M, Kousathanas A, Lahnstein L, Leigh SEA, Leong IUS, Lopez FJ, Maleady-Crowe F, McEntagart M, Minneci F, Moutsianas L, Mueller M, Murugaesu N, Need AC, O'Donovan P, Odhams CA, Patch C, Perez-Gil D, Pereira MB, Pullinger J, Rahim T, Rendon A, Rogers T, Savage K, Sawant K, Scott RH, Siddiq A, Sieghart A, Smith SC, Sosinsky A, Stuckey A, Tanguy M, Taylor Tavares AL, Thomas ERA, Thompson SR, Tucci A, Welland MJ, Williams E, Witkowska K, Wood SM. Genome sequencing reveals underdiagnosis of primary ciliary dyskinesia in bronchiectasis. Eur Respir J 2022; 60:13993003.00176-2022. [PMID: 35728977 DOI: 10.1183/13993003.00176-2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 01/25/2022] [Accepted: 05/12/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Bronchiectasis can result from infectious, genetic, immunological and allergic causes. 60-80% of cases are idiopathic, but a well-recognised genetic cause is the motile ciliopathy, primary ciliary dyskinesia (PCD). Diagnosis of PCD has management implications including addressing comorbidities, implementing genetic and fertility counselling and future access to PCD-specific treatments. Diagnostic testing can be complex; however, PCD genetic testing is moving rapidly from research into clinical diagnostics and would confirm the cause of bronchiectasis. METHODS This observational study used genetic data from severe bronchiectasis patients recruited to the UK 100,000 Genomes Project and patients referred for gene panel testing within a tertiary respiratory hospital. Patients referred for genetic testing due to clinical suspicion of PCD were excluded from both analyses. Data were accessed from the British Thoracic Society audit, to investigate whether motile ciliopathies are underdiagnosed in people with bronchiectasis in the UK. RESULTS Pathogenic or likely pathogenic variants were identified in motile ciliopathy genes in 17 (12%) out of 142 individuals by whole-genome sequencing. Similarly, in a single centre with access to pathological diagnostic facilities, 5-10% of patients received a PCD diagnosis by gene panel, often linked to normal/inconclusive nasal nitric oxide and cilia functional test results. In 4898 audited patients with bronchiectasis, <2% were tested for PCD and <1% received genetic testing. CONCLUSIONS PCD is underdiagnosed as a cause of bronchiectasis. Increased uptake of genetic testing may help to identify bronchiectasis due to motile ciliopathies and ensure appropriate management.
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Affiliation(s)
- Amelia Shoemark
- Respiratory Research Group, Molecular and Cellular Medicine, University of Dundee, Dundee, UK
- Royal Brompton Hospital and NHLI, Imperial College London, London, UK
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
| | - Helen Griffin
- Primary Immunodeficiency Group, Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
| | - Gabrielle Wheway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Claire Hogg
- Royal Brompton Hospital and NHLI, Imperial College London, London, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
| | | | - Carme Camps
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Clinical Informatics Research Office, John Radcliffe Hospital, Oxford, UK
| | - Jenny Taylor
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Clinical Informatics Research Office, John Radcliffe Hospital, Oxford, UK
| | - Mary Carroll
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - James D Chalmers
- Respiratory Research Group, Molecular and Cellular Medicine, University of Dundee, Dundee, UK
| | - Deborah Morris-Rosendahl
- Clinical Genetics and Genomics, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust and NHLI, Imperial College London, London, UK
| | - Hannah M Mitchison
- Genetics and Genomic Medicine Department, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
- These authors contributed equally to this manuscript
| | - Anthony De Soyza
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
- These authors contributed equally to this manuscript
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4
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Wang J, Aaron A, Baidya A, Chan C, Wetzler E, Savage K, Joseph M, Kang Y. Gender differences in psychosocial status of adolescents during COVID-19: a six-country cross-sectional survey in Asia Pacific. BMC Public Health 2021; 21:2009. [PMID: 34736426 PMCID: PMC8568363 DOI: 10.1186/s12889-021-12098-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND School closures and family economic instability caused by the COVID-19 lockdown measures have threatened the mental health and academic progress of adolescents. Through secondary data analysis of World Vision Asia Pacific Region's COVID-19 response-assessments in May-June 2020, this study examined whether adolescents' study, physical, and leisure activities, psychosocial status, and sources of COVID-19 information differed by gender. METHODS The assessments used cross-sectional surveys of adolescents in poor communities served by World Vision (n = 5552 males and n = 6680 females) aged 10-18 years old in six countries. The study households of adolescents were selected either by random sampling or non-probability convenience sampling and assessed using telephone or in-person interviews. Multivariate logistic regression analyses examined the relationship between gender and psychosocial status; daily activities (e.g., play, study); and sources of information about COVID-19. RESULTS Participation in remote education was low (range: 0.5-20.7% across countries), with gender difference found only in Vietnam. Compared to males, female adolescents were less likely to play physically with a range of AOR: 0.36-0.55 (n = 5 countries) or play video games with a range of AOR: 0.55-0.72 (n = 2 countries). Female adolescents were more likely to feel isolated or stressed (India, AOR = 1.13, 95%CI:1.00, 1.26); feel unsafe (the Philippines, AOR = 2.22, 95%CI:1.14, 4.33; Vietnam, AOR = 1.31, 95%CI:1.03, 1.47); be concerned about education (India, AOR = 1.24, 95%CI:1.09, 1.41; Myanmar, AOR = 1.59, 95%CI:1.05, 2.40); or be concerned about household income (India, AOR = 1.13, 95%CI:1.00, 1.28; Vietnam, AOR = 1.31, 95%CI:1.09, 1.58). Female adolescents were also less likely to obtain COVID-19 related information through internet/social media (Bangladesh, AOR = 0.51, 95%CI:0.41, 0.64; India, AOR = 0.84, 95%CI:0.73, 0.96; and Myanmar, AOR = 0.65, 95%CI:0.43, 0.97) and mobile call or short message (India, AOR = 0.88, 95%CI:0.80, 0.98) but more likely to get the information from friends (Vietnam, AOR = 1.18, 95%CI:1.02, 1.36) and family (Bangladesh, AOR = 1.44, 95% CI:1.21, 1.70; India, AOR = 1.29, 95% CI:1.15, 1.45). CONCLUSIONS An understanding of gender differences in the impacts of COVID-19 on adolescents' schooling, physical, and mental health can inform adolescent protection interventions. Psychosocial support during response and recovery phases needs to pay special attention to gender differences, since female adolescents' psychosocial status is at higher risk when facing the challenges of this pandemic.
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Affiliation(s)
- Jun Wang
- Johns Hopkins School of Education, Baltimore, MD, USA
| | - Alec Aaron
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anurima Baidya
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christabel Chan
- World Vision Asia Pacific Regional Office, Singapore, Republic of Singapore
| | | | | | | | - Yunhee Kang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Stark Z, Foulger RE, Williams E, Thompson BA, Patel C, Lunke S, Snow C, Leong IUS, Puzriakova A, Daugherty LC, Leigh S, Boustred C, Niblock O, Rueda-Martin A, Gerasimenko O, Savage K, Bellamy W, Lin VSK, Valls R, Gordon L, Brittain HK, Thomas ERA, Taylor Tavares AL, McEntagart M, White SM, Tan TY, Yeung A, Downie L, Macciocca I, Savva E, Lee C, Roesley A, De Fazio P, Deller J, Deans ZC, Hill SL, Caulfield MJ, North KN, Scott RH, Rendon A, Hofmann O, McDonagh EM. Scaling national and international improvement in virtual gene panel curation via a collaborative approach to discordance resolution. Am J Hum Genet 2021; 108:1551-1557. [PMID: 34329581 PMCID: PMC8456155 DOI: 10.1016/j.ajhg.2021.06.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/27/2021] [Indexed: 02/02/2023] Open
Abstract
Clinical validity assessments of gene-disease associations underpin analysis and reporting in diagnostic genomics, and yet wide variability exists in practice, particularly in use of these assessments for virtual gene panel design and maintenance. Harmonization efforts are hampered by the lack of agreed terminology, agreed gene curation standards, and platforms that can be used to identify and resolve discrepancies at scale. We undertook a systematic comparison of the content of 80 virtual gene panels used in two healthcare systems by multiple diagnostic providers in the United Kingdom and Australia. The process was enabled by a shared curation platform, PanelApp, and resulted in the identification and review of 2,144 discordant gene ratings, demonstrating the utility of sharing structured gene-disease validity assessments and collaborative discordance resolution in establishing national and international consensus.
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Affiliation(s)
- Zornitza Stark
- Australian Genomics Health Alliance, Melbourne, VIC 3052, Australia; Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia; University of Melbourne, Melbourne, VIC 3010, Australia.
| | - Rebecca E Foulger
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Eleanor Williams
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Bryony A Thompson
- University of Melbourne, Melbourne, VIC 3010, Australia; Royal Melbourne Hospital, Melbourne, VIC 3050, Australia
| | - Chirag Patel
- Genetic Health Queensland, Royal Brisbane and Women's Hospital, Brisbane, QLD 4006, Australia
| | - Sebastian Lunke
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia; University of Melbourne, Melbourne, VIC 3010, Australia
| | - Catherine Snow
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Ivone U S Leong
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Arina Puzriakova
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Louise C Daugherty
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Sarah Leigh
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Christopher Boustred
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Olivia Niblock
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Antonio Rueda-Martin
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Oleg Gerasimenko
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Kevin Savage
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - William Bellamy
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Victor San Kho Lin
- Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, VIC 3000, Australia
| | - Roman Valls
- Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, VIC 3000, Australia
| | - Lavinia Gordon
- Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, VIC 3000, Australia
| | - Helen K Brittain
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Ellen R A Thomas
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; Guy's and St Thomas's NHS Trust, London SE1 9RS, UK
| | | | - Meriel McEntagart
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; St George's University Hospitals NHS Trust, London SW17 0QT, UK
| | - Susan M White
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia; University of Melbourne, Melbourne, VIC 3010, Australia
| | - Tiong Y Tan
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia; University of Melbourne, Melbourne, VIC 3010, Australia
| | - Alison Yeung
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia; University of Melbourne, Melbourne, VIC 3010, Australia
| | - Lilian Downie
- University of Melbourne, Melbourne, VIC 3010, Australia; Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Ivan Macciocca
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Elena Savva
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Crystle Lee
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Ain Roesley
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Paul De Fazio
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Jane Deller
- National Health Service England and National Health Service Improvement, London SE1 6LH, UK
| | - Zandra C Deans
- National Health Service England and National Health Service Improvement, London SE1 6LH, UK
| | - Sue L Hill
- National Health Service England and National Health Service Improvement, London SE1 6LH, UK
| | - Mark J Caulfield
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Kathryn N North
- Australian Genomics Health Alliance, Melbourne, VIC 3052, Australia; University of Melbourne, Melbourne, VIC 3010, Australia; Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Richard H Scott
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Augusto Rendon
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Oliver Hofmann
- Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, VIC 3000, Australia
| | - Ellen M McDonagh
- Genomics England, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; Open Targets and European Molecular Biology Laboratory - European Bioinformatics Institute, Wellcome Genome Campus, Hinxton CB10 1SD, UK
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Chahal M, Jiang A, Hayden A, Savage K, Villa D, Scott D, Gerrie A, Lo A, Chan M, Pickles T, Connors J, Sehn L, Freeman C. OUTCOMES AFTER INITIAL REFUSAL OF CURATIVE TREATMENT IN PATIENTS WITH HODGKIN LYMPHOMA IN BRITISH COLUMBIA. Hematol Oncol 2021. [DOI: 10.1002/hon.112_2880] [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: 11/06/2022]
Affiliation(s)
- M. Chahal
- BC Cancer, Medical Oncology Vancouver Canada
| | - A. Jiang
- British Columbia Cancer Research Centre Biostatistics Vancouver Canada
| | - A. Hayden
- BC Cancer Medical Oncology Surrey Canada
| | - K. Savage
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - D. Villa
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - D. Scott
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - A. Gerrie
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - A. Lo
- BC Cancer Division of Radiation Oncology Vancouver Canada
| | - M. Chan
- BC Cancer Division of Radiation Oncology Vancouver Canada
| | - T. Pickles
- BC Cancer Division of Radiation Oncology Vancouver Canada
| | - J. Connors
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - L. Sehn
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
| | - C. Freeman
- BC Cancer Centre for Lymphoid Cancer and Division of Medical Oncology Vancouver Canada
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Metzler J, Jonfa M, Savage K, Ager A. Educational, psychosocial, and protection outcomes of child- and youth-focused programming with Somali refugees in Dollo Ado, Ethiopia. Disasters 2021; 45:67-85. [PMID: 31322750 DOI: 10.1111/disa.12392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Child- and youth-friendly spaces have become a common feature of emergency humanitarian provision. This study reports on the outcomes of child and youth learning centres (CYLCs) in Ethiopia's Buramino Camp established for those fleeing conflict in Somalia. Eighty-five youths completed baseline assessments shortly after arrival and follow-up assessments three to six months later. Caregivers of 106 younger children completed similar appraisals. 693 children attending the CYLCs completed pre- and post-educational assessments, which indicated major gains-significant at p<0.0001-in both literacy (younger children, t=9.06; youth, t=13.87) and numeracy (younger children, t=13.94; youths, t=17.10). Children's CYLC attendance increased reports of met needs among caregivers (t=2.53, p<0.05) and youths (t=2.57, p<0.05), and, among caregivers but not youths, significantly moderated protection concerns (t=2.39, p<0.05, and t=-1.90, p=0.06, respectively). There was general improvement in psychosocial well-being over time for all children; CYLC attendance predicted greater reductions in reported difficulties only among younger children (t=2.51, p<0.05).
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Affiliation(s)
- Janna Metzler
- Senior Research Officer, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, United States
| | - Mesfin Jonfa
- Education in Emergency Specialist, World Vision Ethiopia, Ethiopia
| | - Kevin Savage
- Humanitarian Research Director, World Vision International, Geneva, Switzerland
| | - Alastair Ager
- Professor of Population and Family Health, Columbia University, United States
- Now Director of the Institute for Global Health and Development, Queen Margaret University, United Kingdom
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Tol WA, Ager A, Bizouerne C, Bryant R, El Chammay R, Colebunders R, García-Moreno C, Hamdani SU, James LE, Jansen SCJ, Leku MR, Likindikoki S, Panter-Brick C, Pluess M, Robinson C, Ruttenberg L, Savage K, Welton-Mitchell C, Hall BJ, Harper Shehadeh M, Harmer A, van Ommeren M. Improving mental health and psychosocial wellbeing in humanitarian settings: reflections on research funded through R2HC. Confl Health 2020; 14:71. [PMID: 33292413 PMCID: PMC7602334 DOI: 10.1186/s13031-020-00317-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/16/2020] [Indexed: 01/08/2023] Open
Abstract
Major knowledge gaps remain concerning the most effective ways to address mental health and psychosocial needs of populations affected by humanitarian crises. The Research for Health in Humanitarian Crisis (R2HC) program aims to strengthen humanitarian health practice and policy through research. As a significant portion of R2HC's research has focused on mental health and psychosocial support interventions, the program has been interested in strengthening a community of practice in this field. Following a meeting between grantees, we set out to provide an overview of the R2HC portfolio, and draw lessons learned. In this paper, we discuss the mental health and psychosocial support-focused research projects funded by R2HC; review the implications of initial findings from this research portfolio; and highlight four remaining knowledge gaps in this field. Between 2014 and 2019, R2HC funded 18 academic-practitioner partnerships focused on mental health and psychosocial support, comprising 38% of the overall portfolio (18 of 48 projects) at a value of approximately 7.2 million GBP. All projects have focused on evaluating the impact of interventions. In line with consensus-based recommendations to consider a wide range of mental health and psychosocial needs in humanitarian settings, research projects have evaluated diverse interventions. Findings so far have both challenged and confirmed widely-held assumptions about the effectiveness of mental health and psychosocial interventions in humanitarian settings. They point to the importance of building effective, sustained, and diverse partnerships between scholars, humanitarian practitioners, and funders, to ensure long-term program improvements and appropriate evidence-informed decision making. Further research needs to fill knowledge gaps regarding how to: scale-up interventions that have been found to be effective (e.g., questions related to integration across sectors, adaptation of interventions across different contexts, and optimal care systems); address neglected mental health conditions and populations (e.g., elderly, people with disabilities, sexual minorities, people with severe, pre-existing mental disorders); build on available local resources and supports (e.g., how to build on traditional, religious healing and community-wide social support practices); and ensure equity, quality, fidelity, and sustainability for interventions in real-world contexts (e.g., answering questions about how interventions from controlled studies can be transferred to more representative humanitarian contexts).
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Affiliation(s)
- Wietse A Tol
- Section of Global Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, bg 9, DK-1014, Copenhagen, Denmark.
- Peter C. Alderman Program for Global Mental Health, HealthRight International, New York, NY, USA.
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Alastair Ager
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Cecile Bizouerne
- Mental Health, Child Care Practices, Gender and Protection, Action Contre La Faim, Paris, France
| | - Richard Bryant
- School of Psychology & Traumatic Stress Clinic, University of New South Wales, Sydney, Australia
| | - Rabih El Chammay
- National Mental Health Programme, Ministry of Public Health, Beirut, Lebanon
- Department of Psychiatry, Saint Joseph University, Beirut, Lebanon
| | | | - Claudia García-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Leah E James
- Institute of Behavioral Science, University of Colorado, Boulder, CA, USA
| | - Stefan C J Jansen
- Center for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Samuel Likindikoki
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Catherine Panter-Brick
- Jackson Institute of Global Affairs, Yale University, New Haven, CT, USA
- Department of Anthropology, Yale University, New Haven, CT, USA
| | - Michael Pluess
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | - Courtland Robinson
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, London, UK
| | - Leontien Ruttenberg
- International Medical Relief Services (IMRES), Prior association: Arq International, Europe, Netherlands
| | - Kevin Savage
- Evidence Building, World Vision International, Geneva, Switzerland
| | - Courtney Welton-Mitchell
- Institute of Behavioral Science and Colorado School of Public Health, University of Colorado, Boulder, Denver, USA
| | - Brian J Hall
- Global and Community Mental Health Research Group, New York University (Shanghai), Shanghai, People's Republic of China
| | | | | | - Mark van Ommeren
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Santillan MR, Savage K, Porter M, Parker R, Simon M, Kimball A. 430 Crohn's disease prevalence prior to and following hidradenitis suppurativa diagnosis. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tolchin D, Yeager JP, Prasad P, Dorrani N, Russi AS, Martinez-Agosto JA, Haseeb A, Angelozzi M, Santen G, Ruivenkamp C, Mercimek-Andrews S, Depienne C, Kuechler A, Mikat B, Ludecke HJ, Bilan F, Le Guyader G, Gilbert-Dussardier B, Keren B, Heide S, Haye D, Van Esch H, Keldermans L, Ortiz D, Lancaster E, Krantz ID, Krock BL, Pechter KB, Arkader A, Medne L, DeChene ET, Calpena E, Melistaccio G, Wilkie AO, Suri M, Foulds N, Begtrup A, Henderson LB, Forster C, Reed P, McDonald MT, McConkie-Rosell A, Thevenon J, Le Tanno P, Coutton C, Tsai AC, Stewart S, Maver A, Gorazd R, Pichon O, Nizon M, Cogné B, Isidor B, Martin-Coignard D, Stoeva R, Lefebvre V, Le Caignec C, Ambrose J, Bleda M, Boardman-Pretty F, Boissiere J, Boustred C, Caulfield M, Chan G, Craig C, Daugherty L, de Burca A, Devereau A, Elgar G, Foulger R, Fowler T, Furió-Tarí P, Hackett J, Halai D, Holman J, Hubbard T, Kasperaviciute D, Kayikci M, Lahnstein L, Lawson K, Leigh S, Leong I, Lopez F, Maleady-Crowe F, Mason J, McDonagh E, Moutsianas L, Mueller M, Need A, Odhams C, Patch C, Perez-Gil D, Polychronopoulos D, Pullinger J, Rahim T, Rendon A, Rogers T, Ryten M, Savage K, Scott R, Siddiq A, Sieghart A, Smedley D, Smith K, Sosinsky A, Spooner W, Stevens H, Stuckey A, Thomas E, Thompson S, Tregidgo C, Tucci A, Walsh E, Watters S, Welland M, Williams E, Witkowska K, Wood S, Zarowiecki M. De Novo SOX6 Variants Cause a Neurodevelopmental Syndrome Associated with ADHD, Craniosynostosis, and Osteochondromas. Am J Hum Genet 2020; 106:830-845. [PMID: 32442410 DOI: 10.1016/j.ajhg.2020.04.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/24/2020] [Indexed: 12/21/2022] Open
Abstract
SOX6 belongs to a family of 20 SRY-related HMG-box-containing (SOX) genes that encode transcription factors controlling cell fate and differentiation in many developmental and adult processes. For SOX6, these processes include, but are not limited to, neurogenesis and skeletogenesis. Variants in half of the SOX genes have been shown to cause severe developmental and adult syndromes, referred to as SOXopathies. We here provide evidence that SOX6 variants also cause a SOXopathy. Using clinical and genetic data, we identify 19 individuals harboring various types of SOX6 alterations and exhibiting developmental delay and/or intellectual disability; the individuals are from 17 unrelated families. Additional, inconstant features include attention-deficit/hyperactivity disorder (ADHD), autism, mild facial dysmorphism, craniosynostosis, and multiple osteochondromas. All variants are heterozygous. Fourteen are de novo, one is inherited from a mosaic father, and four offspring from two families have a paternally inherited variant. Intragenic microdeletions, balanced structural rearrangements, frameshifts, and nonsense variants are predicted to inactivate the SOX6 variant allele. Four missense variants occur in residues and protein regions highly conserved evolutionarily. These variants are not detected in the gnomAD control cohort, and the amino acid substitutions are predicted to be damaging. Two of these variants are located in the HMG domain and abolish SOX6 transcriptional activity in vitro. No clear genotype-phenotype correlations are found. Taken together, these findings concur that SOX6 haploinsufficiency leads to a neurodevelopmental SOXopathy that often includes ADHD and abnormal skeletal and other features.
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11
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Walls GM, McConnell L, McAleese J, Murray P, Lynch TB, Savage K, Hanna GG, de Castro DG. Early circulating tumour DNA kinetics measured by ultra-deep next-generation sequencing during radical radiotherapy for non-small cell lung cancer: a feasibility study. Radiat Oncol 2020; 15:132. [PMID: 32471446 PMCID: PMC7260736 DOI: 10.1186/s13014-020-01583-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/25/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The evaluation of circulating tumour DNA (ctDNA) from clinical blood samples, liquid biopsy, offers several diagnostic advantages compared with traditional tissue biopsy, such as shorter processing time, reduced patient risk and the opportunity to assess tumour heterogeneity. The historically poor sensitivity of ctDNA testing, has restricted its integration into routine clinical practice for non-metastatic disease. The early kinetics of ctDNA during radical radiotherapy for localised NSCLC have not been described with ultra-deep next generation sequencing previously. MATERIALS AND METHODS Patients with CT/PET-staged locally advanced, NSCLC prospectively consented to undergo serial venepuncture during the first week of radical radiotherapy alone. All patients received 55Gy in 20 fractions. Plasma samples were processed using the commercially available Roche AVENIO Expanded kit (Roche Sequencing Solutions, Pleasanton, CA, US) which targets 77 genes. RESULTS Tumour-specific mutations were found in all patients (1 in 3 patients; 2 in 1 patient, and 3 in 1 patient). The variant allele frequency of these mutations ranged from 0.05-3.35%. In 2 patients there was a transient increase in ctDNA levels at the 72 h timepoint compared to baseline. In all patients there was a non-significant decrease in ctDNA levels at the 7-day timepoint in comparison to baseline (p = 0.4627). CONCLUSION This study demonstrates the feasibility of applying ctDNA-optimised NGS protocols through specified time-points in a small homogenous cohort of patients with localised lung cancer treated with radiotherapy. Studies are required to assess ctDNA kinetics as a predictive biomarker in radiotherapy. Priming tumours for liquid biopsy using radiation warrants further exploration.
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Affiliation(s)
- G. M. Walls
- Centre for Cancer Research & Cell Biology, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7AE Northern Ireland
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, 51 Lisburn Road, Belfast, BT9 7AB Northern Ireland
| | - L. McConnell
- Centre for Cancer Research & Cell Biology, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7AE Northern Ireland
| | - J. McAleese
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, 51 Lisburn Road, Belfast, BT9 7AB Northern Ireland
| | - P. Murray
- Northern Ireland Biobank, Health Sciences Building, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7AE Northern Ireland
| | - T. B. Lynch
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, 51 Lisburn Road, Belfast, BT9 7AB Northern Ireland
| | - K. Savage
- Centre for Cancer Research & Cell Biology, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7AE Northern Ireland
| | - G. G. Hanna
- Sir Peter MacCallum Department of Oncology, University of Melbourne, 305 Grattan St, Melbourne, VIC 3000 Australia
| | - D. Gonzalez de Castro
- Centre for Cancer Research & Cell Biology, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7AE Northern Ireland
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12
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Doocy S, Busingye M, Lyles E, Colantouni E, Aidam B, Ebulu G, Savage K. Cash-based assistance and the nutrition status of pregnant and lactating women in the Somalia food crisis: A comparison of two transfer modalities. PLoS One 2020; 15:e0230989. [PMID: 32324761 PMCID: PMC7179869 DOI: 10.1371/journal.pone.0230989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 03/12/2020] [Indexed: 12/03/2022] Open
Abstract
Background Large-scale emergency assistance programmes in Somalia use a variety of transfer modalities including in-kind food provision, food vouchers, and cash transfers. Evidence is needed to better understand whether and how such modalities differ in reducing the risk of acute malnutrition in vulnerable groups, such as the 800,000 pregnant and lactating women affected by the 2017/18 food crisis. Methods Changes in diet and acute malnutrition status were assessed among pregnant and lactating women receiving similarly sized household transfers over a four-month period (total value of ~US$450 per household) delivered either as food vouchers or as mixed transfers consisting of in-kind food, vouchers, and cash. Baseline and endline comparisons were conducted for 514 women in Wajid, Somalia. Primary study outcomes were Minimum Dietary Diversity for Women, meal frequency, and mid-upper arm circumference (MUAC), with MUAC<21.0 cm classified as acute malnutrition. Adjusted analyses consisted of difference-in-difference analysis using linear and logistic regression models with inverse probability weighting based on propensity scores to account for the non-randomized design. Findings No significant difference in change in dietary quality was observed between food voucher and mixed transfer recipients; a significant difference in change in mean meal frequency was observed (0.3 meals/day, CI: 0.1–0.5, p = 0.001) and the mixed transfer group had significantly greater meal frequency at endline (p<0.001). Mean MUAC increased significantly among both voucher (0.9cm, CI: 0.6–1.3, p = 0.001) and mixed transfer recipients (1.3cm, CI: 1.1–1.5, p = 0.001) over the intervention period in adjusted analysis, however, the difference in magnitude of change between the two groups was not statistically significant (0.4cm, CI: -0.1–0.08, p = 0.086). Conclusions Within the context of the 2017/18 Somalia food crisis, the modality of assistance provided to pregnant and lactating women (mixed transfers or food-vouchers) made no difference in preventing acute malnutrition and protecting nutritional status.
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Affiliation(s)
- Shannon Doocy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | | | - Emily Lyles
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Elizabeth Colantouni
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Bridget Aidam
- Evidence and Learning Unit, World Vision International, Washington, DC, United States of America
| | - George Ebulu
- Quality Assurance, World Vision Somalia, Mogadishu, Somalia
| | - Kevin Savage
- Evidence Building, World Vision International, Geneva, Switzerland
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13
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Doocy S, Busingye M, Lyles E, Colantouni E, Aidam B, Ebulu G, Savage K. Cash and voucher assistance and children's nutrition status in Somalia. Matern Child Nutr 2020; 16:e12966. [PMID: 32141183 PMCID: PMC7296788 DOI: 10.1111/mcn.12966] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 12/20/2019] [Accepted: 01/21/2020] [Indexed: 11/27/2022]
Abstract
To address ongoing food insecurity and acute malnutrition in Somalia, a broad range of assistance modalities are used, including in‐kind food, food vouchers, and cash transfers. Evidence of the impact of cash and voucher assistance (CVA) on prevention of acute malnutrition is limited in humanitarian and development settings. This study examined the impact of CVA on prevention of child acute malnutrition in 2017/2018 in the context of the Somalia food crisis. Changes in diet and acute malnutrition were measured over a 4‐month period among children age 6–59 months from households receiving household transfers of approximately US$450 delivered either as food vouchers or a mix of in‐kind food, vouchers, and cash. Baseline to endline change in children's dietary diversity, meal frequency, minimum acceptable diet (MAD), mid‐upper arm circumference (MUAC), and acute malnutrition (MUAC < 12.5 cm) were compared using difference‐in‐difference analysis with inverse probability weighting. There were no statistically significant changes in dietary diversity, meal frequency, or the proportion of children with MAD for either intervention group. Adjusted change in mean MUAC showed increases of 0.5 cm (confidence interval [CI; 0.0, 0.7 cm]) in the food voucher group and 0.1 cm (CI [−0.1, 0.4]) in the mixed transfer group. In adjusted analysis, prevalence of acute malnutrition among children under 5 years increased by 0.7% (CI [−13.4, 14.4%]) among food voucher recipients and decreased by 4.8% (CI [−9.9, 8.1%]) in mixed transfer recipients. The change over time in both mean MUAC and acute malnutrition prevalence was similar for both interventions, suggesting that cash and vouchers had similar effects on child nutrition status.
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Affiliation(s)
- Shannon Doocy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Emily Lyles
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth Colantouni
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bridget Aidam
- Evidence & Learning Unit, World Vision International, Washington, DC
| | | | - Kevin Savage
- Humanitarian and Emergency Affairs, World Vision International, Geneva, Switzerland
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Fard MT, Cribb L, Nolidin K, Savage K, Wesnes K, Stough C. Is there a relationship between low-grade systemic inflammation and cognition in healthy people aged 60-75 years? Behav Brain Res 2020; 383:112502. [PMID: 31981652 DOI: 10.1016/j.bbr.2020.112502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/06/2020] [Accepted: 01/21/2020] [Indexed: 01/03/2023]
Abstract
Although inflammation has been associated with cognitive impairment in dementia, less is known about its role in the cognition of middle to older aged healthy people. This study utilised baseline data from the Australian Research Council Longevity Intervention (ARCLI) trial to investigate the relationship between markers of systemic inflammation (TNF-α, IL-6, IL-1β, INF-γ, IL-2, IL-4, IL-10 and hsCRP) and cognitive function in 286 healthy volunteers aged 60-75 years. We assessed cognitive functioning across domains including attention, speed of memory, working memory and episodic memory using the Cognitive Drug Research test battery. Only IFN-γ was related to cognitive function, being associated with greater odds of having low continuity of attention (log2 IFN-γ OR, 1.46; 95 % CI, 1.18-1.85). The relationship between episodic memory, speed of memory and inflammation varied with BMI. In high BMI participants, increased inflammation was associated with worse cognitive function, while this association was reversed in those with low BMI. Outside of the influence of IFN-γ on attention, low-grade systemic inflammation was not robustly associated with cognitive function in this sample of middle to older aged healthy people. Further research is required to understand the role of BMI in the intersection of inflammation and cognitive function.
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Affiliation(s)
- M T Fard
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
| | - L Cribb
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia; Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - K Nolidin
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
| | - K Savage
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
| | - K Wesnes
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia; Wesnes Cognition Ltd, Little Paddock, Streatley Hill, Streatley on Thames, RG8 9RD, UK
| | - C Stough
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia.
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Hermosilla S, Metzler J, Savage K, Ager A. Resilience and adjustment trajectories amongst children in displacement-affected communities in Zarqa, Jordan. J Glob Health Rep 2020; 4. [PMID: 35128077 PMCID: PMC8813053 DOI: 10.29392/001c.18233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The experiences of protracted conflict and displacement are clear threats to children's developmental progress. Understanding the factors that shape the trajectories of children's well-being and adjustment in such contexts is important for informing interventions. METHODS We collected data at three time points from a sample of Syrian refugee and Jordanian children (n=650) residing in Zarqa, Jordan who met eligibility criteria for humanitarian programming. We assessed primary outcomes of protection concerns, caregiver stress, mental health, and developmental assets at three time points: baseline (T1), three months later (T2), and fifteen months after baseline (T3). RESULTS Over the fifteen-month study period (T1-T3) child protection concerns and mental health symptoms improved, caregiver stress remained constant, and developmental assets deteriorated. School attendance was independently associated with improvements in protection concerns (β = -1.05, P=0.01), caregiver stress (β = -0.66, P =0.02), and developmental assets (β = 3.84, P =0.02). Concern over lost livelihoods significantly predicted higher protection concerns (β = 4.08, P <0.001) and caregiver stress (β = 2.32, P <0.001). Attending child-focused programming did not significantly impact primary outcomes. CONCLUSIONS This study documents the capacity for adjustment and adaptation of children in the context of protracted displacement. The significant influences of attending school and concern over lost livelihoods on observed trajectories indicate the importance of addressing structural factors, such as education and employment, in supporting processes of resilience in these populations. Programmatic activities for children may secure valuable shorter-term impacts but here, as elsewhere, failed to impact outcomes longer-term.
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Affiliation(s)
- Sabrina Hermosilla
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Janna Metzler
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Kevin Savage
- Humanitarian and Emergency Affairs, World Vision International, Geneva, Switzerland
| | - Alastair Ager
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA; Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland, UK
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Metzler J, Diaconu K, Hermosilla S, Kaijuka R, Ebulu G, Savage K, Ager A. Short- and longer-term impacts of Child Friendly Space Interventions in Rwamwanja Refugee Settlement, Uganda. J Child Psychol Psychiatry 2019; 60:1152-1163. [PMID: 31106415 PMCID: PMC6852245 DOI: 10.1111/jcpp.13069] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The establishment of Child Friendly Spaces (CFSs) has become a widespread intervention targeting protection and support for displaced children in humanitarian contexts. There is a lack of evidence of impact of these interventions with respect to both short-term outcomes and longer-term developmental trajectories. METHODS We collected data from caregivers of Congolese refugee children residing in Rwamwanja Refugee Settlement at three timepoints. To assess short-term impact of CFSs, we compared indicators assessed shortly after refugees' arrival (baseline, T1) and endline (T2, three to six months after CFS implementation) amongst 430 CFS attenders and 161 nonattenders. Follow-up assessments after the end of CFS programming were conducted 18 months post-baseline (T3) with caregivers of 249 previous CFS attenders and 77 CFS nonattenders. RESULTS In the short-term, attendance at CFSs was associated with better maintenance of psychosocial well-being (PSWB; β = 2.093, p < .001, Cohen's d = .347) and greater increases in developmental assets (β = 2.517, p < .001, Cohen's d = .231), with significantly stronger impacts for girls. CFS interventions meeting higher programing quality criteria were associated with greater impact on both PSWB and development assets (β = 2.603 vs. β = 1.793 and β = 2.942 vs. β = 2.337 for attenders at higher and lower-quality CFSs c.f. nonattenders, respectively). Amongst boys, benefits of program attendance were only indicated for those attending higher-quality CFS (β = 2.084, p = .006 for PSWB). At follow-up, however, there were no discernable impacts of prior CFS attendance on any measures. Age and school attendance were the only characteristics that predicted an outcome - developmental assets - at follow-up. CONCLUSIONS Attendance at CFSs - particularly involving higher-quality programming - supported children's well-being and development. However, sustained impact beyond active CFS programming was not demonstrated. Intervention goals and strategies in humanitarian contexts need to address the challenge of connecting children to other resources to facilitate developmental progress in conditions of protracted displacement.
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Affiliation(s)
- Janna Metzler
- Department of Population and Family HealthMailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Karin Diaconu
- Institute for Global Health and DevelopmentQueen Margaret UniversityEdinburghScotlandUK
| | | | | | | | - Kevin Savage
- Humanitarian and Emergency AffairsWorld Vision InternationalGenevaSwitzerland
| | - Alastair Ager
- Department of Population and Family HealthMailman School of Public HealthColumbia UniversityNew YorkNYUSA,Institute for Global Health and DevelopmentQueen Margaret UniversityEdinburghScotlandUK
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Rivera P, Savage K, Ball A. A Systematic Approach to Spanish Neuropsychological Evaluation: Case Report with a Mexican Woman in an Outpatient Setting. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz029.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective
The following case will demonstrate a systematic approach to neuropsychological evaluation with Spanish-speaking individuals, which includes creating a suitable test battery, interpreting results with appropriate normative samples, and incorporating personal history.
Case Description
61-year-old, right-handed, Mexican female with 2 years of formal education, and with a recent history of subarachnoid hemorrhage with hydrocephalus. She was referred by her social worker and primary care provider to discern whether the reported cognitive complaints were due to a neurocognitive condition or depression.
Diagnostic Impressions and Outcomes
The evaluation was administered entirely in Spanish and some exams were modified to accommodate her limited literacy skills. She exhibited deficits in executive functioning, verbal fluency, and memory. Emotional testing revealed moderate depression with anxious distress, which she attributed to significant changes in everyday life. Her family informed us that she was the “matriarch of the family” and worked as a farm field truck driver, with significant difficulties/lack of engagement in both of these roles. Therefore, diagnoses of probable major vascular neurocognitive disorder and major depressive disorder with anxious distress were assigned. With this information, her providers were able to connect the family with community resources.
Discussion
The Hispanic population continues to be the fastest growing demographic in the United States. As more clinicians will work with members of this ethnicity in outpatient settings, it is important that they incorporate culturally-relevant factors in their approach to testing and interpretation of results. Nonetheless, this case demonstrates the current challenges and limitations, including modification of exams, differences in educational system that underlie test construction, and patient’s history. Recommendations for future areas of study and practice will also be discussed.
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Ansell S, Ramchandren R, Domingo-Domènech E, Rueda A, Trněný M, Feldman T, Lee H, Provencio M, Sillaber C, Cohen J, Savage K, Willenbacher W, Sumbul A, Sacchi M, Armand P. NIVOLUMAB PLUS DOXORUBICIN, VINBLASTINE AND DACARBAZINE FOR NEWLY DIAGNOSED ADVANCED-STAGE CLASSICAL HODGKIN LYMPHOMA: CHECKMATE 205 COHORT D 2-YEAR FOLLOW-UP. Hematol Oncol 2019. [DOI: 10.1002/hon.104_2629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. Ansell
- Division of Hematology; Mayo Clinic; Rochester United States
| | - R. Ramchandren
- Division of Hematology and Oncology; University of Tennessee; Knoxville United States
| | | | - A. Rueda
- Servicio de Oncología; Hospital Costa del Sol; Marbella Spain
| | - M. Trněný
- Department of Haematology; Charles University in Prague and General University Hospital in Prague; Prague Czech Republic
| | - T. Feldman
- Hematology & Oncology; Hackensack University Medical Center; Hackensack United States
| | - H. Lee
- Department of Lymphoma and Myeloma; Division of Cancer Medicine, University of Texas MD Anderson Cancer Center; Houston United States
| | - M. Provencio
- Medical Oncology Department; Hospital Universitario Puerta de Hierro; Madrid Spain
| | - C. Sillaber
- Clinical Division of Oncology; Medical University of Vienna; Vienna Austria
| | - J. Cohen
- Department of Hematology and Medical Oncology; Winship Cancer Institute, Emory University; Atlanta United States
| | - K. Savage
- Department of Pathology and Laboratory Medicine; British Columbia Cancer Center for Lymphoid Cancer; Vancouver Canada
| | - W. Willenbacher
- Department of Internal Medicine; Innsbruck University Hospital & OncoTyrol - Center for Personalized Cancer Medicine; Innsbruck Austria
| | - A. Sumbul
- Bristol-Myers Squibb; Princeton United States
| | - M. Sacchi
- Bristol-Myers Squibb; Princeton United States
| | - P. Armand
- Department of Medical Oncology; Dana-Farber Cancer Institute; Boston United States
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19
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Hermosilla S, Metzler J, Savage K, Musa M, Ager A. Child friendly spaces impact across five humanitarian settings: a meta-analysis. BMC Public Health 2019; 19:576. [PMID: 31092239 PMCID: PMC6521445 DOI: 10.1186/s12889-019-6939-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Humanitarian crises present major threats to the wellbeing of children. These threats include risks of violence, abduction and abuse, emotional distress and the disruption of development. Humanitarian response efforts frequently address these threats through psychosocial programming. Systematic reviews have demonstrated the weak evidence-base regarding the impact of such interventions. This analysis assesses the impact of Child Friendly Spaces (CFS), one such commonly implemented intervention after humanitarian emergencies. METHODS We completed baseline and endline (three-six months post-baseline) assessments regarding protection concerns, psychosocial wellbeing, developmental assets and community resources for a total of 1010 children and 1312 carers in catchment areas for interventions with humanitarian populations in Ethiopia, Uganda, Iraq, Jordan, and Nepal. We estimated intervention effect-sizes with Cohen's d for difference in mean difference scores between attenders and non-attenders - who proved comparable on baseline measures - by site. We then pooled findings for a meta-analysis summarizing overall impacts across domains. RESULTS Amongst children aged 6-11, significant intervention impacts were observed through site-level analysis for protection concerns (Ethiopia, Cohen's d = 0.48, 95% CI 0.08-0.88), psychosocial wellbeing (Ethiopia, d = 0.51, 95% CI 0.10-0.91; and Uganda, d = 0.21, 95% CI 0.02-0.40), and developmental assets (Uganda, d = 0.37, 95% CI 0.15-0.59; and Iraq, d = 0.86, 95% CI 0.18-1.54). Pooled analyses for this age group found impacts of intervention to be significant only for psychosocial wellbeing (d = 0.18, 95% CI 0.03-0.33). Among children aged 12-17, site-level analysis indicated intervention impact for protection concerns in one site (Iraq, d = 0.58, 95% CI 0.07-1.09), with pooled analysis indicating no significant impacts. CONCLUSION CFS can provide - albeit inconsistently - a protective and promotive environment for younger children. CFS show no impact with older children and in connecting children and carers with wider community resources. A major reappraisal of programming approaches and quality assurance mechanisms is required.
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Affiliation(s)
| | - Janna Metzler
- Columbia University, 1051 Riverside Drive, New York, 10032 USA
| | - Kevin Savage
- World Vision International, Chemin de Balexert 7-9, 1219 Châtelaine, Geneva, Switzerland
| | - Miriam Musa
- Columbia University, 1051 Riverside Drive, New York, 10032 USA
| | - Alastair Ager
- Columbia University, 1051 Riverside Drive, New York, 10032 USA
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland EH21 6UU UK
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20
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Gómez-Blanco J, de la Rosa-Trevín JM, Marabini R, Del Cano L, Jiménez A, Martínez M, Melero R, Majtner T, Maluenda D, Mota J, Rancel Y, Ramírez-Aportela E, Vilas JL, Carroni M, Fleischmann S, Lindahl E, Ashton AW, Basham M, Clare DK, Savage K, Siebert CA, Sharov GG, Sorzano COS, Conesa P, Carazo JM. Using Scipion for stream image processing at Cryo-EM facilities. J Struct Biol 2018; 204:457-463. [PMID: 30296492 PMCID: PMC6303188 DOI: 10.1016/j.jsb.2018.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 06/07/2018] [Revised: 10/01/2018] [Accepted: 10/03/2018] [Indexed: 12/11/2022]
Abstract
Three dimensional electron microscopy is becoming a very data-intensive field in which vast amounts of experimental images are acquired at high speed. To manage such large-scale projects, we had previously developed a modular workflow system called Scipion (de la Rosa-Trevín et al., 2016). We present here a major extension of Scipion that allows processing of EM images while the data is being acquired. This approach helps to detect problems at early stages, saves computing time and provides users with a detailed evaluation of the data quality before the acquisition is finished. At present, Scipion has been deployed and is in production mode in seven Cryo-EM facilities throughout the world.
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Affiliation(s)
- J Gómez-Blanco
- Department of Anatomy and Cell Biology, McGill University, Montreal, Canada
| | - J M de la Rosa-Trevín
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Stockholm, Sweden
| | - R Marabini
- Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049 Cantoblanco, Madrid, Spain.
| | - L Del Cano
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - A Jiménez
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - M Martínez
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - R Melero
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - T Majtner
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - D Maluenda
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - J Mota
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - Y Rancel
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - E Ramírez-Aportela
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - J L Vilas
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - M Carroni
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Stockholm, Sweden
| | - S Fleischmann
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Stockholm, Sweden
| | - E Lindahl
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Stockholm, Sweden; Swedish e-Science Research Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - A W Ashton
- Diamond Light Source, Harwell Science and Innovation Campus, Didcot OX11 0DE, United Kingdom
| | - M Basham
- Diamond Light Source, Harwell Science and Innovation Campus, Didcot OX11 0DE, United Kingdom
| | - D K Clare
- Diamond Light Source, Harwell Science and Innovation Campus, Didcot OX11 0DE, United Kingdom
| | - K Savage
- Diamond Light Source, Harwell Science and Innovation Campus, Didcot OX11 0DE, United Kingdom
| | - C A Siebert
- Diamond Light Source, Harwell Science and Innovation Campus, Didcot OX11 0DE, United Kingdom
| | - G G Sharov
- Medical Research Council Laboratory of Molecular Biology, Francis Crick Avenue, Cambridge CB2 OQH, United Kingdom
| | - C O S Sorzano
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - P Conesa
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
| | - J M Carazo
- Biocomputing Unit, National Center for Biotechnology (CSIC), C/ Darwin, 3, Campus Universidad Autónoma, 28049 Cantoblanco, Madrid, Spain
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Stupnikov A, McInerney CE, O’Reilly PG, Roddy AC, Dunne PD, Gilmore A, Savage K, McIntosh SA, Flannery T, Healy E, Ellis HP, Kurian KM, Emmert-Streib F, Prise KM, Salto-Tellez M, McArt DG. P04.46 Variable RNA sequencing depth impacts gene signatures and target compound robustness - case study examining brain tumour (glioma) disease progression. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.280] [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: 11/12/2022] Open
Affiliation(s)
- A Stupnikov
- Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, Baltimore, MD, United States
| | - C E McInerney
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
| | - P G O’Reilly
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
| | - A C Roddy
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
| | - P D Dunne
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
| | - A Gilmore
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
| | - K Savage
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
| | - S A McIntosh
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
| | - T Flannery
- Department of Neurosurgery, Royal Victoria Hospital, Belfast Health & Social Care Trust, Northern Ireland, Belfast, United Kingdom
| | - E Healy
- Regional Service for Neuropathology, Belfast Health and Social Care Trust, Northern Ireland, Belfast, United Kingdom
| | - H P Ellis
- Brain Tumour Research Group, University of Bristol, Bristol, United Kingdom
| | - K M Kurian
- Brain Tumour Research Group, University of Bristol, Bristol, United Kingdom
| | - F Emmert-Streib
- Tampere University of Technology, Tampere, Finland, Tampere, Finland
| | - K M Prise
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
| | - M Salto-Tellez
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
| | - D G McArt
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, Belfast, United Kingdom
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de la Rosa-Trevín JM, Gómez-Blanco J, Conesa P, Rancel Y, del Cano L, Arranz R, Chichón FJ, Martín-Benito J, Carroni M, Fleichman S, Lindahl E, Basham M, Clare DK, Savage K, Siebert CA, Ashton AW, Marabini R, Sorzano COS, Carazo JM. Using Scipion for stream image processing at cryo-EM facilities. Acta Crystallogr A Found Adv 2018. [DOI: 10.1107/s0108767318098380] [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] Open
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23
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Telfer PT, Devereux H, Savage K, Scott F, Dhillon AP, Dusheiko G, Lee CA. Chronic Hepatitis C Virus Infection in Haemophilic Patients: Clinical Significance of Viral Genotype. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1649923] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryWe have undertaken a comprehensive study of hepatitis C virus (HCV) genotype and its clinical significance in haemophilic patients. 189 HCV RNA positive patients were typed, using the Simmonds classification scheme, by restriction fragment length polymorphism (RFLP) in an amplified segment of the 5 non-coding region of the HCV genome. Type 1 was found in 121 (64.0%), type 2 in 23 (12.2%), type 3 in 36 (19.0%), type 4 in 3 (1.6%), type 5 in 2 (1.1%) and mixed infection in 3 (1.6%). There were no type 6 infections and one patient (0.5%) could not be typed. Genotype was not associated with diagnosis, age, or with HIV infection. Type I was associated with higher serum HCV RNA levels, and with a poor response to interferon. Progression to hepatic decompensation has been seen less frequently in those with type 3 compared to type 1 infection (p = 0.07). Three out of eleven patients studied over a longer time course showed a change in genotype, the remainder were persistently infected with HCV type 1. In conclusion, HCV genotype has clinical relevance in the management of haemophilic patients. Those with type 1 are probably more likely to develop serious liver disease and since they respond poorly to inter- feron-α, should be considered for new treatment strategies aimed at sustained clearance of HCV RNA.
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Affiliation(s)
- P T Telfer
- The Haemophilia Centre and Haemostasis Unit, London, UK
| | - H Devereux
- The Haemophilia Centre and Haemostasis Unit, London, UK
| | - K Savage
- The Department of Histopathology, Royal Free Hospital and School of Medicine, London, UK
| | - F Scott
- The Department of Histopathology, Royal Free Hospital and School of Medicine, London, UK
| | - A P Dhillon
- The Department of Histopathology, Royal Free Hospital and School of Medicine, London, UK
| | - G Dusheiko
- The Academic Department of Medicine, Royal Free Hospital and School of Medicine, London, UK
| | - C A Lee
- The Haemophilia Centre and Haemostasis Unit, London, UK
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Johnson JP, Savage K, Gil JA, Eberson CP, Mulcahey MK. Increased Academic Productivity of Orthopaedic Surgery Residents Following 2011 Duty Hour Reform. J Surg Educ 2018; 75:884-887. [PMID: 29273338 DOI: 10.1016/j.jsurg.2017.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 06/08/2017] [Accepted: 12/04/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) mandated increasingly stringent resident duty hour restrictions. With less time required at the hospital, residents theoretically have more time for other academic activities, such as research. Our study seeks to examine whether the number of research publications by orthopaedic residents increased following implementation of the 2011 ACGME duty hour restrictions. DESIGN Pubmed was queried using publicly available alumni lists from programs across the United States. The years 2008 to 2011 were included to assess pre-2011 productivity. The years 2012 to 2015 were included in the post 2011 group. Paired t tests were used to assess differences between groups. Statistical significance was set to p < 0.05 a priori. SETTING A total of 10 orthopedic surgery residency programs across the United States. PARTICIPANTS The study group was composed of 5 of the 2015 top 20 National Institutes of Health (NIH) funded programs and 5 programs without NIH funding. RESULTS When corrected for number of residents per year, there were 0.290 publications per resident/year from 2008 to 2011 increasing to 0.528 publications per resident/year from 2012 to 2015 following implementation of the 2011 work hour restrictions (p = 0.033). When corrected for number of residents per year, there remained no difference in publications per resident from 2008 to 2011 (p = 0.81) or from 2012 to 2015 (p = 0.10) between NIH and non-NIH funded programs. CONCLUSION There has been little data to support the theory that resident work hour restrictions have improved education or patient care in any meaningful way. In our study, there was a statistically significant increase in publications after 2011; however, the number of publications between NIH funded and non-NIH funded programs did not differ. Our study is the first to demonstrate that with increasing duty hour restrictions, orthopaedic surgery residents may be using more of their free time to conduct research.
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Affiliation(s)
- Joey P Johnson
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island.
| | - Kevin Savage
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Joseph A Gil
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Craig P Eberson
- Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Lousiana
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Newman PM, Franke MF, Arrieta J, Carrasco H, Elliott P, Flores H, Friedman A, Graham S, Martinez L, Palazuelos L, Savage K, Tymeson H, Palazuelos D. Community health workers improve disease control and medication adherence among patients with diabetes and/or hypertension in Chiapas, Mexico: an observational stepped-wedge study. BMJ Glob Health 2018. [PMID: 29527344 PMCID: PMC5841495 DOI: 10.1136/bmjgh-2017-000566] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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] [Indexed: 11/22/2022] Open
Abstract
Background Non-communicable diseases (NCDs) contribute greatly to morbidity and mortality in low-income and middle-income countries (LMICs). Community health workers (CHWs) may improve disease control and medication adherence among patients with NCDs in LMICs, but data are lacking. We assessed the impact of a CHW-led intervention on disease control and adherence among patients with diabetes and/or hypertension in Chiapas, Mexico. Methods We conducted a prospective observational study among adult patients with diabetes and/or hypertension, in the context of a stepped-wedge roll-out of a CHW-led intervention. We measured self-reported adherence to medications, blood pressure and haemoglobin A1c at baseline and every 3 months, timed just prior to expansion of the intervention to a new community. We conducted individual-level mixed effects analyses of study data, adjusting for time and clustering by patient and community. Findings We analysed 108 patients. The CHW-led intervention was associated with a twofold increase in the odds of disease control (OR 2.04, 95% CI 1.15 to 3.62). It was also associated with optimal adherence assessed by 30-day recall (OR 1.86; 95% CI 1.15 to 3.02) and a positive self-assessment of adherence behaviour (OR 2.29; 95% CI 1.26 to 4.15), but not by 5-day recall. Interpretation A CHW-led adherence intervention was associated with disease control and adherence among adults with diabetes and/or hypertension. This study supports a role of CHWs in supplementing comprehensive primary care for patients with NCDs in LMICs. Trial registration number NCT02549495.
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Affiliation(s)
- Patrick M Newman
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Molly F Franke
- Harvard Medical School, Department of Global Health and Social Medicine, Boston, Massachusetts, USA
| | - Jafet Arrieta
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Hector Carrasco
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Patrick Elliott
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Hugo Flores
- Compañeros en Salud, Angel Albino Corzo, Chiapas, Mexico
| | - Alexandra Friedman
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | | | - Luis Martinez
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Kevin Savage
- Harvard Medical School, Department of Global Health and Social Medicine, Boston, Massachusetts, USA
| | - Hayley Tymeson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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Gold M, Omari T, Abu-Assi R, Moore D, Heine R, Tobin JM, McCall L, Savage K, Ferris L, Kritas S, Davidson G. P34: DIAGNOSTIC MARKERS IN RELATION TO CHALLENGE-PROVEN INFANT COW’S MILK PROTEIN ALLERGY. Intern Med J 2017. [DOI: 10.1111/imj.34_13578] [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: 11/30/2022]
Affiliation(s)
- M Gold
- Department of Allergy and Immunology Womens and Childrens Hospital; Adelaide Australia
| | - T Omari
- College of Medicine and Public Health; Flinders University; Adelaide Australia
| | - R Abu-Assi
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
| | - D Moore
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
| | - R Heine
- Murdoch Children’s Research Institute; University Melbourne; Melbourne Australia
| | - JM Tobin
- Murdoch Children’s Research Institute; University Melbourne; Melbourne Australia
| | - L McCall
- Murdoch Children’s Research Institute; University Melbourne; Melbourne Australia
| | - K Savage
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
| | - L Ferris
- College of Medicine and Public Health; Flinders University; Adelaide Australia
| | - S Kritas
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
| | - G Davidson
- Department of Gastroenterology, Women's and Children's Hospital; Adelaide Australia
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Soroye M, Ayanbadejo P, Savage K, Oluwole A. Association between periodontal disease and pregnancy outcomes. Odontostomatol Trop 2015; 38:5-16. [PMID: 26939216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the association between periodontal disease and pregnancy outcomes like preterm birth and low birth weight. PATIENTS AND METHOD Interviewer-administered questionnaires were completed by the subjects who attended the antenatal clinic of the Lagos University Teaching Hospital, Lagos. Information obtained included; maternal age, gestational age, marital status, educational status, occupation and expected date of delivery. After delivery, the questionnaire was completed with baby's weight at birth and the actual date of delivery. Clinical assessment of the periodontium was done using Oral Hygiene Index (OHI) and Community Periodontal Index of Treatment Needs (CPITN). Participants were divided into three groups: Test, Control I and Control II groups. Scaling and polishing were done for all patients with periodontal disease before (Test group) and after delivery (Control I). All Control II participants (those without periodontal disease) were given Oral hygiene instructions. Descriptive and comparative analyses were done using Epi info version 2008. RESULTS Four hundred and fifty women received the questionnaire but the response rate was 94%, giving an actual sample size of 423 participants. Maternal age range was between 18 and 34 years with mean age of 29.67 (± 3.37). Gestational age at the point of recruitment was between 10 weeks and 26 weeks with mean of 23.34 (± 4.05). The prevalence of periodontal disease among the study group was 33.38%. About 71% of the participants attained tertiary level of education; only 0.7% had no formal education. There was 9.9% use of alcohol among the participants. The mean oral hygiene score for the participants was 1.94 (± 1.31). The prevalences for preterm deliveries, low birth weight and spontaneous abortion were 12.5%, 12.1% and 1.42% respectively. CONCLUSION This study confirms periodontal disease as a probable risk for adverse pregnancy outcomes such as preterm delivery and low birth weight. Therefore, health workers should be encouraged to promote good oral health among women.
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Newman P, Navarro HF, Palazuelos L, Franke M, Carrasco H, Savage K, Elliott P, Friedman A, Palazuelos D. Evaluation of a community health worker intervention to improve adherence
to therapy for non-communicable disease in Chiapas, Mexico. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.983] [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: 11/25/2022] Open
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Gill S, Savage K, Blackhurst D, Eggert J, Smith K, Wysham W, Winter W, Puls L. Abstract 8: Continuing routine cardiac surveillance in long-term use of pegylated liposomal doxorubicin: Is it necessary? Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kelly MJ, Kinnersley P, Phillips K, Savage K, Farrell E, Morgan B, Whistance R, Lewis V, Mann M, Stephens BL, Blazeby J, Elwyn GJ, Edwards AGK. PP34 Interventions to Promote Informed Consent for Invasive Healthcare Procedures: A Cochrane Systematic Review and Meta-Analysis. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.133] [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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Savage K, Davidson EA, Tang J. Diel patterns of autotrophic and heterotrophic respiration among phenological stages. Glob Chang Biol 2013; 19:1151-1159. [PMID: 23504892 DOI: 10.1111/gcb.12108] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 10/22/2012] [Accepted: 11/13/2012] [Indexed: 06/01/2023]
Abstract
Improved understanding of the links between aboveground production and allocation of photosynthate to belowground processes and the temporal variation in those links is needed to interpret observations of belowground carbon cycling processes. Here, we show that combining a trenching manipulation with high-frequency soil respiration measurements in a temperate hardwood forest permitted identification of the temporally variable influence of roots on diel and seasonal patterns of soil respiration. The presence of roots in an untrenched plot caused larger daily amplitude and a 2-3 h delay in peak soil CO2 efflux relative to a root-free trenched plot. These effects cannot be explained by differences in soil temperature, and they were significant only when a canopy was present during the growing season. This experiment demonstrated that canopy processes affect soil CO2 efflux rates and patterns at hourly and seasonal time scales, and it provides evidence that root and microbial processes respond differently to environmental factors.
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Affiliation(s)
- K Savage
- The Woods Hole Research Center, Falmouth, MA 02540, USA.
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Duncan C, Savage K, Williams M, Dickerson B, Kondas AV, Fitzpatrick KA, Guerrero JL, Spraker T, Kersh GJ. Multiple strains of Coxiella burnetii are present in the environment of St. Paul Island, Alaska. Transbound Emerg Dis 2012; 60:345-50. [PMID: 22747976 DOI: 10.1111/j.1865-1682.2012.01353.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In 2010, Coxiella burnetii was identified at a high prevalence in the placentas of Northern fur seals (Callorhinus ursinus) collected at a single rookery on St. Paul Island Alaska; an area of the United States where the agent was not known to be present. As contamination was hypothesized as a potential cause of false positives, but nothing was known about environmental C. burnetii in the region, an environmental survey was conducted to look for the prevalence and distribution of the organism on the island. While environmental prevalence was low, two strains of the organism were identified using PCR targeting the COM1 and IS1111 genes. The two strains are consistent with the organism that has been increasingly identified in marine mammals as well as a strain type more commonly found in terrestrial environments and associated with disease in humans and terrestrial animals. Further work is needed to elucidate information regarding the ecology of this organism in this region, particularly in association with the coastal environment.
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Affiliation(s)
- C Duncan
- Veterinary Diagnostic Lab, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO 80523, USA.
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Maxwell D, Bailey S, Harvey P, Walker P, Sharbatke-Church C, Savage K. Preventing corruption in humanitarian assistance: perceptions, gaps and challenges. Disasters 2012; 36:140-160. [PMID: 21623891 DOI: 10.1111/j.1467-7717.2011.01245.x] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Corruption is a threat to the purpose of humanitarian assistance. Until fairly recently, humanitarian assistance has not been considered an important arena in broader efforts aimed at curbing corruption, and corruption has not always been considered a particularly important concern for humanitarian assistance despite the obviously challenging nature of the context of humanitarian emergencies. Corruption, though, is a threat to humanitarian action because it can prevent assistance from getting to the people who most need it, and because it can potentially undermine public support for such assistance. This paper examines perceptions of corruption and its affects, documents best practices, and outlines gaps in understanding. It suggests recommendations for improving the capacity of humanitarian agencies to prevent and manage the risk of corruption. Agencies have taken steps to combat corruption and improve accountability--downwards and upwards--but scope remains for improvement and for greater sharing of learning and good practice.
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Affiliation(s)
- Daniel Maxwell
- Feinstein International Center, Tufts University, Medford, MA 02155, USA.
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Paul I, Savage K, Lamers E, Gately K, O'Byrne KJ, Blayney JK, Kerr KM, Sheaff M, Richard DJ, Hamilton PW, James J, Quinn JE, Fennell DA. The effect of PARP inhibition on BAX/BAK independent synthetic lethality of BRCA1-deficient non-small cell lung cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e13519] [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: 11/20/2022] Open
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Krishnasami Z, Wyatt C, Tighiouart H, Creamer R, Hellinger J, Hotta M, Okparavero A, Reddy S, Savage K, Stevens L. 154 The Effect of TDF on Renal Creatinine Secretion. Am J Kidney Dis 2011. [DOI: 10.1053/j.ajkd.2011.02.157] [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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Bahn M, Reichstein M, Davidson EA, Grünzweig J, Jung M, Carbone MS, Epron D, Misson L, Nouvellon Y, Roupsard O, Savage K, Trumbore SE, Gimeno C, Yuste JC, Tang J, Vargas R, Janssens IA. Soil respiration at mean annual temperature predicts annual total across vegetation types and biomes. ACTA ACUST UNITED AC 2010; 7:2147-2157. [PMID: 23293656 DOI: 10.5194/bg-7-2147-2010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Soil respiration (SR) constitutes the largest flux of CO(2) from terrestrial ecosystems to the atmosphere. However, there still exist considerable uncertainties as to its actual magnitude, as well as its spatial and interannual variability. Based on a reanalysis and synthesis of 80 site-years for 57 forests, plantations, savannas, shrublands and grasslands from boreal to tropical climates we present evidence that total annual SR is closely related to SR at mean annual soil temperature (SR(MAT)), irrespective of the type of ecosystem and biome. This is theoretically expected for non water-limited ecosystems within most of the globally occurring range of annual temperature variability and sensitivity (Q(10)). We further show that for seasonally dry sites where annual precipitation (P) is lower than potential evapotranspiration (PET), annual SR can be predicted from wet season SR(MAT) corrected for a factor related to P/PET. Our finding indicates that it can be sufficient to measure SR(MAT) for obtaining a well constrained estimate of its annual total. This should substantially increase our capacity for assessing the spatial distribution of soil CO(2) emissions across ecosystems, landscapes and regions, and thereby contribute to improving the spatial resolution of a major component of the global carbon cycle.
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Affiliation(s)
- M Bahn
- Institute of Ecology, University of Innsbruck, Innsbruck, Austria
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Lambros MBK, Tan DSP, Jones RL, Vatcheva R, Savage K, Tamber N, Fenwick K, Mackay A, Ashworth A, Reis-Filho JS. Genomic profile of a secretory breast cancer with an ETV6-NTRK3 duplication. J Clin Pathol 2009; 62:604-12. [PMID: 19561229 DOI: 10.1136/jcp.2008.059675] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Secretory breast cancer (SBC) is a rare entity characterised by indolent clinical behaviour, distinctive histological features and the presence of a recurrent chromosomal translocation t(12;15)(p13;q25), leading to the formation of the ETV6-NTRK3 fusion gene. AIM To describe the molecular genetic features of a case of SBC which harbours a duplication of the t(12;15) translocation. METHODS Tiling path array comparative genomic hybridisation (aCGH) analysis and fluorescence in situ hybridisation (FISH) using in-house-generated probes for ETV6, NTRK3 and the fusion genes, centromeric probes for chromosomes 12 and 15, and a commercially available split-apart ETV6/NTRK3 probe. RESULTS FISH revealed the presence of a duplication of the translocation t(12;15), which resulted from the gain of one copy of the derivative chromosome der(15)t(12;15), retention of one normal copy of both ETV6 and NTRK3 genes and deletion of the derivative chromosome der(12)t(12;15). Consistent with FISH findings, aCGH revealed copy number gains of ETV6 and NTRK3 and deletions encompassing the regions centromeric to ETV6 and telomeric to NTRK3. Additional regions of copy number changes included gains of 10q21, 10q26.3, 12p13.3-p13.31 15q11-q25.3 and 16pq and losses of 6q24.1-q27, 12p13.2-q12 and 15q25.3-q26.3. CONCLUSIONS To the best of our knowledge, this is the first time a carcinoma has been shown to harbour a duplication of the ETV6-NTRK3 translocation. The presence of an additional copy of the derivative chromosome der(15)t(12;15) coupled with deletion of the other derivative der(12)t(12;15) in the modal population of cancer cells suggests that this was either an early phenomenon or conferred additional growth advantage on neoplastic cells.
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Affiliation(s)
- M B K Lambros
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
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Abdel-Fatah T, Powe D, Lambros M, De Biase D, Savage K, Mackay A, Reis-Filho J, Ellis I. 5175 Columnar cell lesions are the early precursors of some forms of invasive breast carcinoma – a new genetic map for the evolutionary pathway of low nuclear grade breast neoplasia (LNGBN) family. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71067-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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O'Connor O, Pro B, Pinter-Brown L, Popplewell L, Bartlett N, Lechowicz M, Savage K, Coiffier B, Saunders M, Horwitz S. PROPEL: Results of the pivotal, multicenter, phase II study of pralatrexate in patients with relapsed or refractory peripheral T-cell lymphoma (PTCL). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8561 Background: Pralatrexate is a novel targeted antifolate designed to accumulate preferentially in cancer cells. PROPEL, a pivotal phase 2, non-randomized, open-label, international study, is the largest prospective study in patients (pts) with relapsed or refractory PTCL. Methods: Pts received 30 mg/m2 of pralatrexate intravenously weekly for 6 of 7 weeks, supplemented with B12 and folic acid. Primary endpoint = objective response rate (ORR); secondary endpoints = response duration, progression-free survival, and overall survival. Eligibility criteria: histologically confirmed PTCL, disease progression after ≥ 1 prior treatment, and ECOG performance status ≤ 2. Pathology was confirmed by independent central review, response to therapy was assessed by independent central review using International Workshop Criteria (IWC). Results: 115 pts were enrolled, 109 were evaluable for efficacy. 111 treated pts included 76 males (68%) and 35 females (32%). Pts had failed a median of 3 prior regimens and thus were heavily pre-treated. 78 pts (70%) failed CHOP, 18 (16%) had previous autologous stem cell transplant. 25% of pts never responded to any prior therapy; 53% did not respond to last prior therapy. The majority (59 pts, 53%) had PTCL not-otherwise specified. The ORR by central review was 27% (n = 29). 11 pts (10% overall, 38% of responders) had a complete response (CR), 18 pts (17%) had a partial response (PR), and 23 (21%) had stable disease. ORR by investigators assessment was 39% (n = 42). The median duration of response cannot be accurately estimated at this time, though responses of > 1 year have been observed. 69% of responses were after just 1 cycle. 5 responding pts went on to transplant. The most frequent Grade (Gr) 3–4 adverse events were mucosal inflammation (Gr 3 = 17%, Gr 4 = 4%) and thrombocytopenia (Gr 3 = 14%, Gr 4 = 19%). Conclusions: The results of PROPEL show that pralatrexate exhibits substantial activity in pts with relapsed or refractory PTCL, as assessed by a rigorous central review, with durable CRs /PRs, irrespective of the amount of prior therapy. [Table: see text]
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Affiliation(s)
- O. O'Connor
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - B. Pro
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - L. Pinter-Brown
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - L. Popplewell
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - N. Bartlett
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - M. Lechowicz
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - K. Savage
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - B. Coiffier
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - M. Saunders
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - S. Horwitz
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
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Wynnyckyj C, Omelon S, Savage K, Damani M, Chachra D, Grynpas MD. A new tool to assess the mechanical properties of bone due to collagen degradation. Bone 2009; 44:840-8. [PMID: 19150659 DOI: 10.1016/j.bone.2008.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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: 04/01/2008] [Revised: 09/30/2008] [Accepted: 12/09/2008] [Indexed: 10/21/2022]
Abstract
Current clinical tools for evaluating fracture risk focus only on the mineral phase of bone. However, changes in the collagen matrix may affect bone mechanical properties, increasing fracture risk while remaining undetected by conventional screening methods such as dual energy x-ray absorptiometry (DXA) and quantitative ultrasound (QUS). The mechanical response tissue analyzer (MRTA) is a non-invasive, radiation-free potential clinical tool for evaluating fracture risk. The objectives of this study were two-fold: to investigate the ability of the MRTA to detect changes in mechanical properties of bone as a result of treatment with 1 M potassium hydroxide (KOH) and to evaluate the differences between male and female bone in an emu model. DXA, QUS, MRTA and three-point bending measurements were performed on ex vivo emu tibiae before and after KOH treatment. Male and female emu tibiae were endocortically treated with 1 M KOH solution for 1-14 days, resulting in negligible collagen loss (0.05%; by hydroxyproline assay) and overall mass loss (0.5%). Three-point bending and MRTA detected significant changes in modulus between days 1 and 14 of KOH treatment (-18%) while all values measured by DXA and QUS varied by less than 2%. This close correlation between MRTA and three-point bending results support the utility of the MRTA as a clinical tool to predict fracture risk. In addition, the significant reduction in modulus contrasted with the negligible amount of collagen removal from the bone after KOH exposure. As such, the significant changes in bone mechanical properties may be due to partial debonding between the mineral and organic matrix or in situ collagen degradation rather than collagen removal. In terms of sex differences, male emu tibiae had significantly decreased failure stress and increased failure strain and toughness compared to female tibiae with increasing KOH treatment time.
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Affiliation(s)
- C Wynnyckyj
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
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Aldeyab M, Kearney M, Hughes C, Scott M, Tunney M, Gilpin D, Devine M, Watson J, Gardiner A, Funston C, Savage K, McElnay J. Can the use of a rapid polymerase chain screening method decrease the incidence of nosocomial meticillin-resistant Staphylococcus aureus? J Hosp Infect 2009; 71:22-8. [DOI: 10.1016/j.jhin.2008.10.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Accepted: 10/10/2008] [Indexed: 11/30/2022]
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Savage K, Davidson EA, Richardson AD. A conceptual and practical approach to data quality and analysis procedures for high-frequency soil respiration measurements. Funct Ecol 2008. [DOI: 10.1111/j.1365-2435.2008.01414.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Marchiò C, Iravani M, Natrajan R, Lambros MB, Savage K, Tamber N, Fenwick K, Mackay A, Senetta R, Di Palma S, Schmitt FC, Bussolati G, Ellis LO, Ashworth A, Sapino A, Reis-Filho JS. Genomic and immunophenotypical characterization of pure micropapillary carcinomas of the breast. J Pathol 2008; 215:398-410. [PMID: 18484683 DOI: 10.1002/path.2368] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Pure invasive micropapillary carcinoma (MPC) is a special histological type that accounts for 0.7-3% of all breast cancers. MPC has a distinctive growth pattern and a more aggressive clinical behaviour than invasive ductal carcinomas of no special type (IDC-NSTs). To define the molecular characteristics of MPCs, we profiled a series of 12 MPCs and 24 grade and oestrogen receptor (ER)-matched IDC-NSTs using high-resolution microarray comparative genomic hybridization (aCGH). In addition, we generated a tissue microarray containing a series of 24 MPCs and performed immunohistochemical analysis with ER, PR, Ki-67, HER2, CK5/6, CK14, CK17, EGFR, topoisomerase-IIalpha, cyclin D1, caveolin-1, E-cadherin, and beta-catenin antibodies. In situ hybridization probes were employed to evaluate the prevalence of amplification of HER2, TOP2A, EGFR, CCND1, MYC, ESR1, and FGFR1 genes. aCGH analysis demonstrated that MPCs significantly differed from IDC-NSTs at the genomic level. Gains of 1q, 2q, 4p, 6p, 6q23.2-q27, 7p, 7q, 8p, 8q, 9p, 10p, 11q, 12p, 12q, 16p, 17p, 17q, 19p, 20p, 20q, and 21q, and losses of 1p, 2p, 6q11.1-q16.3, 6q21-q22.1, 9p, 11p, 15q, and 19q were more prevalent in MPCs. High-level gains/amplifications of 8p12-p11, 8q12, 8q13, 8q21, 8q23, 8q24, 17q21, 17q23, and 20q13 were significantly associated with MPCs. A comparison between 24 MPCs and a series of 48 grade and ER-matched IDC-NSTs revealed that high cyclin D1 expression, high proliferation rates, and MYC (8q24) amplification were significantly associated with MPCs. Our results demonstrate that MPCs have distinct histological features and molecular genetic profiles supporting the contention that they constitute a distinct pathological entity.
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Affiliation(s)
- C Marchiò
- The Breakthrough Breast Cancer Research Centre--Institute of Cancer Research, London, UK
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Abstract
AIMS To analyse the distribution of nestin expression in different breast tumours and to determine the prognostic impact of nestin expression. METHODS Nestin expression was immunohistochemically analysed in a cohort of 245 invasive breast cancer patients treated with therapeutic surgery followed by anthracycline-based chemotherapy using a semi-quantitative scoring system. RESULTS Nestin was exclusively expressed in grade III breast carcinoma and preferentially expressed in basal-like and triple negative cancers. Nestin-positive tumours displayed high proliferation rates and p53 nuclear expression. Lymph-node positive patients with nestin-positive cancers had a shorter breast cancer specific survival; however nestin was not an independent prognostic factor on multivariate analysis. CONCLUSIONS Nestin expression is preferentially found in basal-like and triple negative breast carcinomas. Further studies are warranted to define the biological role played by nestin in these subgroups of breast cancers.
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Affiliation(s)
- S Parry
- Molecular Pathology Laboratory, The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
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Mahler-Araujo B, Savage K, Parry S, Reis-Filho JS. Reduction of E-cadherin expression is associated with non-lobular breast carcinomas of basal-like and triple negative phenotype. J Clin Pathol 2008; 61:615-20. [DOI: 10.1136/jcp.2007.053991] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [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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Thorat MA, Marchio C, Morimiya A, Savage K, Nakshatri H, Reis-Filho JS, Badve S. Forkhead box A1 expression in breast cancer is associated with luminal subtype and good prognosis. J Clin Pathol 2007; 61:327-32. [PMID: 18037662 DOI: 10.1136/jcp.2007.052431] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS Forkhead box A1 (FOXA1) is a forkhead family transcription factor expressed in breast cancer cells. It is essential for optimal expression of approximately 50% of oestrogen receptor (ER)-related genes. This study explored the FOXA1 relationship with luminal and basal breast cancer subtypes, proliferation markers, and survival in breast cancer patients who had received similar treatment. METHODS A tissue microarray comprising tumours from 245 invasive breast cancer patients with 67 months of median follow-up was analysed for FOXA1 expression by immunohistochemistry. Interpretable FOXA1 expression, obtained in 184 patients, was analysed along with other variables such as tumour grade, size, nodal status, ER, progesterone receptor, HER2/neu, proliferation and basal markers. RESULTS FOXA1 expression (score >3) was seen in 139 of 184 breast cancers. It correlated positively with ERalpha (p<0.0001), progesterone receptor (p<0.0001), and luminal subtype (p<0.0001); negatively with basal subtype (p<0.0001), proliferation markers and high histological grade (p = 0.0327). Univariate analysis showed nodal status, tumour grade, ER, progesterone receptor, FOXA1, basal markers and p53 as significant predictors of overall survival. Multivariate analysis showed that only nodal status (p = 0.0006) and ER (p = 0.0017) were significant predictors of OS. In luminal subtype patient subgroup, FOXA1 expression was associated with better survival (p = 0.0284) on univariate analysis. CONCLUSION Based on this study in patients treated with surgery followed by adjuvant anthracycline-based chemotherapy, FOXA1 expression is associated with good prognosis. It correlates with luminal subtype breast cancer, and could possibly serve as a clinical marker for luminal subtype A. Prognostic ability of FOXA1 in these low-risk breast cancers may prove to be useful in treatment decision making.
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Affiliation(s)
- M A Thorat
- Department of Pathology and Laboratory Medicine, IU School of Medicine, Indianapolis, IN 46202, USA
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Gilpin DF, Tunney MM, Funston C, Savage K, Gardiner A, Kearney MP. Rapid detection of MRSA in a routine diagnostic laboratory using a real-time PCR assay. J Hosp Infect 2007; 67:97-9. [PMID: 17719687 DOI: 10.1016/j.jhin.2007.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Accepted: 06/28/2007] [Indexed: 10/22/2022]
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Abstract
Breast cancers arising in carriers of germline BRCA1 mutations frequently have a basal-like phenotype. Basal-like cancers are characterized by high histological grade, central necrotic areas, foci with metaplastic differentiation, lack of hormone receptor and HER2 (ErbB2) expression, and consistent positivity for basal markers, including CK5/6, CK14, and EGFR. We have used germline manipulation to generate a conditional mouse model of Brca1 deficiency. Transgenic expression of Cre recombinase in the mammary gland of these mice results in deletion of exons encoding the C-terminus of Brca1 and leads to tumour formation when combined with heterozygosity for a p53 mutation. Histologically, these mammary gland tumours were characterized by high histological grade, central necrotic areas, and presence of homologous metaplastic elements. These metaplastic elements consisted of neoplastic spindle cells or squamous cell differentiation in the form of keratin pearls or individual cell keratinization. Immunohistochemical analysis revealed expression of basal-like markers in all cases. The tumour phenotype generated in our mouse model was compared with published data on human basal-like breast carcinomas and also with metaplastic breast cancers with a basal-like phenotype; the comparison showed that we have generated a mouse model of basal-like breast cancer, which should prove useful in testing new and targeted treatments for this type of breast cancer.
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Affiliation(s)
- A McCarthy
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London SW3 6JB, UK
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Turner NC, Reis-Filho JS, Russell AM, Springall RJ, Ryder K, Steele D, Savage K, Gillett CE, Schmitt FC, Ashworth A, Tutt AN. BRCA1 dysfunction in sporadic basal-like breast cancer. Oncogene 2006; 26:2126-32. [PMID: 17016441 DOI: 10.1038/sj.onc.1210014] [Citation(s) in RCA: 461] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Basal-like breast cancers form a distinct subtype of breast cancer characterized by the expression of markers expressed in normal basal/myoepithelial cells. Breast cancers arising in carriers of germline BRCA1 mutations are predominately of basal-like type, suggesting that BRCA1 dysfunction may play a role in the pathogenesis of sporadic basal-like cancers. We analysed 37 sporadic breast cancers expressing the basal marker cytokeratin 5/6, and age- and grade-matched controls, for downregulation of BRCA1. Although BRCA1 promoter methylation was no more common in basal-like cancers (basal 14% vs controls 11%, P=0.72), BRCA1 messenger RNA expression was twofold lower in basal-like breast cancers compared to matched controls (P=0.008). ID4, a negative regulator of BRCA1, was expressed at 9.1-fold higher levels in basal-like breast cancer (P<0.0001), suggesting a potential mechanism of BRCA1 downregulation. BRCA1 downregulation correlated with the presence of multiple basal markers, revealing heterogeneity in the basal-like phenotype. Finally, we found that 63% of metaplastic breast cancers, a rare type of basal-like cancers, had BRCA1 methylation, in comparison to 12% of controls (P<0.0001). The high prevalence of BRCA1 dysfunction identified in this study could be exploited in the development of novel approaches to targeted treatment of basal-like breast cancer.
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Affiliation(s)
- N C Turner
- Chester Beatty Laboratories, The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
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Reis-Filho JS, Milanezi F, Steele D, Savage K, Simpson PT, Nesland JM, Pereira EM, Lakhani SR, Schmitt FC. Metaplastic breast carcinomas are basal-like tumours. Histopathology 2006; 49:10-21. [PMID: 16842242 DOI: 10.1111/j.1365-2559.2006.02467.x] [Citation(s) in RCA: 258] [Impact Index Per Article: 14.3] [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: 12/31/2022]
Abstract
AIMS Recently, an immunohistochemical panel comprising antibodies against HER2, oestrogen receptor (ER), epidermal growth factor receptor (EGFR) and cytokeratin (CK) 5/6 was reported to identify basal-like breast carcinomas, as defined by cDNA microarrays. Our aim was to analyse a series of metaplastic breast carcinomas (MBCs) using this panel plus two other basal markers (CK14 and p63) and progesterone receptor (PR), to define how frequently MBCs show a basal-like immunophenotype. METHODS AND RESULTS Sixty-five cases were retrieved from the pathology archives of the authors' institutions and reviewed by three of the authors. Immunohistochemistry with antibodies for HER2, ER, EGFR, CK5/6, CK14 and p63 was performed according to standard methods. All but six cases (91%) showed the typical immunoprofile of basal-like tumours (ER- and HER2-, EGFR+ and/or CK5/6+). When CK14 and p63 were added to the panel, two additional cases could be classified as basal-like. The majority of MBCs lacked PR, except 4/19 (21%) carcinomas with squamous metaplasia. CONCLUSIONS Our results demonstrate that MBCs show a basal-like phenotype, regardless of the type of metaplastic elements. Moreover, as these neoplasms frequently overexpress EGFR (57%), patients with MBC may benefit from treatment with anti-EGFR drugs.
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Affiliation(s)
- J S Reis-Filho
- The Breakthrough Toby Robins Breast Cancer Research Centre, Institute of Cancer Research, London, UK.
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