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Zhong X, Shi Q, Guo Z. Synergistic Construction of Superhydrophilic PVDF Membranes by Dual Modification Strategies for Efficient Emulsion Separation. Small 2024:e2402538. [PMID: 38770748 DOI: 10.1002/smll.202402538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/21/2024] [Indexed: 05/22/2024]
Abstract
Solving the problem of oil and water pollution is an important topic in environmental protection. The separation of oil-water emulsion with high efficiency and low consumption has been the direction of social efforts. Membrane separation technology combined with surface wettability and pore size screening is considered to be one of the most promising ways to separate oil-water emulsions. In this paper, the polyvinylidene difluoride (PVDF) membrane is prepared by combining the two methods of blending and coating modification as a double barrier. The prepared PVDF membrane can completely wet water, achieve superhydrophilic in air, and superoleophobic underwater. The separation efficiency and flux are 99.57% and 678 L h-1 m-2 bar-1, respectively, for toluene emulsions containing surfactants with an average particle size of 1.7 µm. At the same time, it can also effectively separate different kinds of light/heavy oils. After three cycles of testing still maintain high efficiency of separation. The results show that the prepared PVDF membrane can effectively separate the emulsion containing surfactant with smaller particle size distribution of oil droplets. This method provides a new strategy for the separation of oil-water emulsions and has broad application prospects.
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Affiliation(s)
- Xin Zhong
- Ministry of Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei University, Wuhan, 430000, P. R. China
| | - Qinhan Shi
- Ministry of Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei University, Wuhan, 430000, P. R. China
| | - Zhiguang Guo
- Ministry of Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei University, Wuhan, 430000, P. R. China
- State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou, 730000, P. R. China
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Abedalthagafi M, Bawazeer S, Fawaz RI, Heritage AM, Alajaji NM, Faqeih E. Non-invasive prenatal testing: a revolutionary journey in prenatal testing. Front Med (Lausanne) 2023; 10:1265090. [PMID: 38020177 PMCID: PMC10666054 DOI: 10.3389/fmed.2023.1265090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Non-invasive prenatal testing (NIPT) is a pioneering technique that has consistently advanced the field of prenatal testing to detect genetic abnormalities and conditions with the aim of decreasing the incidence and prevalence of inherited conditions. NIPT remains a method of choice for common autosomal aneuploidies, mostly trisomy 21, and several monogenic disorders. The advancements in gene sequencing techniques have expanded the panel of conditions where NIPT could be offered. However, basic research on the impact of several genetic conditions lags behind the methods of detection of these sequence aberrations, and the impact of the expansion of NIPT should be carefully considered based on its utility. With interest from commercial diagnostics and a lack of regulatory oversight, there remains a need for careful validation of the predictive values of different tests offered. NIPT comes with many challenges, including ethical and economic issues. The scientific evidence, technical feasibility, and clinical benefit of NIPT need to be carefully investigated before new tests and developments are translated into clinical practice. Moreover, the implementation of panel expansion of NIPT should accompany expert genetic counseling pre- and post-testing.
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Affiliation(s)
- Malak Abedalthagafi
- Department of Pathology and Laboratory Medicine, Emory School of Medicine, Atlanta, GA, United States
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
| | - Shahad Bawazeer
- Department of Medical Genetics, Children's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | | | - Nouf M. Alajaji
- Department of Maternal Fetal Medicine, Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Eissa Faqeih
- Department of Medical Genetics, Children's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
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Magomedova AG, Rabadanova AA, Shuaibov AO, Selimov DA, Sobola DS, Rabadanov KS, Giraev KM, Orudzhev FF. Combination NIPS/TIPS Synthesis of α-Fe 2O 3 and α/γ-Fe 2O 3 Doped PVDF Composite for Efficient Piezocatalytic Degradation of Rhodamine B. Molecules 2023; 28:6932. [PMID: 37836776 PMCID: PMC10574218 DOI: 10.3390/molecules28196932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 09/30/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
Highly porous membranes based on polyvinylidene fluoride (PVDF) with the addition of nanoscale particles of non-magnetic and magnetic iron oxides were synthesized using a combined method of non-solvent induced phase separation (NIPS) and thermo-induced phase separation (TIPS) based on the technique developed by Dr. Blade. The obtained membranes were characterized using SEM, EDS, XRD, IR, diffuse reflectance spectroscopy, and fluorescent microscopy. It was shown that the membranes possessed a high fraction of electroactive phase, which increased up to a maximum of 96% with the addition of 2 wt% of α-Fe2O3 and α/γ-Fe2O3 nanoparticles. It was demonstrated that doping PVDF with nanoparticles contributed to the reduction of pore size in the membrane. All membranes exhibited piezocatalytic activity in the degradation of Rhodamine B. The degree of degradation increased from 69% when using pure PVDF membrane to 90% when using the composite membrane. The nature of the additive did not affect the piezocatalytic activity. It was determined that the main reactive species responsible for the degradation of Rhodamine B were •OH and •O2-. It was also shown that under piezocatalytic conditions, composite membranes generated a piezopotential of approximately 2.5 V.
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Affiliation(s)
- Asiyat G. Magomedova
- Smart Materials Laboratory, Department of Inorganic Chemistry and Chemical Ecology, Dagestan State University, St. M. Gadjieva 43-a, Dagestan Republic, 367015 Makhachkala, Russia; (A.G.M.); (A.A.R.); (A.O.S.); (D.A.S.); (K.M.G.)
| | - Alina A. Rabadanova
- Smart Materials Laboratory, Department of Inorganic Chemistry and Chemical Ecology, Dagestan State University, St. M. Gadjieva 43-a, Dagestan Republic, 367015 Makhachkala, Russia; (A.G.M.); (A.A.R.); (A.O.S.); (D.A.S.); (K.M.G.)
| | - Abdulatip O. Shuaibov
- Smart Materials Laboratory, Department of Inorganic Chemistry and Chemical Ecology, Dagestan State University, St. M. Gadjieva 43-a, Dagestan Republic, 367015 Makhachkala, Russia; (A.G.M.); (A.A.R.); (A.O.S.); (D.A.S.); (K.M.G.)
| | - Daud A. Selimov
- Smart Materials Laboratory, Department of Inorganic Chemistry and Chemical Ecology, Dagestan State University, St. M. Gadjieva 43-a, Dagestan Republic, 367015 Makhachkala, Russia; (A.G.M.); (A.A.R.); (A.O.S.); (D.A.S.); (K.M.G.)
| | - Dinara S. Sobola
- Department of Physics, Faculty of Electrical Engineering and Communication, Brno University of Technology, Technicka 10, 616 00 Brno, Czech Republic
| | - Kamil Sh. Rabadanov
- Amirkhanov Institute of Physics of Dagestan Federal Research Center, Russian Academy of Sciences, 367003 Makhachkala, Russia;
| | - Kamal M. Giraev
- Smart Materials Laboratory, Department of Inorganic Chemistry and Chemical Ecology, Dagestan State University, St. M. Gadjieva 43-a, Dagestan Republic, 367015 Makhachkala, Russia; (A.G.M.); (A.A.R.); (A.O.S.); (D.A.S.); (K.M.G.)
| | - Farid F. Orudzhev
- Smart Materials Laboratory, Department of Inorganic Chemistry and Chemical Ecology, Dagestan State University, St. M. Gadjieva 43-a, Dagestan Republic, 367015 Makhachkala, Russia; (A.G.M.); (A.A.R.); (A.O.S.); (D.A.S.); (K.M.G.)
- Amirkhanov Institute of Physics of Dagestan Federal Research Center, Russian Academy of Sciences, 367003 Makhachkala, Russia;
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Ahmad T, Rehman LM, Al-Nuaimi R, de Levay JPBB, Thankamony R, Mubashir M, Lai Z. Thermodynamics and kinetic analysis of membrane: Challenges and perspectives. Chemosphere 2023; 337:139430. [PMID: 37422221 DOI: 10.1016/j.chemosphere.2023.139430] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/18/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Abstract
The ultimate structure of the membrane is determined using two important effects: (i) thermodynamic effect and (ii) kinetic effect. Controlling the mechanism of kinetic and thermodynamic processes in phase separation is essential for enhancing membrane performance. However, the relationship between system parameters and the ultimate membrane morphology is still largely empirical. This review focuses on the fundamental ideas behind thermally induced phase separation (TIPS) and nonsolvent-induced phase separation (NIPS) methods, including both kinetic and thermodynamic elements. The thermodynamic approach to understanding phase separation and the effect of different interaction parameters on membrane morphology has been discussed in detail. Furthermore, this review explores the capabilities and limitations of different macroscopic transport models used for the last four decades to explore the phase inversion process. The application of molecular simulations and phase field to understand phase separation has also been briefly examined. Finally, it discusses the thermodynamic approach to understanding phase separation and the consequence of different interaction parameters on membrane morphology, as well as possible directions for artificial intelligence to fill the gaps in the literature. This review aims to provide comprehensive knowledge and motivation for future modeling work for membrane fabrication via new techniques such as nonsolvent-TIPS, complex-TIPS, non-solvent assisted TIPS, combined NIPS-TIPS method, and mixed solvent phase separation.
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Affiliation(s)
- Tausif Ahmad
- Advanced Membranes and Porous Materials Centre, Division of Physical Science and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia.
| | - Lubna M Rehman
- Advanced Membranes and Porous Materials Centre, Division of Physical Science and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Reham Al-Nuaimi
- Advanced Membranes and Porous Materials Centre, Division of Physical Science and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Jean-Pierre Benjamin Boross de Levay
- Advanced Membranes and Porous Materials Centre, Division of Physical Science and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Roshni Thankamony
- Advanced Membranes and Porous Materials Centre, Division of Physical Science and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Muhammad Mubashir
- Advanced Membranes and Porous Materials Centre, Division of Physical Science and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Zhiping Lai
- Advanced Membranes and Porous Materials Centre, Division of Physical Science and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia.
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Agarwal A, Barik S, Upadhyay A, Patel Y. Pain behavior of children with bilateral idiopathic clubfoot undergoing Ponseti casting and the effect of non-pharmaceutical pain-relieving agents. Arch Orthop Trauma Surg 2023; 143:5603-5608. [PMID: 37052665 DOI: 10.1007/s00402-023-04877-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/04/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION This study prospectively investigated the pain response and physiological parameters [heart rate (HR) and oxygen saturation (SpO2)] during sequential casting in bilateral clubfoot. Additionally, it explored the role of non-nutritive sucking and human care contact on the observed responses during casting. METHODS Subjects were allotted to control group (Group A with no intervention) and two intervention groups (Group B: non-nutritive sucking intervention, Group C: human care contact intervention). Neonatal Infant Pain Score (NIPS), heart rate (HR), and oxygen saturation (SpO2) were used to assess the response. RESULTS The three groups matched in age and gender characteristics of the participants. Pain response was noted across all groups. The left foot demonstrated a statistically significant preexisting tachycardia which rose further during casting (p < 0.01). Intergroup comparisons revealed that the alteration for NIPS during casting was in following sequence (Group A > C > B, p < 0.00001). The effect of interventions offered in Group B and C lasted in the post-cast period as well (B > C). CONCLUSION The clubfoot child exhibited moderate pain response during casting of both feet. A tachycardia was noted prior to initiation of second cast which further exaggerated with subsequent cast. Pacifier (non-nutritive sucking) intervention produced better control of pain response than human care contact during casting for both feet.
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Affiliation(s)
- Anil Agarwal
- Department of Pediatric Orthopedics, Chacha Nehru Bal Chikitsalaya, Delhi, India.
| | | | - Ankur Upadhyay
- Department of Pediatric Orthopedics, Chacha Nehru Bal Chikitsalaya, Delhi, India
| | - Yogesh Patel
- Department of Pediatric Orthopedics, Chacha Nehru Bal Chikitsalaya, Delhi, India
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Claudel N, Barrois M, Vivanti AJ, Rosenblatt J, Salomon LJ, Jouannic JM, Picone O, Carbillon L, Vialard F, Launay E, Tsatsaris V, Curis E, El Khattabi L. Non-invasive cell-free DNA prenatal screening for trisomy 21 as part of primary screening strategy in twin pregnancy. Ultrasound Obstet Gynecol 2023. [PMID: 37470702 DOI: 10.1002/uog.26311] [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] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES The performance of non-invasive prenatal screening using cell-free DNA testing of maternal blood in twin pregnancy is underevaluated, while serum marker-based strategies yield poor results. This study aimed to assess the performance of non-invasive prenatal screening for trisomy 21 in twin pregnancy as a first-tier test. Secondary objectives were to assess its failure rate and factors associated with failure. METHODS This retrospective cohort study included twin pregnancies in which non-invasive prenatal screening using cell-free DNA was performed as the primary screening strategy between May 2017 and October 2019. We used the NIPT VeriSeq® test for in-vitro diagnosis and set a fetal fraction cut-off of 4% for monochorionic pregnancies and 8% for dichorionic ones. Clinical data and pregnancy outcome were collected from physicians or midwives via a questionnaire or were retrieved directly on-site. We calculated the performance of non-invasive cell-free DNA screening for trisomy 21, analyzed its failure rate and assessed potentially associated factors. RESULTS Among 1885 twin pregnancies with follow-up, there were six (0.32%) confirmed cases of trisomy 21. The sensitivity of non-invasive prenatal screening for trisomy 21 was 100% (95% CI, 54.1-100%) and the false-positive rate was 0.23% (95% CI, 0.06-0.59%). The primary failure rate was 4.6%, with 4.0% being due to insufficient fetal fraction. A successful result was obtained for 65.4% of women who underwent a new blood draw, reducing the overall failure rate to 2.8%. Maternal body mass index, gestational age at screening as well as chorionicity were significantly associated with the risk of failure. CONCLUSION This study provides further evidence of the high performance, at an extremely low false-positive rate, of non-invasive prenatal screening in twins as part of a primary screening strategy for trisomy 21. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- N Claudel
- Maternité Port Royal, AP-HP Hôpital Cochin, FHU Prema, Paris, France
- Université Paris Cité, Paris, France
- INSERM UMR_S1139, Paris, France
| | - M Barrois
- Maternité Port Royal, AP-HP Hôpital Cochin, FHU Prema, Paris, France
- Université Paris Cité, Paris, France
- INSERM UMR_S1139, Paris, France
| | - A J Vivanti
- Service de Gynécologie-Obstétrique, DMU Santé des Femmes et des Nouveau-nés, AP-HP Hôpital Antoine Béclère, Clamart, France
- Université Paris-Saclay, Orsay, France
| | - J Rosenblatt
- Service de Gynécologie-Obstétrique, AP-HP Hôpital Universitaire Robert-Debré, Paris, France
| | - L J Salomon
- Université Paris Cité, Paris, France
- Service de Gynécologie-Obstétrique, AP-HP Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - J-M Jouannic
- Département de Médecine Fœtale, Pôle ORIGYNE.6, AP-HP Hôpital Armand Trousseau, Paris, France
- Université Sorbonne Paris Cité, Paris, France
| | - O Picone
- Service de Gynécologie-Obstétrique, AP-HP Hôpital Louis Mourier, Colombes, France
- Université Paris Diderot, INSERM UMR1137, IAME, Paris, France
| | - L Carbillon
- Service de Gynécologie-Obstétrique, AP-HP Hôpital Jean-Verdier, Bondy, France
- Université Paris 13, Bobigny, France
| | - F Vialard
- Service de Cytogénétique, CHI Poissy-Saint Germain en Laye, Poissy, France
| | - E Launay
- Service de Cytogénétique et Biologie Cellulaire, CHU Rennes, Rennes, France
| | - V Tsatsaris
- UR 7537 BioSTM, UFR de Pharmacie, Faculté de Santé, Université Paris Cité, Paris, France
| | - E Curis
- UR 7537 BioSTM, UFR de Pharmacie, Faculté de Santé, Université Paris Cité, Paris, France
- Laboratoire d'Hématologie, Hôpital Lariboisière, AP-HP.nord, Paris, France
| | - L El Khattabi
- Plateforme de Dépistage Prénatal Non Invasif par Analyse de l'ADN Libre Circulant, AP-HP, Hôpital Cochin and Université Paris Cité, Paris, France
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute (ICM), Inserm, CNRS, Hôpital Pitié Salpêtrière, Paris, France
- Unité de Génomique Chromosomique, Département de Génétique Médicale, APHP, Hôpitaux Armand Trousseau et Pitié-Salpêtrière, Paris Brain Institute - ICM, Sorbonne Université, Paris, France
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Maya I, Salzer Sheelo L, Brabbing-Goldstein D, Matar R, Kahana S, Agmon-Fishman I, Klein C, Gurevitch M, Basel-Salmon L, Sagi-Dain L. Clinical utility of expanded non-invasive prenatal screening compared with chromosomal microarray analysis in over 8000 pregnancies without major structural anomaly. Ultrasound Obstet Gynecol 2023; 61:698-704. [PMID: 36776119 DOI: 10.1002/uog.26177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 01/01/2023] [Accepted: 01/27/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To evaluate the theoretical added value of two types of non-invasive prenatal screening (NIPS) expansions in pregnancies without major structural anomalies over the commonly used NIPS for chromosomes 13, 18, 21, X and Y (5-NIPS) and to compare them with the added value of chromosomal microarray analysis (CMA). METHODS This was a retrospective cohort study based on CMA results of all pregnancies with normal ultrasound (including pregnancies with soft markers and with abnormal maternal serum screening) that had undergone amniocentesis between January 2013 to February 2022 and were registered in the database of the Rabin Medical Center genetic laboratory. We calculated the theoretical yield of 5-NIPS and compared the added value of expanded 5-NIPS for common microdeletions (1p36.3-1p36.2, 4p16.3-4p16.2, 5p15.3-5p15.1, 15q11.2-15q13.1 and 22q11.2) and genome-wide NIPS (including variants > 5 Mb) with the added value of CMA in the overall cohort and in subgroups according to indication for invasive testing. RESULTS Among the 8605 examined pregnancies, 122 (1.4%) clinically significant CMA results were demonstrated. Of these, 44 (36.1%) were theoretically detectable on 5-NIPS, with the rates of 1.56% in 642 pregnancies with abnormal maternal serum screening, 0.63% in 318 pregnancies with soft markers, 0.62% in 4378 women with advanced maternal age (≥ 35 years) and 0.15% in 3267 women younger than 35 years. In addition to aneuploidies detectable on 5-NIPS, three (0.03%) cases detectable on 5-NIPS expanded for common microdeletions and nine (0.10%) cases detectable on genome-wide NIPS (excluding common microdeletions) were identified in the overall cohort. The added value of expanded NIPS tools over 5-NIPS was significantly lower compared with that of CMA, for the overall cohort and subgroups. CONCLUSIONS 5-NIPS and even genome-wide NIPS would miss 63.9% and 54.1% of clinically significant CMA findings, respectively. The added value of 5-NIPS expanded to detect common microdeletions over 5-NIPS is about 0.035%, and the overall added value of genome-wide NIPS aimed at large CNVs is about 0.14%, both much lower compared with the added value of CMA (0.91%). These findings should assist healthcare practitioners in guiding couples towards informed decision-making regarding the choice between prenatal invasive testing and NIPS. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- I Maya
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L Salzer Sheelo
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - D Brabbing-Goldstein
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - R Matar
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - S Kahana
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - I Agmon-Fishman
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - C Klein
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - M Gurevitch
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
| | - L Basel-Salmon
- Recanati Genetics Institute, Beilinson Hospital, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Genetics Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Felsenstein Medical Research Center, Rabin Medical Center, Petah Tikva, Israel
| | - L Sagi-Dain
- Genetics Institute, Carmel Medical Center, affiliated to the Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Jha P, Lenaerts L, Vermeesch J, Norton M, Amant F, Glanc P, Poder L. Noninvasive prenatal screening and maternal malignancy: role of imaging. Abdom Radiol (NY) 2023; 48:1590-1598. [PMID: 37095202 DOI: 10.1007/s00261-023-03913-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 04/26/2023]
Abstract
Noninvasive prenatal screening (NIPS) tests for fetal chromosomal anomalies through maternal blood sampling. It is becoming widely available and standard of care for pregnant women in many countries. It is performed in the first trimester of pregnancy, usually between 9 and 12 weeks. Fragments of fetal cell-free deoxyribonucleic acid (DNA) floating in maternal plasma are detected and analyzed by this test to assess for chromosomal aberrations. Similarly, maternal tumor-derived cell-free DNA (ctDNA) released from the tumor cells also circulates in the plasma. Hence, the presence of genomic anomalies originating from maternal tumor-derived DNA may be detected on the NIPS-based fetal risk assessment in pregnant patients. Presence of multiple aneuploidies or autosomal monosomies are the most commonly reported NIPS abnormalities detected with occult maternal malignancies. When such results are received, the search for an occult maternal malignancy begins, in which imaging plays a crucial role. The most commonly detected malignancies via NIPS are leukemia, lymphoma, breast and colon cancers. Ultrasound is a reasonable radiation-free modality for imaging during pregnancy, specially when there are localizing symptoms or findings, such as palpable lumps. While there are no consensus guidelines on the imaging evaluation for these patients, when there are no localizing symptoms or clinically palpable findings, whole body MRI is recommended as the radiation-free modality of choice to search for an occult malignancy. Based on clinical symptoms, practice patterns, and available resources, breast ultrasound, chest radiographs, and targeted ultrasound evaluations can also be performed initially or as a follow-up for MRI findings. CT is reserved for exceptional circumstances due to its higher radiation dose. This article intends to increase awareness of this rare but stressful clinical scenario and guide imaging evaluation for occult malignancy detected via NIPS during pregnancy.
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Affiliation(s)
- Priyanka Jha
- Department of Radiology, Division of Body Imaging, Stanford University School of Medicine, Palo Alto, CA, USA.
| | | | - Joris Vermeesch
- Department of Human Genetics, KU Leuven, Leuven, Belgium
- Centre of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Mary Norton
- Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA, USA
| | - Frédéric Amant
- Department of Oncology, KU Leuven, Leuven, Belgium
- Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
- Center for Gynecological Oncology Amsterdam, Academic Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
- The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Phyllis Glanc
- Department of Radiology, Obstetrics & Gynecology, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Liina Poder
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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Saidel ML, Ananth U, Rose D, Farrell C. Non-Invasive prenatal testing with rolling circle amplification: Real-world clinical experience in a non-molecular laboratory. J Clin Lab Anal 2023; 37:e24870. [PMID: 36972484 PMCID: PMC10156098 DOI: 10.1002/jcla.24870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/17/2023] [Accepted: 03/08/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Non-invasive prenatal testing (NIPT) using cell-free DNA (cfDNA) circulating in maternal blood provides a sensitive and specific screening technique for common fetal aneuploidies, but the high cost and workflow complexity of conventional methodologies limit its widespread implementation. A unique rolling circle amplification methodology reduces cost and complexity, providing a promising alternative for increased global accessibility as a first-tier test. METHODS In this clinical study, 8160 pregnant women were screened on the Vanadis system for trisomies 13, 18, and 21, and positive results were compared to clinical outcomes where available. RESULTS The Vanadis system yielded a 0.07% no-call rate, a 98% overall sensitivity, and a specificity of over 99% based on available outcomes. CONCLUSION The Vanadis system provided a sensitive, specific, and cost-effective cfDNA assay for trisomies 13, 18, and 21, with good performance characteristics and low no-call rate, and it eliminated the need for either next-generation sequencing or polymerase chain reaction amplification.
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Affiliation(s)
- Matthew L Saidel
- Women's Health USA and Medical Director, Women's Health Connecticut, Rocky Hill, Connecticut, USA
| | - Uma Ananth
- Umagen LLC, Shrewsbury, Massachusetts, USA
| | - Donna Rose
- Women's Health Connecticut Laboratory, Rocky Hill, Connecticut, USA
| | - Cara Farrell
- Ancillary Growth Women's Health Connecticut, Rocky Hill, Connecticut, USA
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10
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Zhou Y, Qi M, Zhou YX, Fang SQ. Application of intraperitoneal hyperthermic perfusion chemotherapy in gastric cancer. Shijie Huaren Xiaohua Zazhi 2023; 31:1-7. [DOI: 10.11569/wcjd.v31.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Gastric cancer is one of the most common malignant tumors in China. Intraperitoneal hyperthermic perfusion chemotherapy is a comprehensive therapy that combines intraperitoneal perfusion, hyperthermia, and chemotherapy. It has a good curative effect in peritoneal metastasis of gastric cancer. In recent years, with the continuous progress of technology and the deepening of research, the scope of application of intraperitoneal hyperthermic perfusion chemotherapy is more extensive. In this paper, we discuss intraperitoneal hyperthermic perfusion chemotherapy with regard to its application in gastric cancer, commonly used drugs, safety, and prospects.
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Affiliation(s)
- Yue Zhou
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese medicine, Shanghai 200437, China
| | - Mei Qi
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese medicine, Shanghai 200437, China
| | - Yu-Xuan Zhou
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese medicine, Shanghai 200437, China
| | - Sheng-Quan Fang
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese medicine, Shanghai 200437, China
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11
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Yushkin A, Basko A, Balynin A, Efimov M, Lebedeva T, Ilyasova A, Pochivalov K, Volkov A. Effect of Acetone as Co-Solvent on Fabrication of Polyacrylonitrile Ultrafiltration Membranes by Non-Solvent Induced Phase Separation. Polymers (Basel) 2022; 14:4603. [PMID: 36365596 PMCID: PMC9657875 DOI: 10.3390/polym14214603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 09/28/2023] Open
Abstract
For the first time, the presence of acetone in the casting solutions of polyacrylonitrile (PAN) in dimethylsulfoxide or N-methyl-2-pyrrolidone was studied with regards to thermodynamical aspects of phase separation of polymeric solutions induced by contact with non-solvent (water), formation and performance of porous membranes of ultrafiltration range. The positions of the liquid equilibrium binodals on the phase diagrams of these three-component and pseudo-three-component mixtures were determined. For PAN-N-methyl-2-pyrrolidone-water glass transition curve on a ternary phase diagram was plotted experimentally for the first time. The real-time evolution of the structure of mixtures of PAN with solvents (co-solvents) upon contact with a non-solvent (water) has been studied. The thermodynamic analysis of the phase diagrams of these mixtures, together with optical data, made it possible to propose a mechanism of structure formation during non-solvent induced phase separation of different mixtures. The addition of acetone promotes the formation of a spongy layer on the membrane surface, which decreases the probability of defect formation on the membrane surface and keeps finger-like macrovoids from the underlying layers of the membrane. It was shown that the molecular weight cut-off (MWCO) of the membranes can be improved from 58 down to 1.8 kg/mol by changing the acetone content, while polymer concentration remained the same.
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Affiliation(s)
- Alexey Yushkin
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Prospekt, 119991 Moscow, Russia
| | - Andrey Basko
- G.A. Krestov Institute of Solution Chemistry of the Russian Academy of Sciences, 1 ul. Akademicheskaja, 153045 Ivanovo, Russia
| | - Alexey Balynin
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Prospekt, 119991 Moscow, Russia
| | - Mikhail Efimov
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Prospekt, 119991 Moscow, Russia
| | - Tatyana Lebedeva
- G.A. Krestov Institute of Solution Chemistry of the Russian Academy of Sciences, 1 ul. Akademicheskaja, 153045 Ivanovo, Russia
| | - Anna Ilyasova
- G.A. Krestov Institute of Solution Chemistry of the Russian Academy of Sciences, 1 ul. Akademicheskaja, 153045 Ivanovo, Russia
| | - Konstantin Pochivalov
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Prospekt, 119991 Moscow, Russia
- G.A. Krestov Institute of Solution Chemistry of the Russian Academy of Sciences, 1 ul. Akademicheskaja, 153045 Ivanovo, Russia
| | - Alexey Volkov
- A.V. Topchiev Institute of Petrochemical Synthesis RAS, 29 Leninsky Prospekt, 119991 Moscow, Russia
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12
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van Prooyen Schuurman L, Sistermans EA, Van Opstal D, Henneman L, Bekker MN, Bax CJ, Pieters MJ, Bouman K, de Munnik S, den Hollander NS, Diderich KE, Faas BH, Feenstra I, Go AT, Hoffer MJ, Joosten M, Komdeur FL, Lichtenbelt KD, Lombardi MP, Polak MG, Jehee FS, Schuring-Blom H, Stevens SJ, Srebniak MI, Suijkerbuijk RF, Tan-Sindhunata GM, van der Meij KR, van Maarle MC, Vernimmen V, van Zelderen-Bhola SL, van Ravesteyn NT, Knapen MF, Macville MV, Galjaard RJH. Clinical impact of additional findings detected by genome-wide non-invasive prenatal testing: Follow-up results of the TRIDENT-2 study. Am J Hum Genet 2022; 109:1140-1152. [PMID: 35659929 PMCID: PMC9247828 DOI: 10.1016/j.ajhg.2022.04.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/29/2022] [Indexed: 12/17/2022] Open
Abstract
In the TRIDENT-2 study, all pregnant women in the Netherlands are offered genome-wide non-invasive prenatal testing (GW-NIPT) with a choice of receiving either full screening or screening solely for common trisomies. Previous data showed that GW-NIPT can reliably detect common trisomies in the general obstetric population and that this test can also detect other chromosomal abnormalities (additional findings). However, evidence regarding the clinical impact of screening for additional findings is lacking. Therefore, we present follow-up results of the TRIDENT-2 study to determine this clinical impact based on the laboratory and perinatal outcomes of cases with additional findings. Between April 2017 and April 2019, additional findings were detected in 402/110,739 pregnancies (0.36%). For 358 cases, the origin was proven to be either fetal (n = 79; 22.1%), (assumed) confined placental mosaicism (CPM) (n = 189; 52.8%), or maternal (n = 90; 25.1%). For the remaining 44 (10.9%), the origin of the aberration could not be determined. Most fetal chromosomal aberrations were pathogenic and associated with severe clinical phenotypes (61/79; 77.2%). For CPM cases, occurrence of pre-eclampsia (8.5% [16/189] vs 0.5% [754/159,924]; RR 18.5), and birth weight <2.3rd percentile (13.6% [24/177] vs 2.5% [3,892/155,491]; RR 5.5) were significantly increased compared to the general obstetric population. Of the 90 maternal findings, 12 (13.3%) were malignancies and 32 (35.6%) (mosaic) pathogenic copy number variants, mostly associated with mild or no clinical phenotypes. Data from this large cohort study provide crucial information for deciding if and how to implement GW-NIPT in screening programs. Additionally, these data can inform the challenging interpretation, counseling, and follow-up of additional findings.
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13
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Suzumori N. What are the ethical issues involved in noninvasive prenatal testing in Japan? J Obstet Gynaecol Res 2021; 48:300-305. [PMID: 34729844 DOI: 10.1111/jog.15089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/01/2021] [Accepted: 10/23/2021] [Indexed: 11/26/2022]
Abstract
AIMS Noninvasive prenatal testing (NIPT) of pregnant women has been performed worldwide since 2011, and it is currently performed in more than 90 countries. However, the rate of adoption in Japan remains at less than 2%. This review seeks to identify the ethical and practical issues surrounding noninvasive prenatal screening-including the purpose of the test, its pros and cons, issues surrounding fair treatment, and social factors-to better understand why the adoption rate remains low. METHODS This study examines the complex ethical issues surrounding noninvasive prenatal testing, including the purpose of the test, its pros and cons, issues related to fair treatment, and social factors. RESULTS Although cell-free DNA analysis for common fetal trisomies using maternal blood is highly accurate, lack of access to such testing and discriminatory attitudes in society remain important barriers. Personal choices such as whether to undergo noninvasive prenatal screening and whether to continue a pregnancy are sometimes criticized by those who believe that it leads to the "selection of life" or discrimination against people with disabilities. CONCLUSIONS Obstetrics has changed dramatically in recent years, and prenatal diagnosis technology has also advanced. To keep up with these advances, better information should be provided to ensure the public has a more nuanced understanding of the screening beyond the overused argument that it leads to "selection of life."
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Affiliation(s)
- Nobuhiro Suzumori
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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14
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Abstract
New genomic laboratory technology namely microarrays and high throughput sequencing (HTS) as well as a steady progress in sonographic image capture and processing have changed the practice of prenatal diagnosis during the last decade fundamentally. Pregnancies at high risk for common trisomies are reliably identified by non-invasive prenatal testing (NIPT) and expert sonography has greatly improved the assessment of the fetal phenotype. Preconceptional comprehensive carrier screening using HTS is available for all parents, if they should wish to do so. A definite fetal diagnosis, however, will still require invasive testing for most conditions. Chromosomal microarrays (CMA) have greatly enhanced the resolution in the detection of chromosome anomalies and other causal copy number variations (CNV). Gene panel or whole exome sequencing (WES) is becoming the routine follow up of many anomalies detected by ultrasound after CNVs have been excluded. The benefits and limitations of the various screening as well as diagnostic options are perceived as complex by many who find it challenging to cope with the need for immediate choices. The communication of facts to ensure an informed decision making is obviously a growing challenge with the advent of the new genomic testing options. This contribution provides an overview of the current practice and policies in Switzerland.
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Affiliation(s)
- Isabel Filges
- Institut für Medizinische Genetik und Pathologie and Departement Klinische Forschung, Universitätsspital Basel, Basel, Switzerland
| | - Peter Miny
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Basel, Switzerland
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15
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O'Connor C, Moore R, McParland P, Hughes H, Cathcart B, Higgins S, Mahony R, Carroll S, Walsh J, McAuliffe F. The Natural History of Trisomy 21: Outcome Data from a Large Tertiary Referral Centre. Fetal Diagn Ther 2021; 48:575-581. [PMID: 34583352 DOI: 10.1159/000517729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/24/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study was to prospectively gather data on pregnancy outcomes of prenatally diagnosed trisomy 21 (T21) in a large tertiary referral centre. METHODS Data were gathered prospectively in a large tertiary referral centre over 5 years from 2013 to 2017 inclusively. Baseline demographic and pregnancy outcome data were recorded on an anonymized computerized database. RESULTS There were 1,836 congenital anomalies diagnosed in the study period including 8.9% (n = 165) cases of T21. 79% (n = 131) were age 35 or older at diagnosis. 79/113 (69.9%) women chose a termination of pregnancy (TOP) following a diagnosis of T21. Amongst pregnancies that continued, there were 4 second-trimester miscarriages (4/34, 11.7%), 9 stillbirths (9/34, 26.4%), and 1 neonatal death, giving an overall pregnancy and neonatal loss rate of 14/34 (41.1%). CONCLUSION The risk of foetal loss in prenatally diagnosed T21 is high at 38% with an overall pregnancy loss rate of 41.1%. This information may be of benefit when counselling couples who are faced with a diagnosis of T21 particularly in the context of limited access to TOP.
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Affiliation(s)
- Clare O'Connor
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Rebecca Moore
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland.,UCD Perinatal Research Centre, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Peter McParland
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Heather Hughes
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | | | - Shane Higgins
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Rhona Mahony
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Steve Carroll
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Jennifer Walsh
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland
| | - Fionnuala McAuliffe
- Fetal Medicine, National Maternity Hospital, Dublin, Ireland.,UCD Perinatal Research Centre, University College Dublin, National Maternity Hospital, Dublin, Ireland
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16
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Gormus U, Chaubey A, Shenoy S, Wong YW, Chan LY, Choo BP, Oraha L, Gousseva A, Persson F, Prensky L, Chin E, Hegde M. Assessment and Clinical Utility of a Non-Next-Generation Sequencing-Based Non-Invasive Prenatal Testing Technology. Curr Issues Mol Biol 2021; 43:958-64. [PMID: 34449543 DOI: 10.3390/cimb43020068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Rolling-circle replication (RCR) is a novel technology that has not been applied to cell-free DNA (cfDNA) testing until recently. Given the cost and simplicity advantages of this technology compared to other platforms currently used in cfDNA analysis, an assessment of RCR in clinical laboratories was performed. Here, we present the first validation study from clinical laboratories utilizing RCR technology. Methods: 831 samples from spontaneously pregnant women carrying a singleton fetus, and 25 synthetic samples, were analyzed for the fetal risk of trisomy 21 (T21), trisomy 18 (T18) and trisomy 13 (T13), by three laboratories on three continents. All the screen-positive pregnancies were provided post-test genetic counseling and confirmatory diagnostic invasive testing (e.g., amniocentesis). The screen-negative pregnancies were routinely evaluated at birth for fetal aneuploidies, using newborn examinations, and any suspected aneuploidies would have been offered diagnostic testing or confirmed with karyotyping. Results: The study found rolling-circle replication to be a highly viable technology for the clinical assessment of fetal aneuploidies, with 100% sensitivity for T21 (95% CI: 82.35-100.00%); 100.00% sensitivity for T18 (71.51-100.00%); and 100.00% sensitivity for T13 analyses (66.37-100.00%). The specificities were >99% for each trisomy (99.7% (99.01-99.97%) for T21; 99.5% (98.62-99.85%) for T18; 99.7% (99.03-99.97%) for T13), along with a first-pass no-call rate of 0.93%. Conclusions: The study showed that using a rolling-circle replication-based cfDNA system for the evaluation of the common aneuploidies would provide greater accuracy and clinical utility compared to conventional biochemical screening, and it would provide comparable results to other reported cfDNA methodologies.
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17
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Ju D, Li X, Shi Y, Ma Y, Guo L, Wang Y, Ma R, Zhong Y, Zhang Y, Xue F. Evaluation of the practical applications of fluorescence in situ hybridization in the prenatal diagnosis of positive noninvasive prenatal screenings. J Matern Fetal Neonatal Med 2021; 35:7422-7429. [PMID: 34289797 DOI: 10.1080/14767058.2021.1949449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate the application value and limitations of fluorescence in situ hybridization (FISH) in prenatal diagnosis of positive results for trisomies 13, 18, 21 (T13, T18, T21) and sex chromosome aneuploidies (SCAs) indicated by noninvasive prenatal screening (NIPS). METHODS Samples from women who underwent prenatal diagnosis for the indication of positive NIPS of T13, T18, T21, and SCAs were collected. Each sample was split into two for both karyotype analysis and FISH analysis. The efficiency and consistency of FISH were assessed for the detection of chromosome abnormalities in the indications of positive NIPS results compared with karyotyping. RESULTS A total of 649 pregnant women who scored positive for clinical significance of fetal chromosome abnormalities by NIPS were enrolled in our study, including T 13 (6%), T18 (14.3%), T21 (44.7%), SCAs (35.0%). From the following diagnostic test, the positive predictive value (PPV) of NIPS for T13, T18, T21, and SCAs was 17.9, 60.2, 89.3, and 43.6% respectively. FISH analysis was successful in all samples. Compared with karyotyping, the sensitivity and specificity were 98.3 and 100%, respectively. 95.7% (621/649) were fully concordant with karyotyping. 3.2% (21/649) cases were incompletely concordant with the karyotyping, among these cases, the FISH analysis identified all the aneuploidies, but karyotyping analysis provided more information about the chromosomal structure. There were 7 cases (1.1%, 7/649) of anomalies diagnosed by karyotype but missed out by FISH, all of which occurred in cases with the indication of SCAs. If the indications were confined to cases with a positive NIPS of T13, T18, T21, the diagnostic consistency of the two methods almost perfectly agree, and all the aneuploidies were detected by the FISH assay. FISH analysis was highly consistent in determining whether the fetus was euploid or not in the prenatal diagnosis for the patients with positive NIPS results compared with karyotyping (kappa= 0.976, p < .01). CONCLUSION For the prenatal diagnostic indications of positive NIPS of T13, T18, T21, and SCAs, FISH was equally efficacious in identifying aneuploidies and provided a quick diagnosis to alleviate anxiety. However, the missed risk of FISH analysis for structural chromosomal abnormalities should be taken seriously and fully informed during genetic counseling.
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Affiliation(s)
- Duan Ju
- Department of Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Xiaozhou Li
- Department of Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Yunfang Shi
- Department of Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Yanhong Ma
- Department of Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Liqiong Guo
- Institute of Disaster Medicine, Tianjin University, Tianjin, China
| | - Yanli Wang
- Department of Obstetrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Ruiyu Ma
- Department of Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Yuanyue Zhong
- Department of Obstetrics & Gynecology, Guangdong Province Hospital for Women and Children Healthcare, Guangzhou, China
| | - Ying Zhang
- Department of Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
| | - Fengxia Xue
- Department of Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin, China
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18
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Abstract
Paclitaxel administered into the peritoneal cavity is a chemotherapy agent that shows unusually prolonged retention within the peritoneal space. Using this pharmacokinetic fact as a starting point, the use of this drug to benefit patients with peritoneal metastases was investigated. The pharmacokinetics and drug characteristics of paclitaxel were identified from the oncologic literature. The experience to date with ovarian cancer, malignant peritoneal mesothelioma, gastric cancer and pancreas cancer was explored. Paclitaxel given by repeated instillation through an intraperitoneal port has demonstrable responses in ovarian cancer, peritoneal mesothelioma, gastric cancer and pancreas cancer when peritoneal metastases are present. Its role for prevention of peritoneal metastases in patients at high risk seems less well established. Randomized controlled studies have been positive in ovarian cancer but not in other diseases with peritoneal dissemination. A randomized controlled study in gastric cancer with peritoneal metastases produced suggestive but not conclusive results. Conversion surgery after repeated treatments with intraperitoneal paclitaxel has been reported with gastric cancer and pancreas cancer with peritoneal metastases. The pharmacology of intraperitoneal paclitaxel strongly suggest that intraperitoneal administration should be of benefit to prevent or treat peritoneal metastases. Protocols that the oncologist can follow to realize these potential benefits are not as yet available.
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Affiliation(s)
- Paul H Sugarbaker
- Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, Washington, DC, USA
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19
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Persson F, Prensky L. Variability of "Reported Fetal Fraction" in Noninvasive Prenatal Screening ( NIPS). Clin Chem 2021; 67:863-866. [PMID: 33734324 DOI: 10.1093/clinchem/hvab014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/08/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Fetal fraction is often used to designate no-calls in noninvasive prenatal screening (NIPS). We wished to compare the variability in determining fetal fraction to gold standard methods. METHODS We identified 6 publications with datasets consisting of methods capable of measuring fetal fraction for all samples that also had comparison data from gold standard methods. Examples of gold standard methods included relative Y-chromosome quantification in cases of male fetus pregnancies or relative quantification of the relevant chromosome for pregnancies affected by one of the 3 major trisomies. RESULTS The studies showed that the differences of the various fetal fraction measurement assays as compared to a gold standard measurement displayed a standard deviation (SD) in the range of 1.3-3.4% fetal fraction (FF). The 4 studies that measured FF from fragment size and genomic coordinates or single nucleotide polymorphisms had a lower variability, with a median SD of about 1.6%, whereas 2 other studies using different methods displayed significantly higher variability. CONCLUSION When deciding whether to use the reported FF as a reason to discard samples as no-calls or not, we recommend taking the variability of the FF measurement into consideration.
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Shubina J, Barkov IY, Stupko OK, Kuznetsova MV, Goltsov AY, Kochetkova TO, Trofimov DY, Sukhikh GT. Prenatal diagnosis of Prader-Willi syndrome due to uniparental disomy with NIPS: Case report and literature review. Mol Genet Genomic Med 2020; 8:e1448. [PMID: 32857485 PMCID: PMC7549559 DOI: 10.1002/mgg3.1448] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 12/13/2022] Open
Abstract
Background PWS is challenging to diagnose prenatally due to a lack of precise and well‐characterized fetal phenotypes and noninvasive markers. Here we present the case of prenatal diagnosis of Prader‐Willi syndrome, which was suspected with whole‐genome NIPS. Methods Whole‐genome noninvasive prenatal screening showed a high risk for trisomy 15. Amniocentesis followed by FISH analysis and SNP‐based chromosomal microarray was performed. Results Simultaneous analysis of maternal and fetal samples with SNP microarrays demonstrated maternal uniparental disomy (UPD). Conclusion The presented case is the first case of PWS described in detail, which was suspected by NIPS results. It demonstrates that the choice of confirmation methods concerning the time needed is crucial for the right diagnosis. We suppose that prenatal testing of UPD is essential for chromosome regions, which play a key role in the appearance of various gene‐imprinting failure syndromes like PWS or AS.
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Affiliation(s)
- Jekaterina Shubina
- Federal State Budget Institution "National Medical Research Center for Obstetrics Gynecology and Perinatology named after Academician V I Kulakov", Moscow, Russia
| | - Ilya Y Barkov
- Federal State Budget Institution "National Medical Research Center for Obstetrics Gynecology and Perinatology named after Academician V I Kulakov", Moscow, Russia
| | - Olga K Stupko
- Federal State Budget Institution "National Medical Research Center for Obstetrics Gynecology and Perinatology named after Academician V I Kulakov", Moscow, Russia
| | - Maria V Kuznetsova
- Federal State Budget Institution "National Medical Research Center for Obstetrics Gynecology and Perinatology named after Academician V I Kulakov", Moscow, Russia
| | - Andrey Y Goltsov
- Federal State Budget Institution "National Medical Research Center for Obstetrics Gynecology and Perinatology named after Academician V I Kulakov", Moscow, Russia
| | - Taisya O Kochetkova
- Federal State Budget Institution "National Medical Research Center for Obstetrics Gynecology and Perinatology named after Academician V I Kulakov", Moscow, Russia
| | - Dmitry Y Trofimov
- Federal State Budget Institution "National Medical Research Center for Obstetrics Gynecology and Perinatology named after Academician V I Kulakov", Moscow, Russia
| | - Gennady T Sukhikh
- Federal State Budget Institution "National Medical Research Center for Obstetrics Gynecology and Perinatology named after Academician V I Kulakov", Moscow, Russia
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21
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Sund KL, Khattar D, Boomer T, Caldwell S, Dyer L, Hopkin RJ, Smolarek TA. Confirmatory testing illustrates additional risks for structural sex chromosome abnormalities in fetuses with a non-invasive prenatal screen positive for monosomy X. Am J Med Genet C Semin Med Genet 2020; 184:294-301. [PMID: 32476283 DOI: 10.1002/ajmg.c.31783] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 01/29/2023]
Abstract
More and more women rely on non-invasive prenatal screening (NIPS) to detect fetal sex and risk for aneuploidy. The testing applies massively parallel sequencing or single nucleotide polymorphism (SNP) microarray to circulating cell-free DNA to determine relative copy number. In addition to trisomies 13, 18, and 21, some labs offer screening for sex chromosome abnormalities as part of their test. In this study, an index neonate screened positive for monosomy X and had discordant postnatal chromosomes indicating an X;autosome translocation. This patient prompted a retrospective chart review for similar cases at a large NIPS testing center. The review found 28 patients with an abnormal NIPS for monosomy X who were eventually diagnosed with additional discrepant structural sex chromosome abnormalities including translocations, isochromosomes, deletions, rings, markers, and uniparental disomy. The majority of these were mosaic with monosomy X, but in seven cases, there was no evidence of mosaicism on confirmatory testing. The identification of multiple sex chromosome aneuploidies in these cases supports the need for additional genetic counseling prior to NIPS testing and following abnormal NIPS results that are positive for monosomy X. This finding broadens our knowledge about the variable outcomes of positive monosomy X NIPS results and emphasizes the importance of confirmatory testing and clinical follow up for these patients.
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Affiliation(s)
- Kristen L Sund
- Department of Pediatrics, Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Divya Khattar
- Department of Pediatrics, Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | | | - Lisa Dyer
- Department of Pediatrics, Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Robert J Hopkin
- Department of Pediatrics, Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Teresa A Smolarek
- Department of Pediatrics, Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
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Li W, Zeng F, Fan B, Yu N, Wu J, Yang Y, Huang H, Li SL, Peng Z. Impact of ultrasonography on identifying noninvasive prenatal screening false-negative aneuploidy. Mol Genet Genomic Med 2020; 8:e1213. [PMID: 32198849 PMCID: PMC7284037 DOI: 10.1002/mgg3.1213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/30/2019] [Accepted: 02/24/2020] [Indexed: 11/28/2022] Open
Abstract
Background To evaluate the impact of ultrasonography on identifying noninvasive prenatal screening (NIPS) false‐negative aneuploidy. Methods Analysis of large population‐based NIPS false‐negative aneuploidy data comprising karyotypes, clinical outcomes, and ultrasound results. Results From December 2010 to July 2018, a total of 3,320,457 pregnancies were screened by NIPS performed in BGI; among them, 69 NIPS false‐negative aneuploidy cases with informed consent were confirmed, and ultrasound examination data for 48 cases were not available. Of the 21 cases with ultrasound results, 19 (90.5%) had various abnormalities on ultrasound, and two (9.5%) cases were shown to be normal on ultrasound. Additionally, six of seven live‐born fetuses (approximately 85.7%) were found to have abnormalities on ultrasound. Ventricular septal defects constituted the most frequently observed ultrasound abnormality type among the 21 NIPS false‐negative aneuploidy cases. Conclusion Application of NIPS has increased rapidly worldwide and now accounts for a large proportion of prenatal screening tests in China. This study suggests that ISUOG guideline should be followed practically, and structural abnormal ultrasound findings should not be neglected, even when NIPS produces a negative result. Combining NIPS with an ultrasound examination can further reduce the incidence of live births with aneuploidy.
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Affiliation(s)
- Wei Li
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Fanwei Zeng
- BGI Genomics, BGI-Shenzhen, Shenzhen, China.,Department of Biology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Nan Yu
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Jing Wu
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Yun Yang
- BGI-Wuhan, BGI-Shenzhen, Wuhan, China
| | - Hui Huang
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Sheng-Li Li
- Department of Ultrasound, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Zhiyu Peng
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
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23
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Luo Y, Lin J, Sun Y, Qian Y, Wang L, Chen M, Dong M, Jin F. Non-invasive prenatal screening for Emanuel syndrome. Mol Cytogenet 2020; 13:9. [PMID: 32158503 PMCID: PMC7057502 DOI: 10.1186/s13039-020-0476-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 02/07/2020] [Indexed: 12/27/2022] Open
Abstract
Objective The aim of this study was to validate the results of two Emanuel syndromes detected by non-invasive prenatal screening (NIPS) screening using invasive methods, providing clinical performance of NIPS on chromosome microduplication detection. Methods NIPS was performed to diagnose the Emanuel syndrome. Amniocentesis or cordocentesis was performed to confirm the positive screening result of Emanuel syndrome cases. Fetal sample was detected by karyotyping, fluorescence in situ hybridization (FISH), and single nucleotide polymorphism array (SNP Array). Parental karyotyping and FISH were also carried out. Results Two cases with chromosomal abnormalities of 11q23.3q25 and 22q11.1q11.21 were found by NIPS. Chromosomal karyotyping showed that the two fetuses each have a small supernumerary marker chromosome (sSMC), SNP Array further demonstrated double duplications approximately 18 Mb in 11q23.3q25 and 3 Mb in 22q11.1q11.21. FISH confirmed that the small supernumerary marker chromosome (sSMC) was ish der(22)t(11;22) (TUPLE1+, ARSA-). Ultrasound scan and MRI showed some structure malformations in two fetuses. The two mothers were found to be a balanced carrier: 46,XX, t(11;22)(q23.3;q11.2). Conclusion NIPS could effectively identify Emanuel syndrome, which may indicate risks of a parent being a balanced rearrangement carrier. The followed confirmation test for positive sample is necessary and ensures the accuracy of the diagnosis.
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Affiliation(s)
- Yuqin Luo
- 1Department of Reproductive Genetics, Women's Hospital,School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 Zhejiang China.,2Ministry of Education, Key Laboratory of Reproductive Genetics (Zhejiang University), Hangzhou, People's Republic of China
| | - Jie Lin
- 2Ministry of Education, Key Laboratory of Reproductive Genetics (Zhejiang University), Hangzhou, People's Republic of China
| | - Yixi Sun
- 1Department of Reproductive Genetics, Women's Hospital,School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 Zhejiang China.,2Ministry of Education, Key Laboratory of Reproductive Genetics (Zhejiang University), Hangzhou, People's Republic of China
| | - Yeqing Qian
- 1Department of Reproductive Genetics, Women's Hospital,School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 Zhejiang China.,2Ministry of Education, Key Laboratory of Reproductive Genetics (Zhejiang University), Hangzhou, People's Republic of China
| | - Liya Wang
- 1Department of Reproductive Genetics, Women's Hospital,School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 Zhejiang China.,2Ministry of Education, Key Laboratory of Reproductive Genetics (Zhejiang University), Hangzhou, People's Republic of China
| | - Min Chen
- 1Department of Reproductive Genetics, Women's Hospital,School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 Zhejiang China.,2Ministry of Education, Key Laboratory of Reproductive Genetics (Zhejiang University), Hangzhou, People's Republic of China
| | - Minyue Dong
- 1Department of Reproductive Genetics, Women's Hospital,School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 Zhejiang China.,2Ministry of Education, Key Laboratory of Reproductive Genetics (Zhejiang University), Hangzhou, People's Republic of China
| | - Fan Jin
- 1Department of Reproductive Genetics, Women's Hospital,School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 Zhejiang China.,2Ministry of Education, Key Laboratory of Reproductive Genetics (Zhejiang University), Hangzhou, People's Republic of China.,3Centre of Reproductive Medicine, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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24
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Che H, Villela D, Dimitriadou E, Melotte C, Brison N, Neofytou M, Van Den Bogaert K, Tsuiko O, Devriendt K, Legius E, Esteki MZ, Voet T, Vermeesch JR. Noninvasive prenatal diagnosis by genome-wide haplotyping of cell-free plasma DNA. Genet Med 2020; 22:962-73. [PMID: 32024963 DOI: 10.1038/s41436-019-0748-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 12/27/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Whereas noninvasive prenatal screening for aneuploidies is widely implemented, there is an increasing need for universal approaches for noninvasive prenatal screening for monogenic diseases. Here, we present a cost-effective, generic cell-free fetal DNA (cffDNA) haplotyping approach to scan the fetal genome for the presence of inherited monogenic diseases. METHODS Families participating in the preimplantation genetic testing for monogenic disorders (PGT-M) program were recruited for this study. Two hundred fifty thousand single-nucleotide polymorphisms (SNPs) captured from maternal plasma DNA along with genomic DNA from family members were massively parallel sequenced. Parental genotypes were phased via an available genotype from a close relative, and the fetal genome-wide haplotype and copy number were determined using cffDNA haplotyping analysis based on estimation and segmentation of fetal allele presence in the maternal plasma. RESULTS In all families tested, mutational profiles from cffDNA haplotyping are consistent with embryo biopsy profiles. Genome-wide fetal haplotypes are on average 97% concordant with the newborn haplotypes and embryo haplotypes. CONCLUSION We demonstrate that genome-wide targeted capture and sequencing of polymorphic SNPs from maternal plasma cell-free DNA (cfDNA) allows haplotyping and copy-number profiling of the fetal genome during pregnancy. The method enables the accurate reconstruction of the fetal haplotypes and can be easily implemented in clinical practice.
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25
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Palomaki GE, Wyatt P, Best RG, Lepage N, Ashwood ER, Souers RJ, Thorson JA. Assessment of laboratories offering cell-free (cf) DNA screening for Down syndrome: results of the 2018 College of American Pathology External Educational Exercises. Genet Med 2020; 22:777-784. [PMID: 31929509 DOI: 10.1038/s41436-019-0718-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/22/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Summarize and interpret results from exercises distributed to laboratories offering cell-free (cf) DNA screening for Down syndrome. METHODS The College of American Pathologists distributed three patient-derived plasma specimens twice in 2018. Sequencing platforms, test methods, results, and responses to supplemental questions were collected. Results were not graded but discrepancies were identified. RESULTS Sixty-five laboratories from six continents enrolled; six provided no results. The most common methodology was shotgun/genome sequencing (39/56, 70%). Overall, 40% of the gestational or maternal age responses were incorrect but 45% of the errors were corrected by the next distribution. Fetal fractions from 54 responding laboratories generally agreed with the intended response. No genotyping errors occurred (40/40 for trisomy 21 and 226/226 for euploid challenges) but 10 additional tests failed (3.6%). All 213 fetal sex calls were correct. Participants reported their clinical text for a Down syndrome screen positive test; 39% were classified as inadequate or misleading. CONCLUSION Patient-derived materials are suitable for all enrolled technologies/methodologies, but collecting material is challenging. Suggested clinical text includes the terms "screen positive" and "screen negative." Overall, laboratories performed well. Future efforts will focus on potential manufactured samples, clarifying results reporting and including additional chromosome abnormalities.
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Affiliation(s)
- Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital and the Alpert Medical School at Brown University, Providence, RI, USA.
| | - Philip Wyatt
- Esoterix Genetic Laboratories, Santa Fe, NM, USA
| | - Robert Glen Best
- Biomedical Sciences, University of South Carolina School of Medicine/Prisma Health System, Greenville, SC, USA
| | | | - Edward R Ashwood
- University of Colorado Hospital, Anschutz Medical Campus, Aurora, CO, USA
| | - Rhona J Souers
- Department of Biostatistics, College of American Pathologists, Northfield, IL, USA
| | - John A Thorson
- Department of Pathology, University of California San Diego Health, La Jolla, CA, USA
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26
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van der Meij KR, Sistermans EA, Macville MV, Stevens SJ, Bax CJ, Bekker MN, Bilardo CM, Boon EM, Boter M, Diderich KE, de Die-Smulders CE, Duin LK, Faas BH, Feenstra I, Haak MC, Hoffer MJ, den Hollander NS, Hollink IH, Jehee FS, Knapen MF, Kooper AJ, van Langen IM, Lichtenbelt KD, Linskens IH, van Maarle MC, Oepkes D, Pieters MJ, Schuring-Blom GH, Sikkel E, Sikkema-Raddatz B, Smeets DF, Srebniak MI, Suijkerbuijk RF, Tan-Sindhunata GM, van der Ven AJE, van Zelderen-Bhola SL, Henneman L, Galjaard RJH, Van Opstal D, Weiss MM. TRIDENT-2: National Implementation of Genome-wide Non-invasive Prenatal Testing as a First-Tier Screening Test in the Netherlands. Am J Hum Genet 2019; 105:1091-1101. [PMID: 31708118 DOI: 10.1016/j.ajhg.2019.10.005] [Citation(s) in RCA: 174] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/02/2019] [Indexed: 12/30/2022] Open
Abstract
The Netherlands launched a nationwide implementation study on non-invasive prenatal testing (NIPT) as a first-tier test offered to all pregnant women. This started on April 1, 2017 as the TRIDENT-2 study, licensed by the Dutch Ministry of Health. In the first year, NIPT was performed in 73,239 pregnancies (42% of all pregnancies), 7,239 (4%) chose first-trimester combined testing, and 54% did not participate. The number of trisomies 21 (239, 0.33%), 18 (49, 0.07%), and 13 (55, 0.08%) found in this study is comparable to earlier studies, but the Positive Predictive Values (PPV)-96% for trisomy 21, 98% for trisomy 18, and 53% for trisomy 13-were higher than expected. Findings other than trisomy 21, 18, or 13 were reported on request of the pregnant women; 78% of women chose to have these reported. The number of additional findings was 207 (0.36%); these included other trisomies (101, 0.18%, PPV 6%, many of the remaining 94% of cases are likely confined placental mosaics and possibly clinically significant), structural chromosomal aberrations (95, 0.16%, PPV 32%,) and complex abnormal profiles indicative of maternal malignancies (11, 0.02%, PPV 64%). The implementation of genome-wide NIPT is under debate because the benefits of detecting other fetal chromosomal aberrations must be balanced against the risks of discordant positives, parental anxiety, and a potential increase in (invasive) diagnostic procedures. Our first-year data, including clinical data and laboratory follow-up data, will fuel this debate. Furthermore, we describe how NIPT can successfully be embedded into a national screening program with a single chain for prenatal care including counseling, testing, and follow-up.
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Putra M, Idler J, Patek K, Contos G, Walker C, Olson D, Hicks MA, Chaperon J, Korzeniewski SJ, Patwardhan SC, Sokol RJ. The association of HBB-related significant hemoglobinopathies and low fetal fraction on noninvasive prenatal screening for fetal aneuploidy. J Matern Fetal Neonatal Med 2019; 34:3657-3661. [PMID: 31736384 DOI: 10.1080/14767058.2019.1689558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/25/2022]
Abstract
Objectives: HBB-related significant hemoglobinopathies have been anecdotally associated with low fetal fraction on noninvasive prenatal screening (NIPS). We sought to compare the difference in fetal fraction using NIPS in women with HBB-related significant hemoglobinopathies (HSH) and women with normal hemoglobin.Study design: This is a retrospective case-control study. Cases were women with a diagnosis of HSH using NIPS from a commercial laboratory. The comparison group was women with hemoglobin AA from a tertiary care center database. We tested for differences in median fetal fraction using quantile regression analysis, adjusting for maternal body weight and gestational age.Results: This study includes 35 women with clinically significant HSH and a comparison group of 636 women with hemoglobin AA. Adjusting for gestational age and body weight, the median fetal fraction was 4.1 point lower in the HSH than in the comparison group (β - 4.1; 95% -5.7 to -2.5, p < .05). The rate of no-calls due to low fetal fraction was significantly higher in the clinically significant HSH group than in the comparison group [HSH: n = 9/35, 25.7% versus comparison: n = 32/636, 5.0% (p < .001)].Conclusion: Women with HSH were more likely to have a lower fetal fraction and ultimately a five-fold higher no-call rate. What's already known about this topic?Low fetal fraction is one of the most common causes of no-call result in noninvasive prenatal screeningHigh maternal weight, early gestational age and fetal aneuploidies are associated with low fetal fraction What does this study add?HBB-related significant hemoglobinopathies are associated with low fetal fractionReduction in fetal fraction due to HBB-related significant hemoglobinopathies may also result in higher no-call rate.
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Affiliation(s)
- Manesha Putra
- Department of Reproductive Biology, Division of Maternal-Fetal Medicine, MetroHealth Medical Center, Cleveland, OH, USA.,University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Jay Idler
- Detroit Medical Center, Detroit, MI, USA.,Wayne State University School of Medicine, Detroit, MI, USA
| | - Kara Patek
- Detroit Medical Center, Detroit, MI, USA.,Wayne State University School of Medicine, Detroit, MI, USA
| | - George Contos
- Detroit Medical Center, Detroit, MI, USA.,Wayne State University School of Medicine, Detroit, MI, USA
| | - Christopher Walker
- Detroit Medical Center, Detroit, MI, USA.,Wayne State University School of Medicine, Detroit, MI, USA
| | - Danielle Olson
- Department of Reproductive Biology, Division of Maternal-Fetal Medicine, MetroHealth Medical Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | | | | | | | | | - Robert J Sokol
- Wayne State University School of Medicine, Detroit, MI, USA
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28
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Skotko BG, Allyse MA, Bajaj K, Best RG, Klugman S, Leach M, Meredith S, Michie M, Stoll K, Gregg AR. Adherence of cell-free DNA noninvasive prenatal screens to ACMG recommendations. Genet Med 2019; 21:2285-2292. [PMID: 30940924 DOI: 10.1038/s41436-019-0485-2] [Citation(s) in RCA: 21] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/28/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Noninvasive prenatal screening (NIPS) for fetal aneuploidy via cell-free DNA has been commercially available in the United States since 2011. In 2016, the American College of Medical Genetics and Genomics (ACMG) issued a position statement with specific recommendations for testing laboratories. We sought to evaluate adherence to these recommendations. METHODS We focused on commercial laboratories performing NIPS testing in the United States as of 1 January 2018. Sample laboratory reports and other materials were scored for compliance with ACMG recommendations. Variables scored for common and sex chromosome aneuploidy detection included detection rate, specificity, positive and negative predictive value, and fetal fraction. Labs that performed analysis of copy-number variants and results for aneuploidies other than those commonly reported were identified. Available patient education materials were similarly evaluated. RESULTS Nine of 10 companies reported fetal fraction in their reports, and 8 of 10 did not offer screening for autosomal aneuploidies beyond trisomy 13, 18, and 21. There was inconsistency in the application and reporting of other measures recommended by ACMG. CONCLUSIONS Laboratories varied in the degree to which they met ACMG position statement recommendations. No company adhered to all laboratory guidance.
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Affiliation(s)
- Brian G Skotko
- Division of Medical Genetics, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Megan A Allyse
- Program in Biomedical Ethics Research and Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA
| | - Komal Bajaj
- Division of Reproductive and Medical Genetics, Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert G Best
- University of South Carolina School of Medicine Greenville/Greenville Health System, Greenville, SC, USA
| | - Susan Klugman
- Division of Reproductive and Medical Genetics, Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mark Leach
- National Center for Prenatal & Postnatal Resources, University of Kentucky, Lexington, KY, USA
| | - Stephanie Meredith
- National Center for Prenatal & Postnatal Resources, University of Kentucky, Lexington, KY, USA
| | - Marsha Michie
- Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Katie Stoll
- Genetic Support Foundation, Olympia, WA, USA
| | - Anthony R Gregg
- Departments of Obstetrics and Gynecology and Maternal Fetal Medicine, Baylor University Medical Center, Dallas, TX, USA
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Abstract
Introduction: Gastric cancer is the fourth/fifth most common malignancy worldwide, with only a quarter of patients achieving a 5-year survival rate. It has been estimated that 15-50% or more of patients have peritoneal disease upon surgical exploration. Until the early 1990s, peritoneal metastasis was considered as terminal stage of the disease; in the late 1990s, selected patients with peritoneal metastasis were recategorized as local disease. Over the past two decades, the treatment of peritoneal involvement has transformed, and cytoreductive surgery plus intraperitoneal therapy have drastically altered the natural course of several malignancies. Areas covered: We performed a review of studies available on PubMed from 1 January 2014 to 31 July 2019 and the analysis of their reference citations. We describe the most current intraperitoneal chemotherapy opportunities in the treatment of gastric cancer: hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC), laparoscopic hyperthermic intraperitoneal chemotherapy (LHIPEC), neoadjuvant intraperitoneal and systemic chemotherapy (NIPS), LHIPEC + NIPS, extensive intraoperative peritoneal lavage (EIPL), early postoperative intraperitoneal chemotherapy (EPIC), and pressurized intraperitoneal aerosol chemotherapy (PIPAC). Expert opinion: Comprehensive treatment consisting of CRS combined with perioperative intraperitoneal/systemic chemotherapy can, today, be considered an effective strategy to improve the long-term survival of gastric cancer patients with peritoneal metastasis.
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Affiliation(s)
- Antonio Macrì
- Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program, Messina University Medical School Hospital , Messina , Italy
| | - Federico Morabito
- Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program, Messina University Medical School Hospital , Messina , Italy
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30
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Abstract
Introduction: Gastric cancer is the fourth/fifth most common malignancy worldwide, with only a quarter of patients achieving a 5-year survival rate. It has been estimated that 15-50% or more of patients have peritoneal disease upon surgical exploration. Until the early 1990s, peritoneal metastasis was considered as terminal stage of the disease; in the late 1990s, selected patients with peritoneal metastasis were recategorized as local disease. Over the past two decades, the treatment of peritoneal involvement has transformed, and cytoreductive surgery plus intraperitoneal therapy have drastically altered the natural course of several malignancies. Areas covered: We performed a review of studies available on PubMed from 1 January 2014 to 31 July 2019 and the analysis of their reference citations. We describe the most current intraperitoneal chemotherapy opportunities in the treatment of gastric cancer: hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC), laparoscopic hyperthermic intraperitoneal chemotherapy (LHIPEC), neoadjuvant intraperitoneal and systemic chemotherapy (NIPS), LHIPEC + NIPS, extensive intraoperative peritoneal lavage (EIPL), early postoperative intraperitoneal chemotherapy (EPIC), and pressurized intraperitoneal aerosol chemotherapy (PIPAC). Expert opinion: Comprehensive treatment consisting of CRS combined with perioperative intraperitoneal/systemic chemotherapy can, today, be considered an effective strategy to improve the long-term survival of gastric cancer patients with peritoneal metastasis.
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Affiliation(s)
- Antonio Macrì
- Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program, Messina University Medical School Hospital , Messina , Italy
| | - Federico Morabito
- Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program, Messina University Medical School Hospital , Messina , Italy
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31
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Yao M, Ren J, Akther N, Woo YC, Tijing LD, Kim SH, Shon HK. Improving membrane distillation performance: Morphology optimization of hollow fiber membranes with selected non-solvent in dope solution. Chemosphere 2019; 230:117-126. [PMID: 31102865 DOI: 10.1016/j.chemosphere.2019.05.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 02/28/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 06/09/2023]
Abstract
This study aimed at improving membrane distillation (MD) performance by mixing various non-solvents (NSs) in polymer dope solutions. The effect of each NS on the inner structure and surface morphology of hollow fiber (HF) membrane was investigated. Membrane morphology is manipulated by controlling liquid-liquid (L-L) and solid-liquid (S-L) demixing time, which is a function of the viscosity and water affinity of dope solutions. Consequently, the addition of NSs altered membrane morphology by affecting the diffusion rate during NS induced phase separation (NIPS) process. The performance results showed that the dope solution composed of 11/71.2/17.8 wt% polyvinylidene fluoride (PVDF)/triethyl phosphate (TEP)/toluene produced the most promising HF membrane for MD. The optimal membrane demonstrated a unique bicontinuous structure with increased porosity and mean pore size. The addition of toluene as NS in dope solutions enhanced crystallization process, which increased the Young's modulus of membrane but slightly decreased its maximum tensile strength at break. The optimal PVDF HF membrane demonstrated a steady flux of 18.9 LMH at 60 °C/20 °C of feed/permeate temperatures and a salt rejection of 99.99% when tested for 72 h. The results suggest that incorporation of toluene as a NS into PVDF dope solutions can increase permeation performance in MD by enhancing the morphology of HF membranes.
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Affiliation(s)
- Minwei Yao
- Centre for Technology in Water and Wastewater, School of Civil and Environmental Engineering, University of Technology Sydney (UTS), P. O. Box 123, 15 Broadway, NSW 2007, Australia
| | - Jiawei Ren
- Centre for Technology in Water and Wastewater, School of Civil and Environmental Engineering, University of Technology Sydney (UTS), P. O. Box 123, 15 Broadway, NSW 2007, Australia
| | - Nawshad Akther
- Centre for Technology in Water and Wastewater, School of Civil and Environmental Engineering, University of Technology Sydney (UTS), P. O. Box 123, 15 Broadway, NSW 2007, Australia
| | - Yun Chul Woo
- Department of Land, Water, and Environment Research, Korea Institute of Civil Engineering and Building Technology (KICT), 283 Goyang-Daero, Ilsanseo-Gu, Goyang-Si, Gyeonggi-Do, 10223, Republic of Korea
| | - Leonard D Tijing
- Centre for Technology in Water and Wastewater, School of Civil and Environmental Engineering, University of Technology Sydney (UTS), P. O. Box 123, 15 Broadway, NSW 2007, Australia
| | - Seung-Hyun Kim
- Civil Engineering Department, Kyungnam University, Wolyoung-dong, Changwon, 631-701, Republic of Korea
| | - Ho Kyong Shon
- Centre for Technology in Water and Wastewater, School of Civil and Environmental Engineering, University of Technology Sydney (UTS), P. O. Box 123, 15 Broadway, NSW 2007, Australia.
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32
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Nov-Klaiman T, Raz AE, Hashiloni-Dolev Y. Attitudes of Israeli parents of children with Down syndrome toward non-invasive prenatal screening and the scope of prenatal testing. J Genet Couns 2019; 28:1119-1129. [PMID: 31469214 DOI: 10.1002/jgc4.1162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 05/31/2019] [Revised: 08/05/2019] [Accepted: 08/08/2019] [Indexed: 12/14/2022]
Abstract
Due to its early utilization and increasing ability to provide genetic information, non-invasive prenatal screening (NIPS) has reinforced social and bioethical quandaries concerning prenatal genetics. This paper presents exploratory findings based on 20 semi-structured interviews conducted in 2017-2019 with Israeli parents of children with Down syndrome (DS), four of whom also serving as representatives of DS organizations. Their views are presented regarding the pros and cons of NIPS; the social context of decision-making about NIPS; and views on life with DS and termination of pregnancies on that ground. While illustrating the large heterogeneity of views concerning NIPS and prenatal diagnosis (PND) amongst parents of children with DS, our respondents commonly criticized the imbalanced information provided by professionals regarding DS, seen as sending a discriminating message in line with the public ignorance surrounding DS. These views are further discussed in the multi-cultural, ableist and pro-natal context of Israeli society. We conclude by offering practical implications concerning NIPS, parental autonomy, and informed choice.
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Affiliation(s)
- Tamar Nov-Klaiman
- Department of Sociology & Anthropology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aviad E Raz
- Department of Sociology & Anthropology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yael Hashiloni-Dolev
- Department of Sociology & Anthropology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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33
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Brison N, Storms J, Villela D, Claeys KG, Dehaspe L, de Ravel T, De Waele L, Goemans N, Legius E, Peeters H, Van Esch H, Race V, Robert Vermeesch J, Devriendt K, Van Den Bogaert K. Maternal copy-number variations in the DMD gene as secondary findings in noninvasive prenatal screening. Genet Med 2019; 21:2774-80. [PMID: 31197268 DOI: 10.1038/s41436-019-0564-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/22/2019] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Noninvasive prenatal screening (NIPS) using genome sequencing also reveals maternal copy-number variations (CNVs). Those CNVs can be clinically actionable or harmful to the fetus if inherited. CNVs in the DMD gene potentially causing dystrophinopathies are among the most commonly observed maternal CNVs. We present our experience with maternal DMD gene CNVs detected by NIPS. METHODS We analyzed the data of maternal CNVs detected in the DMD gene revealed by NIPS. RESULTS Of 26,123 NIPS analyses, 16 maternal CNVs in the DMD gene were detected (1/1632 pregnant women). Variant classification regarding pathogenicity and phenotypic severity was based on public databases, segregation analysis in the family, and prediction of the effect on the reading frame. Ten CNVs were classified as pathogenic, four as benign, and two remained unclassified. CONCLUSION NIPS leverages CNV screening in the general population of pregnant women. We implemented a strategy for the interpretation and the return of maternal CNVs in the DMD gene detected by NIPS.
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Koc A, Ozer Kaya O, Ozyilmaz B, Kutbay YB, Kirbiyik O, Ozdemir TR, Erdogan KM, Saka Guvenc M, Oztekin DC, Ozeren M, Pala HG, Ekin A, Gezer C, Sahingoz Yildirim AG, Konuralp Atakul B, Kurtulmus S, Turhan U, Taner CE. Targeted fetal cell-free DNA screening for aneuploidies in 4,594 pregnancies: Single center study. Mol Genet Genomic Med 2019; 7:e00678. [PMID: 31070015 PMCID: PMC6625369 DOI: 10.1002/mgg3.678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/03/2019] [Accepted: 03/13/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Next-generation sequencing (NGS) and discovery of fetal cell-free DNA (cfDNA) in the maternal circulation render possible prenatal screening for trisomy 21 (Down syndrome), trisomy 18, trisomy 13, and sex chromosome aneuploidies. The approach is called "fetal cfDNA screening" and in contrast to noninvasive conventional serum screening, it provides the identification of 98%-99% of fetuses with Down syndrome. METHODS Retrospective analysis of targeted noninvasive prenatal testing (NIPT) (Clarigo Test) pregnancies with moderate risk, which we have reported between 2016 and 2018 years is presented. Two separate laboratory workflows and NGS platforms are used for the same targeted NIPT analysis. RESULTS In total, 4,594 pregnant women were investigated. Initial 3,594 cases are studied by MiSeq platform, the last 1,000 cases by NextSeq. Failure rate for MiSeq platform is 10.9% and for NextSeq is 8.7%. Automatically reported cases constitute 75% of the MiSeq group and 87% of the NextSeq group. CONCLUSIONS Targeted NIPT results suggest that MiSeq platform could be used for NIPT which would be an essential option particularly for laboratories with low sample flow. And, the NextSeq platform has easier wet lab process and also increased success rate in automatic reporting which is suitable for centers with high number of NIPT cases.
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Affiliation(s)
- Altug Koc
- Genetic Diagnosis Center, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Ozge Ozer Kaya
- Genetic Diagnosis Center, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Berk Ozyilmaz
- Genetic Diagnosis Center, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Yasar B Kutbay
- Genetic Diagnosis Center, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Ozgur Kirbiyik
- Genetic Diagnosis Center, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Taha R Ozdemir
- Genetic Diagnosis Center, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Kadri M Erdogan
- Genetic Diagnosis Center, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Merve Saka Guvenc
- Genetic Diagnosis Center, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Deniz C Oztekin
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Mehmet Ozeren
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Halil G Pala
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Atalay Ekin
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Cenk Gezer
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Alkim G Sahingoz Yildirim
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Bahar Konuralp Atakul
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Secil Kurtulmus
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Ugur Turhan
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Cuneyt E Taner
- Perinatology Clinic, Department of Obstetrics and Gynaecology, Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
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Grendár M, Loderer D, Laučeková Z, Švecová I, Hrtánková M, Hornáková A, Nagy B, Žúbor P, Lasabová Z, Danko J. Uncertainty of fetal fraction determination in Non-Invasive Prenatal Screening by highly polymorphic SNPs. J Biotechnol 2019; 299:32-6. [PMID: 31034863 DOI: 10.1016/j.jbiotec.2019.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/22/2022]
Abstract
Fetal fraction and the chromosome representation are the two key quantities used in Non-Invasive Prenatal Screening (NIPS) to determine the aneuploidy status of a fetus. Several methods for fetal fraction determination have been proposed in the literature, including a class of the methods, denoted snpFF, based on high-coverage targeted sequencing of highly polymorphic Single Nucleotide Polymorphisms (SNPs). The variant of snpFF, investigated here, has similar properties as the other variants of snpFF. We point out that the variability of the individual informative SNPs-based estimates of fetal fraction increases with the increase of fetal fraction. At 4% fetal fraction the Inter-Quartile Range (IQR) of the individual estimates of fetal fraction is around 3% and it increases to 6% at 15% fetal fraction. snpFF cannot detect fetal fraction below 2.5% because the number of informative SNPs becomes too small, even zero.
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Hu P, Liang D, Chen Y, Lin Y, Qiao F, Li H, Wang T, Peng C, Luo D, Liu H, Xu Z. An enrichment method to increase cell-free fetal DNA fraction and significantly reduce false negatives and test failures for non-invasive prenatal screening: a feasibility study. J Transl Med 2019; 17:124. [PMID: 30975179 PMCID: PMC6460836 DOI: 10.1186/s12967-019-1871-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/03/2019] [Indexed: 12/18/2022] Open
Abstract
Background Noninvasive prenatal screening (NIPS) based on cell-free fetal DNA (cffDNA) has rapidly been applied into clinic. However, the reliability of this method largely depends on the concentration of cffDNA in the maternal plasma. The chance of test failure results or false negative results would increase when cffDNA fraction is low. In this study, we set out to develop a method to enrich the cffDNA for NIPS based on the size difference between cell-free DNA (cfDNA) of fetal origin and maternal origin, and to evaluate whether the new NIPS method can improve the test quality. Methods We utilized 10,000 previous NIPS data to optimize a size-selection strategy for enrichment. Then, we retrospectively performed our new NIPS method with cffDNA enrichment on the 1415 NIPS samples, including 1404 routine cases and 11 false negative cases, and compared the results to the original NIPS results. Results The 10,000 NIPS data revealed the fetal fraction in short cfDNA fragments (< 160 bp) is significantly higher. By using our new NIPS strategy on the 1404 routine cases, the fetal fraction increased from 11.3 ± 4.2 to 22.6 ± 6.6%, and the new method performed a significant decrease of test-failure rate (0.1% vs 0.7%, P < 0.01). Moreover, in 45.5% (5/11) of the false negative cases, fetal trisomies were successfully detected by our new NIPS method. Conclusions We developed an effective method to enrich cffDNA for NIPS, which shows an increased success rate and a reduced chance of false negative comparing to the ordinary NIPS method. Electronic supplementary material The online version of this article (10.1186/s12967-019-1871-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ping Hu
- State Key Laboratory of Reproductive Medicine, Department of Prenatal Diagnosis, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China
| | - Dong Liang
- State Key Laboratory of Reproductive Medicine, Department of Prenatal Diagnosis, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China
| | - Yangyi Chen
- CapitalBio Technology Inc., Beijing, 101111, China.,CapitalBio Genomics Co., Ltd., Dongguan, 523808, China.,CapitalBio MedLab, Beijing, 102206, China
| | - Ying Lin
- State Key Laboratory of Reproductive Medicine, Department of Prenatal Diagnosis, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China
| | - Fengchang Qiao
- State Key Laboratory of Reproductive Medicine, Department of Prenatal Diagnosis, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China
| | - Hang Li
- State Key Laboratory of Reproductive Medicine, Department of Prenatal Diagnosis, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China
| | - Ting Wang
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215000, Jiangsu, China
| | - Chunfang Peng
- CapitalBio Technology Inc., Beijing, 101111, China.,CapitalBio Genomics Co., Ltd., Dongguan, 523808, China.,CapitalBio MedLab, Beijing, 102206, China
| | - Donghong Luo
- CapitalBio Technology Inc., Beijing, 101111, China.,CapitalBio Genomics Co., Ltd., Dongguan, 523808, China.,CapitalBio MedLab, Beijing, 102206, China
| | - Hailiang Liu
- CapitalBio Technology Inc., Beijing, 101111, China. .,CapitalBio Genomics Co., Ltd., Dongguan, 523808, China. .,CapitalBio MedLab, Beijing, 102206, China.
| | - Zhengfeng Xu
- State Key Laboratory of Reproductive Medicine, Department of Prenatal Diagnosis, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China.
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Hao Y, Liu Y, Ishibashi H, Wakama S, Nishino E, Yonemura Y. Downstaging of lymph node metastasis after neoadjuvant intraperitoneal and systemic chemotherapy in gastric carcinoma with peritoneal metastasis. Eur J Surg Oncol 2019; 45:1493-7. [PMID: 30948161 DOI: 10.1016/j.ejso.2019.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/18/2018] [Accepted: 03/06/2019] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The aim of the present study was to evaluate the clinical features and prognosis of lymph node metastasis (LNM) in gastric cancer patients with peritoneal metastasis (PM) after neoadjuvant intraperitoneal and systemic chemotherapy. METHODS A total of 69 gastric cancer patients with PM and LNM who received neoadjuvant intraperitoneal and systemic chemotherapy (NIPS) of intraperitoneal docetaxel (DXT) and cisplatin (CDDP); intravenous chemotherapy of DXT and CDDP and oral S-1in Kishiwada Tokushukai Hospital between January 2008 and February 2017. After surgical resection, the response of LNMs was studied to confirm the effect of NIPS on LNMs. RESULTS After NIPS, 197 lymph nodes (LNs) (42.5%) were graded as G3, the progression in LNMs were significantly better than in the primary tumors. Until the last follow-up, 1-year overall survival rate was 82.6%, and the median survival period was 22.0 ± 3.7 months. In the group of patients who had achieved a more than 50% G3 grade of the response of LNMs, the median survival period is 38 months; in the less than 50% G3 grade group, it is 14 months, that is a significantly different result. Multivariate analyses showed that the factors PCI, Post-therapeutic N status and response of the LNMs were found to be as independent prognostic factors. CONCLUSION Downstaging of LNMs were achieved in patients of gastric cancer with PM who received NIPS. Downstaging of LNMs after NIPS is related with the prognosis of gastric cancer and should be valued in subsequent surgery for gastric cancer with peritoneal and lymph nodes metastasis.
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Wu Q, Zhang X, Cao G. Impacts of sodium hydroxide and sodium hypochlorite aging on polyvinylidene fluoride membranes fabricated with different methods. J Environ Sci (China) 2018; 67:294-308. [PMID: 29778163 DOI: 10.1016/j.jes.2017.07.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 06/08/2023]
Abstract
This study compared the effects of chemical aging on the polyvinylidene fluoride (PVDF) membranes fabricated with the methods of non-solvent induced phase separation (NIPS) (named NIPS-PVDF) and thermally induced phase separation (TIPS) (named TIPS-PVDF). The chemical solutions of sodium hypochlorite (NaClO) and sodium hydroxide (NaOH) were chosen at the concentration of 5000mg/L. The equivalence of 5 and 10years was respectively selected as the time of aging. The physicochemical evolutions of membrane aging are characterized on the base of morphology analysis, chemical components, permeation ability and mechanical properties. The aging of NIPS-PVDF membrane led to the elimination of surface hydrophilic additives, while NaOH focused on the dehydrofluorination process resulting in the formation of conjugated chains of polyene on the skeleton structure. The chemical components of the surface of TIPS-PVDF membrane were removed continuously during the aging processes of both NaClO and NaOH, which was caused by the saponification of surface additives and the chain scissions of skeleton structure, but without producing any obvious conjugated chains of polyene. All the aging processes led to the increase of contact angle and the decrease of mechanical properties, and the permeability was reduced first and increased later due to the enlargement of surface membrane pores and membrane block. With the influence of membrane aging, selectivity of membrane was decreased (except coliform bacteria). At the beginning of filtration, the turbidity and particle count were at relatively high levels and declined with the filtration process.
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Affiliation(s)
- Qilong Wu
- Graduate School at Shenzhen, Tsinghua University, Guangdong 518055, China; Foshan Water Group, Guangdong 528000, China.
| | - Xihui Zhang
- Graduate School at Shenzhen, Tsinghua University, Guangdong 518055, China; Environmental Science and Technology Laboratory, Tsinghua-Berkeley Shenzhen Institute, Guangdong 518055, China.
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Chen M, Fu XY, Luo YQ, Qian YQ, Pan L, Wang LY, Dong MY. Detection of fetal duplication 16p11.2q12.1 by next-generation sequencing of maternal plasma and invasive diagnosis. J Matern Fetal Neonatal Med 2017; 32:38-45. [PMID: 28882078 DOI: 10.1080/14767058.2017.1369947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of study is to report the feasibility of non-invasive prenatal screening (NIPS) combined with invasive detection by chromosomal analysis in identifying fetal duplication, providing clinical performance of NIPS on copy number variations (CNVs) detection. MATERIAL AND METHODS NIPS was offered to a 35-year-old pregnant woman. Amniocentesis was performed to confirm the positive screening result. Fetal sample was detected by karyotyping, fluorescence in situ hybridization (FISH), and chromosomal microarray (CMA). Parental karyotyping was also conducted. RESULTS NIPS result was positive for chromosome 16, indicating an extra copy of chromosome 16. FISH and chromosomal karyotyping revealed that the fetus had a marker chromosome derived from chromosome 16. CMA further demonstrated an approximately 19-Mb duplication in chromosome 16. The final fetal karyotype was 47,XY,+mar. ish der (16)(D16Z3+).arr 16p11.2q12.1 (30 624 186-49 696 337 × 3). Ultrasound scan and MRI showed some structure malformations. CONCLUSIONS A protocol for CNVs detection by combining a series of genetic methods was presented in this study and a novel marker duplication 16p11.2q12.1 was reported. With the ability to identify subchromosomal deletions and duplications in fetus, NIPS could reduce the possibility of invasive diagnosis. The followed confirmation test for positive sample is necessary and ensures the accuracy of the diagnosis.
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Affiliation(s)
- Min Chen
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Xiao-Ying Fu
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Yu-Qin Luo
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Ye-Qing Qian
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Ling Pan
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Li-Ya Wang
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Min-Yue Dong
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
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Yonemura Y, Canbay E, Li Y, Coccolini F, Glehen O, Sugarbaker PH, Morris D, Moran B, Gonzaletz-Moreno S, Deraco M, Piso P, Elias D, Batlett D, Ishibashi H, Mizumoto A, Verwaal V, Mahtem H. A comprehensive treatment for peritoneal metastases from gastric cancer with curative intent. Eur J Surg Oncol 2016; 42:1123-31. [PMID: 27160355 DOI: 10.1016/j.ejso.2016.03.016] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 03/12/2016] [Accepted: 03/16/2016] [Indexed: 12/29/2022] Open
Abstract
Recently, Peritoneal Surface Oncology Group International (PSOGI) developed a novel comprehensive treatment consisting of cytoreductive surgery (CRS) and perioperative chemotherapy (POC) for the treatment of peritoneal metastases (PM) from gastric cancer with curative intent. This article reviews the results of this treatment and verifies its indication. In this strategy, peritoneal cancer index (PCI) is determined by laparoscopy, and a peritoneal port is placed. Neoadjuvant bidirectional intraperitoneal/systemic chemotherapy (NIPS) is performed for 3 cycles, and then laparotomy is performed. Cytoreductive surgery with peritonectomy procedures and hyperthermic intraperitoneal chemoperfusion (HIPEC) are performed. Multivariate analyses showed that completeness of cytoreduction, pathologic response to NIPS and PCI level and cytologic status after NIPS, as independent prognostic factors. PCI less than cut-off level after NIPS, negative cytology after NIPS, and positive response to NIPS were identified as the indications for comprehensive treatment. Patients who hold these criteria should be considered as the candidates for CRS and HIPEC.
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Affiliation(s)
- Y Yonemura
- Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kusatsu General Hospital, Kishiwada, Shiga, Japan; NPO to Support Peritoneal Surface Malignancy Treatment, Oosaka, 600 8189, Japan.
| | - E Canbay
- NPO to Support Peritoneal Surface Malignancy Treatment, Oosaka, 600 8189, Japan
| | - Y Li
- Department of Peritoneal Surface Oncology, Beijin Shijitan Hospital of Capital Medical University, Beijin, 100038, China
| | - F Coccolini
- General Surgery Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - O Glehen
- Dēpartement de Chirurgie Gēnerale, Centre Hospitalier Lyon-Sud Hospices Civils de Lyon, Universitē Lyon, 69495, France
| | - P H Sugarbaker
- Center of Gastrointestinal Malignancies, Program in Peritoneal Surface Malignancies, MedStar Washington Hospital Center, Washington, DC, 20010, USA
| | - D Morris
- Department of Surgery, St George Hospital, University of New South Wales, Australia
| | - B Moran
- Peritoneal Malignancy Institute Basingstoke, Hampshire Hospitals Foundation Trust, Adelmaston Road, Basingstoke RG24 9NA, UK
| | - S Gonzaletz-Moreno
- Department of Surgical Oncology, Peritoneal Surface Oncology Program, MD Anderson Cancer Center, Madrid, Spain
| | - M Deraco
- National Cancer Institute of Milan, Italy
| | - P Piso
- Krankenhaus Barmherzige Brieder, Teaching Hospital of the University of Regensburg, Regensburg, Germany
| | - D Elias
- Département de Chirurgie Générale, Institut Gustave Roussy, Villejuif, Cedex, France
| | - D Batlett
- Division of Surgical Oncology, Hillman Cancer Center, 5115 Centre Ave, Pittsburgh, PA, 15232, USA
| | - H Ishibashi
- Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kusatsu General Hospital, Kishiwada, Shiga, Japan
| | - A Mizumoto
- Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kusatsu General Hospital, Kishiwada, Shiga, Japan
| | - V Verwaal
- Oncologisch GE Chirurg, Catharina, Ziekenhuis Eindhoven, The Netherlands
| | - H Mahtem
- Department of Surgical Sciences, Uppsala University, Övriga Samarbeten, Akademiska Sjukhuset, Ing 70 1 Tr, 751 85, Uppsala, Sweden
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Steinbach RJ, Allyse M, Michie M, Liu EY, Cho MK. "This lifetime commitment": Public conceptions of disability and noninvasive prenatal genetic screening. Am J Med Genet A 2016; 170A:363-374. [PMID: 26566970 PMCID: PMC4948186 DOI: 10.1002/ajmg.a.37459] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 10/20/2015] [Indexed: 12/15/2022]
Abstract
Recently, new noninvasive prenatal genetic screening technologies for Down syndrome and other genetic conditions have become commercially available. Unique characteristics of these screening tests have reignited long-standing concerns about prenatal testing for intellectual and developmental disabilities. We conducted a web-based survey of a sample of the US public to examine how attitudes towards disability inform views of prenatal testing in the context of these rapidly advancing prenatal genetic screening technologies. Regardless of opinion toward disability, the majority of respondents supported both the availability of screening and the decision to continue a pregnancy positive for aneuploidy. Individuals rationalized their support with various conceptions of disability; complications of the expressivist argument and other concerns from the disability literature were manifested in many responses analyzed.
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Affiliation(s)
| | - Megan Allyse
- Biomedical Ethics Research Program and Center for Individualized Medicine, Mayo Clinic, Rochester, MN 55905 U.S.A
| | - Marsha Michie
- Institute for Health and Aging, University of California, San Francisco, CA 94118 U.S.A
| | - Emily Y. Liu
- Stanford Center for Biomedical Ethics, Stanford, CA 94305 U.S.A
| | - Mildred K. Cho
- Stanford Center for Biomedical Ethics, Stanford, CA 94305 U.S.A
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Floyd E, Allyse MA, Michie M. Spanish- and English-Speaking Pregnant Women's Views on cfDNA and Other Prenatal Screening: Practical and Ethical Reflections. J Genet Couns 2016; 25:965-77. [PMID: 26739840 DOI: 10.1007/s10897-015-9928-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 12/09/2015] [Indexed: 01/08/2023]
Abstract
The rapid clinical implementation of cell-free DNA (cfDNA) screening, a non-invasive method of prenatal genetic screening, has outpaced research on its social and ethical implications. This study is the first to compare the ethical and practical views of Spanish- and English-speaking pregnant women in the United States about cfDNA screening. Semi-structured interviews were conducted with diverse Spanish- and English-speaking women who had received prenatal care at a large academic medical center. Of the 24 interviewees, ten were Latinas who were interviewed in Spanish; English-language interviews were conducted with seven non-Hispanic Asian and seven non-Hispanic White women. Participants held positive opinions concerning the accuracy of cfDNA screening and often noted that it would enhance preparedness. Participants also expressed concerns about the possibility of inaccurate results and the potentially negative effects of cfDNA screening on the experience of pregnancy. Differences emerged between Spanish and English speakers in their portrayals of their relationships with prenatal health care providers, the extent to which they questioned providers' advice, their ethical concerns, and their informational needs. We emphasize the importance of customizing prenatal test counseling to the needs of the individual patient, providing educationally appropriate counseling and literature, and mitigating potential language barriers.
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Affiliation(s)
- Erin Floyd
- Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Megan A Allyse
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA
| | - Marsha Michie
- UCSF Institute for Health and Aging, University of San Francisco, 3333 California St, Box 0646, San Francisco, CA, 94118, USA.
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Patel A, Czerniawski B, Gray S, Lui E. Does topical amethocaine gel reduce pain from heel prick blood sampling in premature infants? A randomized double-blind cross-over controlled study. Paediatr Child Health 2011; 8:222-5. [PMID: 20020001 DOI: 10.1093/pch/8.4.222] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Heel prick blood sampling is the most common painful invasive procedure performed on neonates. Currently, there are no effective ways to provide pain relief from this painful procedure. OBJECTIVE To assess the efficacy of the topical anesthetic amethocaine 4% gel (Ametop, Smith & Nephew Inc, St Laurent) in reducing the pain of heel prick blood sampling in neonates. METHODS A randomized, double-blind, placebo controlled, crossover trial was conducted. Neonates between 33 to 37 weeks' gestational age in their first seven days of life were eligible. Heel prick blood sampling was performed on each participant twice. Each infant was randomly assigned to receive either amethocaine 4% gel or placebo to the heel for the first prick, and then received the alternative agent for the second prick. Prick pain was assessed using both Premature Infant Pain Profile (PIPP) and Neonatal Infant Pain Scale (NIPS). Squeeze pain was assessed by NIPS. RESULTS Ten babies were recruited. There were no significant differences in the average PIPP and NIPS scores between the treatment and placebo groups for both prick and squeeze pains from heel prick blood sampling. For prick pain, linear-regression showed significant correlation between the PIPP and NIPS scores. No adverse reactions were observed after application of either the active or placebo agents. CONCLUSION Topical amethocaine 4% gel is not shown to reduce prick and squeeze pains significantly from heel prick blood sampling in neonates between 33 to 37 weeks' gestational age. Further studies are needed to find ways to provide effective pain relief from this common procedure.
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Affiliation(s)
- Amita Patel
- Neonatal Intensive Care Unit, McMaster Children's Hospital, Hamilton
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