38 results on '"Stober C"'
Search Results
2. Gaps and complex structurally variant loci in phased genome assemblies
- Author
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Porubsky, D., Vollger, M.R., Harvey, W.T., Rozanski, A.N., Ebert, P., Hickey, G., Hasenfeld, P., Sanders, A.D., Stober, C., Korbel, J.O., Paten, B., Marschall, T., and Eichler, E.E.
- Subjects
Cancer Research - Abstract
There has been tremendous progress in phased genome assembly production by combining long-read data with parental information or linked-read data. Nevertheless, a typical phased genome assembly generated by trio-hifiasm still generates more than 140 gaps. We perform a detailed analysis of gaps, assembly breaks, and misorientations from 182 haploid assemblies obtained from a diversity panel of 77 unique human samples. Although trio-based approaches using HiFi are the current gold standard, chromosome-wide phasing accuracy is comparable when using Strand-seq instead of parental data. Importantly, the majority of assembly gaps cluster near the largest and most identical repeats (including segmental duplications [35.4%], satellite DNA [22.3%], or regions enriched in GA/AT-rich DNA [27.4%]). Consequently, 1513 protein-coding genes overlap assembly gaps in at least one haplotype, and 231 are recurrently disrupted or missing from five or more haplotypes. Furthermore, we estimate that 6-7 Mbp of DNA are misorientated per haplotype irrespective of whether trio-free or trio-based approaches are used. Of these misorientations, 81% correspond to bona fide large inversion polymorphisms in the human species, most of which are flanked by large segmental duplications. We also identify large-scale alignment discontinuities consistent with 11.9 Mbp of deletions and 161.4 Mbp of insertions per haploid genome. Although 99% of this variation corresponds to satellite DNA, we identify 230 regions of euchromatic DNA with frequent expansions and contractions, nearly half of which overlap with 197 protein-coding genes. Such variable and incompletely assembled regions are important targets for future algorithmic development and pangenome representation.
- Published
- 2023
3. Semi-automated assembly of high-quality diploid human reference genomes
- Author
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Jarvis, E.D., Formenti, G., Rhie, A., Guarracino, A., Yang, C., Wood, J., Tracey, A., Thibaud-Nissen, F., Vollger, M.R., Porubsky, D., Cheng, H., Asri, M., Logsdon, G.A., Carnevali, P., Chaisson, M.J.P., Chin, C.S., Cody, S., Collins, J., Ebert, P., Escalona, M., Fedrigo, O., Fulton, R.S., Fulton, L.L., Garg, S., Gerton, J.L., Ghurye, J., Granat, A., Green, R.E., Harvey, W., Hasenfeld, P., Hastie, A., Haukness, M., Jaeger, E.B., Jain, M., Kirsche, M., Kolmogorov, M., Korbel, J.O., Koren, S., Korlach, J., Lee, J., Li, D., Lindsay, T., Lucas, J., Luo, F., Marschall, T., Mitchell, M.W., McDaniel, J., Nie, F., Olsen, H.E., Olson, N.D., Pesout, T., Potapova, T., Puiu, D., Regier, A., Ruan, J., Salzberg, S.L., Sanders, A.D., Schatz, M.C., Schmitt, A., Schneider, V.A., Selvaraj, S., Shafin, K., Shumate, A., Stitziel, N.O., Stober, C., Torrance, J., Wagner, J., Wang, J., Wenger, A., Xiao, C., Zimin, A.V., Zhang, G., Wang, T., Li, H., Garrison, E., Haussler, D., Hall, I., Zook, J.M., Eichler, E.E., Phillippy, A.M., Paten, B., Howe, K., and Miga, K.H.
- Subjects
Cancer Research ,Haplotypes ,Genome, Human ,Humans ,Chromosome Mapping ,High-Throughput Nucleotide Sequencing ,Chromosomes, Human ,Genetic Variation ,Sequence Analysis, DNA ,Genomics ,Reference Standards ,Diploidy - Abstract
The current human reference genome, GRCh38, represents over 20 years of effort to generate a high-quality assembly, which has benefitted societysup1,2/sup. However, it still has many gaps and errors, and does not represent a biological genome as it is a blend of multiple individualssup3,4/sup. Recently, a high-quality telomere-to-telomere reference, CHM13, was generated with the latest long-read technologies, but it was derived from a hydatidiform mole cell line with a nearly homozygous genomesup5/sup. To address these limitations, the Human Pangenome Reference Consortium formed with the goal of creating high-quality, cost-effective, diploid genome assemblies for a pangenome reference that represents human genetic diversitysup6/sup. Here, in our first scientific report, we determined which combination of current genome sequencing and assembly approaches yield the most complete and accurate diploid genome assembly with minimal manual curation. Approaches that used highly accurate long reads and parent-child data with graph-based haplotype phasing during assembly outperformed those that did not. Developing a combination of the top-performing methods, we generated our first high-quality diploid reference assembly, containing only approximately four gaps per chromosome on average, with most chromosomes within ±1% of the length of CHM13. Nearly 48% of protein-coding genes have non-synonymous amino acid changes between haplotypes, and centromeric regions showed the highest diversity. Our findings serve as a foundation for assembling near-complete diploid human genomes at scale for a pangenome reference to capture global genetic variation from single nucleotides to structural rearrangements.
- Published
- 2021
4. Decision Strategies while Intoxicated relate to Alcohol-Impaired Driving Attitudes and Intentions
- Author
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Denis M. McCarthy, Sara D McMullin, Clintin P. Davis-Stober, Laura E. Hatz, Courtney A. Motschman, and Stober C
- Subjects
Impaired driving ,Psychology ,Clinical psychology - Abstract
Objective: Approximately 28 million individuals engage in alcohol-impaired driving (AID) every year. This study investigated individuals’ AID decision making strategies under intoxication, their variability across the breath alcohol concentration curve (BrAC), and the association between strategy and AID attitudes and intentions. Method: 79 adults (23.9 years, 57% women) who drank alcohol ≥2 days per week and lived >2 miles away from their typical drinking locations completed an alcohol administration protocol and AID decision making task. AID attitudes, intentions, and behaviors were assessed repeatedly across the BrAC curve. Bayesian cognitive modeling identified decision strategies used by individuals on the AID decision making task, revealing whether alcohol consumption level and/or ride service cost factored into individuals’ decisions to drive while impaired or obtain a ride. Additional analyses tested whether AID attitudes and intentions were related to individuals’ decision strategies. Results: Two decision strategies were examined on the ascending and descending limb of the BrAC curve: compensatory (both consumption level and ride service cost factored into AID decisions) and non-compensatory (only consumption level factored into AID decisions). Switching to a compensatory strategy on the descending limb was associated with lower perceived intoxication, perceiving AID as less dangerous, and being willing to drive above the legal BrAC limit. Conclusions: Results suggest that risk for engaging in AID is higher for those using a cost-sensitive, compensatory strategy when making AID decisions under intoxication. Future research is needed to test whether AID countermeasures (e.g., subsidized ride services) are differentially effective according to decision strategy type.
- Published
- 2021
5. Characterisation of novel anti-human IgE monoclonal antibodies: 2. Effects on interaction of IgE with FcϵRII
- Author
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Stober, C., Lamont, A. G., and Hewitt, E. L.
- Published
- 1999
6. a survey of oncology nurses and physicians
- Author
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LeVasseur, N., Stober, C., Daigle, K., Robinson, A., McDiarmid, S., Mazzarello, S., Hutton, B., Joy, A., Fergusson, D., Hilton, J., McInnes, M., and Clemons, M.
- Subjects
physician surveys ,vascular access ,nurse surveys ,Early-stage breast cancer - Abstract
Despite advances in systemic therapy choices for patients with early-stage breast cancer, optimal practices for intravenous (IV) access remain unknown. That lack of knowledge holds particularly true for the use of central venous access devices (cvads) such as peripherally inserted central catheters (piccs) and implanted vascular access devices (ports). Using a survey of Canadian oncologists and oncology nurses responsible for the care of breast cancer patients, we evaluated current access practices, perceptions of complications, and perceptions of risk, and we estimated complication rates and evaluated perceived risk factors for lymphedema. Survey responses were received from 25 physicians and 57 oncology nurses. Administration of trastuzumab or an anthracycline was associated with a higher likelihood of a cvad being recommended. Other factors associated with recommendation of a cvad included prior difficult IV access and a recommendation from the chemotherapy nurse. Although the complication rates perceived to be associated with the use of piccs and ports remained high, respondents felt that cvads might improve patient quality of life. Risk factors perceived to be associated with the risk of lymphedema were axillary lymph node dissection, radiation to the axilla, and line-associated infection. Factors known to be unrelated to lymphedema risk (specifically, blood draws and blood pressure measurement) continue to be perceived as posing a higher risk. Despite widespread use of chemotherapy for patients with breast cancer, the type of venous access used for treatment varies significantly, as do perceptions about the risks of cvad use and the risk for lymphedema development. Further prospective studies are needed to identify best-practice strategies.
- Published
- 2018
- Full Text
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7. A pragmatic, randomised, multicentre trial comparing 4-weekly vs. 12-weekly administration of bone-targeted agents (denosumab, zoledronate or pamidronate) in patients with bone metastases
- Author
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Clemons, M., primary, Stober, C., additional, Mates, M., additional, Joy, A.A., additional, Robinson, A., additional, Hilton, J., additional, Blanchette, P., additional, Aseyev, O., additional, Pond, G., additional, and Fergusson, D., additional
- Published
- 2019
- Full Text
- View/download PDF
8. A prospective, multicentre, randomized trial comparing vascular access strategies for patients receiving non-trastuzumab containing chemotherapy for early stage breast cancer
- Author
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Awan, A.A., primary, Basulaiman, B., additional, Robinson, A., additional, Stober, C., additional, Fergusson, D., additional, Joy, A.A., additional, Vandermeer, L., additional, Mallick, R., additional, Saunders, D., additional, and Clemons, M., additional
- Published
- 2019
- Full Text
- View/download PDF
9. A cost-utility analysis of administration schedules of G-CSF for primary prophylaxis of chemotherapy-induced febrile neutropenia in early stage breast cancer: Economic evaluation alongside the REaCT-G trial
- Author
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Basulaiman, B., primary, Awan, A.A., additional, Hilton, J., additional, Fergusson, D., additional, Stober, C., additional, Vandermeer, L., additional, Saunders, D., additional, Clemons, M., additional, and Thavorn, K., additional
- Published
- 2019
- Full Text
- View/download PDF
10. Testing probabilistic models of choice using column generation
- Author
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Smeulders, B., Davis-Stober, C., Regenwetter, M., Spieksma, F.C.R., Smeulders, B., Davis-Stober, C., Regenwetter, M., and Spieksma, F.C.R.
- Abstract
In so-called random preference models of probabilistic choice, a decision maker chooses according to an unspecified probability distribution over preference states. The most prominent case arises when preference states are linear orders or weak orders of the choice alternatives. The literature has documented that actually evaluating whether decision makers’ observed choices are consistent with such a probabilistic model of choice poses computational difficulties. This severely limits the possible scale of empirical work in behavioral economics and related disciplines. We propose a family of column generation based algorithms for performing such tests. We evaluate our algorithms on various sets of instances. We observe substantial improvements in computation time and conclude that we can efficiently test substantially larger data sets than previously possible.
- Published
- 2018
11. out of office&rdquo
- Author
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Clemons, M., Joy, A.A., Hilton, J., Arnaout, A., Brackstone, M., Wheatley-Price, P., Stober, C., Dinniwell, R., Mazzarello, S., Costa, M. da, and Hutton, B.
- Published
- 2017
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12. Optimizing Vascular Access for Patients Receiving Intravenous Systemic Therapy for Early-Stage Breast Cancer—A Survey of Oncology Nurses and Physicians
- Author
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LeVasseur, N., primary, Stober, C., additional, Daigle, K., additional, Robinson, A., additional, McDiarmid, S., additional, Mazzarello, S., additional, Hutton, B., additional, Joy, A., additional, Fergusson, D., additional, Hilton, J., additional, McInnes, M., additional, and Clemons, M., additional
- Published
- 2018
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13. Perceptions of Vascular Access for Intravenous Systemic Therapy and Risk Factors for Lymphedema in Early-Stage Breast Cancer—A Patient Survey
- Author
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LeVasseur, N., primary, Stober, C., additional, Ibrahim, M., additional, Gertler, S., additional, Hilton, J., additional, Robinson, A., additional, McDiarmid, S., additional, Fergusson, D., additional, Mazzarello, S., additional, Hutton, B., additional, Joy, A.A., additional, McInnes, M., additional, and Clemons, M., additional
- Published
- 2018
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14. Physician "Out of Office" Alert: Does It Work?
- Author
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Clemons, Mark, primary, Joy, A. A., additional, Hilton, J., additional, Arnaout, A., additional, Brackstone, M., additional, Wheatley-Price, P., additional, Stober, C., additional, Dinniwell, R., additional, Mazzarello, S., additional, da Costa, M., additional, and Hutton, B., additional
- Published
- 2017
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15. ATP-Induced Killing of Mycobacteria by Human Macrophages Is Mediated by Purinergic P2Z(P2X7) Receptors
- Author
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Lammas, D.A., primary, Stober, C., additional, Harvey, C.J., additional, Kendrick, N., additional, Panchalingam, S., additional, and Kumararatne, D.S., additional
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- 1997
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16. LBA 3 A pragmatic, randomised, multicentre trial comparing 4-weekly vs. 12-weekly administration of bone-targeted agents (denosumab, zoledronate or pamidronate) in patients with bone metastases.
- Author
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Clemons, M, Stober, C, Mates, M, Joy, A A, Robinson, A, Hilton, J, Blanchette, P, Aseyev, O, Pond, G, and Fergusson, D
- Subjects
- *
BONE metastasis , *METASTATIC breast cancer , *EXPERIMENTAL medicine , *DENOSUMAB - Published
- 2019
- Full Text
- View/download PDF
17. 211P A cost-utility analysis of administration schedules of G-CSF for primary prophylaxis of chemotherapy-induced febrile neutropenia in early stage breast cancer: Economic evaluation alongside the REaCT-G trial.
- Author
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Basulaiman, B, Awan, A A, Hilton, J, Fergusson, D, Stober, C, Vandermeer, L, Saunders, D, Clemons, M, and Thavorn, K
- Subjects
- *
FEBRILE neutropenia , *COST effectiveness , *BREAST cancer , *PREVENTIVE medicine , *PUBLIC hospitals - Published
- 2019
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18. 205P A prospective, multicentre, randomized trial comparing vascular access strategies for patients receiving non-trastuzumab containing chemotherapy for early stage breast cancer.
- Author
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Awan, A A, Basulaiman, B, Robinson, A, Stober, C, Fergusson, D, Joy, A A, Vandermeer, L, Mallick, R, Saunders, D, and Clemons, M
- Subjects
- *
SURGICAL arteriovenous shunts , *BREAST cancer , *CANCER chemotherapy , *MEDICAL sciences , *WOMEN'S hospitals - Published
- 2019
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19. Smarter in the city? Lizards from urban and semi-natural habitats do not differ in a cognitive task in two syntopic species.
- Author
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Damas-Moreira I, Szabo B, Drosopoulos G, Stober C, Lisičić D, and Caspers BA
- Abstract
Urbanization occurs at a global scale, imposing dramatic and abrupt environmental changes that lead to biodiversity loss. Yet, some animal species can handle these changes, and thrive in such artificial environments. One possible explanation is that urban individuals are equipped with better cognitive abilities, but most studies have focused on birds and mammals and yielded varied results. Reptiles have received much less attention, despite some lizard species being common city dwellers. The Italian wall lizard, Podarcis siculus , and the common wall lizard, Podarcis muralis , are two successful lizards in anthropogenic habitats that thrive in urban locations. To test for differences in a cognitive skill between urban and semi-natural environments, we investigated inhibitory control through a detour task in syntopic populations of the two species, across 249 lizards that were tested in partially artificial field settings. Sophisticated inhibitory control is considered essential for higher degrees of cognitive flexibility and other higher-level cognitive abilities. In this task, we confronted lizards with a transparent barrier, separating them from a desired shelter area that they could only reach by controlling their impulse to go straight and instead detour the barrier. We found no differences between lizards in urban and semi-natural environments, nor between species, but females overall performed better than males. Moreover, 48% of the lizards in our study did not perform a correct trial in any of the 5 trials, hinting at the difficulty of the task for these species. This study is among the first to address lizard cognition, through their inhibitory control, as a potential explanation for success in cities and highlights one should be careful with assuming that urban animals generally have enhanced cognitive performance, as it might be taxa, task, or condition dependent., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of Editorial Office, Current Zoology.)
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- 2024
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20. A Multi-Centre Randomized Study Comparing Two Standard of Care Chemotherapy Regimens for Lower-Risk HER2-Positive Breast Cancer.
- Author
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Fernandes R, Ng TL, Alzahrani MJ, Raphael J, Blanchette P, Black M, Stober C, Pond GR, Cella D, Vandermeer L, Ibrahim M, and Clemons M
- Subjects
- Humans, Female, Quality of Life, Standard of Care, Chemotherapy, Adjuvant, Trastuzumab therapeutic use, Breast Neoplasms drug therapy
- Abstract
Background: Neither paclitaxel plus trastuzumab (P-H) nor docetaxel-cyclophosphamide plus trastuzumab (TC-H) have been prospectively compared in HER2-positive early-stage breast cancer (EBC). A randomized trial was performed to assess the feasibility of a larger study., Methods: Lower-risk HER2-positive EBC patients were randomized to either P-H or TC-H treatment arms. The co-primary feasibility outcomes were: ≥75% patient acceptability rate, active trial participation of ≥50% of medical oncologists, ≥75% and ≥90% treatment completion, and receipt rate of planned cycles of chemotherapy, respectively., Secondary Outcomes: Febrile neutropenia (FN) rate, treatment-related hospitalizations, health-related quality of life (HR-QoL) questionnaires. Analyses were performed by per protocol and intention-to-treat., Results: Between May 2019 and March 2021, 49 of 52 patients agreed to study participation (94% acceptability rate). Fifteen (65%) of 23 medical oncologists approached patients. Rates of FN were higher (8.3% vs. 0%) in the TC-H vs. P-H arm. Median (IQR) changes in scores from baseline in FACT-Taxane Trial Outcome Index at 24 weeks were -4 (-10, -1) vs. -6.5 (-15, -2) for TC-H and P-H arms, respectively., Conclusions: A randomized trial comparing P-H and TC-H was feasible. Expansion to a larger trial would be feasible to explore patient-reported outcomes of these adjuvant HER2 chemotherapy regimens.
- Published
- 2023
- Full Text
- View/download PDF
21. Gaps and complex structurally variant loci in phased genome assemblies.
- Author
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Porubsky D, Vollger MR, Harvey WT, Rozanski AN, Ebert P, Hickey G, Hasenfeld P, Sanders AD, Stober C, Korbel JO, Paten B, Marschall T, and Eichler EE
- Subjects
- Humans, Haplotypes, Segmental Duplications, Genomic, Sequence Analysis, DNA, DNA, Satellite genetics, Polymorphism, Genetic
- Abstract
There has been tremendous progress in phased genome assembly production by combining long-read data with parental information or linked-read data. Nevertheless, a typical phased genome assembly generated by trio-hifiasm still generates more than 140 gaps. We perform a detailed analysis of gaps, assembly breaks, and misorientations from 182 haploid assemblies obtained from a diversity panel of 77 unique human samples. Although trio-based approaches using HiFi are the current gold standard, chromosome-wide phasing accuracy is comparable when using Strand-seq instead of parental data. Importantly, the majority of assembly gaps cluster near the largest and most identical repeats (including segmental duplications [35.4%], satellite DNA [22.3%], or regions enriched in GA/AT-rich DNA [27.4%]). Consequently, 1513 protein-coding genes overlap assembly gaps in at least one haplotype, and 231 are recurrently disrupted or missing from five or more haplotypes. Furthermore, we estimate that 6-7 Mbp of DNA are misorientated per haplotype irrespective of whether trio-free or trio-based approaches are used. Of these misorientations, 81% correspond to bona fide large inversion polymorphisms in the human species, most of which are flanked by large segmental duplications. We also identify large-scale alignment discontinuities consistent with 11.9 Mbp of deletions and 161.4 Mbp of insertions per haploid genome. Although 99% of this variation corresponds to satellite DNA, we identify 230 regions of euchromatic DNA with frequent expansions and contractions, nearly half of which overlap with 197 protein-coding genes. Such variable and incompletely assembled regions are important targets for future algorithmic development and pangenome representation., (© 2023 Porubsky et al.; Published by Cold Spring Harbor Laboratory Press.)
- Published
- 2023
- Full Text
- View/download PDF
22. Semi-automated assembly of high-quality diploid human reference genomes.
- Author
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Jarvis ED, Formenti G, Rhie A, Guarracino A, Yang C, Wood J, Tracey A, Thibaud-Nissen F, Vollger MR, Porubsky D, Cheng H, Asri M, Logsdon GA, Carnevali P, Chaisson MJP, Chin CS, Cody S, Collins J, Ebert P, Escalona M, Fedrigo O, Fulton RS, Fulton LL, Garg S, Gerton JL, Ghurye J, Granat A, Green RE, Harvey W, Hasenfeld P, Hastie A, Haukness M, Jaeger EB, Jain M, Kirsche M, Kolmogorov M, Korbel JO, Koren S, Korlach J, Lee J, Li D, Lindsay T, Lucas J, Luo F, Marschall T, Mitchell MW, McDaniel J, Nie F, Olsen HE, Olson ND, Pesout T, Potapova T, Puiu D, Regier A, Ruan J, Salzberg SL, Sanders AD, Schatz MC, Schmitt A, Schneider VA, Selvaraj S, Shafin K, Shumate A, Stitziel NO, Stober C, Torrance J, Wagner J, Wang J, Wenger A, Xiao C, Zimin AV, Zhang G, Wang T, Li H, Garrison E, Haussler D, Hall I, Zook JM, Eichler EE, Phillippy AM, Paten B, Howe K, and Miga KH
- Subjects
- Humans, Haplotypes genetics, High-Throughput Nucleotide Sequencing methods, High-Throughput Nucleotide Sequencing standards, Sequence Analysis, DNA methods, Sequence Analysis, DNA standards, Reference Standards, Chromosomes, Human genetics, Genetic Variation genetics, Chromosome Mapping standards, Diploidy, Genome, Human genetics, Genomics methods, Genomics standards
- Abstract
The current human reference genome, GRCh38, represents over 20 years of effort to generate a high-quality assembly, which has benefitted society
1,2 . However, it still has many gaps and errors, and does not represent a biological genome as it is a blend of multiple individuals3,4 . Recently, a high-quality telomere-to-telomere reference, CHM13, was generated with the latest long-read technologies, but it was derived from a hydatidiform mole cell line with a nearly homozygous genome5 . To address these limitations, the Human Pangenome Reference Consortium formed with the goal of creating high-quality, cost-effective, diploid genome assemblies for a pangenome reference that represents human genetic diversity6 . Here, in our first scientific report, we determined which combination of current genome sequencing and assembly approaches yield the most complete and accurate diploid genome assembly with minimal manual curation. Approaches that used highly accurate long reads and parent-child data with graph-based haplotype phasing during assembly outperformed those that did not. Developing a combination of the top-performing methods, we generated our first high-quality diploid reference assembly, containing only approximately four gaps per chromosome on average, with most chromosomes within ±1% of the length of CHM13. Nearly 48% of protein-coding genes have non-synonymous amino acid changes between haplotypes, and centromeric regions showed the highest diversity. Our findings serve as a foundation for assembling near-complete diploid human genomes at scale for a pangenome reference to capture global genetic variation from single nucleotides to structural rearrangements., (© 2022. The Author(s).)- Published
- 2022
- Full Text
- View/download PDF
23. Oral magnesium supplements for cancer treatment-induced hypomagnesemia: Results from a pilot randomized trial.
- Author
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Awan A, Basulaiman B, Stober C, Clemons M, Fergusson D, Hilton J, Al Ghareeb W, Goodwin R, Ibrahim M, Hutton B, Vandermeer L, Mallick R, and Vickers MM
- Abstract
Background and Aims: Optimal management of cancer treatment-induced hypomagnesemia (hMg) is not known. We assessed the feasibility of using a novel pragmatic clinical trials model to compare two commonly used oral Mg replacement strategies., Methods: Patients with grade 1 to 3 hMg while receiving either platinum-based chemotherapy or epidermal growth factor receptor inhibitors (EGFRI) were randomized to oral magnesium oxide (MgOx) or oral magnesium citrate (MgCit). The trial methodology utilized the integrated consent model. Feasibility would be successful if; accrual rate was ≥5 patients a month and if measures of patient and physician engagement, were > 50%. Secondary endpoints included; comparison of Mg levels, cardiac arrhythmias, and rates of treatment delay/hospitalizations., Results: From July 2016 to December 2017, an average of 1 patient a month was accrued. All 15 eligible and approached patients consented to participate in the study (100% engagement) and 7/15 were randomized to MgOx and 8/15 to MgCit. The percentage of physicians who approached patients for the study was 4 of 6 (66.6% engagement). The mean slope of change in Mg (mmol/L/day) was 0.0022 (95% CI: -0.0001 to 0.0044) for MgOx and 0.0006 (95% CI, -0.0012 to 0.0024) for MgCit ( P = .2123). Three patients (20%) required IV magnesium while on the study (2 MgCit and 1 MgOx). Grade 1 diarrhea occurred in 3 patients in the MgCit arm., Conclusion: Despite oral magnesium tolerability and meeting most of its feasibility endpoints, this study did not meet its target accrual rate. Alternative designs would be necessary for a definitive efficacy study., Competing Interests: AA reports participating in the Novartis Canada Advisory Board on the use of Ribociclib, BH consults for Cornerstore Research, not related to this research project. All other authors have nothing to disclose., (© 2021 The Authors. Health Science Reports published by Wiley Periodicals LLC.)
- Published
- 2021
- Full Text
- View/download PDF
24. A Randomized Trial Comparing 3- versus 4-Monthly Cardiac Monitoring in Patients Receiving Trastuzumab-Based Chemotherapy for Early Breast Cancer.
- Author
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Dent S, Fergusson D, Aseyev O, Stober C, Pond G, Awan AA, McGee SF, Ng TL, Simos D, Vandermeer L, Saunders D, Hilton JF, Hutton B, and Clemons M
- Subjects
- Female, Humans, Receptor, ErbB-2, Stroke Volume, Trastuzumab adverse effects, Ventricular Function, Left, Breast Neoplasms complications, Breast Neoplasms drug therapy
- Abstract
Purpose: The optimal frequency for cardiac monitoring of left ventricular ejection fraction (LVEF) in patients receiving trastuzumab-based therapy for early breast cancer (EBC) is unknown. We conducted a randomized controlled trial comparing 3- versus 4-monthly cardiac monitoring., Patients and Method: Patients scheduled to receive trastuzumab-containing cancer therapy for EBC with normal (>53%) baseline LVEF were randomized to undergo LVEF assessments every 3 or 4 months. The primary outcome was the change in LVEF from baseline. Secondary outcomes included the rate of cardiac dysfunction (defined as a decrease in the LVEF of ≥10 percentage points, to a value <53%), delays in or discontinuation of trastuzumab therapy, and cardiology referral., Results: Of the 200 eligible and enrolled patients, 100 (50%) were randomized to 3-monthly and 100 (50%) to 4-monthly cardiac monitoring. Of these patients, 98 and 97 respectively underwent at least one cardiac scan. The estimated mean difference in LVEF from baseline was -0.94% (one-sided 95% lower bound: -2.14), which exceeded the pre-defined non-inferiority margin of -4%. There were also no significant differences between the two study arms for any of the secondary endpoints. The rate of detection of cardiac dysfunction was 16.3% (16/98) and 12.4% (12/97) in the 3- and 4-monthly arms, respectively (95% CI: 4.0 [-5.9, 13.8])., Conclusions: Cardiac monitoring every 4 months was deemed non-inferior to that every 3 months in patients with HER2-positive EBC being treated with trastuzumab-based therapy. Given its costs and inconvenience, cardiac monitoring every 4 months should be considered standard practice. Registration: NCT02696707, 18 February 2016.
- Published
- 2021
- Full Text
- View/download PDF
25. Two-year results of a randomised trial comparing 4- versus 12-weekly bone-targeted agent use in patients with bone metastases from breast or castration-resistant prostate cancer.
- Author
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Clemons M, Liu M, Stober C, Pond G, Jemaan Alzahrani M, Ong M, Ernst S, Booth C, Mates M, Abraham Joy A, Aseyev O, Blanchette P, Vandermeer L, Tu M, Thavorn K, and Fergusson D
- Abstract
Background: We present the 2-year results of a randomised trial comparing 4- versus 12-weekly bone-targeting agents (BTAs) in patients with bone metastases from breast or castration-resistant prostate cancer (CRPC)., Patients and Methods: Patients with bone metastases from breast or CRPC, who were going to start or were already receiving BTAs, were randomised to 4- or 12-weekly BTA treatment for 2 years. The endpoints were: symptomatic skeletal events (SSE) rates, time to SSEs, toxicity and cost-effectiveness., Results: Of 263 patients (160 breast cancer, 103 CRPC), 133 (50.6%) and 130 (49.4%) were randomised to the 4- and 12-weekly groups, respectively. BTAs included denosumab (56.3%), zoledronate (24.0%) and pamidronate (19.8%). After 2 years, the cumulative incidence rate (95% CI) of SSEs was 32.7% (24.6% to 41.1%) and 28.1% (20.3% to 36.4%) for the 4- and 12-weekly intervention groups respectively. The hazard ratio for time to first SSE was 0.96 (95% CI = 0.63 to 1.47). However, in a post hoc analysis, those patients who had an on-study SSE, there was a small non-statistical increased risk of subsequent SSEs among patients on the 12-weekly dosing arm (HR = 1.14; 95% CI - 0.90-1.44). BTA-related toxicity rates were similar between study arms. A cost-utility analysis showed that 12-weekly BTA is cost-effective from a public payer's perspective., Conclusion: These results in addition to those previously reported for de-escalating zoledronate, would support that de-escalation of commonly used BTAs is a reasonable and economically valid treatment option. While not statistically significant, the increase in subsequent SSEs in the 12-weekly arm requires further exploration., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Published by Elsevier GmbH.)
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- 2021
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26. Cost-Effectiveness Analysis of 12-Versus 4-Weekly Administration of Bone-Targeted Agents in Patients with Bone Metastases from Breast and Castration-Resistant Prostate Cancer.
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Tu MM, Clemons M, Stober C, Jeong A, Vandermeer L, Mates M, Blanchette P, Joy AA, Aseyev O, Pond G, Fergusson D, Ng TL, and Thavorn K
- Subjects
- Canada, Cost-Benefit Analysis, Humans, Male, Quality-Adjusted Life Years, Bone Neoplasms drug therapy, Prostatic Neoplasms, Castration-Resistant drug therapy
- Abstract
A cost-utility analysis was performed based on the Rethinking Clinical Trials (REaCT) bone-targeted agents (BTA) clinical trial that compared 12-weekly (once every 12 weeks) ( n = 130) versus 4-weekly (once every 4 weeks) ( n = 133) BTA dosing for metastatic breast and castration-resistant prostate (CRPC) cancer. Using a decision tree model, we calculated treatment and symptomatic skeletal event (SSE) costs as well as quality-adjusted life-years (QALYs) for each treatment option. Deterministic and probabilistic sensitivity analyses were performed to assess the robustness of the study findings. The total cost of BTA treatment in Canadian dollars (C$) and estimated QALYs was C$8965.03 and 0.605 QALY in the 4-weekly group versus C$5669.95 and 0.612 QALY in the 12-weekly group, respectively. De-escalation from 4-weekly to 12-weekly BTA reduces cost (C$3293.75) and improves QALYs by 0.008 unit, suggesting that 12-weekly BTA dominates 4-weekly BTA in breast and CRPC patients with bone metastases. Sensitivity analysis suggests high levels of uncertainty in the cost-effectiveness findings. De-escalation of bone-targeted agents is cost-effective from the Canadian public payer's perspective.
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- 2021
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27. Baricitinib set to join the Covid-19 therapeutic arsenal?
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Gudu T, Stober C, Cope AP, Cheriyan J, Galloway J, Wilkinson IB, Kostapanos M, Jayne D, and Hall F
- Subjects
- Antiviral Agents immunology, Antiviral Agents pharmacology, Clinical Trials as Topic, Humans, Immunologic Factors pharmacology, Intracellular Signaling Peptides and Proteins antagonists & inhibitors, Janus Kinase Inhibitors pharmacology, Protein Serine-Threonine Kinases antagonists & inhibitors, Treatment Outcome, Azetidines immunology, Azetidines pharmacology, COVID-19 immunology, Purines immunology, Purines pharmacology, Pyrazoles immunology, Pyrazoles pharmacology, SARS-CoV-2 drug effects, Sulfonamides immunology, Sulfonamides pharmacology, COVID-19 Drug Treatment
- Published
- 2021
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28. Adjuvant bisphosphonate use in patients with early stage breast cancer: Patient perspectives on treatment acceptability and potential de-escalation.
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McGee S, AlZahrani M, Stober C, Ng TL, Cole K, Larocque G, Awan A, Sehdev S, Hilton J, Vandermeer L, Hutton B, Pond G, Saunders D, and Clemons M
- Abstract
Background: Despite the increasing use of adjuvant bisphosphonates for early stage breast cancer (EBC), little is known about the patient experience with such treatments. A patient survey was performed to identify current prescribing practices, perceptions around the role of treatment, the impact of treatment on patients' quality of life, and future trial designs., Methods: EBC patients who had either completed or were currently receiving adjuvant bisphosphonates were sent an anonymized survey. The survey collected information on patient and disease characteristics, bisphosphonate scheduling, compliance, and tolerance. Questions also assessed patient interest in trials of de-escalated bisphosphonate therapy., Results: A total of 255 patients were contacted, with 164 eligible respondents (eligible response rate 164/255, 64.3%). Median patient age was 52 years (range 28 to 82 years). The majority (111/163, 68.1%) were postmenopausal at the time of diagnosis, 23.3% (38/163) were premenopausal, and 7.4% (12/163) were perimenopausal. Most patients (78%) had received chemotherapy. Zoledronate was the most commonly used bisphosphonate (92%), with the majority receiving treatment every 6 months for 3 years (73%). While 66% (107/161) of respondents had experienced side effects with treatment, most had, or expected to, complete treatment (154/163, 94%). Provided there was no detriment in breast cancer outcomes, there was strong interest in future studies of de-escalating adjuvant bisphosphonate therapy., Conclusion: While most patients tolerate their treatment, there is interest in performing trials of de-escalation of these agents., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: SMG reports receipt of honorarium from Novartis for insights on management of breast cancer patients. AAA reports Advisory board: Eli Lily, Exact Sciences, Exactis, Novartis, Pfizer, Honoraria: Apotex, Roche, Travel: Roche. BH and MC reports consulting fees from Cornerstone Research, outside the submitted work. GP reports consulting fees from Merck, Astra-Zeneca, Profound Medical, outside of submitted work; honorarium for DSMB membership from Takeda outside of submitted work; a close family member works for Roche Canada Ltd and owns stock in Roche Ltd. All other authors declare no competing interests., (© 2021 The Authors.)
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- 2021
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29. Optimising weight-loss interventions in cancer patients-A systematic review and network meta-analysis.
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LeVasseur N, Cheng W, Mazzarello S, Clemons M, Vandermeer L, Jones L, Joy AA, Barbeau P, Wolfe D, Ahmadzai N, Hersi M, Stober C, Shorr R, Hilton J, and Hutton B
- Subjects
- Exercise, Humans, Life Style, Prognosis, Randomized Controlled Trials as Topic, Neoplasms diagnosis, Neoplasms physiopathology, Neoplasms therapy, Weight Loss
- Abstract
Background: Excess weight has been associated with increased morbidity and a worse prognosis in adult patients with early-stage cancer. The optimal lifestyle interventions to optimize anthropometric measures amongst cancer patients and survivors remain inconsistent., Objective: To conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the effects of exercise and dietary interventions alone or in combination on anthropometric measures of adult cancer patients and survivors., Methods: A systematic search of Medline, Embase and the Cochrane Trials Registry was performed. Outcomes of interest included changes in weight, body mass index (BMI), and waist circumference. Screening and data collection were performed by two reviewers. Bayesian NMAs were performed., Results: Overall, 98 RCTs were included; 75 were incorporated in NMAs (n = 12,199). Groups of intervention strategies included: 3 exercise interventions, 8 dietary interventions, 7 combination interventions of diet and exercise and standard care. Median intervention duration was 26 weeks. NMA suggested that diet alone (mean difference [MD] -2.25kg, 95% CrI -3.43 to -0.91kg) and combination strategies (MD -2.52kg, 95% CrI -3.54 to -1.62kg) were associated with more weight loss compared to standard care. All dietary interventions achieved a similar magnitude of weight loss (MD range from -2.03kg to -2.52kg). Both diet alone and combination strategies demonstrated greater BMI reductions versus standard care, and each of diet alone, exercise alone and combination strategies demonstrated greater reductions in waist circumference than standard care., Conclusion: Diet and exercise alone or in combination are effective lifestyle interventions to improve anthropometric measures in cancer patients and survivors. All reputable diets appear to be similarly effective to achieve weight loss., Competing Interests: BH has previously received honoraria from Eversana Incorporated for provision of methodologic advice related to the conduct of systematic reviews and meta-analysis. NL has previously received honoraria for participation in advisory boards from Lilly, Novartis, Pfizer, Roche, TerSera and research funds from Abbvie, Exact Sciences, Genomic Health and Lilly. All other authors have no conflicts to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
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- 2021
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30. A Randomized Controlled Trial Comparing Alloderm-RTU with DermACELL in Immediate Subpectoral Implant-Based Breast Reconstruction.
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Arnaout A, Zhang J, Frank S, Momtazi M, Cordeiro E, Roberts A, Ghumman A, Fergusson D, Stober C, Pond G, Jeong A, Vandermeer L, Hutton B, Clemons M, and On Behalf Of The REaCT Investigators
- Subjects
- Collagen, Female, Humans, Mastectomy, Prospective Studies, Retrospective Studies, Breast Neoplasms surgery, Mammaplasty
- Abstract
Background: The effectiveness of different acellular dermal matrices (ADM) used for implant-based reconstruction immediately following mastectomy is an important clinical question. A prospective randomized clinical trial was performed to evaluate the superiority of DermACELL over Alloderm-RTU in reducing drain duration., Methods: Patients undergoing mastectomy with subpectoral immediate and permanent implant-based breast reconstruction were randomized to Alloderm-RTU or DermACELL. The primary outcome was seroma formation, measured by the duration of postoperative drain placement. Secondary outcomes included: post drain removal seroma aspiration, infection, redbreast syndrome, wound dehiscence, loss of the implant, and unplanned return to the operating room., Results: 62 patients were randomized for 81 mastectomies (41 Alloderm-RTU, 40 DermACELL). Baseline characteristics were similar. There was no statistically significant difference in mean drain duration ( p = 0.16), with a trend towards longer duration in the Alloderm-RTU group (1.6 days; 95%CI, 0.7 to 3.9). The overall rate of minor and major complications were statistically similar between the two groups; although patients with Alloderm-RTU had 3 times as many infections requiring antibiotics (7.9% vs. 2.5%) with a risk difference of 5.4 (95%CI -4.5 to 15.2), and twice as many unplanned returns to the operating room (15.8% vs. 7.5%) with a risk difference of 8.3 (95% CI -5.9 to 22.5) as DermACELL., Conclusion: This is the first prospective randomized clinical trial comparing the two most commonly used human-derived ADMs. There was no statistically significant difference in drain duration, minor, or major complications between DermACELL over Alloderm-RTU in immediate subpectoral permanent implant-based breast reconstruction post-mastectomy.
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- 2020
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31. Feasibility outcomes of a randomised, multicentre, pilot trial comparing standard 6-monthly dosing of adjuvant zoledronate with a single one-time dose in patients with early stage breast cancer.
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Awan A, Ng T, Conter H, Raskin W, Stober C, Simos D, Pond G, Dhesy-Thind S, Mates M, Kumar V, Fergusson D, Hutton B, Saunders D, Vandermeer L, and Clemons M
- Abstract
Background: Adjuvant zoledronate is widely used in patients with early stage breast cancer (EBC), but its optimal duration and dosing interval is still unknown. While a single-dose of zoledronate can improve bone density for many years, a proper evaluation of its effects on breast cancer-related outcomes would require a large trial. In this pilot study we evaluated the feasibility of performing such a trial., Methods: Eligible patients with EBC were randomised to receive either one dose of zoledronate or 7 doses (6-monthly dosing for 3 years). Feasibility was assessed by a combination of primary outcomes including: activation of at least 6 Ontario sites within a year, active participation (i.e. approaching eligible patients for study participation) of at least half of the medical oncologists, and enrolment of at least 100 patients across all sites within 9 months of the sixth site being activated., Results: All 6 sites were activated within 1 year and of 47 medical oncologists, 27 (57%) approached patients. Between November 2018 and April 2020, 211 eligible patients were randomised, 106 (50.2%) to a single dose of zoledronate and 105 (49.8%) to 6-monthly dosing. Baseline characteristics of randomised patients included; median age 59 (range 36-88), ER and/or PR positive (85%), Her2 positive (23%), menopausal status (premenopausal [19%], perimenopausal [6.7%] and postmenopausal [74%]) and 74% received neo/adjuvant chemotherapy., Conclusions: All study feasibility endpoints were met in this trial comparing alternative schedules for adjuvant zoledronate. We will now seek funding for performing a larger efficacy trial.Trial registration: NCT03664687., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 The Author(s).)
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- 2020
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32. Primary Febrile Neutropenia Prophylaxis for Patients Who Receive FEC-D Chemotherapy for Breast Cancer: A Systematic Review.
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Fernandes R, Mazzarello S, Stober C, Ibrahim MFK, Dudani S, Perdrizet K, Majeed H, Vandermeer L, Shorr R, Hutton B, Fergusson D, Gyawali B, and Clemons M
- Subjects
- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Breast Neoplasms drug therapy, Chemoprevention, Cyclophosphamide administration & dosage, Docetaxel administration & dosage, Epirubicin administration & dosage, Female, Fluorouracil administration & dosage, Humans, Risk Factors, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols adverse effects, Breast Neoplasms complications, Febrile Neutropenia etiology, Febrile Neutropenia prevention & control
- Abstract
Purpose: Despite widespread use of fluorouracil, epirubicin, cyclophosphamide, docetaxel (FEC-D) chemotherapy in breast cancer, the optimal strategy for primary febrile neutropenia (FN) prophylaxis remains unknown. A systematic review was therefore performed., Methods: Embase, Ovid MEDLINE, PubMed, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials, and conference proceedings were searched from 1946 to April 2016 for trials that reported the effectiveness of primary FN prophylaxis with FEC-D chemotherapy. Outcome measures were incidence of FN; treatment-related hospitalizations; chemotherapy dose delays, reductions, and discontinuations; and adverse events from prophylaxis., Results: Of 2,205 identified citations, eight studies (n = 1,250) met our eligibility criteria. Three additional studies (n = 293) were identified from a prior systematic review. Three randomized controlled trials (n = 576), one phase IV single-arm trial (n = 69), one prospective observational study (n = 37), and six retrospective studies (n = 861) were identified. Agents investigated were pegfilgrastim (n = 108), filgrastim (n = 1,119), and ciprofloxacin (n = 89). The heterogeneity of studies meant that a narrative synthesis of results was performed. Median FN rates for patients who received FEC-D with and without primary prophylaxis were 10.1% (interquartile range [IQR], 3.9% to 22.6%) and 23.9% (IQR, 9.2% to 27.3%), respectively. In the absence of primary prophylaxis, FN was more common during docetaxel than during FEC. Data from six studies showed a median rate of dose reductions and delays of 6.1% (IQR, 3.1% to 14.3%) and 19.3% (IQR, 10.5% to 32.8%), respectively, that occurred as a consequence of FN. Toxicity from prophylaxis itself was rarely reported., Conclusion: Primary FN prophylaxis is effective in patients who receive FEC-D chemotherapy. The paucity of prospective data makes optimal recommendations about the choice and timing of prophylaxis challenging.
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- 2018
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33. Randomised feasibility trial to compare three standard of care chemotherapy regimens for early stage triple-negative breast cancer (REaCT-TNBC trial).
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Hilton J, Stober C, Mazzarello S, Vandermeer L, Fergusson D, Hutton B, and Clemons M
- Subjects
- Adult, Aged, Cyclophosphamide therapeutic use, Docetaxel therapeutic use, Doxorubicin therapeutic use, Endpoint Determination psychology, Epirubicin therapeutic use, Feasibility Studies, Female, Fluorouracil therapeutic use, Humans, Middle Aged, Paclitaxel therapeutic use, Pilot Projects, Random Allocation, Surveys and Questionnaires, Triple Negative Breast Neoplasms pathology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Endpoint Determination statistics & numerical data, Guideline Adherence statistics & numerical data, Triple Negative Breast Neoplasms drug therapy
- Abstract
Introduction: Despite the importance of chemotherapy in the treatment of early stage triple negative breast cancer (TNBC), no one optimal regimen has been identified. We conducted a pilot trial comparing outcomes for the three most commonly used chemotherapy regimens to assess the feasibility of conducting a larger definitive trial., Methods: Using integrated consent, newly diagnosed TNBC patients were randomised to one of three standard regimens: dose-dense doxorubicin-cyclophosphamide then paclitaxel, doxorubicin-cyclophosphamide then weekly paclitaxel or 5-FU-epirubicin-cyclophosphamide then docetaxel. Feasibility endpoints included; physician engagement, accrual rates, physician compliance and patient satisfaction with the integrated consent model. Our anticipated pilot trial sample size was 35 randomised patients in one year., Results: Between August 30th, 2016 and January 31st 2017, 2 patients met eligibility and were randomised. A survey of 10 participating oncologists was performed to identify potential strategies to enhance accrual. Most investigators (9/10) believed that the best regimen for TNBC was unknown, and 4/10 felt this was a pressing clinical question. Physicians' responses suggested that poor accrual was due to: a lack of interest in some study arms as oncologists already had a preferred regimen (4/10) and concerns about trial demands in busy clinics (3/10). The pilot feasibility endpoints were not met and the study was closed., Conclusions: Despite initial interest in the trial question and multiple investigators agreeing to approach patients, this trial failed to meet feasibility endpoints. The reasons for poor accrual were multiple and require further evaluation if this important patient-centred question is to be answered., Trial Registration: ClinicalTrials.gov NCT02688803., Competing Interests: The authors have declared that no competing interests exist.
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- 2018
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34. Testing Probabilistic Models of Choice using Column Generation.
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Smeulders B, Davis-Stober C, Regenwetter M, and Spieksma FCR
- Abstract
In so-called random preference models of probabilistic choice, a decision maker chooses according to an unspecified probability distribution over preference states. The most prominent case arises when preference states are linear orders or weak orders of the choice alternatives. The literature has documented that actually evaluating whether decision makers' observed choices are consistent with such a probabilistic model of choice poses computational difficulties. This severely limits the possible scale of empirical work in behavioral economics and related disciplines. We propose a family of column generation based algorithms for performing such tests. We evaluate our algorithms on various sets of instances. We observe substantial improvements in computation time and conclude that we can efficiently test substantially larger data sets than previously possible.
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- 2018
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35. Prevalence and predictors of tumour necrosis factor inhibitor persistence in psoriatic arthritis.
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Stober C, Ye W, Guruparan T, Htut E, Clunie G, and Jadon D
- Subjects
- Adult, Arthritis, Psoriatic epidemiology, Cohort Studies, Comorbidity, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Metabolic Syndrome epidemiology, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Retrospective Studies, Sex Factors, Tumor Necrosis Factor-alpha antagonists & inhibitors, Adalimumab therapeutic use, Antirheumatic Agents therapeutic use, Arthritis, Psoriatic drug therapy, Etanercept therapeutic use, Medication Adherence
- Abstract
Objectives: To evaluate TNF-α inhibitor (TNFi) persistence when used as first- or second-line biologic therapy for the management of PsA, and to determine baseline clinical and laboratory parameters associated with TNFi persistence., Methods: A retrospective single-centre cohort study was performed on all patients with PsA initiated on TNFi therapy between 2003 and 2015. Demographic, clinical and laboratory characteristics were compared with TNFi persistence, using Kaplan-Meier survival and Cox proportional hazards models., Results: One hundred and eighty-eight patients with PsA were prescribed TNFi therapy as first-line biologic therapy over a period of 635 person-years [46% male, mean (s.d.) age 47.3 (11.4) years; median (interquartile range) disease duration 11 (7-16) years]. At 12 months of follow-up 79% of patients persisted with TNFi therapy, and 73% at 24 months. Of those discontinuing TNFi, 35% stopped due to primary inefficacy, 22% secondary inefficacy and 43% adverse events. Multivariable analysis identified female sex (hazard ratio (HR) 2.57; 95% CI: 1.26, 5.24; P = 0.01) and the presence of metabolic syndrome-related co-morbidities (HR = 2.65, 95% CI: 1.24, 5.69; P = 0.01) as predictors of lower persistence. Of 32 cases treated with a second TNFi, persistence at 12 months was 56%. TNFi persistence was 2-fold less likely in these 32 cases compared with first-line TNFi users (HR = 2.02, 95% CI: 1.20, 3.42; P = 0.01)., Conclusion: Patients with PsA who are female and have metabolic syndrome-related co-morbidities have lower TNFi persistence. Although persistence was lower in patients who had switched to a second TNFi, a substantial proportion of these cases responded, advocating switching to a second TNFi as a valid therapeutic strategy., (© The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com)
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- 2018
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36. Predatory Invitations from Journals: More Than Just a Nuisance?
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Clemons M, de Costa E Silva M, Joy AA, Cobey KD, Mazzarello S, Stober C, and Hutton B
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- Academic Medical Centers, Humans, Publishing, Electronic Mail statistics & numerical data, Journalism, Medical
- Abstract
Physicians and academic researchers are frequently targeted with spam invitations to submit manuscripts to predatory journals. This study was conducted to understand the nature and characteristics of these invitations. All spam e-mails received by an academic medical oncologist over a 3-month period were collected and categorized. Presumed predatory journal invitations were analyzed and cross-checked against Beall's list of "potential, probable, or possible predatory" journals and publishers. Invitations to submit to predatory journals were the most common single type of spam received. The Oncologist 2017;22:236-240., (© AlphaMed Press 2017.)
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- 2017
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37. Role of SAGA in the asymmetric segregation of DNA circles during yeast ageing.
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Denoth-Lippuner A, Krzyzanowski MK, Stober C, and Barral Y
- Subjects
- Anaphase, Centromere metabolism, Chromosomes, Fungal metabolism, DNA, Fungal metabolism, Diffusion, Microfluidic Analytical Techniques, Mitosis, Nuclear Pore metabolism, Plasmids metabolism, Protein Binding, Saccharomyces cerevisiae cytology, Chromosome Segregation, DNA, Circular metabolism, Saccharomyces cerevisiae growth & development, Saccharomyces cerevisiae metabolism, Saccharomyces cerevisiae Proteins metabolism, Trans-Activators metabolism
- Abstract
In eukaryotes, intra-chromosomal recombination generates DNA circles, but little is known about how cells react to them. In yeast, partitioning of such circles to the mother cell at mitosis ensures their loss from the population but promotes replicative ageing. Nevertheless, the mechanisms of partitioning are debated. In this study, we show that the SAGA complex mediates the interaction of non-chromosomal DNA circles with nuclear pore complexes (NPCs) and thereby promotes their confinement in the mother cell. Reciprocally, this causes retention and accumulation of NPCs, which affects the organization of ageing nuclei. Thus, SAGA prevents the spreading of DNA circles by linking them to NPCs, but unavoidably causes accumulation of circles and NPCs in the mother cell, and thereby promotes ageing. Together, our data provide a unifying model for the asymmetric segregation of DNA circles and how age affects nuclear organization.
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- 2014
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38. From genomes to vaccines: Leishmania as a model.
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Almeida R, Norrish A, Levick M, Vetrie D, Freeman T, Vilo J, Ivens A, Lange U, Stober C, McCann S, and Blackwell JM
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- Animals, Gene Expression Profiling, Genes, Protozoan genetics, Humans, Oligonucleotide Array Sequence Analysis, Proteome genetics, Protozoan Proteins genetics, Vaccines, DNA genetics, Genome, Protozoan, Leishmania genetics, Protozoan Vaccines genetics
- Abstract
The 35 Mb genome of Leishmania should be sequenced by late 2002. It contains approximately 8500 genes that will probably translate into more than 10 000 proteins. In the laboratory we have been piloting strategies to try to harness the power of the genome-proteome for rapid screening of new vaccine candidate. To this end, microarray analysis of 1094 unique genes identified using an EST analysis of 2091 cDNA clones from spliced leader libraries prepared from different developmental stages of Leishmania has been employed. The plan was to identify amastigote-expressed genes that could be used in high-throughput DNA-vaccine screens to identify potential new vaccine candidates. Despite the lack of transcriptional regulation that polycistronic transcription in Leishmania dictates, the data provide evidence for a high level of post-transcriptional regulation of RNA abundance during the developmental cycle of promastigotes in culture and in lesion-derived amastigotes of Leishmania major. This has provided 147 candidates from the 1094 unique genes that are specifically upregulated in amastigotes and are being used in vaccine studies. Using DNA vaccination, it was demonstrated that pooling strategies can work to identify protective vaccines, but it was found that some potentially protective antigens are masked by other disease-exacerbatory antigens in the pool. A total of 100 new vaccine candidates are currently being tested separately and in pools to extend this analysis, and to facilitate retrospective bioinformatic analysis to develop predictive algorithms for sequences that constitute potentially protective antigens. We are also working with other members of the Leishmania Genome Network to determine whether RNA expression determined by microarray analyses parallels expression at the protein level. We believe we are making good progress in developing strategies that will allow rapid translation of the sequence of Leishmania into potential interventions for disease control in humans.
- Published
- 2002
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