Publications by authors named "Andrew J Martin"

88 Publications

Levodopa/dopa decarboxylase inhibitor associated microscopic colitis: An under-recognized drug reaction.

Parkinsonism Relat Disord 2021 Apr 20;86:84-90. Epub 2021 Apr 20.

Movement Disorder Unit, Neurology Department, Westmead Hospital, Corner Darcy and Hawkesbury Road, Westmead, NSW 2145, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Electronic address:

Background: Microscopic colitis is a form of inflammatory bowel disease characterized by profuse non-bloody watery diarrhea. Macroscopic abnormality is not present on colonoscopy, and it requires biopsy for diagnosis. Few cases have been attributed to levodopa/dopa-decarboxylase inhibitor therapy.

Method: A retrospective cohort study of 21 patients on levodopa/benserazide and one patient on levodopa-carbidopa intestinal gel with clinically suspected or biopsy proven microscopic colitis.

Results: All 21 patients on oral levodopa/benserazide had resolution of diarrhea with cessation of the medication. Four patients discontinued levodopa permanently. Two were rechallenged with levodopa/benserazide without symptom recurrence. One patient on oral levodopa/carbidopa developed diarrhea only with intermittent dispersible levodopa/benserazide. 14 were switched to levodopa/carbidopa with resolution of diarrhea in 9 but symptom recurrence in 5. One patient on oral levodopa/benserazide developed profuse diarrhea when switched to levodopa-carbidopa intestinal gel. Of 7/22 patients who had colonoscopy and biopsy, 5 had histopathological proven microscopic colitis.

Conclusion: levodopa/dopa-decarboxylase inhibitor induced microscopic colitis may be more common than previously suspected, with the potential to affect treatment compliance and therapeutic options.
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http://dx.doi.org/10.1016/j.parkreldis.2021.03.031DOI Listing
April 2021

The role of mobile technology in promoting social inclusion among adults with intellectual disabilities.

J Appl Res Intellect Disabil 2021 May 5;34(3):840-851. Epub 2021 Mar 5.

Faculty of Arts, Design and Architecture, School of Education, University of New South Wales, Sydney, NSW, Australia.

Background: Mobile technology has the potential to assist adults with intellectual disabilities to initiate and maintain social connections in important areas of their lives, such as family, friends and work/volunteering.

Method: The present study investigated how specific aspects of mobile device/app use are associated with the social inclusion of people with intellectual disabilities. The study also examined what background attributes were associated with particular patterns of mobile device/app use and social inclusion.

Results: The findings revealed that the use of mobile technology among adults with intellectual disabilities was positively associated with their social inclusion with family, friends and work/volunteering. There were also some key background attributes associated with participants' use of mobile technology and the extent to which mobile technology assisted their social inclusion.

Conclusions: Implications for practice and policy are discussed.
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http://dx.doi.org/10.1111/jar.12869DOI Listing
May 2021

[Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial.

Lancet 2021 Feb 11;397(10276):797-804. Epub 2021 Feb 11.

Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.

Background: Lutetium-177 [Lu]Lu-PSMA-617 is a radiolabelled small molecule that delivers β radiation to cells expressing prostate-specific membrane antigen (PSMA), with activity and safety in patients with metastatic castration-resistant prostate cancer. We aimed to compare [Lu]Lu-PSMA-617 with cabazitaxel in patients with metastatic castration-resistant prostate cancer.

Methods: We did this multicentre, unblinded, randomised phase 2 trial at 11 centres in Australia. We recruited men with metastatic castration-resistant prostate cancer for whom cabazitaxel was considered the next appropriate standard treatment. Participants were required to have adequate renal, haematological, and liver function, and an Eastern Cooperative Oncology Group performance status of 0-2. Previous treatment with androgen receptor-directed therapy was allowed. Men underwent gallium-68 [Ga]Ga-PSMA-11 and 2-flourine-18[F]fluoro-2-deoxy-D-glucose (FDG) PET-CT scans. PET eligibility criteria for the trial were PSMA-positive disease, and no sites of metastatic disease with discordant FDG-positive and PSMA-negative findings. Men were randomly assigned (1:1) to [Lu]Lu-PSMA-617 (6·0-8·5 GBq intravenously every 6 weeks for up to six cycles) or cabazitaxel (20 mg/m intravenously every 3 weeks for up to ten cycles). The primary endpoint was prostate-specific antigen (PSA) response defined by a reduction of at least 50% from baseline. This trial is registered with ClinicalTrials.gov, NCT03392428.

Findings: Between Feb 6, 2018, and Sept 3, 2019, we screened 291 men, of whom 200 were eligible on PET imaging. Study treatment was received by 98 (99%) of 99 men randomly assigned to [Lu]Lu-PSMA-617 versus 85 (84%) of 101 randomly assigned to cabazitaxel. PSA responses were more frequent among men in the [Lu]Lu-PSMA-617 group than in the cabazitaxel group (65 vs 37 PSA responses; 66% vs 37% by intention to treat; difference 29% (95% CI 16-42; p<0·0001; and 66% vs 44% by treatment received; difference 23% [9-37]; p=0·0016). Grade 3-4 adverse events occurred in 32 (33%) of 98 men in the [Lu]Lu-PSMA-617 group versus 45 (53%) of 85 men in the cabazitaxel group. No deaths were attributed to [Lu]Lu-PSMA-617.

Interpretation: [Lu]Lu-PSMA-617 compared with cabazitaxel in men with metastatic castration-resistant prostate cancer led to a higher PSA response and fewer grade 3 or 4 adverse events. [Lu]Lu-PSMA-617 is a new effective class of therapy and a potential alternative to cabazitaxel.

Funding: Prostate Cancer Foundation of Australia, Endocyte (a Novartis company), Australian Nuclear Science and Technology Organization, Movember, The Distinguished Gentleman's Ride, It's a Bloke Thing, and CAN4CANCER.
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http://dx.doi.org/10.1016/S0140-6736(21)00237-3DOI Listing
February 2021

A future time perspective of secondary school students' academic engagement and disengagement: A longitudinal investigation.

J Sch Psychol 2021 02 22;84:109-123. Epub 2021 Jan 22.

School of Education, University of New South Wales, Australia.

Students' conceptions of their academic futures, such as completing secondary school, have been found to play a significant role in their current behavior. Indeed, research regarding future time perspectives (FTP) indicates that students with extended FTPs are likely to be more engaged and less disengaged over time. Extended FTPs comprise two critical motivating elements: the cognitive (i.e., importance value) and the dynamic (i.e., school completion aspirations). Although these elements are hypothetically reciprocally related and without temporal limitation to their motivational effects, these claims have largely gone untested. These claims were examined via longitudinal structural equation modelling with cross-lagged panel analysis and invariance testing in a sample of 1327 Australian secondary school students. Findings indicated that importance value is directionally salient over school completion aspirations (such that it may precede school completion aspirations), both are associated with higher engagement and lower disengagement over time, and evidence of temporal limitations on the motivational benefits of the elements of extended FTPs was not found. School-based interventions that focus on improving importance value and school completion aspirations are discussed.
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http://dx.doi.org/10.1016/j.jsp.2020.12.003DOI Listing
February 2021

Boarding and Day School Students: A Large-Scale Multilevel Investigation of Academic Outcomes Among Students and Classrooms.

Front Psychol 2020 5;11:608949. Epub 2021 Jan 5.

The Future Project, The King's School, Sydney, NSW, Australia.

Boarding school is a major educational option for many students (e.g., students living in remote areas, or whose parents are working interstate or overseas, etc.). This study explored the motivation, engagement, and achievement of boarding and day students who are educated in the same classrooms and receive the same syllabus and instruction from the same teachers (thus a powerful research design to enable unique comparisons). Among 2,803 students (boarding = 481; day = 2,322) from 6 Australian high schools and controlling for background attributes and personality, we found predominant parity between boarding and day students in their motivation, engagement, and achievement. We also found that classroom-average motivation, engagement, and achievement was not significantly affected by the number of boarders (relative to day students) in the classroom. In addition, the effects of boarding were generally not moderated by students' background or personality attributes. We conclude that boarders have academic opportunities and outcomes that are comparable to their day student counterparts. Implications for students, teachers, and parents are discussed.
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http://dx.doi.org/10.3389/fpsyg.2020.608949DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813993PMC
January 2021

Association of elevated neonatal thyroid-stimulating hormone levels with school performance and stimulant prescription for attention deficit hyperactivity disorder in childhood.

Eur J Pediatr 2021 Apr 14;180(4):1073-1080. Epub 2020 Oct 14.

The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia.

Untreated severe newborn thyroid deficiency causes neurocognitive impairment; however, the impact of mild thyroid deficiency is not known. This study aimed to examine whether mildly elevated neonatal thyroid-stimulating hormone (TSH) levels are associated with poor school performance or stimulant prescription for attention deficit hyperactivity disorder (ADHD). This record-linkage study included 232,790 term-born infants in Australia with a TSH level below newborn screening threshold (< 15 mIU/L). Among our cohort, as TSH levels increased, the proportion of infants born low birthweight via caesarean section and with disadvantaged socioeconomic status increased. Multivariable logistic regression analysis showed that, compared with infants with 'normal' neonatal TSH level (< 5 mIU/L), those with neonatal TSH 10-15 mIU/L had an increased risk of being exempt from school testing (aOR 1.63 (95% CI 1.06-2.69)) or prescribed a stimulant for ADHD (aOR 1.57 (95% CI 1.10-2.24)), adjusted for perinatal and sociodemographic factors. Among a nested analysis of 460 sibling pairs, siblings with 'mildly elevated' TSH levels were more likely to be exempt from school tests compared with siblings with normal TSH levels (aOR 2.53, 95% CI 1.01-6.33).Conclusion: In this population cohort and sibling analysis, mildly elevated neonatal TSH levels were associated with being exempt from school testing due to significant or complex disability. What is Known: • Newborn screening for severe thyroid hormone deficiency has virtually eliminated congenital hypothyroidism-associated intellectual disability in developed countries. • The impact of mild thyroid hormone deficiency in infants is unclear. What is New: • Children with a mildly elevated neonatal TSH level below current newborn screening cut-offs have an increased likelihood of being exempt from school testing due to significant or complex disability compared with siblings and peers. This study includes a population-based and nested sibling analysis.
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http://dx.doi.org/10.1007/s00431-020-03828-9DOI Listing
April 2021

The Head Retraction Reflex in Niemann-Pick Type C: A Novel Diagnostic Clue.

Mov Disord Clin Pract 2020 Jul 18;7(5):543-547. Epub 2020 Jun 18.

Movement Disorders Unit, Neurology Department Westmead Hospital Westmead New South Wales Australia.

Background: The head retraction reflex (HRR) is characterized by the extension of the neck after percussion stimulation of the central facial region. It is either absent or habituates in normal individuals and can become exaggerated and persistent in certain pathological conditions, having been most commonly reported in hyperekplexia and stiff-person syndrome disorders. It has not, however, been reported in Niemann-Pick type C (NPC), a lipid storage disorder with a variety of neurologic and systemic manifestations. The diagnosis of NPC is often delayed because of the rarity of the condition and the subtlety of clinical signs.

Cases: We present 3 consecutive cases of genetically confirmed NPC with a pathological HRR, which was not present in controls. Neurophysiological analysis showed findings suggestive of myoclonus of brainstem origin.

Conclusion: We propose that the presence of a pathological HRR, an easily performed clinical test, may provide a clue to the diagnosis of NPC.
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http://dx.doi.org/10.1002/mdc3.12976DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328417PMC
July 2020

Lack of Correlation Between Immunohistochemical Expression of SPARC and Invasion in Different Grades of Meningiomas.

Anticancer Res 2020 Jun;40(6):3081-3089

School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, U.K.

Background: Grade I meningiomas are generally benign and non-invasive whereas Grade II (atypical) and Grade III (malignant) meningiomas tend to be invasive with a high risk of recurrence. SPARC, secreted protein, acidic and rich in cysteine, is a multifunctional glycoprotein which has been proposed to be a potential diagnostic marker of invasive meningiomas. There has been increased reporting of atypical meningiomas since the current World Health Organization (WHO) included brain invasion as a grading criterion for classification of these particular meningiomas.

Materials And Methods: The aim of this study was to re-evaluate any correlation between immunohistochemical expression of SPARC in 34 meningiomas of various grades using the current classification (2016). We had previously classified these cases using the 2002 WHO criteria.

Results: There is no correlation between expression of SPARC and invasion in different grades of meningioma.

Conclusion: SPARC does not appear to be a good predictor of invasion in meningiomas.
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http://dx.doi.org/10.21873/anticanres.14289DOI Listing
June 2020

PET-guided repeat transsphenoidal surgery for previously deemed unresectable lateral disease in acromegaly.

Neurosurg Focus 2020 06;48(6):E8

1Cambridge Endocrine Molecular Imaging Group.

Objective: The object of this study was to determine if revision transsphenoidal surgery (TSS), guided by 11C-methionine PET/CT coregistered with volumetric MRI (Met-PET/MRCR), can lead to remission in patients with persistent acromegaly due to a postoperative lateral disease remnant.

Methods: The authors identified 9 patients with persistent acromegaly following primary intervention (TSS ± medical therapy ± radiotherapy) in whom further surgery had initially been discounted because of equivocal MRI findings with suspected lateral sellar and/or parasellar disease (cases with clear Knosp grade 4 disease were excluded). All patients underwent Met-PET/MRCR. Scan findings were used by the pituitary multidisciplinary team to inform decision-making regarding repeat surgery. Revision TSS was performed with wide lateral exploration as guided by the PET findings. Endocrine reassessment was performed at 6-10 weeks after surgery, with longitudinal follow-up thereafter.

Results: Met-PET/MRCR revealed focal tracer uptake in the lateral sellar and/or parasellar region(s) in all 9 patients, which correlated with sites of suspected residual tumor on volumetric MRI. At surgery, tumor was identified and resected in 5 patients, although histological analysis confirmed somatotroph tumor in only 4 cases. In the other 4 patients, no definite tumor was seen, but equivocal tissue was removed. Despite the uncertainty at surgery, all patients showed immediate significant improvements in clinical and biochemical parameters. In the 8 patients for whom long-term follow-up data were available, insulin-like growth factor 1 (IGF-1) was ≤ 1.2 times the upper limit of normal (ULN) in all subjects and ≤ 1 times the ULN in 6 subjects, and these findings have been maintained for up to 28 months (median 8 months, mean 13 months) with no requirement for adjunctive medical therapy or radiotherapy. No patient suffered any additional pituitary deficit or other complication of surgery.

Conclusions: This study provides proof of concept that Met-PET/MRCR can be helpful in the evaluation of residual lateral sellar/parasellar disease in persistent acromegaly and facilitate targeted revision TSS in a subgroup of patients.
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http://dx.doi.org/10.3171/2020.3.FOCUS2052DOI Listing
June 2020

A Multilevel Person-Centered Examination of Teachers' Workplace Demands and Resources: Links With Work-Related Well-Being.

Front Psychol 2020 8;11:626. Epub 2020 Apr 8.

Substantive Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, QC, Canada.

Teachers' healthy and effective functioning at work is impacted by the demands they face and the resources they can access. In this study, person-centered analysis was adopted to identify distinct teacher profiles of demands and resources. We investigated teachers' experiences of two job demands (barriers to professional development and disruptive student behavior), two job resources (teacher collaboration and input in decision-making), and one personal resource (self-efficacy for teaching). Using data from the Teaching and Learning International Survey (TALIS) 2013, the study involved 6,411 teachers from 369 schools in Australia and 2,400 teachers from 154 schools in England. In phase one, latent profile analysis revealed five teacher profiles that were similar across the two countries: the Low-Demand-Flourisher (12%), Mixed-Demand-Flourisher (17%), Job-Resourced-Average (34%), Balanced-Average (15%), and Struggler (21%). The profiles were differently associated with two background characteristics (teacher gender and teaching experience) and two work-related well-being outcomes (job satisfaction and occupational commitment). In phase two, we extended our analysis to the school-level to identify school profiles based on the relative prevalence of the five teacher profiles within a school. Indeed, a yield of large scale datasets such as TALIS is that there are sufficient units at the school-level to enable institutional insights, beyond insights garnered at the individual teacher-level. Two school profiles that were similar in both countries were revealed: the Unsupportive school profile (58%) and the Supportive school profile (42%). The Supportive school profile was associated with higher school-average teacher job satisfaction and occupational commitment than the Unsupportive school profile. Taken together, the findings yield knowledge about salient teacher and school profiles, and provide guidance for possible interventions at the teacher- and school level.
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http://dx.doi.org/10.3389/fpsyg.2020.00626DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156640PMC
April 2020

Infant High-Grade Gliomas Comprise Multiple Subgroups Characterized by Novel Targetable Gene Fusions and Favorable Outcomes.

Cancer Discov 2020 Jul 1;10(7):942-963. Epub 2020 Apr 1.

Department of Neuropathology, University Hospital Hamburg-Eppendorf, and Research Institute Children's Cancer Center, Hamburg, Germany.

Infant high-grade gliomas appear clinically distinct from their counterparts in older children, indicating that histopathologic grading may not accurately reflect the biology of these tumors. We have collected 241 cases under 4 years of age, and carried out histologic review, methylation profiling, and custom panel, genome, or exome sequencing. After excluding tumors representing other established entities or subgroups, we identified 130 cases to be part of an "intrinsic" spectrum of disease specific to the infant population. These included those with targetable MAPK alterations, and a large proportion of remaining cases harboring gene fusions targeting ( = 31), ( = 21), ( = 9), and ( = 4) as their driving alterations, with evidence of efficacy of targeted agents in the clinic. These data strongly support the concept that infant gliomas require a change in diagnostic practice and management. SIGNIFICANCE: Infant high-grade gliomas in the cerebral hemispheres comprise novel subgroups, with a prevalence of , or gene fusions. Kinase fusion-positive tumors have better outcome and respond to targeted therapy clinically. Other subgroups have poor outcome, with fusion-negative cases possibly representing an epigenetically driven pluripotent stem cell phenotype...
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http://dx.doi.org/10.1158/2159-8290.CD-19-1030DOI Listing
July 2020

"On-State" Freezing of Gait: Insights and Treatment With Levodopa Intestinal Gel Infusion.

Mov Disord 2020 05 13;35(5):895-896. Epub 2020 Mar 13.

Movement Disorders Unit, Neurology Department, Westmead Hospital, Westmead, NSW, Australia.

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http://dx.doi.org/10.1002/mds.28021DOI Listing
May 2020

Association of Bolus Feeding With Splanchnic and Cerebral Oxygen Utilization Efficiency Among Premature Infants With Anemia and After Blood Transfusion.

JAMA Netw Open 2020 02 5;3(2):e200149. Epub 2020 Feb 5.

The Charles Perkins Center, The University of Sydney, Sydney, Australia.

Importance: The pathogenesis of transfusion-associated necrotizing enterocolitis remains elusive. Splanchnic hypoperfusion associated with packed red blood cell transfusion (PRBCT) and feeding has been implicated, but studies of splanchnic tissue oxygenation with respect to feeding plus PRBCT are lacking.

Objective: To investigate the oxygen utilization efficiency of preterm gut and brain challenged with bolus feeding during anemia and after transfusion using near-infrared spectroscopy.

Design, Setting, And Participants: This prospective cohort study conducted from September 1, 2014, to November 30, 2016, at a tertiary neonatal intensive care unit included 25 hemodynamically stable infants with gestational age less than 32 weeks, birth weight less than 1500 g, and postmenstrual age younger than 37 weeks. Data analysis was performed from August 1, 2017, to October 31, 2018.

Exposures: Infants received PRBCT (15 mL/kg for 4 hours) and at least 120 mL/kg daily of second hourly bolus feedings.

Main Outcomes And Measures: Splanchnic fractional tissue oxygen extraction (FTOEs) and cerebral fractional tissue oxygen extraction (FTOEc) measures were made during 75-minute feeding cycles that comprised a 15-minute preprandial feeding phase (FP0) and 4 contiguous 15-minute postprandial feeding phases (FP1, FP2, FP3, and FP4; each 15 minutes long). The intraindividual comparisons of feeding-related changes were evaluated during the pretransfusion epoch (TE0: 4 hours before onset of transfusion) and 3 TEs after transfusion (TE1: first 8 hours after PRBCT completion; TE2: 9-16 hours after PRBCT completion; and TE3: 17-24 hours after PRBCT completion).

Results: Of 25 enrolled infants (13 [52%] female; median birth weight, 949 g [interquartile range {IQR}, 780-1100 g]; median gestational age, 26.9 weeks [IQR, 25.9-28.6 weeks]; median enrollment weight, 1670 g [IQR, 1357-1937 g]; and median postmenstrual age, 34 weeks [IQR, 32.9-35 weeks]), 1 infant was excluded because of corrupted near-infrared spectroscopy data. No overall association was found between FTOEs and FPs in a multivariable repeated-measures model that accounted for transfusion epochs (primary analysis approach) (FP0: mean estimate, 11.64; 95% CI, 9.55-13.73; FP1: mean estimate, 12.02; 95% CI, 9.92-14.11; FP2: mean estimate, 12.77; 95% CI, 10.68-14.87; FP3: mean estimate, 12.54; 95% CI, 10.45-14.64; FP4: mean estimate, 12.98; 95% CI, 10.89-15.08; P = .16 for the FP association). However exploratory analyses of postprandial changes in FTOEs undertaken for each transfusion epoch separately found evidence of increased postprandial FTOEs during TE1 (mean [SD] FTOEs, 10.55 [5.5] at FP0 vs 13.21 [5.96] at FP4, P = .046). The primary and exploratory analyses found no association between FTOEc and feeding phases, suggesting that cerebral oxygenation may be protected.

Conclusions And Relevance: The findings suggest that enteral feeding may be associated with gut ischemia and potentially transfusion-associated necrotizing enterocolitis. The postprandial changes in FTOEs appear to warrant further investigation in larger randomized studies.
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http://dx.doi.org/10.1001/jamanetworkopen.2020.0149DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049081PMC
February 2020

A Wilted Flower: Lotus Position Dystonia.

Mov Disord Clin Pract 2020 Feb 8;7(2):206-207. Epub 2020 Jan 8.

Movement Disorders Unit, Department of Neurology Westmead Hospital Sydney NSW Australia.

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http://dx.doi.org/10.1002/mdc3.12886DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011837PMC
February 2020

Nicotinamide for skin cancer chemoprevention: effects of nicotinamide on melanoma in vitro and in vivo.

Photochem Photobiol Sci 2020 Feb;19(2):171-179

Dermatology, Sydney Cancer Centre, Bosch Institute, The University of Sydney and Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.

Nicotinamide (NAM), an amide form of vitamin B3, replenishes cellular energy after ultraviolet radiation (UVR) exposure, thereby enhancing DNA repair and reducing UVR's immunosuppressive effects. NAM reduces actinic keratoses and new keratinocyte cancers in high risk individuals, but its effects on melanoma are unknown. Melanomas arising on NAM or placebo within the ONTRAC skin cancer chemoprevention trial (Oral Nicotinamide To Reduce Actinic Cancer) were examined by immunohistochemistry. The effects of NAM (50 μM, 5 mM and 20 mM) on the viability, proliferation and invasiveness of four human melanoma cell lines and on the viability and proliferation of two human melanocyte lines, with and without UV irradiation were also investigated. 50 μM NAM did not affect viability, proliferation or invasion of melanoma or melanocyte cell lines, whereas concentrations too high to be achievable in vivo reduced viability and proliferation. Nicotinamide did not enhance melanoma viability, proliferation or invasiveness in vitro, providing additional confidence in its safety for use in clinical trials in high risk patients. Peritumoral and tumour infiltrating CD4+ and CD8+ lymphocytes were significantly increased in melanomas arising on NAM compared to those arising on placebo. Given the chemopreventive activity of nicotinamide against keratinocyte cancers, its DNA repair enhancing effects in melanocytes and now its potential enhancement of tumour-infiltrating lymphocytes and lack of adverse effects on melanoma cell growth and proliferation, clinical trials of nicotinamide for melanoma chemoprevention are now indicated.
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http://dx.doi.org/10.1039/c9pp00388fDOI Listing
February 2020

Craniotomy for recurrent glioblastoma: Is it justified? A comparative cohort study with outcomes over 10 years.

Clin Neurol Neurosurg 2020 01 24;188:105568. Epub 2019 Oct 24.

Department of Neurosurgery, Atkinson Morley Wing, St George's Hospital, London, SW17 0QT, UK. Electronic address:

Objective: The role of repeat resection for recurrent glioblastoma multiforme (rGBM) is unclear. This large comparative cohort study assessed overall survival (OS), survival since recurrence (SSR), quality of life, and complications in reoperated versus non-reoperated patients for rGBM.

Patients And Methods: All patients with rGBM between 2005 and 2015, who were discussed by our institution's multi-disciplinary team, and who either did or did not undergo reoperation, were prospectively followed up with data collected and compared. Survival and prognostic factors were analysed using Kaplan-Meier and Cox regression methods.

Results: 312 patients (reoperated, n = 145; non-reoperated, n = 167) were analysed. Median SSR was 10.8 months and 6.9 months in the reoperated and non-reoperated groups respectively (Log-rank test: p = 0.02). Median OS was 24.1 months and 20.4 months in the reoperated and non-reoperated groups, respectively (Log-rank test: p = 0.04). Quality of life as measured by Short Form 36 scores were 59 versus 54 at baseline and 62 versus 51 at four-month follow-up for re-operated and non-reoperated groups, respectively (p < 0.05). Age < 60 years, Karnofsky Performance Status (KPS) ≥ 80, recurrence ≥ 9 months from initial diagnosis, methylguanine methyltransferase (MGMT) promoter methylation, and extent of resection (EOR) > 80 %, each were significant predictors of SSR and OS. Complication rates were 5.5 % and 6.2 % following repeat resection and primary resection, respectively (p > 0.05).

Conclusion: This is the first large prospective comparative cohort study of rGBM and demonstrates that repeat resection confers a small but significant benefit in survival and quality of life over non-operative treatment. Best prognosis is associated with: younger age, KPS ≥ 80, late recurrence, MGMT promoter methylation and EOR > 80 %.
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http://dx.doi.org/10.1016/j.clineuro.2019.105568DOI Listing
January 2020

Comparative outcomes of open, hybrid, and fenestrated branched endovascular repair of extent II and III thoracoabdominal aortic aneurysms.

J Vasc Surg 2020 05 11;71(5):1503-1514. Epub 2019 Nov 11.

Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, Fla.

Objective: Open repair of extent II and III thoracoabdominal aortic aneurysms (TAAA) is associated with substantial morbidity. Alternative strategies, such as hybrid operations combining proximal thoracic endovascular aortic repair with either staged open distal TAAA repair or visceral debranching (hybrid), as well as fenestrated/branched endografts (FEVAR), have been increasingly reported; however, benefits of these approaches compared with direct open surgery remain unclear. The purpose of this study was to compare outcomes of these three different strategies in the management of extent II/III TAAA.

Methods: All extent II/III TAAA repairs (2002-2018) for nonmycotic, degenerative aneurysm or chronic dissection at a single institution were reviewed. The primary end point was 30-day mortality. Secondary end points included incidence of spinal cord ischemia (SCI), complications, unplanned re-operation, 90-day readmission, and out-of-hospital survival. To mitigate impact of covariate imbalance and selection bias, intergroup comparisons were made using inverse probability weighted-propensity analysis. Cox regression was used to estimate survival while cumulative incidence was used to determine reoperation risk.

Results: One hundred ninety-eight patients (FEVAR, 92; hybrid, 40; open, 66) underwent repair. In unadjusted analysis, compared with hybrid/open patients, FEVAR patients were significantly older with more cardiovascular risk factors, but less likely to have a connective tissue disorder or dissection-related indication. Unadjusted 30-day mortality and complication rates were: 30-day mortality, FEVAR 4%, hybrid 13%, open 12% (P = .01); and complications, FEVAR 36%, hybrid 33%, open 50% (P = .11). Permanent SCI was not different among groups (FEVAR 3%, hybrid 3%, open 6%; P = .64). In adjusted analysis, 30-day mortality risk was greater for open vs FEVAR (hazard ratio, 3.6; 95% confidence interval, 1.4-9.2; P = .01) with no difference for hybrid vs open/FEVAR. There was significantly lower risk of any SCI for open vs FEVAR (hazard ratio, 0.3; 95% confidence interval, 0.09-0.96; P = .04); however, no difference in risk of permanent SCI was detected among the three groups. There was no difference in complications or unplanned reoperation, but open patients had the greatest risk of unplanned 90-day readmission. There was a time-varying effect on survival probability, with open repair having a significant survival disadvantage in the first 1 to 6 months after the procedure compared with hybrid/FEVAR patients (Cox model P = .03), but no difference in survival at 1 and 5 years (1- and 5-year survival: FEVAR, 86 ± 3%, 55 ± 8%; hybrid, 86 ± 5%, 60 ± 11%; open 69 ± 7%, 59 ± 8%; Cox-model P = .10).

Conclusions: Extent II/III TAAA repair, regardless of operative strategy, is associated with significant morbidity risk. FEVAR is associated with the lowest 30-day mortality risk compared with hybrid and open repair when estimates are adjusted for preoperative risk factors. These data support greater adoption of FEVAR as first-line therapy to treat complex TAAA disease in anatomically suitable patients who present electively.
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http://dx.doi.org/10.1016/j.jvs.2019.08.236DOI Listing
May 2020

Enzalutamide with Standard First-Line Therapy in Metastatic Prostate Cancer.

N Engl J Med 2019 07 2;381(2):121-131. Epub 2019 Jun 2.

From Monash University (I.D.D., M.F., D.W.P.), Eastern Health (I.D.D.), Australian Urology Associates (M.F.), Monash Health (D.W.P.), and the Peter MacCallum Cancer Centre and the University of Melbourne (S.K.S., S.G.W.), Melbourne, VIC, the National Health and Medical Research Council Clinical Trials Centre, University of Sydney (A.J.M., M.R.S., X.C., W.E.H., E.T., S.Y., A.Y.Z.), the Chris O'Brien Lifehouse (M.R.S., L.G.H., A.Y.Z.), the University of Sydney (L.G.H., G.M.), Royal Prince Alfred Hospital (L.G.H.), Kinghorn Cancer Centre, St. Vincent's Hospital, and Garvan Institute of Medical Research (A.M.J.), Macquarie University (A.Y.Z.), and Western Sydney University (R.R.Z.), Sydney, Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW (M.R.S.), Port Macquarie Base Hospital and Mid North Coast Cancer Institute Port Macquarie, Port Macquarie, NSW (S.B.), Sydney Adventist Hospital, Wahroonga, NSW (G.M.), the ANZUP Cancer Trials Group, Camperdown, NSW (M.M.), the Adelaide Cancer Centre and the University of Adelaide (F.P.) and the Royal Adelaide Hospital (T.H.T.), Adelaide, SA, and Orange Health Service, Central West Cancer Care Centre, Orange, NSW (R.R.Z.) - all in Australia; BC Cancer and the University of British Columbia, Vancouver (K.N.C.), the Cross Cancer Institute and the University of Alberta, Edmonton (S.A.N.), Canadian Cancer Trials Group, Queen's University (W.P., F.V.-B.), and the Kingston Health Sciences Center (F.V.-B.), Kingston, ON, and the University of Ottawa and the Ottawa Hospital Research Institute, Ottawa (M.N.R.) - all in Canada; Guy's and St. Thomas' NHS Foundation Trust Biomedical Research Centre, Cancer Research UK and King's College London, and Sarah Cannon Research UK, London (S.C.), and the Royal Cornwall Hospital, Truro (A. Thomson) - all in the United Kingdom; Auckland City Hospital, Auckland (N.J.L.), and the Waikato District Health Board, Hamilton (A. Tan) - both in New Zealand; Cancer Trials Ireland (J.M., R.M.), Mater Misericordiae University Hospital (J.M.), and St. Vincent's University Hospital and University College Dublin (R.M.D.) - all in Dublin; and Dana-Farber Cancer Institute and Harvard Medical School (C.J.S.) - both in Boston.

Background: Enzalutamide, an androgen-receptor inhibitor, has been associated with improved overall survival in men with castration-resistant prostate cancer. It is not known whether adding enzalutamide to testosterone suppression, with or without early docetaxel, will improve survival in men with metastatic, hormone-sensitive prostate cancer.

Methods: In this open-label, randomized, phase 3 trial, we assigned patients to receive testosterone suppression plus either open-label enzalutamide or a standard nonsteroidal antiandrogen therapy (standard-care group). The primary end point was overall survival. Secondary end points included progression-free survival as determined by the prostate-specific antigen (PSA) level, clinical progression-free survival, and adverse events.

Results: A total of 1125 men underwent randomization; the median follow-up was 34 months. There were 102 deaths in the enzalutamide group and 143 deaths in the standard-care group (hazard ratio, 0.67; 95% confidence interval [CI], 0.52 to 0.86; P = 0.002). Kaplan-Meier estimates of overall survival at 3 years were 80% (based on 94 events) in the enzalutamide group and 72% (based on 130 events) in the standard-care group. Better results with enzalutamide were also seen in PSA progression-free survival (174 and 333 events, respectively; hazard ratio, 0.39; P<0.001) and in clinical progression-free survival (167 and 320 events, respectively; hazard ratio, 0.40; P<0.001). Treatment discontinuation due to adverse events was more frequent in the enzalutamide group than in the standard-care group (33 events and 14 events, respectively). Fatigue was more common in the enzalutamide group; seizures occurred in 7 patients in the enzalutamide group (1%) and in no patients in the standard-care group.

Conclusions: Enzalutamide was associated with significantly longer progression-free and overall survival than standard care in men with metastatic, hormone-sensitive prostate cancer receiving testosterone suppression. The enzalutamide group had a higher incidence of seizures and other toxic effects, especially among those treated with early docetaxel. (Funded by Astellas Scientific and Medical Affairs and others; ENZAMET (ANZUP 1304) ANZCTR number, ACTRN12614000110684; ClinicalTrials.gov number, NCT02446405; and EU Clinical Trials Register number, 2014-003190-42.).
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http://dx.doi.org/10.1056/NEJMoa1903835DOI Listing
July 2019

Neurocognitive Function and Quality of Life Outcomes in the ONTRAC Study for Skin Cancer Chemoprevention by Nicotinamide.

Geriatrics (Basel) 2019 Mar 25;4(1). Epub 2019 Mar 25.

Dermatology and Bosch Institute, University of Sydney at Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.

Nicotinamide (vitamin B3) has photoprotective effects and reduces skin cancer incidence in high risk patients. Nicotinamide also improves cognition in animal models. As part of the ONTRAC (Oral Nicotinamide To Reduce Actinic Cancer) phase III placebo-controlled, randomized trial to assess nicotinamide's efficacy in skin cancer prevention, we included clinical neurocognitive function and patient-reported quality of life assessments at baseline and after 12 months of intervention in individuals with previous skin cancer in order to assess any effect of oral nicotinamide (500 mg po twice daily) on cognitive function and quality of life. In our sample of 310 participants who completed neurocognitive function testing at baseline and at 12 months, we were not able to detect any significant effect of oral nicotinamide on cognitive function nor on quality of life. Further studies of nicotinamide's effects on cognition in humans might include individuals with pre-existing mild cognitive impairment, and it may be that higher doses of nicotinamide are required to significantly influence cognitive function compared to doses required to reduce skin cancer.
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http://dx.doi.org/10.3390/geriatrics4010031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473406PMC
March 2019

Examining the Effect of Evaporation Field on Boron Measurements in SiGe: Insights into Improving the Relationship Between APT and SIMS Measurements of Boron.

Microsc Microanal 2019 Jun 13;25(3):617-624. Epub 2019 Mar 13.

Globalfoundries, Inc.,400 Stone Break Rd Ext, Malta, NY 12020,USA.

Understanding and resolving discrepancies between atom probe tomography (APT) and secondary ion mass spectrometry (SIMS) measurements of B dopants in Si-based materials has long been a problem for those in the semiconductor community who wish to measure B within the source/drain SiGe of a device. APT data collection of Si-based materials is typically optimized for Si, which is logical, but perhaps not ideal for field evaporation of B. Increasing the evaporation field well beyond the typically used 28Si2+:28Si+ ratio of approximately 10:1 up to a ratio of ~200:1 is demonstrated to improve B detection while retaining well-matched Si and Ge concentrations with respect to those measured by SIMS. A range of evaporation conditions are examined from a very low field with high laser energy to an extremely high field with extremely low laser energy demonstrating problems at both far ends of the spectrum and a sweet spot when the operating conditions used produce a 28Si2+:28Si+ ratio of approximately 200:1 (in terms of total counts of each ionization state), which is more than an order of magnitude higher than normally used conditions and results in nicely matched B, Si, and Ge APT measurements with those of SIMS.
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http://dx.doi.org/10.1017/S1431927619000291DOI Listing
June 2019

Understanding Girls' Disengagement: Identifying Patterns and the Role of Teacher and Peer Support using Latent Growth Modeling.

J Youth Adolesc 2019 May 11;48(5):979-995. Epub 2019 Feb 11.

School of Education, University of New South Wales, Sydney, Australia.

Previous work has established a significant increase in disengagement as students progress through secondary school. This work has also established that rates of disengagement appear to be higher among boys, leading to an increased focus on the underlying causes and factors associated with disengagement within this population. However, less is known about the patterns of disengagement exhibited by girls. Given that disengagement is consistently associated with negative personal and academic outcomes, it is important to more closely examine the disengagement trajectories of girls. Moreover, it critical to identify factors that buffer the effects of disengagement that are the most effective for girls. Classroom interpersonal support from teachers and peers have been identified as factors that are likely to mitigate disengagement among girls. The present investigation examined longitudinal data from Australian adolescent girls (N = 302, age range 12-16 years old). Latent growth modeling was used to examine the extent to which disengagement was increasing among secondary school girls in Australia, as well as the effects of teacher and peer social support in slowing this increase. The results showed that disengagement significantly increased across 3 years and that teacher support (but not peer support) was associated with a reduction in girls' upward disengagement trajectories. The results of the current study provide much-needed insight about the developmental trajectories of disengagement among adolescent girls and the role of teachers in buffering these problematic trajectories.
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http://dx.doi.org/10.1007/s10964-019-00986-4DOI Listing
May 2019

Reply to Ritchie-McLean, Susanna; Wilmshurst, Sally, regarding their comment "Can population cohort studies assess the long-term impact of anesthesia in children?"

Paediatr Anaesth 2018 12;28(12):1157-1158

Child Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.

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http://dx.doi.org/10.1111/pan.13520DOI Listing
December 2018

A Reduction in Inflammatory Macrophages May Contribute to Skin Cancer Chemoprevention by Nicotinamide.

J Invest Dermatol 2019 02 20;139(2):467-469. Epub 2018 Sep 20.

Dermatology, Sydney Cancer Centre, Bosch Institute, The University of Sydney and Royal Prince Alfred Hospital, Camperdown, Sydney, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, Australia. Electronic address:

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http://dx.doi.org/10.1016/j.jid.2018.08.018DOI Listing
February 2019

Functional diversity and cooperativity between subclonal populations of pediatric glioblastoma and diffuse intrinsic pontine glioma cells.

Nat Med 2018 08 2;24(8):1204-1215. Epub 2018 Jul 2.

Hospital Sant Joan de Deu, Barcelona, Spain.

The failure to develop effective therapies for pediatric glioblastoma (pGBM) and diffuse intrinsic pontine glioma (DIPG) is in part due to their intrinsic heterogeneity. We aimed to quantitatively assess the extent to which this was present in these tumors through subclonal genomic analyses and to determine whether distinct tumor subpopulations may interact to promote tumorigenesis by generating subclonal patient-derived models in vitro and in vivo. Analysis of 142 sequenced tumors revealed multiple tumor subclones, spatially and temporally coexisting in a stable manner as observed by multiple sampling strategies. We isolated genotypically and phenotypically distinct subpopulations that we propose cooperate to enhance tumorigenicity and resistance to therapy. Inactivating mutations in the H4K20 histone methyltransferase KMT5B (SUV420H1), present in <1% of cells, abrogate DNA repair and confer increased invasion and migration on neighboring cells, in vitro and in vivo, through chemokine signaling and modulation of integrins. These data indicate that even rare tumor subpopulations may exert profound effects on tumorigenesis as a whole and may represent a new avenue for therapeutic development. Unraveling the mechanisms of subclonal diversity and communication in pGBM and DIPG will be an important step toward overcoming barriers to effective treatments.
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http://dx.doi.org/10.1038/s41591-018-0086-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086334PMC
August 2018

The Reliability of Parkour Skills Assessment.

Sports (Basel) 2018 Jan 24;6(1). Epub 2018 Jan 24.

School of Sport, Exercise & Nutrition, Massey University, Palmerston North 4442, New Zealand.

The aim of the study was to determine the reliability of parkour skills assessment in field conditions. Twenty young men completed three trials of a parkour obstacle course on two separate days. The tested group consisted of 10 beginners (age 16 ± 1 years, body mass = 65 ± 12 kg, height = 177 ± 7 cm) and 10 advanced traceurs (age 18 ± 2 years, body mass = 68 ± 14 kg, height = 178 ± 6 cm). The performance was video-recorded and subsequently analyzed by three raters (total score 0⁻45). Median and percentiles were used to characterize results from all sessions by all raters. Inter-rater, intra-session and inter-session reliability were assessed using Krippendorff's α for ordinal data. The Mann-Whitney test was used to assess the differences between beginners and advanced traceurs. Advanced traceurs obtained a total score from 41 to 44 whilst beginners achieved 27 to 33 points. Krippendorff's α for total score ranged from 0.910 to 0.916 between raters, 0.828 to 0.874 between trials, and from 0.839 to 0.924 between days. The proposed parkour course differentiated two different ability levels and the skills assessment demonstrated excellent reliability between raters, trials, and days.
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http://dx.doi.org/10.3390/sports6010006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5969187PMC
January 2018

The impact of general anesthesia on child development and school performance: a population-based study.

Paediatr Anaesth 2018 06 27;28(6):528-536. Epub 2018 Apr 27.

Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, NSW, Australia.

Background: There has been considerable interest in the possible adverse neurocognitive effects of exposure to general anesthesia and surgery in early childhood.

Aims: The aim of this data linkage study was to investigate developmental and school performance outcomes of children undergoing procedures requiring general anesthesia in early childhood.

Methods: We included children born in New South Wales, Australia of 37+ weeks' gestation without major congenital anomalies or neurodevelopmental disability with either a school entry developmental assessment in 2009, 2012, or Grade-3 school test results in 2008-2014. We compared children exposed to general anesthesia aged <48 months to those without any hospitalization. Children with only 1 hospitalization with general anesthesia and no other hospitalization were assessed separately. Outcomes included being classified developmentally high risk at school entry and scoring below national minimum standard in school numeracy and reading tests.

Results: Of 211 978 children included, 82 156 had developmental assessment and 153 025 had school test results, with 12 848 (15.7%) and 25 032 (16.4%) exposed to general anesthesia, respectively. Children exposed to general anesthesia had 17%, 34%, and 23% increased odds of being developmentally high risk (adjusted odds ratio [aOR]: 1.17; 95% CI: 1.07-1.29); or scoring below the national minimum standard in numeracy (aOR: 1.34; 95% CI: 1.21-1.48) and reading (aOR: 1.23; 95% CI: 1.12-1.36), respectively. Although the risk for being developmentally high risk and poor reading attenuated for children with only 1 hospitalization and exposure to general anesthesia, the association with poor numeracy results remained.

Conclusion: Children exposed to general anesthesia before 4 years have poorer development at school entry and school performance. While the association among children with 1 hospitalization with 1 general anesthesia and no other hospitalization was attenuated, poor numeracy outcome remained. Further investigation of the specific effects of general anesthesia and the impact of the underlying health conditions that prompt the need for surgery or diagnostic procedures is required, particularly among children exposed to long duration of general anesthesia or with repeated hospitalizations.
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http://dx.doi.org/10.1111/pan.13390DOI Listing
June 2018

Neonatal Morbidity at Term, Early Child Development, and School Performance: A Population Study.

Pediatrics 2018 02 4;141(2). Epub 2018 Jan 4.

Menzies Centre for Health Policy, School of Public Health, and.

Objectives: Investigate the association between severe neonatal morbidity (SNM) and child development and school performance among term infants.

Methods: The study population included term infants without major congenital conditions born between 2000 and 2007 in New South Wales, Australia, with a linked record of developmental assessment at ages 4 to 6 years in 2009 or 2012 ( = 144 535) or school performance at ages 7 to 9 years from 2009 to 2014 ( = 253 447). Developmental outcomes included special needs or being vulnerable and/or at risk in 1 of 5 developmental domains. School performance outcomes were test exemption, or performing <-1 SD on reading or numeracy tests. Binary generalized estimating equations were used to estimate associations between SNM and outcomes, adjusting for sociodemographic, perinatal, and assessment and/or test characteristics.

Results: Overall, 2.1% of infants experienced SNM. The adjusted odds ratio (95% confidence interval) for SNM and physical health was 1.18 (1.08-1.29), 1.14 (1.02-1.26) for language and cognitive skills, and 1.14 (1.06-1.24) and 1.13 (1.05-1.21) for scoring <-1 SD in reading and numeracy, respectively. SNM was most strongly associated with special needs 1.34 (1.15-1.55) and test exemption 1.50 (1.25-1.81). SNM infants born at 37 to 38 weeks' gestation and who were small for gestational age had the greatest likelihood of poorer outcomes.

Conclusions: Term infants with SNM have greater odds of poor neurodevelopment in childhood. These findings provide population-based information for families and can inform clinical counseling and guidelines for follow-up and early intervention.
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http://dx.doi.org/10.1542/peds.2017-1726DOI Listing
February 2018

Analyzing the channel dopant profile in next-generation FinFETs via atom probe tomography.

Ultramicroscopy 2018 03 20;186:104-111. Epub 2017 Dec 20.

GlobalFoundries, Inc., Malta, NY 12020, United States.

Dopant analysis in next-generation semiconductor devices has become increasingly difficult for traditionally used analytical techniques. Atom probe tomography has been viewed by some as a possible solution to these challenges because of its three-dimensional capabilities, forcing the atom probe to mature at a rapid pace in this particular field. This work presents a well-rounded analysis of how APT can be used to examine B dopant diffusion into the channel of a next-generation FinFET, where the channel dimensions and the number of dopants atoms are significantly smaller than any devices measured by APT to date. Complimentary EELS analysis of the gate and channel provides a better understanding of how distortions and artifacts in the APT reconstruction affect the overall integrity of the dataset. Dopant measurements in the channel are confirmed through in-depth mass spectrum analysis and compared with values proposed by TCAD modeling.
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http://dx.doi.org/10.1016/j.ultramic.2017.12.013DOI Listing
March 2018

Cognitive improvement following repair of a basal encephalocele.

Acta Neurochir (Wien) 2018 06 17;160(6):1225-1229. Epub 2017 Dec 17.

Neurosurgical Department, Atkinson Morley Wing, St George's Hospital, London, UK.

We report the case of a 55-year-old woman presenting with progressive memory impairment secondary to a transsphenoidal encephalocele involving her dominant medial temporal lobe. Her clinical deterioration was accompanied by radiological progression in the encephalocele's size and associated encephalomalacia. Through a temporal craniotomy, her encephalocele was resected and the defect closed. Baseline neuropsychological assessment indicated global cognitive impairment, but post-operatively, she reported improved memory and concentration. Standardized assessment reflected an improvement in perceptual skills and an associated improved recall of a complex figure. This is the first case report to date of a patient's memory improving following treatment of a basal encephalocele.
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http://dx.doi.org/10.1007/s00701-017-3422-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5948288PMC
June 2018

Adaptability-what it is and what it is not: Comment on Chandra and Leong (2016).

Authors:
Andrew J Martin

Am Psychol 2017 10;72(7):696-698

University of New South Wales.

Chandra and Leong (2016) propose a new model of adaptability: the diversified portfolio model (DPM) of adaptability. Further thought and research on adaptability is a welcome addition to the limited body of work conducted on this topic to date. However, in their discussion there is a lack of definitional clarity, and there is frequent conflation of adaptability and resilience. It is also the case that the hypothesized adaptability model is general and could apply to many psychological constructs and processes (not just adaptability). In addition, there are gaps in research suggested by the authors that have been addressed by other researchers and there is a good deal of contemporary adaptability research that is not cited. Addressing these limitations in future work is vital to the further development of theory, research, and practice in the area of adaptability. (PsycINFO Database Record
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http://dx.doi.org/10.1037/amp0000163DOI Listing
October 2017