Publications by authors named "Scott Macfarlane"

16 Publications

  • Page 1 of 1

Listening to the experts: Parents' perspectives around infection risk and returning to education and social activities following their child's diagnosis of acute lymphoblastic leukemia.

Cancer Rep (Hoboken) 2021 May 14:e1424. Epub 2021 May 14.

National Child Cancer Network, Auckland, New Zealand.

Background: During a child's prolonged treatment for acute lymphoblastic leukemia (ALL), there is a need to balance their increased risk of developing infection-related complications with meeting their educational and social needs.

Aims: To determine the safe timing of return to social activities for children undergoing treatment for ALL and to determine how parents perceive and act on advice related to infection risk while navigating their child's "return to normal."

Methods And Results: Medical and educational attendance records were reviewed for 47 children who were diagnosed with ALL and 24 semi-structured qualitative interviews were conducted with a representative sample of their parents. The majority of children (69%) did not return to education prior to the start of maintenance therapy regardless of the advice that the families received from their healthcare team. Those who returned earlier were at no greater risk of major infection complications (mean = 0.5) than those who did not return until after commencing maintenance (mean = 0.4, P = .74). Parents spoke of the difficulty in obtaining practical, consistent, and timely advice and of balancing infection risk with a desire to return to normalcy. Inconsistent advice and constant vigilance placed a burden on parents which often profoundly affected their mental wellbeing. Overall, parents wanted to make their own decisions about how and when their child returned to education and social activities. They made these decisions based on many factors, of which infection risk was just one.

Conclusion: Following the study conclusion, a national working group was established-including parent representatives-to implement the study recommendations. This includes the development of a range of practical resources to better support families. Health professional guidelines provide quantitative data pertaining to infection risk, while emphasizing that the returning decisions ultimately rest with the families. This research demonstrates that listening to parents-who are the experts through their lived experiences-is a critical element in creating policies that are responsive, meaningful, and widely accepted.
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http://dx.doi.org/10.1002/cnr2.1424DOI Listing
May 2021

Associations between childhood cancer treatment and tooth agenesis.

N Z Med J 2020 10 9;133(1523):41-54. Epub 2020 Oct 9.

Paediatric Dentist, DayOne Paediatric Dental, Christchurch.

Aim: The aim of this study was to determine the prevalence of dental developmental disturbances in long-term survivors of childhood malignancies in New Zealand children. This study reports associations with potential risk factors to inform oncologists and dentists of the likelihood of dental abnormalities.

Methods: The study population was children aged 14-16 years old who were diagnosed with cancer prior to 10 years of age. A total of 156 children were eligible, of which 59 participated in this study. The indices used in this study were Holtta's Defect Index (HDI), and Oral Health Impact Profile-14 (OHIP-14).

Results: The prevalence of agenesis was 15.3%, microdontia 6.8% and root abnormalities 32.2%. Cyclophosphamide equivalent doses above 8,000mg/m2, stem cell therapy (SCT), and head and neck radiation therapy (HNRT) were associated with a higher mean number of teeth missing due to agenesis. SCT and HNRT were associated with a higher total HDI. A binary logistic regression was carried out to determine the odds of agenesis and found that HNRT was the main contributing factor (OR=7.7, p-value=0.04). The linear regression model found that dactinomycin and agenesis correlated with the largest mean OHIP-14.

Conclusion: This study found that childhood cancer survivors in New Zealand had a high prevalence of developmental dental abnormalities and it identified potential risk factors related to their cancer treatment. Inequitable access to oral rehabilitation for this patient group argues for a mechanism for consistent improved access to publicly funded dental care across district health boards in New Zealand.
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October 2020

Understanding the basics of patenting.

Nat Biotechnol 2020 03;38(3):263-270

SUNY Upstate Medical Center, Syracuse, NY, USA.

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http://dx.doi.org/10.1038/s41587-020-0447-xDOI Listing
March 2020

Cancer Care at a Crossroads: time to make a choice.

N Z Med J 2019 04 12;132(1493):6-11. Epub 2019 Apr 12.

General Practitioner and Primary Care Lead for the Bowel Screening Programme.

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April 2019

Childhood cancer registration in New Zealand: A registry collaboration to assess and improve data quality.

Cancer Epidemiol 2018 08 11;55:104-109. Epub 2018 Jun 11.

Starship Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand.

Aim: To evaluate the completeness and accuracy of child cancer registration in New Zealand.

Methods: Registrations for children aged 0-14 diagnosed between 1/1/2010 and 31/12/2014 were obtained from the New Zealand Cancer Registry (NZCR) and the New Zealand Children's Cancer Registry (NZCCR). Six key data fields were matched using National Health Index numbers in order to identify and resolve registration discrepancies. Capture-recapture methods were used to assess the completeness of cancer registration.

Results: 794 unique cases were reported; 718 from the NZCR, 721 from the NZCCR and 643 from both registries. 27 invalid cancer registrations were identified, including 19 residents of the Pacific Islands who had travelled to New Zealand for treatment. The NZCCR provided 55 non-malignant central nervous system tumour and 16 Langerhans cell histiocytosis cases which were not registered by the NZCR. The NZCR alerted the NZCCR to 18 cases missed due to human error and 23 cases that had not been referred to the specialist paediatric oncology centres. 762 cases were verified as true incident cases, an incidence rate of 166.8 per million. Registration accuracy for six key data fields was 98.6%. According to their respective inclusion criteria case completeness was 99.3% for the NZCR and 94.4% for the NZCCR. For childhood malignancies covered by both registries, capture-recapture methods estimated case ascertainment at greater than 99.9%.

Conclusion: With two national registries covering childhood cancers, New Zealand is uniquely positioned to undertake regular cooperative activities to ensure high quality data is available for research and patient care.
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http://dx.doi.org/10.1016/j.canep.2018.06.001DOI Listing
August 2018

The alphabet soup of agreements.

Nat Biotechnol 2018 03;36(3):220-224

Office of Technology Transfer, SUNY Upstate Medical University, Syracuse, New York, USA.

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http://dx.doi.org/10.1038/nbt.4088DOI Listing
March 2018

Differences Between Relative and Absolute Speed and Metabolic Thresholds in Rugby League.

Int J Sports Physiol Perform 2018 Mar 1;13(3):298-304. Epub 2018 Mar 1.

Purpose: To compare relative and absolute speed and metabolic thresholds for quantifying match output in elite rugby league.

Methods: Twenty-six professional players competing in the National Rugby League were monitored with global positioning systems (GPS) across a rugby-league season. Absolute speed (moderate-intensity running [MIR > 3.6 m/s] and high-intensity running [HIR > 5.2 m/s]) and metabolic (>20 W/kg) thresholds were compared with individualized ventilatory (first [VT] and second [VT]) thresholds estimated from the 30-15 Intermittent Fitness Test (30-15), as well as the metabolic threshold associated with VT (HP), to examine difference in match-play demands.

Results: VT mean values represent 146%, 138%, 167%, and 144% increases in the HIR dose across adjustables, edge forwards, middle forwards, and outside backs, respectively. Distance covered above VT was almost certainly greater (ES range = 0.79-1.03) than absolute thresholds across all positions. Trivial to small differences were observed between VT and MIR, while small to moderate differences were reported between HP and HP.

Conclusions: These results reveal that the speed at which players begin to run at higher intensities depends on individual capacities and attributes. As such, using absolute HIR speed thresholds underestimates the physical HIR load. Moreover, absolute MIR and high metabolic thresholds may over- or underestimate the work undertaken above these thresholds depending on the respective fitness of the individual. Therefore, using relative thresholds enables better prescription and monitoring of external training loads based on measured individual physical capacities.
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http://dx.doi.org/10.1123/ijspp.2016-0645DOI Listing
March 2018

Analysis of common cytogenetic abnormalities in New Zealand pediatric ALL shows ethnically diverse carriage of ETV6-RUNX1, without a corresponding difference in survival.

Pediatr Blood Cancer 2017 Dec 9;64(12). Epub 2017 Jun 9.

Starship Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand.

Background: The frequency of common cytogenetic abnormalities in pediatric acute lymphoblastic leukemia (ALL) is known to vary by geographic location and ethnic origin. This study aimed to determine the frequency of hypodiploidy, ETV6-RUNX1, BCR-ABL1, and MLL rearrangement within New Zealand's pediatric ALL population and to assess whether the frequency of these ALL prognostic markers varies according to ethnicity.

Procedure: The New Zealand Children's Cancer Registry provided information for all registered pediatric ALL patients that were diagnosed between 2000 and 2009, with medical records available for 246 patients. Each patient's medical record was reviewed to determine the frequency of hypodiploidy, ETV6-RUNX1, BCR-ABL1, MLL rearrangement, and cell lineage. Chi-square tests for independence were undertaken to compare the frequencies of cytogenetic abnormalities according to prioritized ethnicity.

Results: The frequency of cytogenetic ALL abnormalities in the New Zealand pediatric population were consistent with international reference values. A low frequency of ETV6-RUNX1 was evident for Maori pediatric ALL patients (5.4%, P = 0.018), when compared to Pacific peoples (21.1%) and non-Maori/non-Pacific peoples (27.4%). This has not impacted on outcome, however, with equivalent 5-year overall survival being observed in Maori (89.4%) compared to Pacific peoples (92.0%) and non-Maori/non-Pacific peoples (90.2%).

Conclusions: A lower frequency of the favorable prognostic marker ETV6-RUNX1 was observed in Maori pediatric ALL patients. This did not translate into poorer survival. Future research into biological and nonbiological prognostic factors in this patient population may assist in explaining this finding.
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http://dx.doi.org/10.1002/pbc.26676DOI Listing
December 2017

Small Numbers, Big Challenges: Adolescent and Young Adult Cancer Incidence and Survival in New Zealand.

J Adolesc Young Adult Oncol 2017 Jun 16;6(2):277-285. Epub 2017 Feb 16.

8 Children's Cancer Research Group, University of Otago, Christchurch, New Zealand .

Purpose: This study was undertaken to determine cancer survival and describe the unique spectrum of cancers diagnosed among New Zealand's adolescents and young adult (AYA) population.

Methods: Registrations for 1606 15-24 year olds diagnosed with a new primary malignant tumor between 2000 and 2009 were obtained from the New Zealand Cancer Registry and classified according to AYA diagnostic group and subgroup, age, sex, and prioritized ethnicity. Age-standardized incidence rates (IRs) per million person years and 5-year relative survival ratios were calculated.

Results: Cancer incidence was 228.6 per million for adolescents aged 15-19 years and 325.7 per million for young adults aged 20-24 years. Overall IRs were consistent across all ethnic groups but there were unique ethnic differences by tumor group including a higher incidence of bone tumors, carcinoma of the gastrointestinal tract, and gonadal germ cell tumors among Maori, a higher incidence of leukemia among Pacific peoples, and a higher incidence of melanoma among non-Maori/non-Pacific peoples. Five-year relative survival for adolescents (75.1%) and AYA overall (80.6%) appeared poorer than had been achieved in other high-income countries. Maori (69.5%) and Pacific (71.3%) AYA had lower 5-year survival compared to non-Maori/non-Pacific peoples (84.2%).

Conclusion: The survival disparities observed require further investigation to identify and address the causes of these inferior outcomes. The newly established AYA Cancer Network Aotearoa has been tasked with improving cancer survival and care and ensuring equality of access for New Zealand AYAs with cancer.
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http://dx.doi.org/10.1089/jayao.2016.0074DOI Listing
June 2017

Closing the deal.

Nat Biotechnol 2016 12;34(12):1222-1225

Technology Transfer, SUNY Upstate Medical University, Syracuse, New York, USA.

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http://dx.doi.org/10.1038/nbt.3687DOI Listing
December 2016

Congenital self-healing reticulohistiocytosis: the need for investigation.

Australas J Dermatol 2016 Feb;57(1):76-7

Paediatric Oncology, Starship Hospital, Auckland, New Zealand.

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http://dx.doi.org/10.1111/ajd.12222DOI Listing
February 2016

The Validity and Reliability of Global Positioning Systems in Team Sport: A Brief Review.

J Strength Cond Res 2016 May;30(5):1470-90

1The School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia; 2Performance Sciences Department, Brisbane Broncos Rugby League Club, Brisbane, Australia; and 3Applied Sport Science and Exercise Testing Laboratory, Faculty of Science and Information Technology, University of Newcastle, Ourimbah, Australia.

The use of global positioning systems (GPS) has increased dramatically over the last decade. Using signals from orbiting satellites, the GPS receiver calculates the exact position of the device and the speed at which the device is moving. Within team sports GPS devices are used to quantify the external load experienced by an athlete, allowing coaches to better manage trainings loads and potentially identify athletes who are overreaching or overtraining. This review aims to collate all studies that have tested either (or both) the validity or reliability of GPS devices in a team sport setting, with a particular focus on (a) measurements of distance, speed, velocities, and accelerations across all sampling rates and (b) accelerometers, player/body load and impacts in accelerometer-integrated GPS devices. A comprehensive search of the online libraries identified 22 articles that fit search criteria. The literature suggests that all GPS units, regardless of sampling rate, are capable of tracking athlete's distance during team sport movements with adequate intraunit reliability. One Hertz and 5Hz GPS units have limitations in their reporting of distance during high-intensity running, velocity measures, and short linear running (particularly those involving changes of direction), although these limitations seem to be overcome during measures recorded during team sport movements. Ten Hertz GPS devices seem the most valid and reliable to date across linear and team sport simulated running, overcoming many limitations of earlier models, whereas the increase to 15Hz GPS devices have had no additional benefit.
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http://dx.doi.org/10.1519/JSC.0000000000001221DOI Listing
May 2016

Licensing lessons learned: if I knew then what I know now.

Nat Biotechnol 2013 Apr;31(4):362-3

Office of Industrial Liaison, New York University Langone Medical Center, New York, New York, USA.

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http://dx.doi.org/10.1038/nbt.2551DOI Listing
April 2013

Paediatric cancer in low-income and middle-income countries.

Lancet Oncol 2013 Mar 20;14(3):e104-16. Epub 2013 Feb 20.

International Network for Cancer Treatment and Research, Brussels, Belgium.

Patterns of cancer incidence across the world have undergone substantial changes as a result of industrialisation and economic development. However, the economies of most countries remain at an early or intermediate stage of development-these stages are characterised by poverty, too few health-care providers, weak health systems, and poor access to education, modern technology, and health care because of scattered rural populations. Low-income and middle-income countries also have younger populations and therefore a larger proportion of children with cancer than high-income countries. Most of these children die from the disease. Chronic infections, which remain the most common causes of disease-related death in all except high-income countries, can also be major risk factors for childhood cancer in poorer regions. We discuss childhood cancer in relation to global development and propose strategies that could result in improved survival. Education of the public, more and better-trained health professionals, strengthened cancer services, locally relevant research, regional hospital networks, international collaboration, and health insurance are all essential components of an enhanced model of care.
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http://dx.doi.org/10.1016/S1470-2045(13)70008-1DOI Listing
March 2013

The role of intracellular Ca2+ in the regulation of proteinase-activated receptor-2 mediated nuclear factor kappa B signalling in keratinocytes.

Br J Pharmacol 2005 Jun;145(4):535-44

Department of Physiology & Pharmacology, University of Strathclyde, Strathclyde Institute for Biomedical Sciences, 27 Taylor Street, Glasgow G4 0NR, Scotland.

1 In this study, we examined the role of Ca2+ in linking proteinase-activated receptor-2 (PAR2) to the nuclear factor kappa B (NFkappaB) pathway in a skin epithelial cell line NCTC2544 stably expressing PAR2 (clone G). 2 In clone G, PAR2-mediated NFkappaB luciferase reporter activity and NFkappaB DNA-binding activity was reduced by preincubation with BAPTA-AM but not BAPTA. Trypsin stimulation of inhibitory kappa B kinases, IKKalpha and IKKbeta, was also inhibited following pretreatment with BAPTA-AM. 3 BAPTA/AM also prevented PAR2-mediated IKKalpha activation in cultured primary human keratinocytes. 4 The effect of BAPTA-AM was also selective for the IKK/NFkappaB signalling axis; PAR2 coupling to ERK, or p38 MAP kinase was unaffected. 5 Pharmacological inhibition of the Ca2+-dependent regulatory protein calcineurin did not inhibit trypsin-stimulated IKK activity or NFkappaB-DNA binding; however, inhibition of Ca2+-dependent protein kinase C isoforms or InsP3 formation using GF109203X or the phospholipase C inhibitor U73122, respectively, reduced both IKK activity and NFkappaB-DNA binding. 6 Mutation of PAR2 within the C-terminal to produce a mutant receptor, which does not couple to Ca2+ signalling, but is able to activate ERK, abrogated NFkappaB-DNA binding and IKK activity stimulated by trypsin. 7 These results suggest a predominant role for the InsP3/Ca2+ axis in the regulation of IKK signalling and NFkappaB transcriptional activation.
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http://dx.doi.org/10.1038/sj.bjp.0706204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1576156PMC
June 2005

The role of the C-terminal tail in protease-activated receptor-2-mediated Ca2+ signalling, proline-rich tyrosine kinase-2 activation, and mitogen-activated protein kinase activity.

Cell Signal 2004 Jan;16(1):21-9

Department of Physiology and Pharmacology, Strathclyde Institute for Biomedical Sciences, University of Strathclyde, 27 Taylor Street, Glasgow, Scotland G4 ONR, UK.

C-terminal truncation mutants were made to investigate the role of the C-terminus in coupling proteinase-activated receptor-2 (PAR-2) to various signalling pathways. Membrane expression of the delta15, delta34, delta43, and delta34-43 mutants was similar; however, expression of deltatail was lost, as was agonist-mediated internalisation of deltatail, delta43, and delta34-43. Additionally, trypsin and SLIGKV-stimulated [3H]IP accumulation was abrogated in cells transiently expressing delta43 or delta34-43 truncations, but remained unaffected in cells expressing delta34 or delta15. PAR-2 agonist-stimulated intracellular Ca(2+) mobilisation and PYK-2 activity were also abolished by deltatail, delta43, and delta34-43 mutants. However, trypsin-stimulated stress-activated protein kinases (SAPKs) or extracellular signal-regulated kinase (ERK) activities were unaffected by the delta34-43 mutation, although activity was abrogated following delta43 or deltatail truncations, suggesting that Ca(2+) mobilisation, PYK-2, or receptor internalisation are not requied for activation of SAPKs or ERK. These studies identify a novel sequence within the PAR-2 C-terminus essential for InsP(3) generation and PYK-2 activity but not mitogen-activated protein kinase (MAPK) activation.
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http://dx.doi.org/10.1016/s0898-6568(03)00095-0DOI Listing
January 2004