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Article ; Online: Just-in-Time: A Caregiver-Mediated Intervention for Toddlers With Autism.

Bailey, Kathryn M / Rodgers, Mary E / Quinn, Emily D / Thompson, Suzanne / Nietfeld, Jennifer / Kaiser, Ann P

American journal of speech-language pathology

2024 Volume 33, Issue 3, Page(s) 1209–1225

Abstract: Purpose: We investigated effects of an adaptive telehealth coaching model on caregiver implementation of enhanced milieu teaching (EMT) with newly diagnosed toddlers with autism.: Method: Three caregiver-child dyads participated in a multiple- ... ...

Abstract	Purpose: We investigated effects of an adaptive telehealth coaching model on caregiver implementation of enhanced milieu teaching (EMT) with newly diagnosed toddlers with autism. Method: Three caregiver-child dyads participated in a multiple-baseline-across-behaviors, single-case design. Caregivers were taught EMT via telehealth using the teach-model-coach-review approach. EMT strategies were taught sequentially in four components corresponding to design tiers. Caregivers reported their needs for support and adaptation via weekly surveys. Primary outcomes were measures of caregiver's implementation, including (a) a fidelity checklist for wholistic use of EMT and (b) a percentage of correct use of a subset of key EMT strategies (e.g., matched turns, target talk, expansions, play actions, milieu episodes). Generalization and maintenance of caregiver strategy use in uncoached home activities were measured. The number of different words used by children was measured as a secondary, descriptive outcome. Social validity data were collected through ratings and interviews at the end of the study. Results: There was a functional relation between the intervention and caregiver's implementation of EMT for all dyads. Caregiver's use of EMT strategies often generalized and maintained post-intervention. Child response to intervention was variable. Social validity data indicated that the model was beneficial to caregivers and children. Conclusions: An adaptive telehealth coaching model is effective for teaching caregivers of toddlers with autism to implement EMT and potentially helps to bridge the gap between diagnosis and comprehensive intervention. Further exploration of the relation between caregiver fidelity and dosage of active ingredients and child spoken language outcomes is needed. Supplemental material: https://doi.org/10.23641/asha.25156223.
MeSH term(s)	Humans ; Caregivers/education ; Caregivers/psychology ; Male ; Female ; Child, Preschool ; Telemedicine/methods ; Infant ; Autistic Disorder/therapy ; Autistic Disorder/psychology ; Treatment Outcome
Language	English
Publishing date	2024-02-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	1154406-5
ISSN	1558-9110 ; 1058-0360
ISSN (online)	1558-9110
ISSN	1058-0360
DOI	10.1044/2023_AJSLP-23-00279
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Article ; Online: False positive congenital cytomegalovirus saliva screening results with an FDA-approved assay at two institutions.

Atwood, Emily N / Esper, Frank P / Bailey, Kaitlin / Doud, Mary Kathryn / Benton, Alison M / Friesen, Jeremy / Rodgers, Matthew J / Humphries, Romney M / Rhoads, Daniel D / Gaston, David C / Wang, Hannah

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology

2023 Volume 166, Page(s) 105527

Abstract: Background: Congenital cytomegalovirus (CMV) infection is a significant cause of childhood hearing loss and developmental delay. Congenital CMV screening was implemented at two large hospital-affiliated laboratories using the FDA-approved Alethia CMV ... ...

Abstract	Background: Congenital cytomegalovirus (CMV) infection is a significant cause of childhood hearing loss and developmental delay. Congenital CMV screening was implemented at two large hospital-affiliated laboratories using the FDA-approved Alethia CMV Assay Test System. In July 2022, an increase in suspected false-positive results was noted, leading to implementation of prospective quality management strategies. Methods: The Alethia assay was performed per manufacturer-provided instructions on saliva swab specimens. After discovery of possible elevated false-positive rates, all positive results were confirmed by repeat Alethia testing on the same specimen, orthogonal polymerase chain reaction (PCR) on the same specimen, and/or clinical adjudication. Additionally, root cause analyses were conducted to pinpoint the source of false-positive results. Results: At Cleveland Clinic (CCF), 696 saliva specimens were tested after initiation of the prospective quality management strategy, of which 36 (5.2%) were positive for CMV. Five of 36 (13.9%) were confirmed CMV positive by repeat Alethia testing and orthogonal PCR. Vanderbilt Medical Center (VUMC) tested 145 specimens, of which 11 (7.6%) were positive. Two of 11 (18.2%) confirmed as positive by orthogonal PCR or clinical adjudication. The remaining specimens (31 from CCF and 9 from VUMC) were negative for CMV by repeat Alethia and/or orthogonal PCR testing. Discussion: These findings suggest a false positive rate of 4.5-6.2%, higher than the 0.2% reported for this assay in FDA claims. Laboratories using Alethia CMV may consider prospective quality management to evaluate all positive results. False-positive results can lead to unnecessary follow-up care and testing, and decreased confidence in laboratory testing.
MeSH term(s)	Infant, Newborn ; Humans ; Cytomegalovirus/genetics ; Saliva ; Prospective Studies ; Neonatal Screening/methods ; Cytomegalovirus Infections ; DNA, Viral/analysis
Chemical Substances	DNA, Viral
Language	English
Publishing date	2023-06-24
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1446080-4
ISSN	1873-5967 ; 1386-6532
ISSN (online)	1873-5967
ISSN	1386-6532
DOI	10.1016/j.jcv.2023.105527
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Zs.A 3790: Show issues

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Article ; Online: ImmunoPET imaging of TIGIT in the glioma microenvironment.

Scientific reports

2024 Volume 14, Issue 1, Page(s) 5305

Abstract: Glioblastoma (GBM) is the most common primary malignant brain tumor. Currently, there are few effective treatment options for GBM beyond surgery and chemo-radiation, and even with these interventions, median patient survival remains poor. While immune ... ...

Abstract	Glioblastoma (GBM) is the most common primary malignant brain tumor. Currently, there are few effective treatment options for GBM beyond surgery and chemo-radiation, and even with these interventions, median patient survival remains poor. While immune checkpoint inhibitors (ICIs) have demonstrated therapeutic efficacy against non-central nervous system cancers, ICI trials for GBM have typically had poor outcomes. TIGIT is an immune checkpoint receptor that is expressed on activated T-cells and has a role in the suppression of T-cell and Natural Killer (NK) cell function. As TIGIT expression is reported as both prognostic and a biomarker for anti-TIGIT therapy, we constructed a molecular imaging agent, [
MeSH term(s)	Humans ; Animals ; Mice ; Tissue Distribution ; Glioma/diagnostic imaging ; Glioblastoma/diagnostic imaging ; Positron-Emission Tomography ; Receptors, Immunologic ; Tumor Microenvironment
Chemical Substances	Receptors, Immunologic ; TIGIT protein, human
Language	English
Publishing date	2024-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-55296-y
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Article ; Online: Advancing the science on chemical classes.

Maffini, Maricel V / Rayasam, Swati D G / Axelrad, Daniel A / Birnbaum, Linda S / Cooper, Courtney / Franjevic, Shari / MacRoy, Patrick M / Nachman, Keeve E / Patisaul, Heather B / Rodgers, Kathryn M / Rossi, Mark S / Schettler, Ted / Solomon, Gina M / Woodruff, Tracey J

Environmental health : a global access science source

2023 Volume 21, Issue Suppl 1, Page(s) 120

Abstract: Background: Hazard identification, risk assessment, regulatory, and policy activity are usually conducted on a chemical-by-chemical basis. Grouping chemicals into categories or classes is an underutilized approach that could make risk assessment and ... ...

Abstract	Background: Hazard identification, risk assessment, regulatory, and policy activity are usually conducted on a chemical-by-chemical basis. Grouping chemicals into categories or classes is an underutilized approach that could make risk assessment and management of chemicals more efficient for regulators. Objective and methods: While there are some available methods and regulatory frameworks that include the grouping of chemicals (e.g.,same molecular mechanism or similar chemical structure) there has not been a comprehensive evaluation of these different approaches nor a recommended course of action to better consider chemical classes in decision-making. This manuscript: 1) reviews current national and international approaches to grouping; 2) describes how groups could be defined based on the decision context (e.g., hazard/risk assessment, restrictions, prioritization, product development) and scientific considerations (e.g., intrinsic physical-chemical properties); 3) discusses advantages of developing a decision tree approach for grouping; 4) uses ortho-phthalates as a case study to identify and organize frameworks that could be used across agencies; and 5) discusses opportunities to advance the class concept within various regulatory decision-making scenarios. Results: Structural similarity was the most common grouping approach for risk assessment among regulatory agencies (national and state level) and non-regulatory organizations, albeit with some variations in its definition. Toxicity to the same target organ or to the same biological function was also used in a few cases. The phthalates case study showed that a decision tree approach for grouping should include questions about uses regulated by other agencies to encourage more efficient, coherent, and protective chemical risk management. Discussion and conclusion: Our evaluation of how classes of chemicals are defined and used identified commonalities and differences based on regulatory frameworks, risk assessments, and business strategies. We also identified that using a class-based approach could result in a more efficient process to reduce exposures to multiple hazardous chemicals and, ultimately, reduce health risks. We concluded that, in the absence of a prescribed method, a decision tree approach could facilitate the selection of chemicals belonging to a pre-defined class (e.g., chemicals with endocrine-disrupting activity; organohalogen flame retardants [OFR]) based on the decision-making context (e.g., regulatory risk management).
MeSH term(s)	Humans ; Hazardous Substances/toxicity ; Risk Assessment/methods
Chemical Substances	Hazardous Substances
Language	English
Publishing date	2023-01-12
Publishing country	England
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2092232-2
ISSN	1476-069X ; 1476-069X
ISSN (online)	1476-069X
ISSN	1476-069X
DOI	10.1186/s12940-022-00919-y
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Article ; Online: Patterns of germline and somatic testing after universal tumor screening for Lynch syndrome: A clinical practice survey of active members of the Collaborative Group of the Americas on Inherited Gastrointestinal Cancer.

Hodan, Rachel / Rodgers-Fouche, Linda / Arora, Sanjeevani / Dominguez-Valentin, Mev / Kanth, Priyanka / Katona, Bryson W / Mraz, Kathryn A / Roberts, Maegan E / Vilar, Eduardo / Soto-Azghani, Cynthia M / Brand, Randall E / Esplin, Edward D / Perez, Kimberly

Journal of genetic counseling

2022 Volume 31, Issue 4, Page(s) 949–955

Abstract: Clinical guidelines recommend universal tumor screening (UTS) of colorectal and endometrial cancers for Lynch syndrome (LS). There are limited guidelines for how to integrate germline testing and somatic tumor testing after a mismatch repair deficient ( ... ...

Abstract	Clinical guidelines recommend universal tumor screening (UTS) of colorectal and endometrial cancers for Lynch syndrome (LS). There are limited guidelines for how to integrate germline testing and somatic tumor testing after a mismatch repair deficient (dMMR) tumor is identified. We sought to characterize current practice patterns and barriers to preferred practice among clinical providers in high-risk cancer programs. A clinical practice survey was sent to 423 active members of the Collaborative Group of the Americas on Inherited Gastrointestinal Cancer (CGA-IGC) with a follow-up survey sent to 103 clinician responders. The survey outlined clinical vignettes and asked respondents their preferred next test. The survey intended to assess: (1) the role of patient age and family history in risk assessment and (2) barriers to preferred genetic testing. Genetic test options included targeted germline testing based on dMMR expression, germline testing for LS, germline testing with a multigene cancer panel including LS, or paired tumor/germline testing including LS. In October 2020, 117 of 423 (28%) members completed the initial survey including 103 (88%) currently active clinicians. In April 2021, a follow-up survey was sent to active clinicians, with 45 (44%) completing this second survey. After selecting their preferred next germline or paired tumor/germline tumor test based on the clinical vignette, 39% of respondents reported wanting to make a different choice for the initial genetic test without any testing barriers. The proportion of respondents choosing a different initial genetic test was dependent on the proband's age at diagnosis and specified family history. The reported barriers included patient's lack of insurance coverage, patient unable/unwilling to self-pay for proposed testing, and inadequate tumor tissue. Responders reported insurance, financial constraints, and limited tumor tissue as influencing preferred genetic testing in high-risk clinics, thus resulting in possible under-diagnosis of LS and impacting potential surveillance and cascade testing of at-risk relatives.
MeSH term(s)	Americas ; Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis ; Colorectal Neoplasms, Hereditary Nonpolyposis/genetics ; Early Detection of Cancer/methods ; Endometrial Neoplasms/diagnosis ; Endometrial Neoplasms/genetics ; Endometrial Neoplasms/pathology ; Female ; Gastrointestinal Neoplasms/diagnosis ; Gastrointestinal Neoplasms/genetics ; Genetic Testing/methods ; Germ Cells/pathology ; Humans ; Immunohistochemistry ; Surveys and Questionnaires
Language	English
Publishing date	2022-02-26
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1117799-8
ISSN	1573-3599 ; 1059-7700
ISSN (online)	1573-3599
ISSN	1059-7700
DOI	10.1002/jgc4.1567
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Article ; Online: EVALUATING THE IMPACTS OF COINFECTION ON IMMUNE SYSTEM FUNCTION OF THE DEER MOUSE ( PEROMYSCUS MANICULATUS) USING SIN NOMBRE VIRUS AND BARTONELLA AS MODEL PATHOGEN SYSTEMS.

Lehmer, Erin M / Lavengood, Kathryn / Miller, Mason / Rodgers, Jacob / Fenster, Steven D

Journal of wildlife diseases

2017 Volume 54, Issue 1, Page(s) 66–75

Abstract: Simultaneous infections with multiple pathogens can alter the function of the host's immune system, often resulting in additive or synergistic morbidity. We examined how coinfection with the common pathogens Sin Nombre virus (SNV) and Bartonella sp. ... ...

Abstract	: Simultaneous infections with multiple pathogens can alter the function of the host's immune system, often resulting in additive or synergistic morbidity. We examined how coinfection with the common pathogens Sin Nombre virus (SNV) and Bartonella sp. affected aspects of the adaptive and innate immune responses of wild deer mice ( Peromyscus maniculatus). Adaptive immunity was assessed by measuring SNV antibody production; innate immunity was determined by measuring levels of C-reactive protein (CRP) in blood and the complement activity of plasma. Coinfected mice had reduced plasma complement activity and higher levels of CRP compared to mice infected with either SNV or Bartonella. However, antibody titers of deer mice infected with SNV were more than double those of coinfected mice. Plasma complement activity and CRP levels did not differ between uninfected deer mice and those infected with only Bartonella, suggesting that comorbid SNV and Bartonella infections act synergistically, altering the innate immune response. Collectively, our results indicated that the immune response of deer mice coinfected with both SNV and Bartonella differed substantially from individuals infected with only one of these pathogens. Results of our study provided unique, albeit preliminary, insight into the impacts of coinfection on immune system function in wild animal hosts and underscore the complexity of the immune pathways that exist in coinfected hosts.
MeSH term(s)	Adaptive Immunity ; Animals ; Animals, Wild ; Antibodies, Viral/blood ; Bartonella Infections/complications ; Bartonella Infections/microbiology ; Bartonella Infections/veterinary ; Bartonella Infections/virology ; C-Reactive Protein ; Hantavirus Pulmonary Syndrome/complications ; Hantavirus Pulmonary Syndrome/microbiology ; Hantavirus Pulmonary Syndrome/veterinary ; Hantavirus Pulmonary Syndrome/virology ; Immunity, Innate ; Peromyscus ; Rodent Diseases/microbiology ; Rodent Diseases/pathology ; Rodent Diseases/virology ; Sin Nombre virus
Chemical Substances	Antibodies, Viral ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2017-10-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	410709-3
ISSN	1943-3700 ; 0090-3558
ISSN (online)	1943-3700
ISSN	0090-3558
DOI	10.7589/2017-01-015
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Article: Evaluating the impacts of coinfection on immune system function of the deer mouse (peromyscus maniculatus) using sin nombre virus and bartonella as model pathogen systems

Lehmer, Erin M / Jacob Rodgers / Kathryn Lavengood / Mason Miller / Steven D. Fenster

Journal of wildlife diseases. 2018 Jan., v. 54, no. 1

2018

Abstract	: Simultaneous infections with multiple pathogens can alter the function of the host's immune system, often resulting in additive or synergistic morbidity. We examined how coinfection with the common pathogens Sin Nombre virus (SNV) and Bartonella sp. affected aspects of the adaptive and innate immune responses of wild deer mice (Peromyscus maniculatus). Adaptive immunity was assessed by measuring SNV antibody production; innate immunity was determined by measuring levels of C-reactive protein (CRP) in blood and the complement activity of plasma. Coinfected mice had reduced plasma complement activity and higher levels of CRP compared to mice infected with either SNV or Bartonella. However, antibody titers of deer mice infected with SNV were more than double those of coinfected mice. Plasma complement activity and CRP levels did not differ between uninfected deer mice and those infected with only Bartonella, suggesting that comorbid SNV and Bartonella infections act synergistically, altering the innate immune response. Collectively, our results indicated that the immune response of deer mice coinfected with both SNV and Bartonella differed substantially from individuals infected with only one of these pathogens. Results of our study provided unique, albeit preliminary, insight into the impacts of coinfection on immune system function in wild animal hosts and underscore the complexity of the immune pathways that exist in coinfected hosts.
Keywords	adaptive immunity ; antibodies ; antibody formation ; Bartonella ; blood ; complement ; C-reactive protein ; hosts ; immune system ; innate immunity ; mice ; mixed infection ; models ; morbidity ; pathogens ; Peromyscus maniculatus ; Sin Nombre virus ; wild animals
Language	English
Dates of publication	2018-01
Size	p. 66-75.
Publishing place	Wildife Disease Association
Document type	Article
ZDB-ID	410709-3
ISSN	1943-3700 ; 0090-3558
ISSN (online)	1943-3700
ISSN	0090-3558
DOI	10.7589/2017-01-015
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Do flame retardant concentrations change in dust after older upholstered furniture is replaced?

Rodgers, Kathryn M / Bennett, Deborah / Moran, Rebecca / Knox, Kristin / Stoiber, Tasha / Gill, Ranjit / Young, Thomas M / Blum, Arlene / Dodson, Robin E

Environment international

2021 Volume 153, Page(s) 106513

Abstract: Upholstered furniture has been a major source of chemical flame retardant (FR) exposures in US homes since the 1970s. FRs are a large group of chemicals, many of which are associated with adverse health effects, including cancer, reproductive toxicity, ... ...

Abstract	Upholstered furniture has been a major source of chemical flame retardant (FR) exposures in US homes since the 1970s. FRs are a large group of chemicals, many of which are associated with adverse health effects, including cancer, reproductive toxicity, and neurotoxicity. California homes have some of the highest dust concentrations of FRs, due to Technical Bulletin 117 (TB117), California's outdated flammability standard for furniture foam that was generally followed across the US and Canada. In 2014, this standard was updated to a smolder standard for furniture fabric called TB117-2013, and it is no longer reliant on FRs. This update provided an opportunity to measure differences in FR dust levels in California homes before and after residents replaced older upholstered furniture, or its foam, with products that met the new standard and were expected to be FR-free. We collected dust from homes of participants who had plans to replace older upholstered furniture, or furniture foam, with FR-free options. We returned for follow-up dust collection six, 12, and 18 months following replacement. Concentrations of three polybrominated diphenyl ethers (PBDEs) (BDE-47, BDE-99, BDE-100), three chlorinated organophosphate ester FRs (tris(2-chloroethyl) phosphate (TCEP), tris(2-chloroisopropyl) phosphate (TCIPP), and tris(1,3-dichloroisopropyl) phosphate (TDCIPP)), and one aryl organophosphate ester FR triphenyl phosphate (TPHP), were widely detected in participant homes. All measured FRs decreased in nearly all homes after the older upholstered furniture was replaced. The decreases in FRs were significant in both homes that replaced entire pieces of furniture and those that replaced only the furniture foam. This study demonstrates that replacing older upholstered furniture or foam significantly reduces concentrations of a range of FRs in the home. Foam replacement offers a potentially more economic alternative that produces a lower volume of waste.
MeSH term(s)	Air Pollution, Indoor/analysis ; Canada ; Dust/analysis ; Environmental Monitoring ; Flame Retardants/analysis ; Halogenated Diphenyl Ethers/analysis ; Humans ; Interior Design and Furnishings ; Organophosphates/analysis ; Phosphates
Chemical Substances	Dust ; Flame Retardants ; Halogenated Diphenyl Ethers ; Organophosphates ; Phosphates
Language	English
Publishing date	2021-03-23
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	554791-x
ISSN	1873-6750 ; 0160-4120
ISSN (online)	1873-6750
ISSN	0160-4120
DOI	10.1016/j.envint.2021.106513
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Article ; Online: A science-based agenda for health-protective chemical assessments and decisions: overview and consensus statement.

Woodruff, Tracey J / Rayasam, Swati D G / Axelrad, Daniel A / Koman, Patricia D / Chartres, Nicholas / Bennett, Deborah H / Birnbaum, Linda S / Brown, Phil / Carignan, Courtney C / Cooper, Courtney / Cranor, Carl F / Diamond, Miriam L / Franjevic, Shari / Gartner, Eve C / Hattis, Dale / Hauser, Russ / Heiger-Bernays, Wendy / Joglekar, Rashmi / Lam, Juleen /

Levy, Jonathan I / MacRoy, Patrick M / Maffini, Maricel V / Marquez, Emily C / Morello-Frosch, Rachel / Nachman, Keeve E / Nielsen, Greylin H / Oksas, Catherine / Abrahamsson, Dimitri Panagopoulos / Patisaul, Heather B / Patton, Sharyle / Robinson, Joshua F / Rodgers, Kathryn M / Rossi, Mark S / Rudel, Ruthann A / Sass, Jennifer B / Sathyanarayana, Sheela / Schettler, Ted / Shaffer, Rachel M / Shamasunder, Bhavna / Shepard, Peggy M / Shrader-Frechette, Kristin / Solomon, Gina M / Subra, Wilma A / Vandenberg, Laura N / Varshavsky, Julia R / White, Roberta F / Zarker, Ken / Zeise, Lauren

Environmental health : a global access science source

2023 Volume 21, Issue Suppl 1, Page(s) 132

Abstract: The manufacture and production of industrial chemicals continues to increase, with hundreds of thousands of chemicals and chemical mixtures used worldwide, leading to widespread population exposures and resultant health impacts. Low-wealth communities ... ...

Abstract	The manufacture and production of industrial chemicals continues to increase, with hundreds of thousands of chemicals and chemical mixtures used worldwide, leading to widespread population exposures and resultant health impacts. Low-wealth communities and communities of color often bear disproportionate burdens of exposure and impact; all compounded by regulatory delays to the detriment of public health. Multiple authoritative bodies and scientific consensus groups have called for actions to prevent harmful exposures via improved policy approaches. We worked across multiple disciplines to develop consensus recommendations for health-protective, scientific approaches to reduce harmful chemical exposures, which can be applied to current US policies governing industrial chemicals and environmental pollutants. This consensus identifies five principles and scientific recommendations for improving how agencies like the US Environmental Protection Agency (EPA) approach and conduct hazard and risk assessment and risk management analyses: (1) the financial burden of data generation for any given chemical on (or to be introduced to) the market should be on the chemical producers that benefit from their production and use; (2) lack of data does not equate to lack of hazard, exposure, or risk; (3) populations at greater risk, including those that are more susceptible or more highly exposed, must be better identified and protected to account for their real-world risks; (4) hazard and risk assessments should not assume existence of a "safe" or "no-risk" level of chemical exposure in the diverse general population; and (5) hazard and risk assessments must evaluate and account for financial conflicts of interest in the body of evidence. While many of these recommendations focus specifically on the EPA, they are general principles for environmental health that could be adopted by any agency or entity engaged in exposure, hazard, and risk assessment. We also detail recommendations for four priority areas in companion papers (exposure assessment methods, human variability assessment, methods for quantifying non-cancer health outcomes, and a framework for defining chemical classes). These recommendations constitute key steps for improved evidence-based environmental health decision-making and public health protection.
MeSH term(s)	Humans ; Environmental Exposure/adverse effects ; Environmental Exposure/prevention & control ; Environmental Health ; Environmental Pollutants/analysis ; Public Health ; Risk Assessment ; Consensus Development Conferences as Topic
Chemical Substances	Environmental Pollutants
Language	English
Publishing date	2023-01-12
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2092232-2
ISSN	1476-069X ; 1476-069X
ISSN (online)	1476-069X
ISSN	1476-069X
DOI	10.1186/s12940-022-00930-3
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Article: Current chemoprevention approaches in Lynch syndrome and Familial adenomatous polyposis: a global clinical practice survey.

Mraz, Kathryn A / Hodan, Rachel / Rodgers-Fouche, Linda / Arora, Sanjeevani / Balaguer, Francesc / Guillem, Jose G / Jeter, Joanne M / Kanth, Priyanka / Li, Dan / Liska, David / Melson, Joshua / Perez, Kimberly / Ricker, Charite / Shirts, Brian H / Vilar, Eduardo / Katona, Bryson W / Dominguez-Valentin, Mev

Frontiers in oncology

2023 Volume 13, Page(s) 1141810

Abstract: Background: International chemoprevention preferences and approaches in Lynch syndrome (LS) and : Aim: To describe current chemoprevention strategies for patients with LS or FAP/AFAP (referred to collectively as FAP) practiced by members of four ... ...

Abstract	Background: International chemoprevention preferences and approaches in Lynch syndrome (LS) and Aim: To describe current chemoprevention strategies for patients with LS or FAP/AFAP (referred to collectively as FAP) practiced by members of four international hereditary cancer societies through administration of a survey. Results: Ninety-six participants across four hereditary gastrointestinal cancer societies responded to the survey. Most respondents (91%, 87/96) completed information regarding their demographics and practice characteristics relating to hereditary gastrointestinal cancer and chemoprevention clinical practices. Sixty-nine percent (60/87) of respondents offer chemoprevention for FAP and/or LS as a part of their practice. Of the 75% (72/96) of survey respondents who were eligible to answer practice-based clinical vignettes based off of their responses to ten barrier questions regarding chemoprevention, 88% (63/72) of those participants completed at least one case vignette question to further characterize chemoprevention practices in FAP and/or LS. In FAP, 51% (32/63) would offer chemoprevention for rectal polyposis, with sulindac - 300 mg (18%, 10/56) and aspirin (16%, 9/56) being the most frequently selected options. In LS, 93% (55/59) of professionals discuss chemoprevention and 59% (35/59) frequently recommend chemoprevention. Close to half of the respondents (47%, 26/55) would recommend beginning aspirin at time of commencement of the patient's first screening colonoscopy (usually at age 25yrs). Ninety-four percent (47/50) of respondents would consider a patient's diagnosis of LS as an influential factor for aspirin use. There was no consensus on the dose of aspirin (≤100 mg, >100 mg - 325 mg or 600 mg) to offer patients with LS and there was no agreement on how other factors, such as BMI, hypertension, family history of colorectal cancer, and family history of heart disease, would affect the recommendation for aspirin use. Possible harm among older patients (>70 years) was identified as the most common reason to discourage aspirin use. Conclusion: Although chemoprevention is widely discussed and offered to patients with FAP and LS by an international group of hereditary gastrointestinal cancer experts, there is significant heterogeneity in how it is applied in clinical practice.
Language	English
Publishing date	2023-05-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1141810
Database	MEDical Literature Analysis and Retrieval System OnLINE

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