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  1. Article: Defining and Reporting on Critical Values in Genetics: A Laboratory Survey.

    Goh, Elaine S / Stavropoulos, Dimitrios J / Adeli, Khosrow

    The journal of applied laboratory medicine

    2021  Volume 6, Issue 5, Page(s) 1299–1304

    Abstract: Background: Although an obvious critical value in metabolic genetics would be ammonia, it is more challenging to define critical values in molecular genetics and cytogenetics. The objective of this study was to survey genetic laboratories in Ontario, ... ...

    Abstract Background: Although an obvious critical value in metabolic genetics would be ammonia, it is more challenging to define critical values in molecular genetics and cytogenetics. The objective of this study was to survey genetic laboratories in Ontario, Canada, to determine whether different centers considered similar results as critical and thus potentially deserving of a different reporting process.
    Methods: An online 11-question survey was emailed to Ontario laboratory directors, and the results were analyzed.
    Results: The response rate was 82% (9/11). Cytogenetics and molecular genetics services were each provided by 7 of the 9 centers, with 3 centers providing biochemical/metabolic genetics services and 1 providing maternal marker serum screening services. The case type (e.g., prenatal, newborn, or expedited by the ordering physician) was one factor. Quantitative fluorescence PCR for autosomal aneuploidy, pathogenic variants in both prenatal and postnatal settings, and oncological results were considered critical cytogenetics results. Pathogenic prenatal cases, indeterminate results, and unexpected results were considered more critical for molecular genetics. Critical results were more likely to prompt a telephone call or email to the ordering physician.
    Conclusion: Ontario genetics laboratories tended to have similar reporting processes for critical results. Both the types of cases and the pathogenicity of the result define what values are considered critical.
    MeSH term(s) Female ; Genetic Testing ; Humans ; Infant, Newborn ; Laboratories ; Pregnancy ; Prenatal Diagnosis
    Language English
    Publishing date 2021-06-04
    Publishing country England
    Document type Journal Article
    ISSN 2576-9456
    ISSN 2576-9456
    DOI 10.1093/jalm/jfab040
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Correspondence on "cost or price of sequencing? implications for economic evaluations in genomic medicine" by Grosse and Gudgeon.

    Li, Chunmei / Vandersluis, Stacey / Holubowich, Corinne / Ungar, Wendy J / Goh, Elaine S / Boycott, Kym M / Sikich, Nancy / Dhalla, Irfan / Ng, Vivian

    Genetics in medicine : official journal of the American College of Medical Genetics

    2021  Volume 24, Issue 1, Page(s) 251–252

    MeSH term(s) Cost-Benefit Analysis ; Evidence-Based Medicine ; Genomic Medicine ; Humans
    Language English
    Publishing date 2021-11-30
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1455352-1
    ISSN 1530-0366 ; 1098-3600
    ISSN (online) 1530-0366
    ISSN 1098-3600
    DOI 10.1016/j.gim.2021.08.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Use of eConsult to enhance genetics service delivery in primary care: A multimethod study.

    Carroll, June C / Liddy, Clare / Afkham, Amir / Keely, Erin / Goh, Elaine S / Graham, Gail E / Permaul, Joanne A / Allanson, Judith / Heisey, Ruth / Makuwaza, Tutsirai / Manca, Donna P / O'Brien, Mary Ann / Grunfeld, Eva

    Genetics in medicine : official journal of the American College of Medical Genetics

    2022  Volume 24, Issue 10, Page(s) 2034–2041

    Abstract: Purpose: Electronic consultation (eConsult) is a freely-available secure online platform connecting primary care providers (PCPs) to geneticists. Our purpose was to determine whether eConsult is effective in improving genetics service delivery in ... ...

    Abstract Purpose: Electronic consultation (eConsult) is a freely-available secure online platform connecting primary care providers (PCPs) to geneticists. Our purpose was to determine whether eConsult is effective in improving genetics service delivery in primary care.
    Methods: PCP questionnaires regarding eConsult's utility, geneticists' tracking form assessments of eConsult type and appropriateness, and geneticists' interviews on implementing eConsult were carried out.
    Results: In 2 regions of Ontario, Canada, from January 2019 to June 2020, there were 305 genetics eConsults. For 169 (55%), PCPs indicated receiving good advice for a new course of action; for 110 (36%), referral was now avoided; and for 261 (86%), eConsult was perceived valuable for patient management. Of the 131 geneticist-completed tracking forms, cancer questions were most common (68, 52%). For 63 (48%), geneticists disagreed/strongly disagreed PCPs should know the answer to the referral question. From the interview data, it was observed that geneticists described eConsult positively and suggested how it might improve access and efficiencies if integrated into genetic service delivery. Dealing with eConsults virtually could reduce waitlists, and suggesting appropriate investigations for PCPs could improve efficiencies.
    Conclusion: eConsult offers a potential solution for receiving timely genetics advice and avoiding unnecessary patient referrals, however, greater effect on access and wait times will need systematic integration into PCP and geneticist practice.
    MeSH term(s) Genetic Services ; Health Services Accessibility ; Humans ; Ontario ; Primary Health Care/methods ; Referral and Consultation ; Telemedicine/methods
    Language English
    Publishing date 2022-08-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1455352-1
    ISSN 1530-0366 ; 1098-3600
    ISSN (online) 1530-0366
    ISSN 1098-3600
    DOI 10.1016/j.gim.2022.07.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Cost-effectiveness of genome-wide sequencing for unexplained developmental disabilities and multiple congenital anomalies.

    Li, Chunmei / Vandersluis, Stacey / Holubowich, Corinne / Ungar, Wendy J / Goh, Elaine S / Boycott, Kym M / Sikich, Nancy / Dhalla, Irfan / Ng, Vivian

    Genetics in medicine : official journal of the American College of Medical Genetics

    2020  Volume 23, Issue 3, Page(s) 451–460

    Abstract: Purpose: Genetic testing is routine practice for individuals with unexplained developmental disabilities and multiple congenital anomalies. However, current testing pathways can be costly and time consuming, and the diagnostic yield low. Genome-wide ... ...

    Abstract Purpose: Genetic testing is routine practice for individuals with unexplained developmental disabilities and multiple congenital anomalies. However, current testing pathways can be costly and time consuming, and the diagnostic yield low. Genome-wide sequencing, including exome sequencing (ES) and genome sequencing (GS), can improve diagnosis, but at a higher cost. This study aimed to assess the cost-effectiveness of genome-wide sequencing in Ontario, Canada.
    Methods: A cost-effectiveness analysis was conducted using a discrete event simulation from a public payer perspective. Six strategies involving ES or GS were compared. Outcomes reported were direct medical costs, number of molecular diagnoses, number of positive findings, and number of active treatment changes.
    Results: If ES was used as a second-tier test (after the current first-tier, chromosomal microarray, fails to provide a diagnosis), it would be less costly and more effective than standard testing (CAN$6357 [95% CI: 6179-6520] vs. CAN$8783 per patient [95% CI: 2309-31,123]). If ES was used after standard testing, it would cost an additional CAN$15,228 to identify the genetic diagnosis for one additional patient compared with standard testing. The results remained robust when parameters and assumptions were varied.
    Conclusion: ES would likely be cost-saving if used earlier in the diagnostic pathway.
    MeSH term(s) Abnormalities, Multiple ; Child ; Cost-Benefit Analysis ; Developmental Disabilities/diagnosis ; Developmental Disabilities/genetics ; Humans ; Ontario ; Whole Exome Sequencing
    Language English
    Publishing date 2020-10-28
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1455352-1
    ISSN 1530-0366 ; 1098-3600
    ISSN (online) 1530-0366
    ISSN 1098-3600
    DOI 10.1038/s41436-020-01012-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Challenges in Diagnosing Rare Genetic Causes of Common In Utero Presentations: Report of Two Patients with Mucolipidosis Type II (I-Cell Disease).

    Costain, Gregory / Inbar-Feigenberg, Michal / Saleh, Maha / Yaniv-Salem, Shimrit / Ryan, Greg / Morgen, Eric / Goh, Elaine S / Nishimura, Gen / Chitayat, David

    Journal of pediatric genetics

    2018  Volume 7, Issue 3, Page(s) 134–137

    Abstract: Traditional approaches to prenatal genetic diagnosis for common presentations such as short femurs or intrauterine growth restriction are imperfect, and whole-exome sequencing is an emerging option. Mucolipidosis type II (I-cell disease) is an ultra-rare ...

    Abstract Traditional approaches to prenatal genetic diagnosis for common presentations such as short femurs or intrauterine growth restriction are imperfect, and whole-exome sequencing is an emerging option. Mucolipidosis type II (I-cell disease) is an ultra-rare autosomal recessive lysosomal storage disorder with the potential for prenatal-onset skeletal and placental manifestations. We describe the prenatal signs in two recent unrelated patients with confirmed diagnoses soon after birth. In both cases, parents were consanguineous but there was no known family history of mucolipidosis type II. False reassurance was provided after negative testing for another disease with overlapping prenatal manifestations already present in one of the families, emphasizing that offspring of consanguineous parents can be at risk for more than one recessive condition. Our experience illustrates the potential advantages in expanding prenatal applications of WES for the identification of rare single gene disorders in offspring of consanguineous unions.
    Language English
    Publishing date 2018-03-09
    Publishing country Germany
    Document type Case Reports
    ISSN 2146-4596
    ISSN 2146-4596
    DOI 10.1055/s-0038-1636995
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Loss of symmetric cell division of apical neural progenitors drives

    Banks, Emily / Francis, Vincent / Lin, Sheng-Jia / Kharfallah, Fares / Fonov, Vladimir / Levesque, Maxime / Han, Chanshuai / Kulasekaran, Gopinath / Tuznik, Marius / Bayati, Armin / Al-Khater, Reem / Alkuraya, Fowzan S / Argyriou, Loukas / Babaei, Meisam / Bahlo, Melanie / Bakhshoodeh, Behnoosh / Barr, Eileen / Bartik, Lauren / Bassiony, Mahmoud /
    Bertrand, Miriam / Braun, Dominique / Buchert, Rebecca / Budetta, Mauro / Cadieux-Dion, Maxime / Calame, Daniel / Cope, Heidi / Cushing, Donna / Efthymiou, Stephanie / Elmaksoud, Marwa A / El Said, Huda G / Froukh, Tawfiq / Gill, Harinder K / Gleeson, Joseph G / Gogoll, Laura / Goh, Elaine S-Y / Gowda, Vykuntaraju K / Haack, Tobias B / Hashem, Mais O / Hauser, Stefan / Hoffman, Trevor L / Hogue, Jacob S / Hosokawa, Akimoto / Houlden, Henry / Huang, Kevin / Huynh, Stephanie / Karimiani, Ehsan G / Kaulfuß, Silke / Korenke, G Christoph / Kritzer, Amy / Lee, Hane / Lupski, James R / Marco, Elysa J / McWalter, Kirsty / Minassian, Arakel / Minassian, Berge A / Murphy, David / Neira-Fresneda, Juanita / Northrup, Hope / Nyaga, Denis / Oehl-Jaschkowitz, Barbara / Osmond, Matthew / Person, Richard / Pehlivan, Davut / Petree, Cassidy / Sadleir, Lynette G / Saunders, Carol / Schoels, Ludger / Shashi, Vandana / Spillman, Rebecca C / Srinivasan, Varunvenkat M / Torbati, Paria N / Tos, Tulay / Zaki, Maha S / Zhou, Dihong / Zweier, Christiane / Trempe, Jean-François / Durcan, Thomas M / Gan-Or, Ziv / Avoli, Massimo / Alves, Cesar / Varshney, Guarav K / Maroofian, Reza / Rudko, David A / McPherson, Peter S

    medRxiv : the preprint server for health sciences

    2024  

    Abstract: Developmental and epileptic encephalopathies (DEEs) are a heterogenous group of epilepsies in which altered brain development leads to developmental delay and seizures, with the epileptic activity further negatively impacting neurodevelopment. ... ...

    Abstract Developmental and epileptic encephalopathies (DEEs) are a heterogenous group of epilepsies in which altered brain development leads to developmental delay and seizures, with the epileptic activity further negatively impacting neurodevelopment. Identifying the underlying cause of DEEs is essential for progress toward precision therapies. Here we describe a group of individuals with biallelic variants in
    Language English
    Publishing date 2024-01-31
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2022.08.23.22278845
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Challenges in Diagnosing Rare Genetic Causes of Common In Utero Presentations: Report of Two Patients with Mucolipidosis Type II (I-Cell Disease)

    Costain, Gregory / Inbar-Feigenberg, Michal / Saleh, Maha / Yaniv-Salem, Shimrit / Ryan, Greg / Morgen, Eric / Goh, Elaine S. / Nishimura, Gen / Chitayat, David

    Journal of Pediatric Genetics

    2018  Volume 07, Issue 03, Page(s) 134–137

    Abstract: Traditional approaches to prenatal genetic diagnosis for common presentations such as short femurs or intrauterine growth restriction are imperfect, and whole-exome sequencing is an emerging option. Mucolipidosis type II (I-cell disease) is an ultra-rare ...

    Abstract Traditional approaches to prenatal genetic diagnosis for common presentations such as short femurs or intrauterine growth restriction are imperfect, and whole-exome sequencing is an emerging option. Mucolipidosis type II (I-cell disease) is an ultra-rare autosomal recessive lysosomal storage disorder with the potential for prenatal-onset skeletal and placental manifestations. We describe the prenatal signs in two recent unrelated patients with confirmed diagnoses soon after birth. In both cases, parents were consanguineous but there was no known family history of mucolipidosis type II. False reassurance was provided after negative testing for another disease with overlapping prenatal manifestations already present in one of the families, emphasizing that offspring of consanguineous parents can be at risk for more than one recessive condition. Our experience illustrates the potential advantages in expanding prenatal applications of WES for the identification of rare single gene disorders in offspring of consanguineous unions.
    Keywords lysosomal storage disease ; mucolipidosis ; prenatal diagnosis ; genetic testing ; skeletal dysplasia
    Language English
    Publishing date 2018-03-09
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2146-460X ; 2146-4596
    ISSN (online) 2146-460X
    ISSN 2146-4596
    DOI 10.1055/s-0038-1636995
    Database Thieme publisher's database

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  8. Article ; Online: New insights into the clinical and molecular spectrum of the novel CYFIP2-related neurodevelopmental disorder and impairment of the WRC-mediated actin dynamics.

    Begemann, Anaïs / Sticht, Heinrich / Begtrup, Amber / Vitobello, Antonio / Faivre, Laurence / Banka, Siddharth / Alhaddad, Bader / Asadollahi, Reza / Becker, Jessica / Bierhals, Tatjana / Brown, Kathleen E / Bruel, Ange-Line / Brunet, Theresa / Carneiro, Maryline / Cremer, Kirsten / Day, Robert / Denommé-Pichon, Anne-Sophie / Dyment, Dave A / Engels, Hartmut /
    Fisher, Rachel / Goh, Elaine S / Hajianpour, M J / Haertel, Lucia Ribeiro Machado / Hauer, Nadine / Hempel, Maja / Herget, Theresia / Johannsen, Jessika / Kraus, Cornelia / Le Guyader, Gwenaël / Lesca, Gaetan / Mau-Them, Frédéric Tran / McDermott, John Henry / McWalter, Kirsty / Meyer, Pierre / Õunap, Katrin / Popp, Bernt / Reimand, Tiia / Riedhammer, Korbinian M / Russo, Martina / Sadleir, Lynette G / Saenz, Margarita / Schiff, Manuel / Schuler, Elisabeth / Syrbe, Steffen / Van der Ven, Amelie Theresa / Verloes, Alain / Willems, Marjolaine / Zweier, Christiane / Steindl, Katharina / Zweier, Markus / Rauch, Anita

    Genetics in medicine : official journal of the American College of Medical Genetics

    2020  Volume 23, Issue 3, Page(s) 543–554

    Abstract: Purpose: A few de novo missense variants in the cytoplasmic FMRP-interacting protein 2 (CYFIP2) gene have recently been described as a novel cause of severe intellectual disability, seizures, and hypotonia in 18 individuals, with p.Arg87 substitutions ... ...

    Abstract Purpose: A few de novo missense variants in the cytoplasmic FMRP-interacting protein 2 (CYFIP2) gene have recently been described as a novel cause of severe intellectual disability, seizures, and hypotonia in 18 individuals, with p.Arg87 substitutions in the majority.
    Methods: We assembled data from 19 newly identified and all 18 previously published individuals with CYFIP2 variants. By structural modeling and investigation of WAVE-regulatory complex (WRC)-mediated actin polymerization in six patient fibroblast lines we assessed the impact of CYFIP2 variants on the WRC.
    Results: Sixteen of 19 individuals harbor two previously described and 11 novel (likely) disease-associated missense variants. We report p.Asp724 as second mutational hotspot (4/19 cases). Genotype-phenotype correlation confirms a consistently severe phenotype in p.Arg87 patients but a more variable phenotype in p.Asp724 and other substitutions. Three individuals with milder phenotypes carry putative loss-of-function variants, which remain of unclear pathogenicity. Structural modeling predicted missense variants to disturb interactions within the WRC or impair CYFIP2 stability. Consistent with its role in WRC-mediated actin polymerization we substantiate aberrant regulation of the actin cytoskeleton in patient fibroblasts.
    Conclusion: Our study expands the clinical and molecular spectrum of CYFIP2-related neurodevelopmental disorder and provides evidence for aberrant WRC-mediated actin dynamics as contributing cellular pathomechanism.
    MeSH term(s) Actins/genetics ; Adaptor Proteins, Signal Transducing/metabolism ; Humans ; Intellectual Disability/genetics ; Neurodevelopmental Disorders/genetics ; Seizures
    Chemical Substances Actins ; Adaptor Proteins, Signal Transducing ; CYFIP2 protein, human
    Language English
    Publishing date 2020-11-05
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1455352-1
    ISSN 1530-0366 ; 1098-3600
    ISSN (online) 1530-0366
    ISSN 1098-3600
    DOI 10.1038/s41436-020-01011-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Molecular characterization of NRXN1 deletions from 19,263 clinical microarray cases identifies exons important for neurodevelopmental disease expression.

    Lowther, Chelsea / Speevak, Marsha / Armour, Christine M / Goh, Elaine S / Graham, Gail E / Li, Chumei / Zeesman, Susan / Nowaczyk, Malgorzata J M / Schultz, Lee-Anne / Morra, Antonella / Nicolson, Rob / Bikangaga, Peter / Samdup, Dawa / Zaazou, Mostafa / Boyd, Kerry / Jung, Jack H / Siu, Victoria / Rajguru, Manjulata / Goobie, Sharan /
    Tarnopolsky, Mark A / Prasad, Chitra / Dick, Paul T / Hussain, Asmaa S / Walinga, Margreet / Reijenga, Renske G / Gazzellone, Matthew / Lionel, Anath C / Marshall, Christian R / Scherer, Stephen W / Stavropoulos, Dimitri J / McCready, Elizabeth / Bassett, Anne S

    Genetics in medicine : official journal of the American College of Medical Genetics

    2016  Volume 19, Issue 1, Page(s) 53–61

    Abstract: Purpose: The purpose of the current study was to assess the penetrance of NRXN1 deletions.: Methods: We compared the prevalence and genomic extent of NRXN1 deletions identified among 19,263 clinically referred cases to that of 15,264 controls. The ... ...

    Abstract Purpose: The purpose of the current study was to assess the penetrance of NRXN1 deletions.
    Methods: We compared the prevalence and genomic extent of NRXN1 deletions identified among 19,263 clinically referred cases to that of 15,264 controls. The burden of additional clinically relevant copy-number variations (CNVs) was used as a proxy to estimate the relative penetrance of NRXN1 deletions.
    Results: We identified 41 (0.21%) previously unreported exonic NRXN1 deletions ascertained for developmental delay/intellectual disability that were significantly greater than in controls (odds ratio (OR) = 8.14; 95% confidence interval (CI): 2.91-22.72; P < 0.0001). Ten (22.7%) of these had a second clinically relevant CNV. Subjects with a deletion near the 3' end of NRXN1 were significantly more likely to have a second rare CNV than subjects with a 5' NRXN1 deletion (OR = 7.47; 95% CI: 2.36-23.61; P = 0.0006). The prevalence of intronic NRXN1 deletions was not statistically different between cases and controls (P = 0.618). The majority (63.2%) of intronic NRXN1 deletion cases had a second rare CNV at a prevalence twice as high as that for exonic NRXN1 deletion cases (P = 0.0035).
    Conclusions: The results support the importance of exons near the 5' end of NRXN1 in the expression of neurodevelopmental disorders. Intronic NRXN1 deletions do not appear to substantially increase the risk for clinical phenotypes.Genet Med 19 1, 53-61.
    MeSH term(s) Calcium-Binding Proteins ; Cell Adhesion Molecules, Neuronal/genetics ; Child ; DNA Copy Number Variations ; Exons/genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Introns/genetics ; Male ; Microarray Analysis ; Nerve Tissue Proteins/genetics ; Neural Cell Adhesion Molecules ; Neurodevelopmental Disorders/epidemiology ; Neurodevelopmental Disorders/genetics ; Neurodevelopmental Disorders/physiopathology ; Penetrance ; Phenotype ; Sequence Deletion
    Chemical Substances Calcium-Binding Proteins ; Cell Adhesion Molecules, Neuronal ; NRXN1 protein, human ; Nerve Tissue Proteins ; Neural Cell Adhesion Molecules
    Language English
    Publishing date 2016-05-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1455352-1
    ISSN 1530-0366 ; 1098-3600
    ISSN (online) 1530-0366
    ISSN 1098-3600
    DOI 10.1038/gim.2016.54
    Database MEDical Literature Analysis and Retrieval System OnLINE

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