Jessica C Pickles, Amy R Fairchild, Thomas J Stone, Lorelle Brownlee, Ashirwad Merve, Shireena A Yasin, Aimee Avery, Saira W Ahmed, Olumide Ogunbiyi, Jamie Gonzalez Zapata, Abigail F Peary, Marie Edwards, Lisa Wilkhu, Carryl Dryden, Dariusz Ladon, Mark Kristiansen, Catherine Rowe, Kathreena M Kurian, James A R Nicoll, Clare Mitchell, Tabitha Bloom, David A Hilton, Safa Al-Sarraj, Lawrence Doey, Paul N Johns, Leslie R Bridges, Aruna Chakrabarty, Azzam Ismail, Nitika Rathi, Khaja Syed, G Alistair Lammie, Clara Limback-Stanic, Colin Smith, Antonia Torgersen, Frances Rae, Rebecca M Hill, Steven C Clifford, Yura Grabovska, Daniel Williamson, Matthew Clarke, Chris Jones, David Capper, Martin Sill, Andreas von Deimling, Stefan M Pfister, David T W Jones, Darren Hargrave, Jane Chalker, Thomas S Jacques
{"title":"DNA methylation-based profiling for paediatric CNS tumour diagnosis and treatment: a population-based study.","authors":"Jessica C Pickles, Amy R Fairchild, Thomas J Stone, Lorelle Brownlee, Ashirwad Merve, Shireena A Yasin, Aimee Avery, Saira W Ahmed, Olumide Ogunbiyi, Jamie Gonzalez Zapata, Abigail F Peary, Marie Edwards, Lisa Wilkhu, Carryl Dryden, Dariusz Ladon, Mark Kristiansen, Catherine Rowe, Kathreena M Kurian, James A R Nicoll, Clare Mitchell, Tabitha Bloom, David A Hilton, Safa Al-Sarraj, Lawrence Doey, Paul N Johns, Leslie R Bridges, Aruna Chakrabarty, Azzam Ismail, Nitika Rathi, Khaja Syed, G Alistair Lammie, Clara Limback-Stanic, Colin Smith, Antonia Torgersen, Frances Rae, Rebecca M Hill, Steven C Clifford, Yura Grabovska, Daniel Williamson, Matthew Clarke, Chris Jones, David Capper, Martin Sill, Andreas von Deimling, Stefan M Pfister, David T W Jones, Darren Hargrave, Jane Chalker, Thomas S Jacques","doi":"10.1016/S2352-4642(19)30342-6","DOIUrl":"10.1016/S2352-4642(19)30342-6","url":null,"abstract":"<p><strong>Background: </strong>Marked variation exists in the use of genomic data in tumour diagnosis, and optimal integration with conventional diagnostic technology remains uncertain despite several studies reporting improved diagnostic accuracy, selection for targeted treatments, and stratification for trials. Our aim was to assess the added value of molecular profiling in routine clinical practice and the impact on conventional and experimental treatments.</p><p><strong>Methods: </strong>This population-based study assessed the diagnostic and clinical use of DNA methylation-based profiling in childhood CNS tumours using two large national cohorts in the UK. In the diagnostic cohort-which included routinely diagnosed CNS tumours between Sept 1, 2016, and Sept 1, 2018-we assessed how the methylation profile altered or refined diagnosis in routine clinical practice and estimated how this would affect standard patient management. For the archival cohort of diagnostically difficult cases, we established how many cases could be solved using modern standard pathology, how many could only be solved using the methylation profile, and how many remained unsolvable.</p><p><strong>Findings: </strong>Of 484 patients younger than 20 years with CNS tumours, 306 had DNA methylation arrays requested by the neuropathologist and were included in the diagnostic cohort. Molecular profiling added a unique contribution to clinical diagnosis in 107 (35%; 95% CI 30-40) of 306 cases in routine diagnostic practice-providing additional molecular subtyping data in 99 cases, amended the final diagnosis in five cases, and making potentially significant predictions in three cases. We estimated that it could change conventional management in 11 (4%; 95% CI 2-6) of 306 patients. Among 195 historically difficult-to-diagnose tumours in the archival cohort, 99 (51%) could be diagnosed using standard methods, with the addition of methylation profiling solving a further 34 (17%) cases. The remaining 62 (32%) cases were unresolved despite specialist pathology and methylation profiling.</p><p><strong>Interpretation: </strong>Together, these data provide estimates of the impact that could be expected from routine implementation of genomic profiling into clinical practice, and indicate limitations where additional techniques will be required. We conclude that DNA methylation arrays are a useful diagnostic adjunct for childhood CNS tumours.</p><p><strong>Funding: </strong>The Brain Tumour Charity, Children with Cancer UK, Great Ormond Street Hospital Children's Charity, Olivia Hodson Cancer Fund, Cancer Research UK, and the National Institute of Health Research.</p>","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":"103 1","pages":"121-130"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85840466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Regina Guthold, Gretchen A Stevens, Leanne M Riley, Fiona C Bull
{"title":"Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants.","authors":"Regina Guthold, Gretchen A Stevens, Leanne M Riley, Fiona C Bull","doi":"10.1016/S2352-4642(19)30323-2","DOIUrl":"10.1016/S2352-4642(19)30323-2","url":null,"abstract":"<p><strong>Background: </strong>Physical activity has many health benefits for young people. In 2018, WHO launched More Active People for a Healthier World, a new global action on physical activity, including new targets of a 15% relative reduction of global prevalence of insufficient physical activity by 2030 among adolescents and adults. We describe current prevalence and trends of insufficient physical activity among school-going adolescents aged 11-17 years by country, region, and globally.</p><p><strong>Methods: </strong>We did a pooled analysis of cross-sectional survey data that were collected through random sampling with a sample size of at least 100 individuals, were representative of a national or defined subnational population, and reported prevalence of of insufficient physical activity by sex in adolescents. Prevalence had to be reported for at least three of the years of age within the 10-19-year age range. We estimated the prevalence of insufficient physical activity in school-going adolescents aged 11-17 years (combined and by sex) for individual countries, for four World Bank income groups, nine regions, and globally for the years 2001-16. To derive a standard definition of insufficient physical activity and to adjust for urban-only survey coverage, we used regression models. We estimated time trends using multilevel mixed-effects modelling.</p><p><strong>Findings: </strong>We used data from 298 school-based surveys from 146 countries, territories, and areas including 1·6 million students aged 11-17 years. Globally, in 2016, 81·0% (95% uncertainty interval 77·8-87·7) of students aged 11-17 years were insufficiently physically active (77·6% [76·1-80·4] of boys and 84·7% [83·0-88·2] of girls). Although prevalence of insufficient physical activity significantly decreased between 2001 and 2016 for boys (from 80·1% [78·3-81·6] in 2001), there was no significant change for girls (from 85·1% [83·1-88·0] in 2001). There was no clear pattern according to country income group: insufficient activity prevalence in 2016 was 84·9% (82·6-88·2) in low-income countries, 79·3% (77·2-87·5) in lower-middle-income countries, 83·9% (79·5-89·2) in upper-middle-income countries, and 79·4% (74·0-86·2) in high-income countries. The region with the highest prevalence of insufficient activity in 2016 was high-income Asia Pacific for both boys (89·0%, 62·8-92·2) and girls (95·6%, 73·7-97·9). The regions with the lowest prevalence were high-income western countries for boys (72·1%, 71·1-73·6), and south Asia for girls (77·5%, 72·8-89·3). In 2016, 27 countries had a prevalence of insufficient activity of 90% or more for girls, whereas this was the case for two countries for boys.</p><p><strong>Interpretation: </strong>The majority of adolescents do not meet current physical activity guidelines. Urgent scaling up of implementation of known effective policies and programmes is needed to increase activity in adolescents. Investment and leadership at all levels to","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":"37 6 1","pages":"23-35"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6919336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79907847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Localising movement disorders in childhood.","authors":"N. Bamford, K. McVicar","doi":"10.1016/s2352-4642(19)30330-x","DOIUrl":"https://doi.org/10.1016/s2352-4642(19)30330-x","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84244277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Avoiding a rigid age of paediatrics.","authors":"M. Rigby","doi":"10.1016/S2352-4642(19)30341-4","DOIUrl":"https://doi.org/10.1016/S2352-4642(19)30341-4","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":"1 1","pages":"e14"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84633181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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