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Zayed S, Goodman C, Mutsaers A, Palma D, Velker V, Laba J, Nguyen T. Evaluating the Oncology Research Internship (ORIoN) during the COVID-19 Pandemic: A Comparison of Virtual and In-Person Iterations. Int J Radiat Oncol Biol Phys 2022. [PMCID: PMC9595455 DOI: 10.1016/j.ijrobp.2022.07.1789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Purpose/Objective(s) The Oncology Research Internship (ORIoN), a novel resident-supervised initiative for medical students (MS), was first established in 2018 and found to be mutually beneficial to both residents and MS. The COVID-19 pandemic halted many scholarly programs, including ORIoN, which relied heavily on mentorship through in-person interactions. We report results of the first virtual program, adapted to the COVID-19 pandemic, and compare participant feedback to previous in-person iterations. Materials/Methods ORIoN application details were published online and emailed to first- and second-year MS. A panel of 3 physicians reviewed and scored applications independently. Successful MS applicants were paired with volunteer resident supervisors; each pair supervised by a staff oncologist. Compared to previous years, all meetings, correspondences and presentations between MS, residents, and supervising oncologists were conducted exclusively remotely. Only chart reviews were conducted on-site by MS. At the program's conclusion, each MS delivered a live virtual oral presentation of their completed case report, previously done in-person. Resident and MS participants completed questionnaires pre-/post program. Responses were collected on a 5-point Likert scale with open-ended free-text responses. Survey results from this virtual and the previous in-person programs were compared. Results Of 54 applications (previously 32 in 2018), 9 MS (three first-year, six second-year) were accepted and assigned to 9 volunteer residents (6 radiation oncology, 2 medical oncology, 1 pathology). To date, 9 manuscripts have been completed with 2 submitted for publication (1 published, 1 under review). Survey response rates were 100% (9/9) for residents and 89% (8/9) for MS. In the post-program surveys comparing the virtual and prior in-person programs, 87.5% (7/8) MS felt comfortable completing a clinical research project (22% strongly agree (SA), 62.5% agree (A), previously 25% and 75% respectively) and 100% (8/8) felt comfortable writing a case report (50% SA, 50% A, previously 75%, 25% respectively). All MS felt comfortable giving an oral research presentation (37.5% SA, 62.5% A) and teaching another MS to complete a case report (37.5% SA, 50% A). Similar to the in-person program, MS unanimously agreed that ORIoN was a beneficial experience (100%) and felt the program contributed to their career goals (100%, previously 88%). Post-program, all residents felt comfortable as a supervisor (67% SA, 22% A, previously 33%, 67% respectively), reviewing manuscripts (56% SA, 33% A, previously 33%, 50% respectively) and providing constructive feedback to trainees (67% SA, 33% A, previously 17%, 67% respectively). Conclusion Compared to the previous in-person program, the virtual ORIoN retained strongly favorable ratings from MS and residents alike. These findings support adapting similar scholarly and mentorship programs to a virtual setting when in-person interactions are not feasible.
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Lee K, Stackhouse C, Anderson J, Bash R, Yue Z, Nguyen T, Eustace N, Ianov L, Langford C, Wang J, Xing C, Yang E, Hjelmeland A, Miller C, Chen J, Gillespie G, Willey C. Deploying a Systems Biology Approach to Identify Drivers of Radiation Resistance in Glioblastoma Multiforme (GBM) Patient-Derived Xenograft (PDX) Models. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Boyd G, Nguyen T, Efstathiou J, Kamran S, Zietman A, Miyamoto D, Wang Y. Dosimetric Analysis of Radiation Treatment Plans Based on a Deep Learning Auto Contouring Model for Patients with Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Purnat TD, Ishizumi A, Yau B, White B, Bertrand-Ferrandis C, Briand S, Nguyen T. Delivering actionable infodemic insights and recommendations for the COVID-19 pandemic response. Eur J Public Health 2022; 32:ckac129.645. [PMCID: PMC9593848 DOI: 10.1093/eurpub/ckac129.645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024] Open
Abstract
Issue The COVID-19 pandemic and current recovery efforts have been complicated by a parallel infodemic. The infodemic has manifested itself in the rapid spread of questions, concerns and misinformation that can affect population attitudes and behavior harmful to health -promoting stigma and discrediting science, non-recommended treatments and cures, politicizing health programs and eroding trust in health workers and health systems. Description WHO's COVID-19 Pillar 2 (risk communication, community engagement and infodemic management) developed an integrated public health infodemic insights methodology for weekly analysis of social media, traditional media and other data sources to identify, categorize, and understand the key concerns and narratives expressed, and inform risk communication and response activities. Results The infodemic characterization, integrated analysis and insights generation consisted of a 3-step mixed-methods approach. First, data was collected from publicly available social and news media and categorized into categories of conversations by a COVID-19 public health taxonomy. Second, the dataset was analyzed and compared week-on-week to identify changes in narratives and conversation sentiment. Third, the digital infodemic intelligence was reviewed by a group of subject matter experts and triangulated with other data sources to derive infodemic insights and provide recommendations for action for the week. The methodology has been applied to inform COVID-19 response, COVID-19 vaccine demand promotion, and preparing for mass gatherings or mass immunization campaigns. Lessons The methodology for infodemic intelligence generation and integration has introduced evidence-based analytical practices for generation of infodemic insights and recommendations for action into the work of WHO. It must be further adapted for use by different health programmes and preparedness functions, and is described WHO Field Infodemiology Manual. Key messages • Health authorities can use infodemic insights to respond to people’s concerns, questions and information deficits in a timely and effective manner. • An evidence-based methodology has been developed and validated to generate infodemic insights and recommendations for action during an acute health event or emergency.
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Ludolph R, Takahashi R, Nguyen T, Briand S. The WHO initiative to measure the effectiveness and impact of PHSM – key activities in 2022. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The presentation will focus on two main outcomes of the WHO initiative: a global research agenda to steer future evidence generation on PHSM, and a central monitoring system for PHSM research. In September 2021, a global technical consultation with over 60 global experts was organized to review the existing evidence on PHSM and identify the initiative's priorities. The consultation provided an opportunity to have an initial discussion on potential research priorities. This became the basis for an iterative online consultation process. The draft research agenda includes seven main research themes including effectiveness, unintended consequences, methodological challenges and implementation considerations affecting the uptake of and adherence to PHSM. Workshop participants will be invited to comment on the suggested themes and propose additional priority questions for the research agenda. The central research monitoring system will consist of a global repository of primary studies and reviews investigating the effectiveness and broader multisectoral impact of PHSM. Indexed studies will be mapped against the key themes of the research agenda, facilitating real-time monitoring and evaluation of its progress. An AI-based mechanism for automated updating of systematic reviews will complement the database. This one-stop shop will allow researchers and decision-makers worldwide to access the latest evidence on PHSM and keep track of the synthesized effectiveness and impact of different interventions and combinations. The platform will further provide a protected working interface. This monitoring system for PHSM research enables timely access to and utilization of evidence indecision-making processes during health emergencies and fosters international collaboration on the analysis and interpretation of data. Workshop participants will be invited to review the alpha version of the platform.
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Ishizumi A, Purnat T, Ludolph R, Cecchini S, Yau B, Bertrand-Ferrandis C, Briand S, Nguyen T. Infodemic management for public health practitioners: landscape analysis and practical tools. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Issue
Infodemics (i.e., overflow of information in physical and digital spaces that makes it difficult for people to make good health decisions) can undermine emergency response, but capacity for infodemic management has been limited in countries thus far. Specifically, there is a need to build capacities in the field with practical and scalable tools.
Description of the problem
WHO has developed tools and trainings to quickly build and enhance infodemic management (IM) capacity at the country-level, such as tools for rapid generation of IM insights and a framework for conducting landscape analyses to establish sustainable IM capacities. These were developed in collaboration with multidisciplinary experts who provided feedback. We sought to create tools that can be a basis for introducing evidence-generation in health information systems to inform emergency preparedness and response, and mainstream methods into routine infodemic diagnostics activities.
Results
The tools and trainings provide a comprehensive framework for diagnosing and addressing infodemics, such as a public health taxonomy to guide digital intelligence analysis and integrated analysis methods for generation of actionable insights. Additionally, the landscape analysis framework outlines steps for assessing strategic needs and assets for routinizing IM functions as part of existing public health systems and programs.
Lessons
The tools and trainings will be deployed in the field to evaluate utility. Feedback from users in the global WHO infodemic manager community will be systematically captured.
Key messages
• Field responders need practical tools and trainings that guide quick infodemic response during health emergencies.
• These tools and trainings can be used to diagnose and intervene on infodemics, even in settings where infodemic insights units are not yet established.
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Ishizumi A, Dunn AG, Purnat T, Yau B, Bertrand-Ferrandis C, White B, Briand S, Nguyen T. Measuring the burden of infodemics on health outcomes through harmonized global metrics. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Issue/problem
Infodemics happen when an excess of information makes it difficult for people to discern what they see and hear to make good health decisions. Several challenges limit the usefulness of applying infodemiology research to the practice of managing infodemics including inconsistency in how information exposure is measured and a lack of focus on assessing associations with health behaviors.
Description of the problem
In 2021, WHO partnered with the University of Sydney to develop a study toolkit. We sought to create novel tools for measuring information exposure that can be easily deployed, linked to surveys measuring health behaviors, and implements a standardized study protocol so that data can be directly synthesized into a global analysis of information risk factors associated with health behaviors.
Results
A web-based study platform was developed, comprising tools for capturing information exposures within studies that link to health behavior surveys. The first tool is a smartphone application that asks users to actively record relevant information they see or hear in diary. The second application is a web browser plugin that passively tracks webpages with relevant keywords. Because localized studies follow a standardized protocol and de-identified participant data are recorded in a common format, local study investigators can opt-in to contributing study data to support global surveillance efforts.
Lessons
Through standardization of measurement tools and relevant study protocols, the toolkit can be used to quickly collect and synthesize data for global or regional analysis of infodemics, including in Europe. Validation of the toolkit in the field is needed to inform its open-source release.
Key messages
• A toolkit for measuring information risk factors associated with behavioral outcomes was developed.
• Global collaboration using the toolkit can improve synthesisability of studies investigating infodemic burden of disease.
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Ho D, Vu L, Nguyen Van T, Nguyen T. Great Safety and Efficacy of a New Drug-eluting-stent manufactured in a developing country at minimal cost: the VSTENT at 3 years follow-up. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In the care patients with coronary artery disease, a new drug-eluting stent, the VSTENT, covered with sirolimus was designed and manufactured in a developing country at minimal cost. Beside the clinical concern, from an engineering perspective, the questions were: Was this stent flexible? What was its radial strength? Did this stent brace itself against the wall with a strong strut network? What was the cell size and design?
Methods
From 6.2019 to 8.2020, 150 patients from 5 hospitals underwent PCI with a new VSTENT in 212 lesions. At the index PCI (D1), a subgroup of 61 patients (40%) was preselected to undergo additional imaging procedures including intravascular ultrasound (IVUS=41) or optical coherence tomography (OCT=20). All patients were followed-up clinically every month for one year. At 6 months (D180) they underwent digital subtraction angiography (DSA=143) or a second IVUS or OCT for the intravascular subgroup. The rate of invasive imaging follow-up was 95% for DSA, 92% for IVUS and 95% for OCT. The rate of major adverse cardiovascular events (MACE: mortality, in-stent restenosis (ISR), Target lesion revascularization (TLR) and data on radial strength, longitudinal flexibility, expansion and coverage were calculated.
Results
In all patients, the technical success was 100% (successful balloon inflation, complete stent expansion, uneventful balloon removal). The VSTENTs were deployed in arteries of all sizes: small with diameter (D) = 2.5mm in 11.3%, D= 2.75mm in 24.1%, and in large arteries D= or >3mm in 66.6% of patients. The stent length varied from 15–38mm with 80% >20mm. 92% had good apposition as evidenced by OCT or IVUS. There was no acute in-stent thrombus, no loss of side branch and no perforation. There was one cardiac arrest with successful resuscitation. The bench and angiographic data on radial strength, longitudinal flexibility, expansion and coverage were excellent
In Figure 1, The VSTENT design has open cells in the middle and closed cell at both distal segments. This design of mixed closed and open cell increases the radial strength at both ends while preventing the diametric difference (dog-boning effect)
In Figure 2, after deployment of a VSTENT, the size of the open cell design in the middle of the stent is approximately 3.40 mm2 while the size of the distal closed cells design is 1.7 mm2.
At 6 months, the rate of angiographic ISR inside the stent and within the 5 mm from the two ends was 3.5%. The rate of late lumen loss was 0.8mm in the in-stent segment and 0.07mm within 5mm of the two ends. The composite MACE was 4.7% with 1 mortality (0.7%) and 4 TLRs. At 36 months follow-up, only one TLR was reported.
Conclusions
At 3 years follow-up, the rate of angiographic ISR and TLR of the VSTENT was low. The data on radial strength, longitudinal flexibility, expansion and coverage were excellent. The VSTENT could be an affordable choice for interventional cardiology service in developing countries.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): United Healthcare
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Hsu W, Nguyen T, Le T, Pham T, Le T, Dang C, Nguyen B, Vu P, Cao T, Vu L, Talarico E. What are the ideal systolic and diastolic blood pressure which do not injure the intima of iliac and coronary arteries? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
For patients with coronary artery disease, hypertension (HTN) is a major risk factor. How could uncontrolled HTN start atherosclerosis? In our prior research, laminar flow in coronary arteries prevented the formation of plaques while turbulent flow injured the intima and triggered atherosclerosis. In this present study our question was: Which blood pressure (BP) level is optimal in not producing turbulence and so not injuring the intima?
Methods
At first, a systolic BP<120mmHg and diastolic BP<75mmHg) were arbitrarily set as controlled (group A) while a BP of >160/105mmHg as uncontrolled (group B). All patients underwent a dynamic coronary angiogram recorded at 15 images/second or 0.06 seconds per image. The first image was of the index artery completely filled with contrast. In subsequent images the blood in white color moved in over a background of black contrast (Figure 1A). In 1B, 0.06 seconds later, the blood arrived at the mid segment (white arrow). In 1C, the flood moved forward, however there was darker contrast hanging at the mid segment, marking the location of collision from the retrograde against the antegrade flow (white arrow). The reason was that in uncontrolled BP the contraction of the left ventricle was stronger so in systole, the coronary blood could reverse its course, run on a retrograde direction, collide against the antegrade flow and create turbulence (1C).
At the end, before deploying a vascular closure device, an iliac angiogram was performed. In Figure 2, on a black background of contrast, the blood in white color moved forward with a pointed tip of laminar flow. 0.06 seconds later, the laminar tip was stopped abruptly with all the layers recoiling on each other like a falling stack of dominoes. In the next image. a large swirl of disorganized mixing of blood and contrast suggested the presence of turbulence caused by the collision.
The data to be collected were (1) the duration of the antegrade and retrograde flow, (2) duration of the collision (turbulence at the collision site)
Results
In the group A (BP <120/75 mmHg), 90% of 20 patients had no retrograde flow nor collision in the iliac and short collision in coronary arteries (<0.12 secs). In 30 patients of group B (BP >160/105 mmHg), the duration of retrograde flow and collision in the iliac artery were prolonged at >0.24 msecs. In the coronary arteries, the duration was prolonged at 0.18 msecs (all p<0.05 compared with group A). These locations of turbulence correlated with the location of plaques in our prior studies.
Conclusion
In patients with uncontrolled HTN, the retrograde flow was prolonged, and the turbulence was intense. In contrary, for patients with controlled BP, there was no retrograde flow and weaker collision in coronary arteries. The results suggest that a BP of <120/75 mmHg may not trigger the atherosclerotic process. New clinical trials with larger number of patients should be performed in search for the lowest ideal blood pressure.
Funding Acknowledgement
Type of funding sources: None.
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Wang M, Liu D, Nguyen T, McNamara D, Barlera S, Pileggi S, Mestroni L, Merlo M, Sinagra G, Pinet F, Krejci J, Kilianova A, De Groote P, Weishilboum R, Pereira N. NAV3 is a genetic determinant of myocardial recovery in dilated cardiomyopathy and attenuates cardiac fibrosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A genome-wide association study (GWAS) assessing change in left ventricular ejection fraction (LVEF) in dilated cardiomyopathy (DCM), a surrogate marker of morbidity and mortality in heart failure (HF), had not been performed previously and could provide insight into novel biological pathways that could lead to the development of new drugs that might target myocardial recovery. The presence and extent of cardiac fibrosis in DCM is independently associated with myocardial recovery and cardiovascular mortality.
Purpose
To identify the biological relevance of genetic targets that are associated with change in LVEF in patients with DCM.
Methods
A GWAS was performed using DNA from 686 patients with recent onset DCM who were on standard HF therapy using change in LVEF at a median of 6 months after initial diagnosis. Cultured human cardiac fibroblasts (HCFs) were used as an in vitro model to study the functional and biological relevance of the gene target identified in the GWAS. Specifically, HCFs were transfected with siRNA by using the Lipofectamine™ RNAiMAX Transfection Reagent for gene knockdown (KD). RNA-seq was performed using the Illumina TruSeq protocol with expression analysis conducted with the EdgeR package. Ingenuity Pathway Analysis was used.
Results
A single-nucleotide polymorphism, rs11105445(G>A), mapping to the neuron navigator 3 (NAV3) gene (rs11105445, p=2.37E-07; beta 2.74±0.53) was associated with improvement in LVEF. We performed a phenome-wide association study using data from the UK Biobank and demonstrated that genetic variation in NAV3 was significantly associated with HF mortality (p=3.2E-28), highlighting the potential importance of this gene in HF. Using GTEx data we demonstrated that in LV tissue the minor allele A was associated with ↓NAV3 expression (p=0.03) suggesting that ↓NAV3 expression might be associated with improvement in LVEF. We demonstrated that NAV3 KD significantly ↓TGF-β1 mediated HCF transdifferentiation into myofibroblasts, ↓α-smooth muscle actin (ACTA2) and ↓collagen I (COL1A1), therefore NAV3 KD was anti-fibrotic (see Figure 1), 1a. HCFs treated by vehicle/TGF-β1 after KD of NAV3/ctrl, and ACTA2 and COL1A1 were analyzed by qPCR; 1b. Representative immunofluorescence staining for α-SMA (in green), RNA-seq after NAV3 KD followed by pathway analysis suggested that NAV3 exerted its effect by regulating cell cycle related proteins (Figure 2), 2a. Volcano plot shows significant differentially expressed genes identified by RNA-seq analysis (down-regulated in blue, up-regulated in red); 2b. NAV3 KD significantly increased expression of cell cycle related proteins, which was validated by Western blot.
Conclusions
Decreased expression of NAV3 is associated with myocardial recovery in DCM, most likely due to its anti-fibrotic effect via direct regulation of cell cycle proteins. The role of NAV3 as a novel therapeutic target in DCM needs to be explored.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Mayo Clinic Center for Individualized MedicineMayo Clinic Department of Cardiovascular Medicine
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Kinney E, Kim J, Kalinda T, McCracken C, Gosman A, Stevens D, Stanley N, Nguyen T, Kea B. 310 Emergency Department Oral Anticoagulation Prescribing Practices for Acute Atrial Fibrillation: Pre-Implementation of an Electronic Clinical Decision Support Tool. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Ricciuti B, Alessi JV, Elkrief A, Wang X, Cortellini A, Li YY, Vaz VR, Gupta H, Pecci F, Barrichello A, Lamberti G, Nguyen T, Lindsay J, Sharma B, Felt K, Rodig SJ, Nishino M, Sholl LM, Barbie DA, Negrao MV, Zhang J, Cherniack AD, Heymach JV, Meyerson M, Ambrogio C, Jänne PA, Arbour KC, Pinato DJ, Skoulidis F, Schoenfeld AJ, Awad MM, Luo J. Dissecting the clinicopathologic, genomic, and immunophenotypic correlates of KRAS G12D-mutated non-small-cell lung cancer. Ann Oncol 2022; 33:1029-1040. [PMID: 35872166 PMCID: PMC11006449 DOI: 10.1016/j.annonc.2022.07.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Allele-specific KRAS inhibitors are an emerging class of cancer therapies. KRAS-mutant (KRASMUT) non-small-cell lung cancers (NSCLCs) exhibit heterogeneous outcomes, driven by differences in underlying biology shaped by co-mutations. In contrast to KRASG12C NSCLC, KRASG12D NSCLC is associated with low/never-smoking status and is largely uncharacterized. PATIENTS AND METHODS Clinicopathologic and genomic information were collected from patients with NSCLCs harboring a KRAS mutation at the Dana-Farber Cancer Institute (DFCI), Memorial Sloan Kettering Cancer Center, MD Anderson Cancer Center, and Imperial College of London. Multiplexed immunofluorescence for CK7, programmed cell death protein 1 (PD-1), programmed death-ligand 1 (PD-L1), Foxp3, and CD8 was carried out on a subset of samples with available tissue at the DFCI. Clinical outcomes to PD-(L)1 inhibition ± chemotherapy were analyzed according to KRAS mutation subtype. RESULTS Of 2327 patients with KRAS-mutated (KRASMUT) NSCLC, 15% (n = 354) harbored KRASG12D. Compared to KRASnon-G12D NSCLC, KRASG12D NSCLC had a lower pack-year (py) smoking history (median 22.5 py versus 30.0 py, P < 0.0001) and was enriched in never smokers (22% versus 5%, P < 0.0001). KRASG12D had lower PD-L1 tumor proportion score (TPS) (median 1% versus 5%, P < 0.01) and lower tumor mutation burden (TMB) compared to KRASnon-G12D (median 8.4 versus 9.9 mt/Mb, P < 0.0001). Of the samples which underwent multiplexed immunofluorescence, KRASG12D had lower intratumoral and total CD8+PD1+ T cells (P < 0.05). Among 850 patients with advanced KRASMUT NSCLC who received PD-(L)1-based therapies, KRASG12D was associated with a worse objective response rate (ORR) (15.8% versus 28.4%, P = 0.03), progression-free survival (PFS) [hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.45-2.00, P = 0.003], and overall survival (OS; HR 1.45, 1.05-1.99, P = 0.02) to PD-(L)1 inhibition alone but not to chemo-immunotherapy combinations [ORR 30.6% versus 35.7%, P = 0.51; PFS HR 1.28 (95%CI 0.92-1.77), P = 0.13; OS HR 1.36 (95%CI 0.95-1.96), P = 0.09] compared to KRASnon-G12D. CONCLUSIONS KRASG12D lung cancers harbor distinct clinical, genomic, and immunologic features compared to other KRAS-mutated lung cancers and worse outcomes to PD-(L)1 blockade. Drug development for KRASG12D lung cancers will have to take these differences into account.
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Krishnan S, Niemcyzk G, Parr C, Liu Y, Nguyen T, Avery L, Ducas J, Liu S. IDENTIFYING SOCIAL FACTORS THAT MAY LIMIT EARLY DISCHARGE IN LOW-RISK ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Langenfeld J, Reinhart B, Lyden E, Nguyen T. 70 A Comparative Evaluation of 3D Printed Versus Standard Suture Materials. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Menkovic I, Schampaert E, Champagne M, Hadjis A, Hatem R, Nguyen T, Poulin F, Williams S, Carreau S, Kouz R. PHARMACIST-LED TITRATION CLINIC FOR HFREF MEDICATION : RESULTS FROM ITS FIRST 2 YEARS OF EXISTENCE. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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dos Reis BR, Nguyen T, White RR. PSV-A-3 Insulin in Sheep Under Different Patterns of Heat Stress. J Anim Sci 2022. [DOI: 10.1093/jas/skac247.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Livestock welfare and production are readily affected by thermal environment. However, the coordinate physiological shifts associated with heat stress differ substantially when animals have the opportunity to acclimate to thermal environments, or when night cooling occurs. Although some of these responses to thermal environment change have been characterized within some species, physiological signals in sheep associated with gradual versus drastic changes in ambient temperature have not been well studied. The objective of this study was to investigate changes in insulin concentration in sheep exposed to\ thermal environments representing different patterns of temperature change. We hypothesized that insulin would increase in response to rapidly elevated temperature. Six sheep (Suffolk, Dorset, or Suffolk x Dorset, 74.3 ± 13.3 kg) were assigned to 1 of 2 groups exposed to a cross-over experiment. Groups were assigned to 1 of 2 rooms, where they were housed for 20 d, prior to switching rooms. The thermal environment changed five times per period (every 4 d), starting at thermoneutral (20°C, 27°C, 35°C, 27°C, 20°C) in one room and hot (35°C, 27°C, 20°C, 27°C, 35°C) in the other room. Blood samples were collected via jugular venipuncture on day four of each sampling period. Plasma samples were analyzed for concentrations of insulin and glucagon by using a commercial enzyme-linked immunosorbent assay (Ovine Insulin ELISA kit, Eagle Biosciences Inc, #INO91-K01) per manufacturer’s instructions. Relationships were analyzed as a generalized linear model with insulin concentration as the response variable and temperature, room, period, and animal as fixed effects; 2- and 3-way interactions among temperature, room, and period were also evaluated. Insulin concentration ranged from 0.02 to 0.61 ng/mL, and was significantly influenced by animal (P = 0.044) and the interaction (P =0.004) between room and period. The interaction supports the idea that the pattern of heat loading, so more than absolute heat load modulates physiological adaptation to environment in the short-term
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Luo J, Soosman S, Schenker M, Mazzola E, Voligny E, Smokovich A, Nguyen T, Michael K, Jänne P, Rabin M, Glazer D, Johnson B. EP13.01-006 Safety of Image Guided Research Biopsies in Patients with Thoracic Malignancies. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Wildhagen M, Pudenz T, Nguyen T, Kirschning A, Beutel S. Whole‐cell biocatalytical production of the sesquiterpene presilphiperfolan‐8
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Abbott R, Abbott TD, Acernese F, Ackley K, Adams C, Adhikari N, Adhikari RX, Adya VB, Affeldt C, Agarwal D, Agathos M, Agatsuma K, Aggarwal N, Aguiar OD, Aiello L, Ain A, Ajith P, Albanesi S, Allocca A, Altin PA, Amato A, Anand C, Anand S, Ananyeva A, Anderson SB, Anderson WG, Andrade T, Andres N, Andrić T, Angelova SV, Ansoldi S, Antelis JM, Antier S, Appert S, Arai K, Araya MC, Areeda JS, Arène M, Arnaud N, Aronson SM, Arun KG, Asali Y, Ashton G, Assiduo M, Aston SM, Astone P, Aubin F, Austin C, Babak S, Badaracco F, Bader MKM, Badger C, Bae S, Baer AM, Bagnasco S, Bai Y, Baird J, Ball M, Ballardin G, Ballmer SW, Balsamo A, Baltus G, Banagiri S, Bankar D, Barayoga JC, Barbieri C, Barish BC, Barker D, Barneo P, Barone F, Barr B, Barsotti L, Barsuglia M, Barta D, Bartlett J, Barton MA, Bartos I, Bassiri R, Basti A, Bawaj M, Bayley JC, Baylor AC, Bazzan M, Bécsy B, Bedakihale VM, Bejger M, Belahcene I, Benedetto V, Beniwal D, Bennett TF, Bentley JD, BenYaala M, Bergamin F, Berger BK, Bernuzzi S, Berry CPL, Bersanetti D, Bertolini A, Betzwieser J, Beveridge D, Bhandare R, Bhardwaj U, Bhattacharjee D, Bhaumik S, Bilenko IA, Billingsley G, Bini S, Birney R, Birnholtz O, Biscans S, Bischi M, Biscoveanu S, Bisht A, Biswas B, Bitossi M, Bizouard MA, Blackburn JK, Blair CD, Blair DG, Blair RM, Bobba F, Bode N, Boer M, Bogaert G, Boldrini M, Bonavena LD, Bondu F, Bonilla E, Bonnand R, Booker P, Boom BA, Bork R, Boschi V, Bose N, Bose S, Bossilkov V, Boudart V, Bouffanais Y, Bozzi A, Bradaschia C, Brady PR, Bramley A, Branch A, Branchesi M, Brau JE, Breschi M, Briant T, Briggs JH, Brillet A, Brinkmann M, Brockill P, Brooks AF, Brooks J, Brown DD, Brunett S, Bruno G, Bruntz R, Bryant J, Bulik T, Bulten HJ, Buonanno A, Buscicchio R, Buskulic D, Buy C, Byer RL, Cadonati L, Cagnoli G, Cahillane C, Bustillo JC, Callaghan JD, Callister TA, Calloni E, Cameron J, Camp JB, Canepa M, Canevarolo S, Cannavacciuolo M, Cannon KC, Cao H, Capote E, Carapella G, Carbognani F, Carlin JB, 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Ju L, Junker J, Juste V, Kalaghatgi CV, Kalogera V, Kamai B, Kandhasamy S, Kang G, Kanner JB, Kao Y, Kapadia SJ, Kapasi DP, Karat S, Karathanasis C, Karki S, Kashyap R, Kasprzack M, Kastaun W, Katsanevas S, Katsavounidis E, Katzman W, Kaur T, Kawabe K, Kéfélian F, Keitel D, Key JS, Khadka S, Khalili FY, Khan S, Khazanov EA, Khetan N, Khursheed M, Kijbunchoo N, Kim C, Kim JC, Kim K, Kim WS, Kim YM, Kimball C, Kinley-Hanlon M, Kirchhoff R, Kissel JS, Kleybolte L, Klimenko S, Knee AM, Knowles TD, Knyazev E, Koch P, Koekoek G, Koley S, Kolitsidou P, Kolstein M, Komori K, Kondrashov V, Kontos A, Koper N, Korobko M, Kovalam M, Kozak DB, Kringel V, Krishnendu NV, Królak A, Kuehn G, Kuei F, Kuijer P, Kumar A, Kumar P, Kumar R, Kumar R, Kuns K, Kuwahara S, Lagabbe P, Laghi D, Lalande E, Lam TL, Lamberts A, Landry M, Lane BB, Lang RN, Lange J, Lantz B, La Rosa I, Lartaux-Vollard A, Lasky PD, Laxen M, Lazzarini A, Lazzaro C, Leaci P, Leavey S, Lecoeuche YK, Lee HM, Lee HW, Lee J, Lee K, Lehmann J, Lemaître A, Leroy N, Letendre N, Levesque C, Levin Y, Leviton JN, Leyde K, Li AKY, Li B, Li J, Li TGF, Li X, Linde F, Linker SD, Linley JN, Littenberg TB, Liu J, Liu K, Liu X, Llamas F, Llorens-Monteagudo M, Lo RKL, Lockwood A, London LT, Longo A, Lopez D, Portilla ML, Lorenzini M, Loriette V, Lormand M, Losurdo G, Lott TP, Lough JD, Lousto CO, Lovelace G, Lucaccioni JF, Lück H, Lumaca D, Lundgren AP, Lynam JE, Macas R, MacInnis M, Macleod DM, MacMillan IAO, Macquet A, Hernandez IM, Magazzù C, Magee RM, Maggiore R, Magnozzi M, Mahesh S, Majorana E, Makarem C, Maksimovic I, Maliakal S, Malik A, Man N, Mandic V, Mangano V, Mango JL, Mansell GL, Manske M, Mantovani M, Mapelli M, Marchesoni F, Marion F, Mark Z, Márka S, Márka Z, Markakis C, Markosyan AS, Markowitz A, Maros E, Marquina A, Marsat S, Martelli F, Martin IW, Martin RM, Martinez M, Martinez VA, Martinez V, Martinovic K, Martynov DV, Marx EJ, Masalehdan H, Mason K, Massera E, Masserot A, Massinger TJ, Masso-Reid M, Mastrogiovanni S, Matas A, Mateu-Lucena M, Matichard F, Matiushechkina M, Mavalvala N, McCann JJ, McCarthy R, McClelland DE, McClincy PK, McCormick S, McCuller L, McGhee GI, McGuire SC, McIsaac C, McIver J, McRae T, McWilliams ST, Meacher D, Mehmet M, Mehta AK, Meijer Q, Melatos A, Melchor DA, Mendell G, Menendez-Vazquez A, Menoni CS, Mercer RA, Mereni L, Merfeld K, Merilh EL, Merritt JD, Merzougui M, Meshkov S, Messenger C, Messick C, Meyers PM, Meylahn F, Mhaske A, Miani A, Miao H, Michaloliakos I, Michel C, Middleton H, Milano L, Miller A, Miller AL, Miller B, Millhouse M, Mills JC, Milotti E, Minazzoli O, Minenkov Y, Mir LM, Miravet-Tenés M, Mishra C, Mishra T, Mistry T, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Mo G, Moguel E, Mogushi K, Mohapatra SRP, Mohite SR, Molina I, Molina-Ruiz M, Mondin M, Montani M, Moore CJ, Moraru D, Morawski F, More A, Moreno C, Moreno G, Morisaki S, Mours B, Mow-Lowry CM, Mozzon S, Muciaccia F, Mukherjee A, Mukherjee D, Mukherjee S, Mukherjee S, Mukherjee S, Mukund N, Mullavey A, Munch J, Muñiz EA, Murray PG, Musenich R, Muusse S, Nadji SL, Nagar A, Napolano V, Nardecchia I, Naticchioni L, Nayak B, Nayak RK, Neil BF, Neilson J, Nelemans G, Nelson TJN, Nery M, Neubauer P, Neunzert A, Ng KY, Ng SWS, Nguyen C, Nguyen P, Nguyen T, Nichols SA, Nissanke S, Nitoglia E, Nocera F, Norman M, North C, Nuttall LK, Oberling J, O'Brien BD, O'Dell J, Oelker E, Oganesyan G, Oh JJ, Oh SH, Ohme F, Ohta H, Okada MA, Olivetto C, Oram R, O'Reilly B, Ormiston RG, Ormsby ND, Ortega LF, O'Shaughnessy R, O'Shea E, Ossokine S, Osthelder C, Ottaway DJ, Overmier H, Pace AE, Pagano G, Page MA, Pagliaroli G, Pai A, Pai SA, Palamos JR, Palashov O, Palomba C, Pan H, Panda PK, Pang PTH, Pankow C, Pannarale F, Pant BC, Panther FH, Paoletti F, Paoli A, Paolone A, Park H, Parker W, Pascucci D, Pasqualetti A, Passaquieti R, Passuello D, Patel M, Pathak M, Patricelli B, Patron AS, Paul S, Payne E, Pedraza M, Pegoraro M, Pele A, Penn S, Perego A, Pereira A, Pereira T, Perez CJ, Périgois C, Perkins CC, Perreca A, Perriès S, Petermann J, Petterson D, Pfeiffer HP, Pham KA, Phukon KS, Piccinni OJ, Pichot M, Piendibene M, Piergiovanni F, Pierini L, Pierro V, Pillant G, Pillas M, Pilo F, Pinard L, Pinto IM, Pinto M, Piotrzkowski K, Pirello M, Pitkin MD, Placidi E, Planas L, Plastino W, Pluchar C, Poggiani R, Polini E, Pong DYT, Ponrathnam S, Popolizio P, Porter EK, Poulton R, Powell J, Pracchia M, Pradier T, Prajapati AK, Prasai K, Prasanna R, Pratten G, Principe M, Prodi GA, Prokhorov L, Prosposito P, Prudenzi L, Puecher A, Punturo M, Puosi F, Puppo P, Pürrer M, Qi H, Quetschke V, Quitzow-James R, Raab FJ, Raaijmakers G, Radkins H, Radulesco N, Raffai P, Rail SX, Raja S, Rajan C, Ramirez KE, Ramirez TD, Ramos-Buades A, Rana J, Rapagnani P, Rapol UD, Ray A, Raymond V, Raza N, Razzano M, Read J, Rees LA, Regimbau T, Rei L, Reid S, Reid SW, Reitze DH, Relton P, Renzini A, Rettegno P, Rezac M, Ricci F, Richards D, Richardson JW, Richardson L, Riemenschneider G, Riles K, Rinaldi S, Rink K, Rizzo M, Robertson NA, Robie R, Robinet F, Rocchi A, Rodriguez S, Rolland L, Rollins JG, Romanelli M, Romano R, Romel CL, Romero-Rodríguez A, Romero-Shaw IM, Romie JH, Ronchini S, Rosa L, Rose CA, Rosińska D, Ross MP, Rowan S, Rowlinson SJ, Roy S, Roy S, Roy S, Rozza D, Ruggi P, Ryan K, Sachdev S, Sadecki T, Sadiq J, Sakellariadou M, Salafia OS, Salconi L, Saleem M, Salemi F, Samajdar A, Sanchez EJ, Sanchez JH, Sanchez LE, Sanchis-Gual N, Sanders JR, Sanuy A, Saravanan TR, Sarin N, Sassolas B, Satari H, Sathyaprakash BS, Sauter O, Savage RL, Sawant D, Sawant HL, Sayah S, Schaetzl D, Scheel M, Scheuer J, Schiworski M, Schmidt P, Schmidt S, Schnabel R, Schneewind M, Schofield RMS, Schönbeck A, Schulte BW, Schutz BF, Schwartz E, Scott J, Scott SM, Seglar-Arroyo M, Sellers D, Sengupta AS, Sentenac D, Seo EG, Sequino V, Sergeev A, Setyawati Y, Shaffer T, Shahriar MS, Shams B, Sharma A, Sharma P, Shawhan P, Shcheblanov NS, Shikauchi M, Shoemaker DH, Shoemaker DM, ShyamSundar S, Sieniawska M, Sigg D, Singer LP, Singh D, Singh N, Singha A, Sintes AM, Sipala V, Skliris V, Slagmolen BJJ, Slaven-Blair TJ, Smetana J, Smith JR, Smith RJE, Soldateschi J, Somala SN, Son EJ, Soni K, Soni S, Sordini V, Sorrentino F, Sorrentino N, Soulard R, Souradeep T, Sowell E, Spagnuolo V, Spencer AP, Spera M, Srinivasan R, Srivastava AK, Srivastava V, Staats K, Stachie C, Steer DA, Steinlechner J, Steinlechner S, Stevenson S, Stops DJ, Stover M, Strain KA, Strang LC, Stratta G, Strunk A, Sturani R, Stuver AL, Sudhagar S, Sudhir V, Suh HG, Summerscales TZ, Sun H, Sun L, Sunil S, Sur A, Suresh J, Sutton PJ, Swinkels BL, Szczepańczyk MJ, Szewczyk P, Tacca M, Tait SC, Talbot CJ, Talbot C, Tanasijczuk AJ, Tanner DB, Tao D, Tao L, Martín ENTS, Taranto C, Tasson JD, Tenorio R, Terhune JE, Terkowski L, Thirugnanasambandam MP, Thomas M, Thomas P, Thompson JE, Thondapu SR, Thorne KA, Thrane E, Tiwari S, Tiwari S, Tiwari V, Toivonen AM, Toland K, Tolley AE, Tonelli M, Torres-Forné A, Torrie CI, E Melo IT, Töyrä D, Trapananti A, Travasso F, Traylor G, Trevor M, Tringali MC, Tripathee A, Troiano L, Trovato A, Trozzo L, Trudeau RJ, Tsai DS, Tsai D, Tsang KW, Tse M, Tso R, Tsukada L, Tsuna D, Tsutsui T, Turbang K, Turconi M, Ubhi AS, Udall RP, Ueno K, Unnikrishnan CS, Urban AL, Utina A, Vahlbruch H, Vajente G, Vajpeyi A, Valdes G, Valentini M, Valsan V, van Bakel N, van Beuzekom M, van den Brand JFJ, Van Den Broeck C, Vander-Hyde DC, van der Schaaf L, van Heijningen JV, Vanosky J, van Remortel N, Vardaro M, Vargas AF, Varma V, Vasúth M, Vecchio A, Vedovato G, Veitch J, Veitch PJ, Venneberg J, Venugopalan G, Verkindt D, Verma P, Verma Y, Veske D, Vetrano F, Viceré A, Vidyant S, Viets AD, Vijaykumar A, Villa-Ortega V, Vinet JY, Virtuoso A, Vitale S, Vo T, Vocca H, von Reis ERG, von Wrangel JSA, Vorvick C, Vyatchanin SP, Wade LE, Wade M, Wagner KJ, Walet RC, Walker M, Wallace GS, Wallace L, Walsh S, Wang JZ, Wang WH, Ward RL, Warner J, Was M, Washington NY, Watchi J, Weaver B, Webster SA, Weinert M, Weinstein AJ, Weiss R, Weller CM, Wellmann F, Wen L, Weßels P, Wette K, Whelan JT, White DD, Whiting BF, Whittle C, Wilken D, Williams D, Williams MJ, Williamson AR, Willis JL, Willke B, Wilson DJ, Winkler W, Wipf CC, Wlodarczyk T, Woan G, Woehler J, Wofford JK, Wong ICF, Wu DS, Wysocki DM, Xiao L, Yamamoto H, Yang FW, Yang L, Yang Y, Yang Z, Yap MJ, Yeeles DW, Yelikar AB, Ying M, Yoo J, Yu H, Yu H, Zadrożny A, Zanolin M, Zelenova T, Zendri JP, Zevin M, Zhang J, Zhang L, Zhang T, Zhang Y, Zhao C, Zhao G, Zhao Y, Zhou R, Zhou Z, Zhu XJ, Zimmerman AB, Zucker ME, Zweizig J, Jeong D, Shandera S. Search for Subsolar-Mass Binaries in the First Half of Advanced LIGO's and Advanced Virgo's Third Observing Run. PHYSICAL REVIEW LETTERS 2022; 129:061104. [PMID: 36018635 DOI: 10.1103/physrevlett.129.061104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/18/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
We report on a search for compact binary coalescences where at least one binary component has a mass between 0.2 M_{⊙} and 1.0 M_{⊙} in Advanced LIGO and Advanced Virgo data collected between 1 April 2019 1500 UTC and 1 October 2019 1500 UTC. We extend our previous analyses in two main ways: we include data from the Virgo detector and we allow for more unequal mass systems, with mass ratio q≥0.1. We do not report any gravitational-wave candidates. The most significant trigger has a false alarm rate of 0.14 yr^{-1}. This implies an upper limit on the merger rate of subsolar binaries in the range [220-24200] Gpc^{-3} yr^{-1}, depending on the chirp mass of the binary. We use this upper limit to derive astrophysical constraints on two phenomenological models that could produce subsolar-mass compact objects. One is an isotropic distribution of equal-mass primordial black holes. Using this model, we find that the fraction of dark matter in primordial black holes in the mass range 0.2 M_{⊙}<m_{PBH}<1.0 M_{⊙} is f_{PBH}≡Ω_{PBH}/Ω_{DM}≲6%. This improves existing constraints on primordial black hole abundance by a factor of ∼3. The other is a dissipative dark matter model, in which fermionic dark matter can collapse and form black holes. The upper limit on the fraction of dark matter black holes depends on the minimum mass of the black holes that can be formed: the most constraining result is obtained at M_{min}=1 M_{⊙}, where f_{DBH}≡Ω_{DBH}/Ω_{DM}≲0.003%. These are the first constraints placed on dissipative dark models by subsolar-mass analyses.
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Nadesapillai S, Peek R, Nguyen T, Vassart S, Smeets D, Van de Zande G, Braat D, Van der Velden J, Fleischer K, Dolmans MM. O-034 Xenotransplantation of ovarian cortex tissue from young girls with Turner Syndrome in a mice model: is normal follicular development possible? Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does aneuploidy of granulosa and stromal cells affect folliculogenesis of small follicles in girls with mosaic Turner Syndrome (TS)?
Summary answer
Our results showed that despite high level aneuploidy in granulosa cells of small follicles and stromal cells folliculogenesis was not affected in mosaic TS patients.
What is known already
In 2018 the TurnerFertility study was initiated to explore if ovarian tissue cryopreservation (OTC) is a viable option for TS patients to preserve their fertility at an early age. In this study, karyotyping of ovarian cells in 7 mosaic TS patients showed that the majority of oocytes had a normal X chromosomal content, while granulosa and stromal cells were aneuploid. Until now, it remains unclear if follicular development is affected, and consequently the success rate of autotransplantation after OTC in girls with TS.
Study design, size, duration
A collaboration project was initiated between Radboudumc, The Netherlands and UCLouvain, Belgium to assess folliculogenesis of small follicles in TS patients by using a xenograft mice model. Ovarian cortex tissue was obtained from 18 mosaic TS patients and 13 age-matched controls.
Participants/materials, setting, methods
After unilateral ovariectomy, one fragment of the ovarian tissue was used for research. One part of this fragment was used for fluorescence in situ hybridization (FISH) to determine the X chromosomal content of ovarian cells in non-grafted tissue. The other part was xenografted into severe combined immunodeficient mice. After 5 months, grafts were retrieved and analysed for aneuploidy by FISH. The expression of 6 proteins essential for folliculogenesis was analysed by immunohistochemistry and immunofluorescence.
Main results and the role of chance
The mean follicle density in ovarian tissue of TS patients before grafting was significantly lower compared to controls. FISH analysis showed that 97% of the oocytes in non-grafted tissue had a normal X chromosomal content. Follicles of TS patients contained mainly or exclusively 45,X granulosa cells, but different levels of X chromosome mosaicism between TS patients and between follicles of the same patient were observed.
In total, 12/18 grafts contained follicles after 5 months xenografting. Follicle density of both TS patients and controls decreased significantly after xenotransplantation. Despite the presence of high level aneuploidy in granulosa and stromal cells in the tissue before grafting, secondary and even antral follicles were observed after xenotransplantation. Remarkably, a shift from high to low percentage of 45,X granulosa cells was observed during folliculogenesis. Immunohistochemistry showed that proliferating cell nuclear antigen (PCNA) positive follicles from TS patients increased during grafting to almost 100%. Secretion of anti-Müllerian hormone by granulosa cells was impaired before grafting in peri/postpubertal TS girls, but recovered after grafting. Expression of c-kit receptor and bone morphogenetic protein 15 (BMP15) in peri/postpubertal TS patients remained abnormal after xenotransplantation, while secretion of growth differentiation factor 9 (GDF9) and kit ligand was similar to controls.
Limitations, reasons for caution
In this study, only ovarian tissue of mosaic TS patients was examined, because the chances of finding ovarian follicles in this subgroup is considerably higher than in other TS patients. Subtle effects of reduced expression of c-kit receptor and BMP15 on folliculogenesis might have gone unnoticed.
Wider implications of the findings
Small follicles of mosaic TS patients are able to grow to secondary and antral follicles, despite the presence of aneuploid granulosa and stromal cells before grafting. Therefore, OTC could be a realistic option for young mosaic TS patients to preserve their fertility provided that sufficient numbers of follicles are present.
Trial registration number
NCT03381300
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Pham H, Le A, Nguyen A, Ha U, Nguyen T, Pham T, Ho T, Vuong L. P-580 Cumulative live birth rate of oocyte in-vitro maturation with a pre-maturation step in women with polycystic ovary syndrome or high antral follicle count. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the cumulative live birth rate (CLBR) at 24 months of women undergoing oocyte in vitro maturation (IVM) a with pre-maturation step (CAPA-IVM)?
Summary answer
The CLBR at 24 months with CAPA-IVM was 38.2%.
What is known already
IVM with a pre-maturation step, known as capacitation IVM (CAPA-IVM) improves the competence of oocytes matured in-vitro by sustaining meiotic arrest to allow the synchronization of cytoplasmic and genetic maturation of the oocytes. Results from a randomized controlled trial showed that CAPA-IVM resulted in a live birth rate after the first transfer of 35.2% which was non-inferior to IVF. There is a lack of data on cumulative live birth following CAPA-IVM.
Study design, size, duration
A multi-center, retrospective study, performed at IVFMD, My Duc Hospital and IVFMD Phu Nhuan, My Duc Phu Nhuan Hospital from 1 January 2017 to 31 December 2019.
Participants/materials, setting, methods
All women with polycystic ovary syndrome (PCOS) or high antral follicle count (AFC) treated with a CAPA-IVM cycle were recruited to the study. All embryos were frozen at day 3. Cumulative live birth was difined as at least one live birth resulting from initiated CAPA-IVM cycle. If the women did not return for embryo transfer, outcomes were followed up until 24 months from aspiration day. Logistic regression was performed to assess which factors predicted CLBR.
Main results and the role of chance
Between 1 January 2019 and 31 December 2019, there were 374 eligible women included in the study, among them, 368 patients had embryos for transfer (98.4%) and six patients had no embryo for transfer (1.6%). A total of 496 frozen embryo transfer (FET) cycles from 368 patients were performed. Mean age and body max index (BMI) were 29.5±3.21 years and 22.3±3.09, respectively. The maturation rate was 63.2%. The median number of embryos was 4.0 [2.00; 6.00]. The cumulative clinical pregnancy rate was 60.4%, cumulative ongoing pregnancy rate was 51.6%. At 24 months after starting the treatment, the CLBR of CAPA-IVM was 38.2%. Multivariate analysis showed that patient age and number of metaphase II oocytes were the predictive factors for cumulative live birth after CAPA-IVM.
Limitations, reasons for caution
The study limitation derives from its retrospective nature. The generalizability of the study may be limited due to the single ethnicity group.
Wider implications of the findings
In patients with PCOS or high AFC, CAPA-IVM was viable and resulted in acceptable CLBR. CAPA-IVM may be the first-line treatment for women with PCOS or high AFC requiring assisted reproduction.
Trial registration number
not applicable
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Crowley E, Turner D, Ma C, Nguyen T, McKay H, Schneider R, Silverberg A, Muise A, Feagan B, Griffiths A, Jairath V. A42 HETEROGENEITY IN EFFICACY AND SAFETY ENDPOINTS FOR PEDIATRIC CLINICAL TRIALS IN INFLAMMATORY BOWEL DISEASE: A NEED FOR HARMONIZATION. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859363 DOI: 10.1093/jcag/gwab049.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
NOT PUBLISHED AT AUTHOR’S REQUEST Funding Agencies: None
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