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Larios D, Duhaime AC, Kung JH, Gierga D, Ho AY, MacDonald SM, Slutzman J. Using Life Cycle Assessment as a Tool to Evaluate the Environmental Impact of Radiation Oncology and Inform Treatment Decision-Making in Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e595. [PMID: 37785797 DOI: 10.1016/j.ijrobp.2023.06.1950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The effects of climate change negatively impact patient health and healthcare delivery across the cancer care continuum. Environmental impacts arising from radiation therapy (RT), as measured with formal life cycle assessment (LCA) methods, have not been reported to date. LCA is a standardized approach to systematically analyze the effects a product or process has on the environment by accounting for all its components and their life cycle. Here, we used LCA to compare the footprint of RT delivery among several environmental impact categories, including carbon (CO2) emissions, in early-stage breast cancer (ESBC) regimens with clinical equivalency. MATERIALS/METHODS We used LCA methods to estimate the environmental footprint of ESBC treatments across 9 standard impact categories including greenhouse gases, ozone depletion, smog, carcinogenics, and respiratory effects, in a cohort of 50 patients receiving moderate hypofractionation (mod-hEBRT) to 42.4 Gy in 16 fractions (n = 25) and ultra-hypofractionation (ultra-hEBRT) to 26 Gy in 5 fractions (n = 25). We analyzed life-cycle emissions associated with patient and staff commute, RT quality assurance and set-up equipment, linear accelerator (LINAC) requirements, clinic supplies, and linen use. Facility emission estimates are underway. All calculations were done in SimaPro 9.4 using the ecoinvent 3.8 database and TRACI 2.1 impact assessment methods. Confidence intervals were calculated using stochastic computations. RESULTS Total emissions associated with delivering a full course of mod-hEBRT versus ultra-hEBRT averaged 502 kg CO2-eq (95% CI, 484 to 521) and 264 kg CO2-eq (95% CI, 252 to 277), respectively. The largest contributors to total emissions in each group were patient and staff transportation (301.8 vs 196.4 kg CO2-eq, respectively) and LINAC equipment and utilization (175 vs 55.2 kg CO2-eq, respectively). In addition, treatment with mod-hEBRT was found to have, on average, a larger environmental footprint over ultra-hEBRT across all impact categories. The leading contributor to these environmental impacts continued to be patient and staff transportation, which accounted for 91.1% of ozone depletion, 63.2% of smog, 55.3% of acidification, 86.4% of carcinogenics, 53.2% of respiratory effects, 79.7% of ecotoxicity, and 67.9% of fossil fuel depletion in mod-hEBRT. CONCLUSION We present the first LCA estimating the environmental footprint of mod versus ultra-hEBRT in ESBC patients. Evaluation of emissions and environmental impacts demonstrate lower carbon and environmental footprints in shorter RT courses that are otherwise clinically equivalent. These data provide the opportunity to consider practice changes in RT delivery that utilize clinically appropriate and ecologically informed regimens in the treatment of ESBC patients.
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Affiliation(s)
- D Larios
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - A C Duhaime
- Department of Neurosurgery and MGH Center for the Environment and Health, Massachusetts General Hospital, Boston, MA
| | - J H Kung
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - D Gierga
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - A Y Ho
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
| | - S M MacDonald
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - J Slutzman
- Department of Emergency Medicine and MGH Center for the Environment and Health, Massachusetts General Hospital, Boston, MA
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Taghian AG, Naoum GE, Smith L, Ioakeim-Ioannidou M, Ababneh H, Macdonald S, Ho AY. Increased Complication Rates with Proton Therapy in Breast Cancer Patients with Immediate, Implant-Based Reconstruction: Single-Institution Comparative Effectiveness Analysis. Int J Radiat Oncol Biol Phys 2023; 117:S45. [PMID: 37784504 DOI: 10.1016/j.ijrobp.2023.06.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To compare the impact of protons vs. photons on breast reconstruction complications, for patients (pts) receiving postmastectomy radiation (PMRT) with either single-stage direct-to-implant (DTI) or two-staged expander/implant (TE/I). MATERIALS/METHODS We reviewed the charts of 578 pts who underwent immediate reconstruction followed by radiation at our institution between 2010 and 2020. Pts with implant-based reconstruction using either TE/I or DTI and PMRT delivery in the presence of the prosthesis were included. Pts enrolled in active ongoing clinical trials were excluded from the analysis. The photon group received 3D conformal or IMRT/VMAT treatment with a median dose of 50-50.4 Gy in 25 to 28 fractions. For proton pts, treatment was delivered mainly with pencil beam scanning technique (PBS); few pts received passively scattered proton spread-out Bragg peak (SOBP). The complications were defined as infection/skin necrosis (I/N) requiring operative debridement, capsular contracture (CC) necessitating capsulotomy, and overall implant failure (ORF) as the removal of the permanent implant irrespective of replacement outcomes (i.e., with and without salvage reconstruction). We fit inverse-probability weighted cumulative incidence curves to adjust for confounding and non-random loss to follow-up. Various sensitivity analyses were conducted. RESULTS Four hundred ninety-five pts were available for the final analysis with an overall median follow-up of 55 months. 66 (13%) received protons, of which14 were treated with SOBP protons. 137 (28%) and 256 (56%) received photons with and without chest wall boost (CWB), respectively. The 5-year inverse probability-weighted risk of CC post-PMRT was 31% for protons vs. 10% for photons (RR:3.09, 95% CI: 1.77, 5.40). The 5 years ORF risk was 35.6% in protons compared to 22.7% in photons pts (RR: 1.57; 95% CI 1.0, 2.48). Hazard ratios from the adjusted Cox models were 3.79 (p<0.001) for CC and 2.05 (p<0.01) for ORF. No difference in I/N was noted between protons and photons pts. Sensitivity analysis showed that protons significantly increased CC risk vs photons both with CWB (HR:3.56, P<0.001) and without CWB (HR:3.9, p<0.001). Similar outcomes were observed with ORF, where protons increased the rate of ORF compared to photons, irrespective of CWB (HR 1.8, p = 0.038 with CWB; HR 2.4, p = 0.004 without CWB). No differences between PBS and SOBP proton techniques were noted. CONCLUSION Compared to photons, proton therapy increases the risk of capsular contracture requiring surgical intervention and hence overall reconstruction failure. This data should inform discussions about the risks and benefits of protons in patients with reconstruction, while awaiting mature data from ongoing clinical trials (RADCOMP) utilizing protons for breast cancer.
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Affiliation(s)
| | - G E Naoum
- Harvard Medical School, Radiation oncology department, Massachusetts general hospital, Boston, MA; Northwestern University McGaw medical Center, Chicago, IL
| | - L Smith
- Massachusetts General Hospital, Boston, MA
| | - M Ioakeim-Ioannidou
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - H Ababneh
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - A Y Ho
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
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Ioakeim-Ioannidou M, Gao RW, Dunn SA, Harmsen WS, Smith N, Mullikin TC, Harless C, Connoly J, Keenan JC, Boughey JC, Liu L, Shumway D, MacDonald SM, Corbin KS, Mutter RW, Ho AY. Proton vs. Photons for Breast Cancer Patients with Immediate, Implant-Based Reconstruction Receiving Postmastectomy Radiotherapy: A Multicenter Pooled Analysis. Int J Radiat Oncol Biol Phys 2023; 117:S175. [PMID: 37784435 DOI: 10.1016/j.ijrobp.2023.06.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Proton therapy improves postmastectomy radiotherapy (PMRT) normal tissue sparing compared with photon techniques. However, little is understood about its effect on reconstruction outcomes. The primary objective was to evaluate complication rates in breast cancer patients treated with proton (PRO) versus photon (PHO) PMRT following immediate, implant-based breast reconstruction. MATERIALS/METHODS Consecutive patients with breast cancer who underwent mastectomy and immediate reconstruction with a tissue expander (TE) or permanent implant (PI) and PRO or PHO PMRT between 2011 and 2022 were included from two institutions. Complication rate was defined as the sum of reconstruction failure (explantation without replacement), unplanned prosthesis exchange, and other unplanned revisional surgery. Each complication type was analyzed as an independent endpoint. RESULTS Among 733 patients, median follow-up was 4.4 years; 36.5% (267) were treated with PRO and 63.5% (466) with PHO. There was no difference in age, BMI, or comorbidities between the two groups. PRO was more likely to have had, two-stage reconstruction and pre-pectoral implant placement (p<.01). Median dose was 50-50.4 Gy in 25-28 fractions, with only 50 receiving hypofractionation. Bolus was used in all PHO patients. Regional nodes were more likely to be included in PRO (99.6% v. 83.7% PHO, p<.01). Although there was no difference in the use of chest wall boost between groups, the axillary nodes were more frequently boosted in PRO (25.1% vs 2.8% PHO, p<.01). The overall rate of complications at 4 years was 26.7% (95% CI = 23.3-30.5). The 4-year rate of reconstruction failure, unplanned exchange, and other surgery was 8.2% (95% CI = 6.3-10.7), 17.4% (95% CI = 14.6-20.8), and 12.5% (95% CI = 10.1-15.5), respectively. On MVA, PRO did not confer an increased risk of reconstruction complications compared to PHO. Significant risk factors for reconstruction failure included TE-to-autologous approach [HR versus direct-to-implant reference: 4.05 (95% CI = 1.60-10.22)], TE-to-permanent implant approach [HR = 2.06 (95% CI = 1.12-3.79)], chest wall boost [HR = 2.20 (95% CI = 1.21-4.02)], and any lymph node boost [HR = 2.33 (95% CI = 1.10-4.97)]. Compared to direct-to-implant, two-stage reconstruction was also associated with a higher rate of unplanned exchange [HR for TE/PI = 1.49 (95% CI = 1.01-2.20)] and revisional surgery [HR for TE-to-autologous = 3.95 (95% CI = 1.64-9.52)]. Prepectoral implant placement was correlated with reduced risk of revisional surgery, relative to subpectoral placement [HR = 0.42 (95% CI = 0.22-0.81)]. CONCLUSION This represents the largest combined series to date comparing PRO and PHO PMRT. Despite a higher rate of two-stage reconstruction, nodal irradiation, and nodal boost in PRO, there was no significant difference in the risk of complications between protons and photons. Differences in PRO delivery techniques between institutions and dosimetric details such as skin dose will be presented in person.
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Affiliation(s)
- M Ioakeim-Ioannidou
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - R W Gao
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - S A Dunn
- Massachusetts General Hospital, Boston, MA
| | - W S Harmsen
- Department of Biostatistics and Health Sciences Research, Mayo Clinic, Rochester, MN
| | - N Smith
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - T C Mullikin
- Department of Radiation Oncology, Duke University, Rochester, MN
| | - C Harless
- Department of Plastic Surgery, Mayo Clinic, Rochester, MN
| | - J Connoly
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, Boston, MA
| | - J C Keenan
- Massachusetts General Hospital, Boston, MA
| | - J C Boughey
- Department of Breast Surgery, Mayo Clinic, Rochester, MN
| | - L Liu
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, Boston, MA
| | - D Shumway
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - S M MacDonald
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - K S Corbin
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - R W Mutter
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - A Y Ho
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
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Rammohan N, Ho A, Kruser T, Besson P, Bandt S. Hippocampal Avoidance Confers Protection against Accelerated Brain Aging when Compared to Conventional Whole Brain Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ho A, Xu M, Millar S. 745 Regional expression of secreted WNT inhibitors dictates formation of hairless and poorly haired skin. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Rammohan N, Ho A, Bajaj A, Kruser T, Korutz A, Tate M, Sachdev S. MO-0379 Extent of white matter connectivity has prognostic significance in MGMT-unmethylated glioblastoma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02345-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Averbuch D, De Greef J, Duréault A, Wendel L, Tridello G, Lebeaux D, Mikulska M, Gil L, Knelange N, Zuckerman T, Roussel X, Robin C, Xhaard A, Aljurf M, Beguin Y, Le Bourgeois A, Botella-Garcia C, Khanna N, Van Praet J, Kröger N, Blijlevens N, Ducastelle Leprêtre S, Ho A, Roos-Weil D, Yeshurun M, Lortholary O, Fontanet A, de la Camara R, Coussement J, Maertens J, Styczynski J. Nocardia infections in hematopoietic cell transplant recipients: a multicenter international retrospective study of the Infectious Diseases Working Party (IDWP) of the European Society for Blood and Marrow Transplantation (EBMT). Clin Infect Dis 2021; 75:88-97. [PMID: 34596213 DOI: 10.1093/cid/ciab866] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nocardiosis is rare after hematopoietic cell transplantation (HCT). Little is known regarding its presentation, management, and outcome in this population. METHODS In this retrospective international study, we reviewed nocardiosis episodes in HCT recipients (01.01.2000-31.12.2018; 135 transplant centers; 33 countries) and described their clinical, microbiological, radiological, and outcome characteristics. RESULTS We identified 81 nocardiosis episodes in 74 allo- and 7 auto-HCT recipients. Nocardiosis occurred at a median of 8 (IQR 4-18) months post-HCT. The most frequently involved organs were lungs (70/81; 86%) and brain (30/81; 37%); 29 (36%) patients were afebrile; 46/81 (57%) had disseminated infections. The most common lung imaging findings were consolidations (33/68; 49%) or nodules (32/68; 47%); and brain imaging findings were multiple brain abscesses (19/30; 63%). 10/30 (33%) patients with brain involvement lacked neurological symptoms. 14/48 (29%) patients were bacteremic. N. farcinica was the most common among molecularly identified species (27%, 12/44). Highest susceptibility rates were reported to linezolid 45/45 (100%), amikacin 56/57 (98%), trimethoprim-sulfamethoxazole 57/63 (90%), and imipenem 49/57 (86%).One-year and last follow-up (IQR: 4-42.5 months) all-cause mortality were 40% (32/81) and 52% (42/81), respectively. In the multivariable analysis, underlying disease not in complete remission (HR 2.81, 95%CI 1.32-5.95), and prior bacterial infection (HR 3.42, 95%CI 1.62-7.22) were associated with higher one-year all-cause mortality. CONCLUSIONS Nocardiosis is a late post-HCT infection usually manifesting as a pulmonary disease with frequent dissemination, brain infection and bacteremia. Brain imaging should be performed in HCT recipients with nocardiosis regardless of neurological symptoms. Overall mortality is high.
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Affiliation(s)
- D Averbuch
- Pediatric Infectious Diseases Faculty of Medicine, Hebrew University of Jerusalem; Hadassah Medical Center, Jerusalem, Israel
| | - J De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Duréault
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Paris, France
| | - L Wendel
- EBMT Data Office, Leiden, Netherlands
| | - G Tridello
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - D Lebeaux
- Université de Paris, F-75006 Paris, France.,Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, Paris, France
| | - M Mikulska
- Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy
| | - L Gil
- University of Medical Sciences, Poznan, Poland
| | | | | | - X Roussel
- University hospital of Besançon, hematology department, Besançon, France
| | - C Robin
- Henri Mondor University Hospital, Creteil, France
| | - A Xhaard
- Hematology-transplantation, Hospital St-Louis, Paris Diderot University, Paris, France
| | - M Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Y Beguin
- CHU of Liège and University of Liège, Liège, Belgium
| | | | | | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology. University and University Hospital of Basel, Basel, Switzerland
| | - J Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - N Kröger
- Department of Stem Cell Transplantation, University Medical Center, Hamburg, Germany
| | - N Blijlevens
- Radboud university medical center, Nijmegen, The Netherlands
| | | | - A Ho
- Singapore General Hospital, Singapore, Singapore
| | - D Roos-Weil
- Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - M Yeshurun
- Institution of Hematology, Rabin medical Center, Petah Tikva, Israel and Sacker School of Medicine, Tel Aviv University, Israel
| | - O Lortholary
- Paris University, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Necker Enfants malades University Hospital, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals, Molecular Mycology Unit, CNRS UMR 2000, Institut Pasteur, Paris, France
| | - A Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Global Health Department, Paris, France.,PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | | | - J Coussement
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.,National Centre for Infection in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Maertens
- Department of Haematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - J Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
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Marta GN, Ramiah D, Kaidar-Person O, Kirby A, Coles C, Jagsi R, Hijal T, Sancho G, Zissiadis Y, Pignol JP, Ho AY, Cheng SHC, Offersen BV, Meattini I, Poortmans P. The Financial Impact on Reimbursement of Moderately Hypofractionated Postoperative Radiation Therapy for Breast Cancer: An International Consortium Report. Clin Oncol (R Coll Radiol) 2021; 33:322-330. [PMID: 33358283 DOI: 10.1016/j.clon.2020.12.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/06/2020] [Accepted: 12/08/2020] [Indexed: 12/16/2022]
Abstract
AIMS Moderately hypofractionated breast irradiation has been evaluated in several prospective studies, resulting in wide acceptance of shorter treatment protocols for postoperative breast irradiation. Reimbursement for radiation therapy varies between private and public systems and between countries, impacting variably financial considerations in the use of hypofractionation. The aim of this study was to evaluate the financial impact of moderately hypofractionated breast irradiation by reimbursement system in different countries. MATERIALS AND METHODS The study was designed by an international group of radiation oncologists. A web-questionnaire was distributed to representatives from each country. The participants were asked to involve the financial consultant at their institution. RESULTS Data from 13 countries from all populated continents were collected (Europe: Denmark, France, Italy, the Netherlands, Spain, UK; North America: Canada, USA; South America: Brazil; Africa: South Africa; Oceania: Australia; Asia: Israel, Taiwan). Clinicians and/or departments in most of the countries surveyed (77%) receive remuneration based on the number of fractions delivered to the patient. The financial loss per patient estimated resulting from applying moderately hypofractionated breast irradiation instead of conventional fractionation ranged from 5-10% to 30-40%, depending on the healthcare provider. CONCLUSION Although a generalised adoption of moderately hypofractionated breast irradiation would allow for a considerable reduction in social and economic burden, the financial loss for the healthcare providers induced by fee-for-service remuneration may be a factor in the slow uptake of these regimens. Therefore, fee-for-service reimbursement may not be preferable for radiation oncology. We propose that an alternative system of remuneration, such as bundled payments based on stage and diagnosis, may provide more value for all stakeholders.
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Affiliation(s)
- G N Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo, Brazil.
| | - D Ramiah
- Department of Radiation Oncology, Donald Gordon Medical Centre, Johannesburg, South Africa
| | - O Kaidar-Person
- Breast Cancer Radiation Unit, Radiation Oncology Institute, Sheba Medical Center, Ramat Gan, Israel
| | - A Kirby
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, London, UK; Institute of Cancer Research, London, UK
| | - C Coles
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - R Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
| | - T Hijal
- Division of Radiation Oncology, McGill University Health Centre, Montréal, Quebec, Canada
| | - G Sancho
- Department of Radiation Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Y Zissiadis
- Department of Radiation Oncology, Genesis Cancer Care, Wembley, WA, Australia
| | - J-P Pignol
- Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - A Y Ho
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - S H-C Cheng
- Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - B V Offersen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - I Meattini
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy; Department of Biomedical, Experimental, and Clinical Sciences "M. Serio", University of Florence, Florence, Italy
| | - P Poortmans
- Department of Radiation Oncology, Iridium Kankernetwerk, Wilrijk-Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk-Antwerp, Belgium
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Kang J, Tchekmedyian V, Fan M, Wang H, Kitpanit S, Mohamed N, Rybkin A, Lee A, Chen L, Yu Y, Riaz N, McBride S, Tsai C, Ho A, Dunn L, Fetten J, Pfister D, Zhang Z, Lee N, Sherman E. Split High-Dose Cisplatin: An Alternate High-Dose Cisplatin Administration Schedule for Definitive Chemoradiation in Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ho A, Pietropaolo A, Hughes T, Way C, Lily W, Prattley S, Somani B. Apnoea is not necessary for flexible ureteroscopy and lasertripsy (FURSL) of renal stones: Prospective study over 6.5 years. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33849-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Alchawaf A, Dawod M, Al-Ani M, Barriuso J, Ferrera A, Ho A, Braun M, Paton N, Saunders M, Wilson G, Alam N, Hasan J, Marti FM, Kamposioras K, Mullamitha S. P-339 Real-world data (RWD) of the use of trifluridine/tipiracil hydrochloride (TFT) in patients with metastatic colorectal cancer: The Greater Manchester experience. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
BACKGROUND The COVID-19 pandemic caused by SARS-CoV-2 remains a significant issue for global health, economics and society. A wealth of data has been generated since its emergence in December 2019, and it is vital for clinicians to keep up with this data from across the world at a time of uncertainty and constantly evolving guidelines and clinical practice. OBJECTIVES Here we provide an update for clinicians on the recent developments in the virology, diagnostics, clinical presentation, viral shedding, and treatment options for COVID-19 based on current literature. SOURCES We considered published peer-reviewed papers and non-peer-reviewed pre-print manuscripts on COVID19 and related aspects with an emphasis on clinical management aspects. CONTENT We describe the virological characteristics of SARS-CoV-2 and the clinical course of COVID-19 with an emphasis on diagnostic challenges, duration of viral shedding, severity markers and current treatment options. IMPLICATIONS The key challenge in managing COVID-19 remains patient density. However, accurate diagnosis as well as early identification and management of high-risk severe cases are important for many clinicians. For improved management of cases, there is a need to understand test probability of serology, qRT-PCR and radiological testing, and the efficacy of available treatment options that could be used in severe cases with a high risk of mortality.
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Affiliation(s)
- M Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St Andrews, UK.
| | - C G G Bamford
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - A Ho
- MRC-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, UK
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Campbell M, Fathi R, Cheng S, Ho A, Gilbert E. Rhamnus prinoides
(gesho) stem extract prevents co‐culture biofilm formation by
Streptococcus mutans
and
Candida albicans. Lett Appl Microbiol 2020; 71:294-302. [DOI: 10.1111/lam.13307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 04/16/2020] [Accepted: 04/27/2020] [Indexed: 01/02/2023]
Affiliation(s)
- M. Campbell
- Department of Biology Georgia State University Atlanta GA USA
| | - R. Fathi
- Department of Biology Georgia State University Atlanta GA USA
| | - S.Y. Cheng
- Department of Biology Georgia State University Atlanta GA USA
| | - A. Ho
- Department of Biology Georgia State University Atlanta GA USA
| | - E.S. Gilbert
- Department of Biology Georgia State University Atlanta GA USA
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Riaz N, Sherman E, Pei X, Schoder H, Paudyal R, Katabi N, Ma D, Tsai C, McBride S, Morris L, Boyle J, Singh B, Foote R, Ho A, Wong R, Humm J, Dave A, Pfister D, Reis-Filho J, Lee N. Genetic and micro-environmental factors influencing response to definitive 30Gy chemo-radiotherapy (chemoRT) in HPV Positive Oropharyngeal Cancer (OPC). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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15
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Fan D, Fan M, Wang H, Lee A, Yu Y, Chen L, Tsai C, McBride S, Riaz N, Bernstein M, Mueller B, Gelblum D, Fetten J, Dunn L, Michel L, Pfister D, Ho A, Boyle J, Cohen M, Roman B, Cracchiolo J, Morris L, Ganly I, Singh B, Shaha A, Patel S, Shah J, Wong R, Sherman E, Lee N, Kang J. Last-line Local Treatment with the Quad Shot Regimen for Previously Irradiated Head and Neck Cancers. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Gallo C, Foroughi P, Meagher E, Vellody R, Yadav B, Ho A, Heisenberg D, Cleary K, Sharma K. 3:00 PM Abstract No. 156 Computer-assisted needle navigation for pediatric central venous cannulation: a feasibility study. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Ferrarotto R, Ho A, Wirth L, Muzaffar J, Rodriguez C, Dekel E, Walker R, Nadri-Shay C, Vergara-Silva A. ACCURACY a phase (P) II trial of AL101, a pan-Notch inhibitor, in recurrent/metastatic (R/M) adenoid cystic carcinoma (ACC) patients (pts) with Notch activating mutations (Notch act mut): Preliminary safety and efficacy data. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Tan K, Chow WS, Leung J, Ho A, Ozaki R, Kam G, Li J, Choi CH, Tsang MW, Chan N, Lee KK, Chan KW. Clinical considerations when adding a sodium-glucose co-transporter-2 inhibitor to insulin therapy in patients with diabetes mellitus. Hong Kong Med J 2019; 25:312-319. [PMID: 31416990 DOI: 10.12809/hkmj197802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- K Tan
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - W S Chow
- Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - J Leung
- Department of Integrated Medical Service, Ruttonjee and Tang Shiu Kin Hospitals, Hong Kong
| | - A Ho
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - R Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - G Kam
- Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong
| | - J Li
- Department of Medicine, Yan Chai Hospital, Tsuen Wan, Hong Kong
| | - C H Choi
- Department of Medicine, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - M W Tsang
- Specialist in Endocrinology, Private Practice
| | - N Chan
- Specialist in Endocrinology, Private Practice
| | - K K Lee
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - K W Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
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Jackson LH, Price AN, Hutter J, Ho A, Roberts TA, Slator PJ, Clough JR, Deprez M, McCabe L, Malik SJ, Chappell L, Rutherford MA, Hajnal JV. Respiration resolved imaging with continuous stable state 2D acquisition using linear frequency SWEEP. Magn Reson Med 2019; 82:1631-1645. [PMID: 31183892 PMCID: PMC6682494 DOI: 10.1002/mrm.27834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/04/2019] [Accepted: 05/09/2019] [Indexed: 01/31/2023]
Abstract
Purpose To investigate the potential of continuous radiofrequency (RF) shifting (SWEEP) as a technique for creating densely sampled data while maintaining a stable signal state for dynamic imaging. Methods We present a method where a continuous stable state of magnetization is swept smoothly across the anatomy of interest, creating an efficient approach to dense multiple 2D slice imaging. This is achieved by introducing a linear frequency offset to successive RF pulses shifting the excited slice by a fraction of the slice thickness with each successive repeat times (TR). Simulations and in vivo imaging were performed to assess how this affects the measured signal. Free breathing, respiration resolved 4D volumes in fetal/placental imaging is explored as potential application of this method. Results The SWEEP method maintained a stable signal state over a full acquisition reducing artifacts from unstable magnetization. Simulations demonstrated that the effects of SWEEP on slice profiles was of the same order as that produced by physiological motion observed with conventional methods. Respiration resolved 4D data acquired with this method shows reduced respiration artifacts and resilience to non‐rigid and non‐cyclic motion. Conclusions The SWEEP method is presented as a technique for improved acquisition efficiency of densely sampled short‐TR 2D sequences. Using conventional slice excitation the number of RF pulses required to enter a true steady state is excessively high when using short‐TR 2D acquisitions, SWEEP circumvents this limitation by creating a stable signal state that is preserved between slices.
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Affiliation(s)
- L H Jackson
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - A N Price
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - J Hutter
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - A Ho
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom.,Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom
| | - T A Roberts
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - P J Slator
- Centre for Medical Image Computing, University College London, London, United Kingdom
| | - J R Clough
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - M Deprez
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - L McCabe
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - S J Malik
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - L Chappell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom
| | - M A Rutherford
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - J V Hajnal
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
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Ho A, Xiao S, Madi A, Chihara N, Regev A, Kuchroo V. 087 Molecular and cellular mechanisms of tolerogenic signature induction in CD4+ T cells by apoptotic cells. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Tait E, Byrne O, O'Doherty D, Evans B, Ajithkumar T, Begum G, Ho A. EP-1880 A planning study evaluating the use of 4DCT vs 3DCT in pancreas planning, both conventional and SABR. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32300-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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McArthur HL, Basho R, Shiao SL, Park D, Mita M, Chung A, Arnold B, Martin C, Dang C, Karlan S, Knott S, Giuliano A, Ho A. Abstract P2-09-07: Preoperative pembrolizumab (Pembro) with radiation therapy (RT) in patients with operable triple-negative breast cancer (TNBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-09-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Radiation therapy (RT) induces immune-mediated cell death and could generate a rich supply of tumor antigens if administered in the pre-operative, curative-intent setting. The addition of PD-1 mediated checkpoint blockade to pre-operative RT could thus, generate robust anti-tumor immune responses, induce long-term tumor-specific memory, and ultimately, improve cure rates. This study aims to establish the safety of pre-operative pembrolizumab (pembro)-mediated immune modulation with a RT “boost” equivalent in patients with operable triple negative breast cancer (TNBC) for whom lumpectomy and adjuvant RT are planned (NCT03366844). Serial research biopsies permit interrogation of conventional biomarkers including tumor infiltrating lymphocytes (TILs) and novel immune correlates as potential predictors of response to pembro alone versus pembro with RT.
Methods: Ten women with operable, primary TNBC >2cm for whom breast-conserving therapy is planned are being enrolled in this single-institution pilot study. Study treatment consists of 1 cycle of pre-operative pembro (200 mg IV) alone, followed 3 weeks later by a RT boost (24 Gy/3 fractions) to the primary breast tumor concurrently with pembro (+/- 5 days). Curative-intent, standard-of-care, neoadjuvant chemotherapy (NAC) or breast-conserving surgery is then undertaken within 8 weeks of study enrollment (i.e. within 5 weeks of pembro #2). Adjuvant RT is administered per standard-of-care after surgery, but without a boost dose. Research blood and fresh tumor biopsies are obtained at baseline and after cycles 1 and 2 of pembro. Co-primary endpoints are: 1) safety/tolerability, as defined by the number of patients who do not necessitate a delay in standard-of-care chemotherapy or surgery and 2) change in TIL score. Secondary endpoints include safety/toxicity up to 19 weeks after study enrollment, pCR rates and disease-free survival. Correlative analysis will include single-cell RNA sequencing of the tumor immune infiltrate and multispectral immunohistochemistry
Results: Seven patients enrolled between 12/19/17 and 7/1/18. As of 7/1/18, 5 patients have completed the experimental pembro/RT phase of the trial and are currently completing standard-of-care NAC; 1 patient is currently being treated in the experimental pembro/RT phase; and 1 patient with a cT2N0 tumor at baseline achieved a pathologic complete response (pCR, ypT0/Tis ypN0) after completing the experimental pembro/RT phase followed by anthracycline- and taxane-based NAC. No grade 3 or 4 toxicities have been observed during pembro/RT in the 6 patients completing the experimental phase to date. Three additional patients will be enrolled
Conclusions: This is the first trial of curative-intent, pre-operative checkpoint blockade with RT in breast cancer and the strategy appears to be well tolerated to date. At the time of presentation, safety, change in TIL score, and pCR rates for all patients completing the experimental and NAC phases of the study will be reported.
Citation Format: McArthur HL, Basho R, Shiao SL, Park D, Mita M, Chung A, Arnold B, Martin C, Dang C, Karlan S, Knott S, Giuliano A, Ho A. Preoperative pembrolizumab (Pembro) with radiation therapy (RT) in patients with operable triple-negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-09-07.
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Affiliation(s)
- HL McArthur
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - R Basho
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - SL Shiao
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - D Park
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - M Mita
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - A Chung
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - B Arnold
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - C Martin
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - C Dang
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - S Karlan
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - S Knott
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - A Giuliano
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - A Ho
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
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McArthur H, Basho R, Shiao S, Park D, Dang C, Karlan S, Knott S, Mita M, Dilauro Abaya C, Giuliano A, Dadmanesh F, Ho A. Preoperative pembrolizumab (Pembro) with radiation therapy (RT) in patients with operable triple-negative breast cancer (TNBC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Brodie MA, Pliner EM, Ho A, Li K, Chen Z, Gandevia SC, Lord SR. Big data vs accurate data in health research: Large-scale physical activity monitoring, smartphones, wearable devices and risk of unconscious bias. Med Hypotheses 2018; 119:32-36. [PMID: 30122488 DOI: 10.1016/j.mehy.2018.07.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/29/2018] [Accepted: 07/14/2018] [Indexed: 10/28/2022]
Abstract
Fundamental to the advancement of scientific knowledge is unbiased, accurate and validated measurement techniques. Recent United Nations and landmark Nature publications highlight the global uptake of mobile technology and the staggering potential for big data to encourage people to be physically active and to influence health policy. However, concerns exist about inconsistencies in smartphone health apps. Big data has many benefits, but noisy data may lead to wrong conclusions. In reaction to the increasing availability of low quality data; we call for a rigorous debate into the validity of substituting big data for accurate data in health research. We evaluated the step counting accuracy of a smartphone app previously used by 717,527 people from 111 countries. Our new data (from 48 participants; aged 21-59 years; body mass index 17.7-33.5 kg/m2) revealed significant (15-66%) undercounting by Apple phones. In contrast to the generally positive performances of wearable devices for stereotypical treadmill like walking, we observed extraordinarily large (0-200% of steps taken) error ranges for both Android and Apple phones. Unconscious bias (developers' perceptions of usual behaviour) may be embedded into many unvalidated smartphone apps. Consumer-grade wearable devices appear unsuitable to detect steps in people with slow, short or non-stereotypical gait patterns. Specifically, there is a risk of systematically undercounting the steps by obese people, females or people from different ethnic groups resulting in biases when reporting associations between physical inactivity and obesity. More research is required to develop smartphone apps suitable for all people of the heterogeneous global population.
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Affiliation(s)
- M A Brodie
- Falls Balance & Injury Research Centre, Neuroscience Research Australia, NSW, Australia; Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia.
| | - E M Pliner
- Falls Balance & Injury Research Centre, Neuroscience Research Australia, NSW, Australia; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - A Ho
- Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia
| | - Kalina Li
- Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia
| | - Z Chen
- Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia
| | - S C Gandevia
- Falls Balance & Injury Research Centre, Neuroscience Research Australia, NSW, Australia; School of Medicine, University of New South Wales, NSW, Australia
| | - S R Lord
- Falls Balance & Injury Research Centre, Neuroscience Research Australia, NSW, Australia; School of Medicine, University of New South Wales, NSW, Australia
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Ho A, Chau N, Garcia IB, Ferte C, Even C, Burrows F, Kessler L, Mishra V, Magnuson K, Scholz C, Gualberto A. Preliminary Results From a Phase 2 Trial of Tipifarnib in HRAS-Mutant Head and Neck Squamous Cell Carcinomas. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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Osborn V, Tsai C, Sherman E, Pfister D, Baxi S, Dunn L, Ho A, Michel L, Riaz N, Higginson D, Leeman J, Patel S, Xie P, Li X, Lee N, McBride S. Bolus Versus Weekly Chemotherapy in Definitive Chemoradiation for Nasopharyngeal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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McArthur H, Barker C, Gucalp A, Lebron Zapata L, Wen Y, Phung A, Wilgucki M, Henrich M, Arnold B, Zhang Z, Ho A. A single-arm, phase ii study assessing the efficacy of pembrolizumab (pembro) plus radiotherapy (RT) in metastatic triple negative breast cancer (mTNBC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Hehlmann R, Lauseker M, Saußele S, Pfirrmann M, Krause S, Kolb HJ, Neubauer A, Hossfeld DK, Nerl C, Gratwohl A, Baerlocher GM, Heim D, Brümmendorf TH, Fabarius A, Haferlach C, Schlegelberger B, Müller MC, Jeromin S, Proetel U, Kohlbrenner K, Voskanyan A, Rinaldetti S, Seifarth W, Spieß B, Balleisen L, Goebeler MC, Hänel M, Ho A, Dengler J, Falge C, Kanz L, Kremers S, Burchert A, Kneba M, Stegelmann F, Köhne CA, Lindemann HW, Waller CF, Pfreundschuh M, Spiekermann K, Berdel WE, Müller L, Edinger M, Mayer J, Beelen DW, Bentz M, Link H, Hertenstein B, Fuchs R, Wernli M, Schlegel F, Schlag R, de Wit M, Trümper L, Hebart H, Hahn M, Thomalla J, Scheid C, Schafhausen P, Verbeek W, Eckart MJ, Gassmann W, Pezzutto A, Schenk M, Brossart P, Geer T, Bildat S, Schäfer E, Hochhaus A, Hasford J. Assessment of imatinib as first-line treatment of chronic myeloid leukemia: 10-year survival results of the randomized CML study IV and impact of non-CML determinants. Leukemia 2017; 31:2398-2406. [PMID: 28804124 PMCID: PMC5668495 DOI: 10.1038/leu.2017.253] [Citation(s) in RCA: 185] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023]
Abstract
Chronic myeloid leukemia (CML)-study IV was designed to explore whether treatment with imatinib (IM) at 400 mg/day (n=400) could be optimized by doubling the dose (n=420), adding interferon (IFN) (n=430) or cytarabine (n=158) or using IM after IFN-failure (n=128). From July 2002 to March 2012, 1551 newly diagnosed patients in chronic phase were randomized into a 5-arm study. The study was powered to detect a survival difference of 5% at 5 years. After a median observation time of 9.5 years, 10-year overall survival was 82%, 10-year progression-free survival was 80% and 10-year relative survival was 92%. Survival between IM400 mg and any experimental arm was not different. In a multivariate analysis, risk group, major-route chromosomal aberrations, comorbidities, smoking and treatment center (academic vs other) influenced survival significantly, but not any form of treatment optimization. Patients reaching the molecular response milestones at 3, 6 and 12 months had a significant survival advantage. For responders, monotherapy with IM400 mg provides a close to normal life expectancy independent of the time to response. Survival is more determined by patients' and disease factors than by initial treatment selection. Although improvements are also needed for refractory disease, more life-time can currently be gained by carefully addressing non-CML determinants of survival.
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Affiliation(s)
- R Hehlmann
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - M Lauseker
- IBE, Universität München, Munich, Germany
| | - S Saußele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - S Krause
- Medizinische Klinik 5, Universitätsklinikum, Erlangen, Germany
| | - H J Kolb
- Medizinische Klinik III, Universität München, Munich, Germany
| | - A Neubauer
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - D K Hossfeld
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - C Nerl
- Klinikum Schwabing, Munich, Germany
| | | | | | - D Heim
- Universitätsspital, Basel, Switzerland
| | | | - A Fabarius
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | | | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - U Proetel
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - K Kohlbrenner
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - A Voskanyan
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - S Rinaldetti
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - W Seifarth
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - B Spieß
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - M C Goebeler
- Medizinische Klinik und Poliklinik, Universitätsklinikum, Würzburg, Germany
| | - M Hänel
- Klinik für innere Medizin 3, Chemnitz, Germany
| | - A Ho
- Medizinische Klinik V, Universität Heidelberg, Heidelberg, Germany
| | - J Dengler
- Onkologische Schwerpunktpraxis, Heilbronn, Germany
| | - C Falge
- Medizinische Klinik 5, Klinikum Nürnberg-Nord, Nürnberg, Germany
| | - L Kanz
- Medizinische Abteilung 2, Universitätsklinikum, Tübingen, Germany
| | - S Kremers
- Caritas Krankenhaus, Lebach, Germany
| | - A Burchert
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - M Kneba
- 2. Medizinische Klinik und Poliklinik, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - F Stegelmann
- Klinik für Innere Medizin 3, Universitätsklinikum, Ulm, Germany
| | - C A Köhne
- Klinik für Onkologie und Hämatologie, Oldenburg, Germany
| | | | - C F Waller
- Innere Medizin 1, Universitätsklinikum, Freiburg, Germany
| | - M Pfreundschuh
- Klinik für Innere Medizin 1, Universität des Saarlandes, Homburg, Germany
| | - K Spiekermann
- Medizinische Klinik III, Universität München, Munich, Germany
| | - W E Berdel
- Medizinische Klinik A, Universitätsklinikum, Münster, Germany
| | - L Müller
- Onkologie Leer UnterEms, Leer, Germany
| | - M Edinger
- Klinik und Poliklinik für Innere Medizin 3, Universitätsklinikum, Regensburg, Germany
| | - J Mayer
- Masaryk University Hospital, Brno, Czech Republic
| | - D W Beelen
- Klinik für Knochenmarktransplantation, Essen, Germany
| | - M Bentz
- Medizinische Klinik 3, Städtisches Klinikum, Karlsruhe, Germany
| | - H Link
- Klinik für Innere Medizin 3, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - B Hertenstein
- 1. Medizinische Klinik, Klinikum Bremen Mitte, Bremen, Germany
| | | | - M Wernli
- Kantonsspital, Aarau, Switzerland
| | - F Schlegel
- St Antonius-Hospital, Eschweiler, Germany
| | - R Schlag
- Hämatologische-Onkologische Schwerpunktpraxis, Würzburg, Germany
| | - M de Wit
- Vivantes Klinikum Neukölln, Berlin, Germany
| | - L Trümper
- Klinik für Hämatologie und medizinische Onkologie, Universitätsmedizin, Göttingen, Germany
| | - H Hebart
- Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany
| | - M Hahn
- Onkologie Zentrum, Ansbach, Germany
| | - J Thomalla
- Praxisklinik für Hämatologie und Onkologie, Koblenz, Germany
| | - C Scheid
- Klinik 1 für Innere Medizin, Universitätsklinikum, Köln, Germany
| | - P Schafhausen
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - W Verbeek
- Ambulante Hämatologie und Onkologie, Bonn, Germany
| | - M J Eckart
- Internistische Schwerpunktpraxis, Erlangen, Germany
| | | | | | - M Schenk
- Barmherzige Brüder, Regensburg, Germany
| | - P Brossart
- Medizinische Klinik 3, Universität, Bonn, Germany
| | - T Geer
- Diakonie, Schwäbisch Hall, Germany
| | - S Bildat
- Medizinische Klinik 2, Herford, Germany
| | - E Schäfer
- Onkologische Schwerpunktpraxis, Bielefeld, Germany
| | - A Hochhaus
- Klinik für Innere Medizin 2, Universitätsklinikum, Jena, Germany
| | - J Hasford
- IBE, Universität München, Munich, Germany
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de Solis CA, Hosek MP, Holehonnur R, Ho A, Banerjee A, Luong JA, Jones LE, Chaturvedi D, Ploski JE. Adeno-associated viral serotypes differentially transduce inhibitory neurons within the rat amygdala. Brain Res 2017; 1672:148-162. [PMID: 28764932 DOI: 10.1016/j.brainres.2017.07.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/21/2017] [Accepted: 07/26/2017] [Indexed: 11/18/2022]
Abstract
Recombinant adeno-associated viruses (AAV) are frequently used to make localized genetic manipulations within the rodent brain. It is accepted that the different viral serotypes possess differing affinities for particular cell types, but it is not clear how these properties affect their ability to transduce specific neuronal cell sub-types. Here, we examined ten AAV serotypes for their ability to transduce neurons within the rat basal and lateral nuclei of the amygdala (BLA) and the central nucleus of the amygdala (CeA). AAV2 based viral genomes designed to express either green fluorescent protein (GFP) from a glutamate decarboxylase (GAD65) promoter or the far-red fluorescent protein (E2-Crimson) from a phosphate-activated glutaminase (PAG) promoter were created and pseudotyped as AAV2/1, AAV2/4, AAV2/5, AAV2/6, AAV2/7, AAV 2/8, AAV2/9, AAV2/rh10, AAV2/DJ and AAV2/DJ8. These viruses were infused into the BLA and CeA at equal titers and twenty-one days later tissue within the amygdala was examined for viral transduction efficiency. These serotypes transduced neurons with similar efficiency, except for AAV4 and AAV5, which exhibited significantly less efficient neuronal transduction. Notably, AAV4 and AAV5 possess the most divergent capsid protein sequences compared to the other commonly available serotypes. We found that the Gad65-GFP virus did not exclusively express GFP within inhibitory neurons, as assessed by fluorescent in situ hybridization (FISH), but when this virus was used to transduce CeA neurons, the majority of the neurons that expressed GFP were in fact inhibitory neurons and this was likely due to the fact that this nucleus contains a very high percentage of inhibitory neurons.
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Affiliation(s)
- C A de Solis
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - M P Hosek
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - R Holehonnur
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - A Ho
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - A Banerjee
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - J A Luong
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - L E Jones
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - D Chaturvedi
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - J E Ploski
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States.
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Pinard J, Roman M, Kurtzman D, Ho A, Femia A, Vleugels R. 401 Cancer risk in clinically amyopathic dermatomyositis: A retrospective cohort study at four tertiary care centers. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Searle A, Spink MJ, Ho A, Chuter VH. Association between ankle equinus and plantar pressures in people with diabetes. A systematic review and meta-analysis. Clin Biomech (Bristol, Avon) 2017; 43:8-14. [PMID: 28167343 DOI: 10.1016/j.clinbiomech.2017.01.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 12/20/2016] [Accepted: 01/30/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diabetes is one of the most common chronic diseases in the world and is associated with a life-time risk of foot ulcer of 12-25%. Diabetes related restriction in ankle joint range of dorsiflexion is proposed to contribute to elevated plantar pressures implicated in the development of foot ulcers. METHODS A systematic search of EBSCO Megafile Premier (containing MEDLINE, CINAHL, SPORTSdiscus and Academic Search Complete) and The Cochrane Library was conducted to 23rd November 2016. Two authors independently reviewed and selected relevant studies. Meta-analysis of study data were conducted where possible. FINDINGS Fifteen studies met the inclusion criteria. Three studies were eligible to be included in the meta-analysis which found that equinus has a significant, but small, effect on increased plantar pressures (ES=0.26, CI 95% 0.11 to 0.41, p=0.001). Of the remaining studies, eight found evidence of an association between limited ankle dorsiflexion and increased plantar pressures while four studies found no relationship. INTERPRETATION Limited ankle joint dorsiflexion may be an important factor in elevating plantar pressures, independent of neuropathy. Limited ankle dorsiflexion and increased plantar pressures were found in all the studies where the sample population had a history of neuropathic foot ulceration. In contrast, the same association was not found in those studies where the population had neuropathy and no history of foot ulcer. Routine screening for limited ankle dorsiflexion range of motion in the diabetic population would allow for early provision of conservative treatment options to reduce plantar pressures and lessen ulcer risk.
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Affiliation(s)
- A Searle
- School of Health Sciences, Faculty of Health, University of Newcastle, Australia.
| | - M J Spink
- School of Health Sciences, Faculty of Health, University of Newcastle, Australia
| | - A Ho
- School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Australia
| | - V H Chuter
- School of Health Sciences, Faculty of Health, University of Newcastle, Australia
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Naik H, Qiu X, Brown MC, Eng L, Pringle D, Mahler M, Hon H, Tiessen K, Thai H, Ho V, Gonos C, Charow R, Pat V, Irwin M, Herzog L, Ho A, Xu W, Jones JM, Howell D, Liu G. Socioeconomic status and lifestyle behaviours in cancer survivors: smoking and physical activity. ACTA ACUST UNITED AC 2016; 23:e546-e555. [PMID: 28050143 DOI: 10.3747/co.23.3166] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE Smoking cessation and increased physical activity (pa) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis. METHODS As part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors. RESULTS Of 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering pa questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that pa had no effect or could worsen fatigue and quality of life (p ≤ 0.0001). CONCLUSIONS In cancer survivors, education level was a major modifier of smoking and pa behaviours. Lower socioeconomic status was associated with incorrect perceptions about pa. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs.
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Affiliation(s)
- H Naik
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - X Qiu
- Biostatistics, Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - M C Brown
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - L Eng
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - D Pringle
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - M Mahler
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - H Hon
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - K Tiessen
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - H Thai
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - V Ho
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - C Gonos
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - R Charow
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - V Pat
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - M Irwin
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - L Herzog
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - A Ho
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - W Xu
- Biostatistics, Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - J M Jones
- Toronto General Research Institute, Toronto and
| | - D Howell
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - G Liu
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto;; Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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Ho A, Wei G, Maneval E, Esquibel V, Berger M, Haque S, Patel R, Walsh C, Hornby Z, Multani P, Li G, Drilon A. Overcoming drug resistance to Trk inhibition by rational combination of entrectinib and trametinib: from bench to bedside. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32615-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wong VW, Ho A, Fiakos E, Lau NS, Russell H. Introduction of New South Wales adult subcutaneous insulin-prescribing chart in a tertiary hospital: its impact on inpatient glycaemic control. Intern Med J 2016; 46:1323-1328. [DOI: 10.1111/imj.13229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 07/25/2016] [Accepted: 08/13/2016] [Indexed: 01/08/2023]
Affiliation(s)
- V. W. Wong
- Liverpool Diabetes Collaborative Research Unit; Ingham Institute for Applied Medical Research, SWS Clinical School; Sydney New South Wales Australia
- Diabetes and Endocrine Service; Liverpool Hospital; Sydney New South Wales Australia
| | - A. Ho
- South Western Sydney Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - E. Fiakos
- Pharmacy Department; Liverpool Hospital; Sydney New South Wales Australia
| | - N. S. Lau
- Liverpool Diabetes Collaborative Research Unit; Ingham Institute for Applied Medical Research, SWS Clinical School; Sydney New South Wales Australia
- Diabetes and Endocrine Service; Liverpool Hospital; Sydney New South Wales Australia
| | - H. Russell
- Diabetes and Endocrine Service; Liverpool Hospital; Sydney New South Wales Australia
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Ali S, Fedorchak K, Schrock A, Johnson J, Gowen K, Elvin J, Vergilio JA, Klempner S, Mehra R, Ho A, Pavlick D, Suh J, Bordoni R, Jung D, Stephens P, Chung C, Ross J, Miller V. Advanced acinic cell carcinoma harbors kinase rearrangements including BRAF kinase domain duplications. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tyagi N, Sutton E, Hunt M, Apte A, Zhang J, Oh J, Mechalakos J, Mehrara B, Matros E, Ho A. SU-D-207B-04: Morphological Features of MRI as a Correlate of Capsular Contracture in Breast Cancer Patients with Implant-Based Reconstructions. Med Phys 2016. [DOI: 10.1118/1.4955672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Zhang Z, Ho A, Wang X, Brown P, Guha-Thakurta N, Ferguson S, Fave X, Zhang L, Mackin D, Court L, Li J, Yang J. TU-D-207B-01: A Prediction Model for Distinguishing Radiation Necrosis From Tumor Progression After Gamma Knife Radiosurgery Based On Radiomics Features From MR Images. Med Phys 2016. [DOI: 10.1118/1.4957509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ho A, Aston S, Jary H, Alaerts M, Menyere M, Mallewa J, Nyirenda M, Everett D, French N, Heyderman R. The impact of HIV infection on the burden and severity of influenza illness in Malawian adults. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Pantuck AJ, Pettaway CA, Dreicer R, Corman J, Katz A, Ho A, Aronson W, Clark W, Simmons G, Heber D. A randomized, double-blind, placebo-controlled study of the effects of pomegranate extract on rising PSA levels in men following primary therapy for prostate cancer. Prostate Cancer Prostatic Dis 2015; 18:242-8. [PMID: 26169045 DOI: 10.1038/pcan.2015.32] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 06/02/2015] [Accepted: 06/02/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND The primary objective of this study was to compare the effects of pomegranate juice on PSA doubling times (PSADT) in subjects with rising PSA levels after primary therapy for prostate cancer. METHODS Double-blind, placebo-controlled multi-institutional study, evaluated the effects of pomegranate liquid extract on serum PSA levels. The primary end point of this study was change in serum PSADT. Additional secondary and exploratory objectives were to evaluate the safety of pomegranate juice and to determine the interaction of manganese superoxide dismutase (MnSOD) AA genotype and pomegranate treatment on PSADT. RESULTS One-hundred eighty-three eligible subjects were randomly assigned to the active and placebo groups with a ratio of 2:1 (extract N=102; placebo N=64; juice N=17). The majority of adverse events were of moderate or mild grade. Median PSADT increased from 11.1 months at baseline to 15.6 months in the placebo group (P<0.001) compared with an increase from 12.9 months at baseline to 14.5 months in the extract group (P=0.13) and an increase from 12.7 at baseline to 20.3 in the juice group (P=0.004). However, none of these changes were statistically significant between the three groups (P>0.05). Placebo AA patients experienced a 1.8 month change in median PSADT from 10.9 months at baseline to 12.7 months (P=0.22), while extract patients experienced a 12 month change in median PSADT from 13.6 at baseline to 25.6 months (P=0.03). CONCLUSIONS Compared with placebo, pomegranate extract did not significantly prolong PSADT in prostate cancer patients with rising PSA after primary therapy. A significant prolongation in PSADT was observed in both the treatment and placebo arms. Men with the MnSOD AA genotype may represent a group that is more sensitive to the antiproliferative effects of pomegranate on PSADT; however, this finding requires prospective hypothesis testing and validation.
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Affiliation(s)
- A J Pantuck
- Department of Urology, Institute of Urologic Oncology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - C A Pettaway
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - R Dreicer
- Cleveland Clinic Foundation, Cleveland, OH, USA
| | - J Corman
- Virginia Mason Medical Center, Seattle, WA, USA
| | - A Katz
- Winthrop University Hospital, Garden City, NY, USA
| | - A Ho
- Winthrop University Hospital, Garden City, NY, USA
| | - W Aronson
- 1] Department of Urology, Institute of Urologic Oncology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA [2] VA Medical Center Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - W Clark
- Alaska Clinical Research Center, Anchorage, AL, USA
| | - G Simmons
- Five Valleys Urology, Missoula, MT, USA
| | - D Heber
- 1] Department of Urology, Institute of Urologic Oncology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA [2] Department of Medicine and Clinical Nutrition, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
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Bhattacharya I, Hussain T, Kadam M, Sutherland S, Ho A, Bernhardt V, Ah-See M, Shah N, Ostler P, Miles D, Makris A. Eligibility for Entry into First Line Metastatic Trials in Patients with Disease Recurrence within 12 Months of Adjuvant Chemotherapy for Early Stage Breast Cancer. Clin Oncol (R Coll Radiol) 2015. [DOI: 10.1016/j.clon.2015.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lin H, Gao Y, Liu T, Gelblum D, Ho A, Powell S, Tang X, Xu X. SU-F-BRB-02: Towards Quantitative Clinical Decision On Deep Inspiration Breath Hold (DIBH) Or Prone for Left-Sided Breast Irradiation. Med Phys 2015. [DOI: 10.1118/1.4925197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Sabelstrom H, Jandial R, Shchors K, Masic S, Ho A, Vandenberg S, Nicolaides TP, Nguyen K, Yakovenko S, Prados MD, James CD, Berger MS, Evan GI, Snyder EY, Weiss WA, Persson AI. HG-13 * SOX9 AS A DOWN-STREAM TARGET IN RAS/MEK-DRIVEN PEDIATRIC GLIOMA. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov061.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kuo L, Ballangrud A, Ho A, Mechalakos J, Li G, Hong L. SU-E-T-209: Comparison of Plan Quality Between Arm Avoidance (AA) Vs. Non Arm Avoidance VMAT Planning Techniques for Breast Cancer Patients with Bilateral Implant Reconstructions Receiving Postmastectomy Radiation. Med Phys 2015. [DOI: 10.1118/1.4924570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Powell J, Powell S, Lennon M, Ho A, Murrant N. Paediatric ventilation tube insertion: our experience of seventy-five children in audiology-led follow-up. Clin Otolaryngol 2015; 40:385-9. [PMID: 25598389 DOI: 10.1111/coa.12380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 11/28/2022]
Affiliation(s)
- J Powell
- Department of Otolaryngology-Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK
| | - S Powell
- Department of Otolaryngology-Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK
| | - M Lennon
- Department of Audiology, Cumberland Infirmary, Carlisle, UK
| | - A Ho
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - N Murrant
- Department of Otolaryngology-Head and Neck Surgery, Cumberland Infirmary, Carlisle, UK
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Schmitt M, Müller L, Keyßer G, Lorenz HM, Ho A, Wuchter P. Zelltherapie in der Rheumatologie: Chancen und Risiken der Therapie mit mesenchymalen Stromazellen. AKTUEL RHEUMATOL 2014. [DOI: 10.1055/s-0034-1395611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- M. Schmitt
- Medizinische Klinik V (Hämatologie, Onkologie, Rheumatologie), Universitätsklinikum Heidelberg, Universität Heidelberg, Heidelberg
| | - L. Müller
- Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Innere Medizin IV
| | - G. Keyßer
- Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Innere Medizin II, Arbeitsbereich Rheumatologie
| | - H.-M. Lorenz
- Medizinische Klinik V (Hämatologie, Onkologie, Rheumatologie), Universitätsklinikum Heidelberg, Universität Heidelberg, Heidelberg
| | - A. Ho
- Medizinische Klinik V (Hämatologie, Onkologie, Rheumatologie), Universitätsklinikum Heidelberg, Universität Heidelberg, Heidelberg
| | - P. Wuchter
- Medizinische Klinik V (Hämatologie, Onkologie, Rheumatologie), Universitätsklinikum Heidelberg, Universität Heidelberg, Heidelberg
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Zhang Y, Brownstein AJ, Buonora M, Niikura K, Ho A, Correa da Rosa J, Kreek MJ, Ott J. Self administration of oxycodone alters synaptic plasticity gene expression in the hippocampus differentially in male adolescent and adult mice. Neuroscience 2014; 285:34-46. [PMID: 25446355 DOI: 10.1016/j.neuroscience.2014.11.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/19/2014] [Accepted: 11/04/2014] [Indexed: 11/16/2022]
Abstract
Abuse and addiction to prescription opioids such as oxycodone (a short-acting Mu opioid receptor (MOP-r) agonist) in adolescence is a pressing public health issue. We have previously shown differences in oxycodone self-administration behaviors between adolescent and adult C57BL/6J mice and expression of striatal neurotransmitter receptor genes, in areas involved in reward. In this study, we aimed to determine whether oxycodone self-administration differentially affects genes regulating synaptic plasticity in the hippocampus of adolescent compared to adult mice, since the hippocampus may be involved in learning aspects associated with chronic drug self administration. Hippocampus was isolated for mRNA analysis from mice that had self administered oxycodone (0.25 mg/kg/infusion) 2h/day for 14 consecutive days or from yoked saline controls. Gene expression was analyzed with real-time polymerase chain reaction (PCR) using a commercially available "synaptic plasticity" PCR array containing 84 genes. We found that adolescent and adult control mice significantly differed in the expression of several genes in the absence of oxycodone exposure, including those coding for mitogen-activated protein kinase, calcium/calmodulin-dependent protein kinase II gamma subunit, glutamate receptor, ionotropic AMPA2 and metabotropic 5. Chronic oxycodone self administration increased proviral integration site 1 (Pim1) and thymoma viral proto-oncogene 1 mRNA levels compared to controls in both age groups. Both Pim1 and cadherin 2 mRNAs showed a significant combined effect of Drug Condition and Age × Drug Condition. Furthermore, the mRNA levels of both cadherin 2 and cAMP response element modulators showed an experiment-wise significant difference between oxycodone and saline control in adult but not in adolescent mice. Overall, this study demonstrates for the first time that chronic oxycodone self-administration differentially alters synaptic plasticity gene expression in the hippocampus of adolescent and adult mice.
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Affiliation(s)
- Y Zhang
- The Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10065, USA.
| | - A J Brownstein
- The Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10065, USA
| | - M Buonora
- The Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10065, USA
| | - K Niikura
- The Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10065, USA
| | - A Ho
- The Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10065, USA
| | - J Correa da Rosa
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY 10065, USA
| | - M J Kreek
- The Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10065, USA
| | - J Ott
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; The Laboratory of Statistical Genetics, The Rockefeller University, New York, NY, USA
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Hajj C, Huguet F, Wu A, Shi W, Zhang Z, O'Reilly E, Winston C, Reidy D, Ho A, Allen P, Goodman K. Chemotherapy and Intensity Modulated Radiation Therapy for Locally Advanced Pancreatic Cancer Achieves Prolonged Survival. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ho A, Pritchard H, Barker R. G01 Verbal Learning, Recall And Recognition In Huntington's Disease. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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