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Demars M, McDowell T, Renaud J, Scott A, Fruci M, Topp E. Persistence and evidence for accelerated biodegradation of streptomycin in agricultural soils. Sci Total Environ 2024:172502. [PMID: 38636872 DOI: 10.1016/j.scitotenv.2024.172502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 04/20/2024]
Abstract
Some antibiotics are used for the treatment of various bacterial crop diseases, and there is a concern that this practice may represent a selection pressure that increases the reservoir of antibiotic resistance carried by bacteria in crop production systems. Since the 1950s the aminoglycoside antibiotic streptomycin has been widely used for the treatment of some bacterial crop diseases such as fire blight in apples and pears. Following application, the time that bacteria will be exposed to the antibiotic, and therefore the pressure for selection of resistance, will vary according to the environmental persistence of the antibiotic. In the present study, the dissipation of streptomycin was examined in soils supplemented with 5 mg streptomycin/kg soil and incubated for 21 days under laboratory conditions. The impact of two key rate-controlling variables, soil texture (sandy loam, loam, clay loam) and temperature (4, 20, 30 °C) on streptomycin persistence were explored. -Robust methods for streptomycin extraction and analysis by LC-MS/MS were developed. Streptomycin dissipation followed first order kinetics, with the time to dissipate 50 % of the parent compound (DT50) in soils of varying texture incubated at 20 °C ranging from about seven to 15 days. In contrast, the DT50 of streptomycin in autoclaved loam soil incubated at 20 °C was about 111 days. At 4 °C the DT50 ranged from 49 to 137 days. Under no incubation conditions were any extractable transformation products obtained. Streptomycin was dissipated significantly more rapidly in field soil that had a prior history of exposure to the antibiotic than in soil that did not. Taken together, these results indicate that streptomycin is amenable to biodegradation in agricultural soils with DT50s of several days when temperature is permissive.
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Affiliation(s)
- Megan Demars
- London Research and Development Centre, Agriculture and Agri-Food Canada, London, ON, Canada; Department of Biology, University of Western Ontario, London, ON, Canada
| | - Tim McDowell
- London Research and Development Centre, Agriculture and Agri-Food Canada, London, ON, Canada
| | - Justin Renaud
- London Research and Development Centre, Agriculture and Agri-Food Canada, London, ON, Canada
| | - Andrew Scott
- London Research and Development Centre, Agriculture and Agri-Food Canada, London, ON, Canada
| | - Michael Fruci
- London Research and Development Centre, Agriculture and Agri-Food Canada, London, ON, Canada; Department of Microbiology and Immunology, University of Western Ontario, London, ON, Canada
| | - Edward Topp
- London Research and Development Centre, Agriculture and Agri-Food Canada, London, ON, Canada; Department of Biology, University of Western Ontario, London, ON, Canada.
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Scott A, Topp E, Revellin C, Hartmann A, Fruci M. Complete genome sequence of Bradyrhizobium ottawaense strain MIAE 01942 isolated from soybean nodules grown in antibiotic-amended soil. Microbiol Resour Announc 2024; 13:e0000424. [PMID: 38501779 PMCID: PMC11008171 DOI: 10.1128/mra.00004-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/08/2024] [Indexed: 03/20/2024] Open
Abstract
Bradyrhizobium ottawaense MIAE 01942 is a symbiotic nitrogen-fixing bacterium isolated from the root nodules of soybeans grown in agricultural soils amended with veterinary antibiotics. The genome consists of a single 8.45 Mb circular chromosome that harbors genes involved in nitrogen fixation, denitrification, and antibiotic and metal resistance.
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Affiliation(s)
- Andrew Scott
- Agriculture and Agri-Food Canada, London Research and Development Centre, London, Ontario, Canada
| | - Edward Topp
- Agroécologie Research Unit, INRAE, Université de Bourgogne, Dijon, France
- Department of Biology, University of Western Ontario, London, Ontario, Canada
| | - Cécile Revellin
- Agroécologie Research Unit, INRAE, Université de Bourgogne, Dijon, France
| | - Alain Hartmann
- Agroécologie Research Unit, INRAE, Université de Bourgogne, Dijon, France
| | - Michael Fruci
- Agriculture and Agri-Food Canada, London Research and Development Centre, London, Ontario, Canada
- Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada
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Mikhail-Lette M, Cordero L, Lievens Y, Al-Ibraheem A, Urbain JL, Chera B, Muylle K, Vaandering A, Rosa AA, Cerci JJ, Sathekge M, Minjgee M, Nansalmaa E, Erdenechimeg S, Ruiz RL, Scott A, Paez D, Giammarile F, Veduta A, Minoshima E, Vichare S, Abdel-Wahab M. Six country vignettes: Strengthening radiotherapy and theranostics. J Cancer Policy 2024; 40:100471. [PMID: 38556128 DOI: 10.1016/j.jcpo.2024.100471] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/29/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND For cancer patient populations worldwide, the synchronous scale-up of diagnostics and treatments yields meaningful gains in survival and quality of life. Among advanced cancer therapies, radiotherapy (RT) and theranostics are key to achieving practical, high-quality, and personalized precision medicine - targeting disease manifestations of individual patients and broad populations, alike. Aiming to learn from one another across different world regions, the six country vignettes presented here depict both challenges and victories in de novo establishment or improvement of RT and theranostics infrastructure. METHODS The International Atomic Energy Agency (IAEA) convened global RT and theranostics experts from diverse world regions and contexts to identify relevant challenges and report progress in their own six countries: Belgium, Brazil, Costa Rica, Jordan, Mongolia, and South Africa. These accounts are collated, compared, and contrasted herein. RESULTS Common challenges persist which could be more strategically assessed and addressed. A quantifiable discrepancy entails personnel. The estimated radiation oncologists (ROs), nuclear medicine physicians (NMPs), and medical physicists (MPs for RT and nuclear medicine) per million inhabitants in the six collective countries respectively range between 2.69-38.00 ROs, 1.00-26.00 NMPs, and 0.30-3.45 MPs (Table 1), reflecting country-to-country inequities which largely match World Bank country-income stratifications. CONCLUSION Established goals for RT and nuclear medicine advancement worldwide have proven elusive. The pace of progress could be hastened by enhanced approaches such as more sustainably phased implementation; better multinational networking to share lessons learned; routine quality and safety audits; as well as capacity building employing innovative, resource-sparing, cutting-edge technologic approaches. Bodies such as ministries of health, professional societies, and the IAEA shall serve critical roles in convening and coordinating more innovative RT and theranostics translational research, including expanding nuanced global database metrics to inform, reach, and potentiate milestones most meaningfully. POLICY SUMMARY Aligned with WHO 25×25 NCDs target; WHA70.12 and WHA76.5 resolutions.
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Affiliation(s)
- Miriam Mikhail-Lette
- International Atomic Energy Agency Department of Nuclear Sciences and Applications, Division of Human Health, Nuclear Medicine and Diagnostic Imaging Section, Vienna, Austria.
| | - Lisbeth Cordero
- International Atomic Energy Agency Department of Nuclear Sciences and Applications, Division of Human Health, Nuclear Medicine and Diagnostic Imaging Section, Vienna, Austria
| | - Yolande Lievens
- Department of Radiation Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Jean-Luc Urbain
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Bhishamjit Chera
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA
| | | | - Aude Vaandering
- Department of Radiation Oncology, Université Catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium
| | - Arthur Accioly Rosa
- Department of Radiation Oncology, Oncoclínicas Salvador and Hospital Santa Izabel, Salvador, Bahia, Brazil
| | - Juliano Julio Cerci
- Department of Nuclear Medicine, Quanta Diagnóstico e Terapia, Curitiba, Brazil
| | - Mike Sathekge
- Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | | | | | | | - Rolando Loría Ruiz
- Radiation Therapy Center Siglo 21, Hospital México and Clínica Bíblica, Caja Costarricense de Seguro Social, San Jose, Costa Rica
| | - Andrew Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia; School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Diana Paez
- International Atomic Energy Agency Department of Nuclear Sciences and Applications, Division of Human Health, Nuclear Medicine and Diagnostic Imaging Section, Vienna, Austria
| | - Francesco Giammarile
- International Atomic Energy Agency Department of Nuclear Sciences and Applications, Division of Human Health, Nuclear Medicine and Diagnostic Imaging Section, Vienna, Austria
| | - Anna Veduta
- International Atomic Energy Agency Department of Nuclear Sciences and Applications, Division of Human Health, Nuclear Medicine and Diagnostic Imaging Section, Vienna, Austria
| | - Erika Minoshima
- International Atomic Energy Agency Department of Nuclear Sciences and Applications, Division of Human Health, Nuclear Medicine and Diagnostic Imaging Section, Vienna, Austria
| | - Shrikant Vichare
- International Atomic Energy Agency Department of Nuclear Sciences and Applications, Division of Human Health, Nuclear Medicine and Diagnostic Imaging Section, Vienna, Austria
| | - May Abdel-Wahab
- International Atomic Energy Agency Department of Nuclear Sciences and Applications, Division of Human Health, Nuclear Medicine and Diagnostic Imaging Section, Vienna, Austria
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Pal S, Nare Z, Rao VA, Smith BO, Morrison I, Fitzgerald EA, Scott A, Bingham MJ, Pesnot T. Accelerating BRPF1b hit identification with BioPhysical and Active Learning Screening (BioPALS). ChemMedChem 2024; 19:e202300590. [PMID: 38372199 DOI: 10.1002/cmdc.202300590] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/29/2023] [Revised: 01/25/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
We report the development of BioPhysical and Active Learning Screening (BioPALS); a rapid and versatile hit identification protocol combining AI-powered virtual screening with a GCI-driven biophysical confirmation workflow. Its application to the BRPF1b bromodomain afforded a range of novel micromolar binders with favorable ADMET properties. In addition to the excellent in silico/in vitro confirmation rate demonstrated with BRPF1b, binding kinetics were determined, and binding topologies predicted for all hits. BioPALS is a lean, data-rich, and standardized approach to hit identification applicable to a wide range of biological targets.
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Affiliation(s)
- Sandeep Pal
- Concept Life Sciences, Frith Knoll Road, Chapel-en-le-Frith, SK23 0PG, High Peak, UK
| | - Zandile Nare
- Concept Life Sciences, Frith Knoll Road, Chapel-en-le-Frith, SK23 0PG, High Peak, UK
| | - Vincenzo A Rao
- Concept Life Sciences, Frith Knoll Road, Chapel-en-le-Frith, SK23 0PG, High Peak, UK
| | - Brian O Smith
- University of Glasgow, School of Molecular Biosciences, College of Medical Veterinary and Life Sciences, G12 8QQ, Glasgow, UK
| | - Ian Morrison
- Concept Life Sciences, Frith Knoll Road, Chapel-en-le-Frith, SK23 0PG, High Peak, UK
| | | | - Andrew Scott
- Concept Life Sciences, Frith Knoll Road, Chapel-en-le-Frith, SK23 0PG, High Peak, UK
| | - Matilda J Bingham
- Concept Life Sciences, Frith Knoll Road, Chapel-en-le-Frith, SK23 0PG, High Peak, UK
| | - Thomas Pesnot
- Concept Life Sciences, Frith Knoll Road, Chapel-en-le-Frith, SK23 0PG, High Peak, UK
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Jaumdally S, Tomasicchio M, Pooran A, Esmail A, Kotze A, Meier S, Wilson L, Oelofse S, van der Merwe C, Roomaney A, Davids M, Suliman T, Joseph R, Perumal T, Scott A, Shaw M, Preiser W, Williamson C, Goga A, Mayne E, Gray G, Moore P, Sigal A, Limberis J, Metcalfe J, Dheda K. Frequency, kinetics and determinants of viable SARS-CoV-2 in bioaerosols from ambulatory COVID-19 patients infected with the Beta, Delta or Omicron variants. Nat Commun 2024; 15:2003. [PMID: 38443359 PMCID: PMC10914788 DOI: 10.1038/s41467-024-45400-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/04/2023] [Accepted: 01/22/2024] [Indexed: 03/07/2024] Open
Abstract
Airborne transmission of SARS-CoV-2 aerosol remains contentious. Importantly, whether cough or breath-generated bioaerosols can harbor viable and replicating virus remains largely unclarified. We performed size-fractionated aerosol sampling (Andersen cascade impactor) and evaluated viral culturability in human cell lines (infectiousness), viral genetics, and host immunity in ambulatory participants with COVID-19. Sixty-one percent (27/44) and 50% (22/44) of participants emitted variant-specific culture-positive aerosols <10μm and <5μm, respectively, for up to 9 days after symptom onset. Aerosol culturability is significantly associated with lower neutralizing antibody titers, and suppression of transcriptomic pathways related to innate immunity and the humoral response. A nasopharyngeal Ct <17 rules-in ~40% of aerosol culture-positives and identifies those who are probably highly infectious. A parsimonious three transcript blood-based biosignature is highly predictive of infectious aerosol generation (PPV > 95%). There is considerable heterogeneity in potential infectiousness i.e., only 29% of participants were probably highly infectious (produced culture-positive aerosols <5μm at ~6 days after symptom onset). These data, which comprehensively confirm variant-specific culturable SARS-CoV-2 in aerosol, inform the targeting of transmission-related interventions and public health containment strategies emphasizing improved ventilation.
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Affiliation(s)
- S Jaumdally
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - M Tomasicchio
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Pooran
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Esmail
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Kotze
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - S Meier
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - L Wilson
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - S Oelofse
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - C van der Merwe
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Roomaney
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - M Davids
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - T Suliman
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - R Joseph
- Division of Medical Virology, Wellcome Centre for Infectious Diseases in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - T Perumal
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - A Scott
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa
| | - M Shaw
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - W Preiser
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus; Medical Virology, National Health Laboratory Service Tygerberg, Parow, Cape Town, South Africa
| | - C Williamson
- Division of Medical Virology, Wellcome Centre for Infectious Diseases in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- National Health Laboratory Service (NHLS), Cape Town, South Africa
| | - A Goga
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa
| | - E Mayne
- Department of Immunology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
- Division of Immunology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - G Gray
- South African Medical Research Council, Cape Town, South Africa
| | - P Moore
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- SA MRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - A Sigal
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Max Planck Institute for Infection Biology, Berlin, Germany
| | - J Limberis
- Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Centre, University of California, San Francisco, San Francisco, CA, USA
| | - J Metcalfe
- Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital and Trauma Centre, University of California, San Francisco, San Francisco, CA, USA
| | - K Dheda
- Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa.
- Centre for the Study of Antimicrobial Resistance, South African Medical Research Council, Cape Town, South Africa.
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
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Founti P, Narayan A, Raja A, Nathwani N, Tur SB, Thomas R, Scott A, Martins A, Nolan W. Outcomes of newly referred patients with suspected angle closure: do we need to redefine the clinical pathways? Eye (Lond) 2024; 38:514-519. [PMID: 37684375 PMCID: PMC10858203 DOI: 10.1038/s41433-023-02713-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 08/13/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND/OBJECTIVES To investigate outcomes of referrals for suspected angle closure and explore whether anterior segment optical coherence tomography (AS-OCT) can be used to tighten triaging criteria in a glaucoma virtual clinic. SUBJECTS/METHODS Retrospectively collected data. The first audit (04/2018-03/2019) identified referrals for suspected angle closure without other glaucoma-related findings (primary angle closure suspect (PACS) referrals). All patients underwent gonioscopy. The second audit (04-08/2019) identified patients with suspected angle closure in a virtual clinic. Management outcomes were assessed, using gonioscopy as reference standard. The outcomes of the second audit were re-audited after changing the triaging criterion from angle width <10° to iridotrabecular contact (ITC) in ≥1 quadrants on AS-OCT. RESULTS Out of 1754 glaucoma referrals (first audit), 24.6% (431/1754) were PACS referrals. Of these, only 10.7% (42/393) had an occludable angle on gonioscopy, with 97.6% (41/42) being PACS. Of these, 78% (32/41) underwent laser peripheral iridotomy. Out of 137 referrals in the virtual clinic (second audit), 66.4% (91/137) were triaged to the face-to-face clinic. Of these, 31.9% (29/91) were discharged. AS-OCT had positive and negative predictive value of 74.3% (95% confidence intervals (CI) 57.8-86.0) and 82.1% (95% CI 70.0-90.2%), respectively, in detecting ITC in ≥1 quadrants. In the re-audit 45.9% (45/98) of those with suspected angle closure were triaged for gonioscopy, with 24.4% (11/45) of them being discharged. CONCLUSION PACS referrals represent a substantial burden to hospital-based services and their accuracy is low. ITC in ≥1 quadrants on AS-OCT can be useful in triaging those who need further evaluation with gonioscopy.
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Affiliation(s)
- Panayiota Founti
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Akshay Narayan
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Aneela Raja
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Neil Nathwani
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Rachel Thomas
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Andrew Scott
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Alessandra Martins
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Save Sight Institute, Discipline of Ophthalmology and Eye Health, University of Sydney, Sydney, NSW, Australia
| | - Winifred Nolan
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- National Institute for Health and Care Research (NIHR) Biomedical Research Centre, Moorfields and UCL Institute of Ophthalmology, London, UK
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Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Falkenberry E, Reeves M, Scott A, Myrick D, Fallini C, Bassell G, Katz D. LSD1/KDM1A is essential for neural stem cell differentiation in mice. bioRxiv 2023:2023.12.02.569711. [PMID: 38076951 PMCID: PMC10705553 DOI: 10.1101/2023.12.02.569711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
The proper regulation of neural stem cell differentiation is required for the proper specification of the central nervous system. Here we investigated the function of the H3K4me1/2 demethylase LSD1/KDM1A during neural stem differentiation in mice. Conditional deletion of LSD1 in nestin- positive neural stem cells results in 100% perinatal lethality after birth with severe motor coordination deficits, retarded growth and defects in brain morphology. Despite these severe defects, motor neuron progenitors and the initial motor neuron population are specified normally and motor neurons with normal morphology can be cultured from these mice in vitro. However, motor neurons cultured from mice lacking LSD1 in neural stem cells continue to inappropriately maintain critical neural stem cell proteins. Taken together these results suggest that, as in other mouse stem cell populations, LSD1 is required to deactivate the stem cell program to enable normal neural stem cell differentiation. However, unlike in other mouse stem cell populations, the inappropriate maintenance of the stem cell program during neural stem cell differentiation may compromise neuronal function rather than neuronal specification.
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Affiliation(s)
- E.C. Falkenberry
- Department of Cell Biology, Emory University School of Medicine, Atlanta GA 30322, USA
| | - M. Reeves
- Department of Cell Biology, Emory University School of Medicine, Atlanta GA 30322, USA
| | | | | | - C. Fallini
- Department of Cell and Molecular Biology, University of Rhode Island, Kingston, RI 02881, USA
| | - G.J. Bassell
- Department of Cell Biology, Emory University School of Medicine, Atlanta GA 30322, USA
| | - D.J. Katz
- Department of Cell Biology, Emory University School of Medicine, Atlanta GA 30322, USA
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10
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González-Andrades M, Fung SSM, Potic J, Chidambaram JD, Karimi A, Quigley C, Pontoppidan-Toms R, Scott A, Rasmussen MLR. Harmonizing ophthalmic residency surgical training across Europe: A proposed surgical curriculum. Eye (Lond) 2023; 37:3256-3262. [PMID: 36932160 PMCID: PMC10564786 DOI: 10.1038/s41433-023-02502-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/29/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND One of the core aims of the European Union of Medical Specialists is to harmonize training across Europe by creating European Training Requirements for all medical specialties including Ophthalmology. The theoretical part is already defined by the EBO, however as ophthalmology also includes surgical skills, we herein propose a surgical minimum curriculum for ophthalmology residents in Europe. METHODS National and international ophthalmic training curricula which are publicly available in English were reviewed and compared. The final proposal was created from 5 criteria: 1. Disease prevalence; 2. Patient safety; 3. Case-trainee ratio; 4. Skill transfer; and 5. Technical difficulty. RESULTS In total 7 different training curricula from across the world were compared. Among the surgical procedures, cataract surgery has the highest median number of procedures required to be completed during residency: 86 procedures (50-350). Followed by oculoplastics: 28 procedures (10-40) and panretinal photocoagulation: 27.5 procedures (10-49) Full procedural competence is proposed in 9 surgical skills, including YAG laser posterior capsulotomy, retinal argon laser, intravitreal injection, corneal foreign body removal, removal of corneal sutures, facial and periocular laceration repair, eyelid laceration repair, minor eyelid procedures, and punctal occlusion. These procedures are deemed essential and feasible for all ophthalmology residents in Europe to perform independently upon completion of their training. CONCLUSION This proposal should be regarded as a recommendation based on comparable surgical curricula in use worldwide to establish standards across European countries and may serve as valuable insight to those responsible for compiling ETRs for ophthalmology, or their national curriculums.
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Affiliation(s)
- Miguel González-Andrades
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, Cordoba, Spain
| | - Simon S M Fung
- Department of Ophthalmology, University of California Los Angeles, Los Angeles, USA
| | - Jelena Potic
- Clinic for Eye Diseases, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
- Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland
| | - Jaya D Chidambaram
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Ayesha Karimi
- Department of Ophthalmology, Frimley Park Hospital, Portsmouth Road, Frimley, GU16 7UJ, UK
| | - Clare Quigley
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | | | | | - Marie Louise R Rasmussen
- Department of Ophthalmology, Rigshospitalet, Copenhagen and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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Elaimy AL, Al-Holou W, Scott A, Marini BL, Pai A, Wen B, Wang L, Sun D, Heth JA, Umemura Y, Wahl DR. A Phase 0 Study Assessing the Intracranial Activity of a Metabolic Radiosensitizer in Patients with Glioblastoma. Int J Radiat Oncol Biol Phys 2023; 117:e102. [PMID: 37784629 DOI: 10.1016/j.ijrobp.2023.06.872] [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) Efforts to overcome treatment resistance in glioblastoma (GBM) have been unsuccessful due to tumor heterogeneity and poor intracranial drug penetration. Targeting altered metabolism is a promising approach to improve GBM therapy despite this heterogeneity. Mycophenolate mofetil (MMF) is an inhibitor of purine synthesis that sensitizes GBM to radiation and temozolomide (TMZ) in vitro and in vivo, but its ability to cross the blood brain barrier and inhibit GBM metabolism in patients is unknown. NCT04477200 is a phase 0/1 dose escalation study of MMF combined with radiation and temozolomide in GBM. Here we report the phase 0 results of this study assessing the intracranial activity of MMF. MATERIALS/METHODS Purine (GTP and IMP) and mycophenolic acid (MPA, the active metabolite of MMF) concentrations were determined using mass spectrometry in flash-frozen tumor (enhancing and non-enhancing) and normal cortex obtained from 8 patients with recurrent GBM who received MMF (500, 1000, 1500 and 2000 mg BID, N = 2 patients each dose level) for 1 week prior to re-resection and 5 control patients who did not receive MMF prior to re-resection. Plasma MPA concentration was similarly quantified to calculate the enhancing tumor, non-enhancing tumor and normal cortex to plasma MPA ratios. RESULTS Patients who received MMF had a mean MPA concentration of 2.2 ± 0.7 µM in the enhancing tumor samples, 1.2 ± 0.5 µM in the non-enhancing tumor samples and 1.3 ± 0.5 µM in normal cortex. MPA concentration was negligible in control patients. This corresponded to tissue/plasma MPA ratios of 0.31, 0.17 and 0.10 for enhancing tumor, non-enhancing tumor and normal cortex, respectively. The GTP/IMP ratio was decreased by 75% in enhancing tumor in MMF-treated patients compared to untreated controls (p = 0.009), indicating effective target engagement and inhibition of purine synthesis. The GTP/IMP ratio was also decreased in cortex and non-enhancing tumor, though a paucity of control samples prevented statistical analysis. CONCLUSION Twice daily MMF treatment yields intracranial drug concentrations above 1 µM and lowers the GTP/IMP ratio in GBMs, consistent with target engagement. As we have previously observed radiosensitization in vitro with MPA concentrations of 1 µM, these data suggest that MMF may achieve adequate CNS penetration for therapeutic benefit. The Phase 1 component of this study to determine the dose limiting toxicity and maximally tolerated dose of MMF when combined with reirradiation in recurrent GBM and radiation and TMZ in newly diagnosed GBM is ongoing.
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Affiliation(s)
- A L Elaimy
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - W Al-Holou
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - A Scott
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - B L Marini
- College of Pharmacy, University of Michigan, Ann Arbor, MI
| | - A Pai
- College of Pharmacy, University of Michigan, Ann Arbor, MI
| | - B Wen
- College of Pharmacy, University of Michigan, Ann Arbor, MI
| | - L Wang
- College of Pharmacy, University of Michigan, Ann Arbor, MI
| | - D Sun
- College of Pharmacy, University of Michigan, Ann Arbor, MI
| | - J A Heth
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - Y Umemura
- Department of Neurology, University of Michigan, Ann Arbor, MI
| | - D R Wahl
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
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Edwards DM, Hopkins A, Scott A, Mannan R, Cao X, Zhang L, Andren A, Heth JA, Muraszko K, Sagher O, Orringer D, Hollon T, Hervey-Jumper S, Venneti S, Camelo-Piragua S, Al-Holou W, Chinnaiyan A, Lyssiotis CA, Wahl DR. Identification of Excellent Prognosis IDH Wildtype Glioblastomas Using Genomic and Metabolic Profiling. Int J Radiat Oncol Biol Phys 2023; 117:e101. [PMID: 37784627 DOI: 10.1016/j.ijrobp.2023.06.870] [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) High grade gliomas (HGGs) are aggressive brain tumors with altered cellular metabolism. HGGs can carry mutations in the tricarboxylic acid (TCA) cycle enzyme isocitrate dehydrogenase 1 (IDH1), conferring distinct biology and improved patient prognosis compared to IDH wildtype (wt) tumors. Using metabolomic analyses of tumor tissue, we previously showed that IDH wt and IDH mutant (IDH mut) tumors have unique metabolomic signatures that correlate with different survival outcomes. Among this cohort of 69 HGG samples, we identified two unique patient tumors that metabolically clustered with IDH mut tumors, but lacked both the IDH mutation and its product 2-hydroxyglutarate. We aimed to discover unique mutations in these two tumors that may impart an IDH mutant-like phenotype in the absence of an IDH1 or IDH2 mutation. MATERIALS/METHODS Whole exome sequencing (WES) was performed on frozen tumor samples from two patients diagnosed as glioblastoma (GBM), IDH wt via Agilent v5 + IncRNA platform. Alignment to the hg38 genome and variant calling were completed using an accelerated implementation of GATK's BWA and MuTect2 algorithms from Sentieon. Variants were filtered based on supporting reads and variant allele thresholds, with synonymous variants and common SNPs removed. High-confidence variants were further filtered by membership in the four KEGG pathways associated with IDH1 and IDH2. Identified variants were corroborated with metabolomics data from the two unique IDH wt tumors compared with classical GBM IDH wt, oligodendrogliomas IDH mut and astrocytomas IDH mut to identify putative drivers of an IDH mutant-like metabolomic phenotype in these unique IDH wt tumors. RESULTS Despite the lack of an IDH mutation, one patient survived 45.6 months and the other patient remains alive at last follow up 64 months post diagnosis, much longer than the 16-18-month median survival typical of patients with GBM IDH wt. WES of outlier IDH wt tumor samples revealed 65 unique mutations in the queried KEGG pathways, of which 34 had a variant allele frequency > = 0.15. These variants were processed in Gprofiler, confirming expected enrichment of the carboxylic acid metabolic biologic process, a functional gene set consisting of TCA genes, among these variants (p = 0.002, 3.6-fold enrichment). Accordingly, metabolite levels of intermediates of the TCA cycle, including malate and isocitrate were decreased in the outlier tumor samples compared to classic GBMs IDH wt (p<0.001). Presence of genetic alterations in key variants of the carboxylic acid metabolic biologic process (including ME1, GYP4F3, PTGIS, PFKL, PSPH, AKR1A1, HK2, NOS1) correlated with improved overall survival among GBM patients in the TCGA (p = 0.04). Laboratory validation of these findings in preclinical GBM models is ongoing. CONCLUSION Disruption of the TCA cycle independent of an IDH mutation is associated with favorable survival in GBM. Pharmacologic inhibition of these pathways may be a promising strategy to improve GBM outcomes.
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Affiliation(s)
- D M Edwards
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - A Hopkins
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - A Scott
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - R Mannan
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - X Cao
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - L Zhang
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI
| | - A Andren
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI
| | - J A Heth
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - K Muraszko
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - O Sagher
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - D Orringer
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - T Hollon
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - S Hervey-Jumper
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - S Venneti
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | | | - W Al-Holou
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - A Chinnaiyan
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - C A Lyssiotis
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI
| | - D R Wahl
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
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Rieu R, Prestwich RJ, Paterson C, Vohra S, Swan A, Noble D, Srinivasan D, Dixon L, Chiu K, Scott A, Mendes R, Khan S, Pilar A, Thompson A, Nutting CM, McPartlin A. A Multicenter Study of Clinician and Patient Reported Acute and Late Toxicity after Radical (Chemo)Radiotherapy for Non-Endemic Nasopharyngeal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e619. [PMID: 37785855 DOI: 10.1016/j.ijrobp.2023.06.2001] [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) Curative (chemo)radiotherapy ((CT)RT) for Nasopharyngeal cancers (NPC) achieves excellent disease control but is associated with significant late toxicities despite modern treatment delivery. Contemporary late toxicity data, including patient reported outcomes (PROs), is limited in the non-endemic population; we present a large contemporary series of toxicity outcomes and late PROs following treatment of non-endemic NPC. MATERIALS/METHODS Adult patients completing radical (CT)RT for primary NPC between February 2016 and 2020 at 7 large UK cancer centers were identified on institutional databases. Patients were excluded if they had prior head and neck cancer or prior therapeutic head and neck surgery (except neck dissection). Patients with an active other cancer were excluded from PRO assessment. Demographic, treatment, acute toxicity and outcome data were collected retrospectively from patient records. Disease-free patients were invited to complete an M.D. Anderson Dysphagia Index (MDADI) and University of Washington (UoW) Quality of Life (QoL) PROs questionnaires. RESULTS A total of 180 eligible patients were identified: 68% male, median age 54 years, 11% ≥70 years. EBV status was positive in 61% (unknown 12%). Patients had stage I (5%), II (22%), III (37%), IV (36%) disease; 95% were performance status ≤1 at baseline. Median follow-up was 31.2 months (range 0-68). A total of 54% received 70Gy in 33-35# and 43% received 65-66 Gy in 30-33#. 66% received induction and 65% received concurrent chemotherapy. 9.5% had residual disease at the first follow-up scan. Subsequent locoregional or distant recurrence occurred in 5% and 12% respectively. At last assessment, 84% patients were alive, 16% had died (of which 70% had active disease). Acute treatment toxicity included: 63% of patients required enteral support (median duration 98 days) with 9% a feeding tube at 1 year post treatment. 18% G3 dermatitis, 53% G3 mucositis. 82% requiring opioids and 40% admitted for symptom management. 90 patients completed the PROs (76% response rate) at a median of 37.8 months post treatment (Table 1). These demonstrate significant QoL detriment: 28% report significant pain, 24% require regular analgesia, and 59% report significant impact on daily activity. This was found to persist at different timepoints (not shown). CONCLUSION Excellent cancer survival outcomes are seen in a non-selected, non-endemic NPC population. However significant acute and late toxicity following radical treatment is identified which can profoundly negatively impact QoL in a relatively young cohort. This highlights the importance of ongoing efforts to reduce toxicity and supports the prospective evaluation of potential toxicity sparing technologies, such as proton beam radiotherapy.
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Affiliation(s)
- R Rieu
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - R J Prestwich
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - C Paterson
- Beatson West of Scotland Cancer Centre, Radiation Oncology Department, Glasgow, United Kingdom
| | - S Vohra
- Beaton West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - A Swan
- Edinburgh Cancer Centre, Western General Hospital, Crewe Road South, Edinburgh, United Kingdom
| | - D Noble
- Edinburgh Cancer Centre, Western General Hospital, Crewe Road South, Edinburgh, United Kingdom
| | - D Srinivasan
- Western General Hospital, Edinburgh, United Kingdom
| | - L Dixon
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK, Sheffield, United Kingdom
| | - K Chiu
- Mount Vernon Cancer Centre, Department of Clinical Oncology, Northwood, United Kingdom
| | - A Scott
- Mount Vernon Hospital, Department of Clinical Oncology, Northwood, United Kingdom
| | - R Mendes
- University College London Hospital, London, United Kingdom
| | - S Khan
- University College London Hospital, London, United Kingdom
| | - A Pilar
- University College London Hospital, London, United Kingdom
| | - A Thompson
- North Middlesex University Hospital, Cambridge CB2 8AP, United Kingdom
| | - C M Nutting
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A McPartlin
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
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Tran TT, Cole M, Tomas E, Scott A, Topp E. Potential selection and maintenance of manure-originated multi-drug resistant plasmids at sub-clinical concentrations for tetracycline family antibiotics. Can J Microbiol 2023; 69:339-350. [PMID: 37267627 DOI: 10.1139/cjm-2022-0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The goal of this study was to (a) determine the minimum selection concentrations of tetracycline family antibiotics necessary to maintain plasmids carrying tetracycline-resistant genes and (b) correlate these results to environmental hotspot concentrations reported in previous studies. This study used two plasmids (pT295A and pT413A) originating from dairy manure in a surrogate Escherichia coli host CV601. The minimum selection concentrations of antibiotics tested in nutrient-rich medium were determined as follows: 0.1 mg/L for oxytetracycline, 0.45 mg/L for chlortetracycline, and 0.13-0.25 mg/L for tetracycline. Mixing oxytetracycline and chlortetracycline had minimum selection concentration values increased 2-fold compared to those in single antibiotic tests. Minimum selection concentrations found in this study were lower than reported environmental hotspot concentrations, suggesting that tetracycline family antibiotics were likely to be the driver for the selection and maintenance of these plasmids. Relatively high plasmid loss rates (>90%) were observed when culturing a strain carrying a tetracycline-resistant plasmid in antibiotic-free nutrient-rich and nutrient-defined media. Overall, results suggested that these plasmids can be maintained at concentrations environmentally relevant in wastewater treatment plants, sewage, manure, and manured soil; however, they are unstable and easily lost in the absence of antibiotics.
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Affiliation(s)
- Tam T Tran
- London Research and Development Centre, Agriculture and Agri-Food Canada, 1391 Sandford St, London, ON N5V 4T3, Canada
- Department of Biology, University of Western Ontario, 1151 Richmond St, London, ON N6A 3K7, Canada
| | - Marlena Cole
- London Research and Development Centre, Agriculture and Agri-Food Canada, 1391 Sandford St, London, ON N5V 4T3, Canada
| | - Emily Tomas
- London Research and Development Centre, Agriculture and Agri-Food Canada, 1391 Sandford St, London, ON N5V 4T3, Canada
| | - Andrew Scott
- London Research and Development Centre, Agriculture and Agri-Food Canada, 1391 Sandford St, London, ON N5V 4T3, Canada
| | - Edward Topp
- London Research and Development Centre, Agriculture and Agri-Food Canada, 1391 Sandford St, London, ON N5V 4T3, Canada
- Department of Biology, University of Western Ontario, 1151 Richmond St, London, ON N6A 3K7, Canada
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Perez-Diaz N, Hoffman E, Clements J, Cruickshank R, Doherty A, Ebner D, Elloway J, Fu J, Kelsall J, Millar V, Saib O, Scott A, Woods I, Hutter V. Longitudinal characterization of TK6 cells sequentially adapted to animal product-free, chemically defined culture medium: considerations for genotoxicity studies. Front Toxicol 2023; 5:1177586. [PMID: 37469456 PMCID: PMC10353604 DOI: 10.3389/ftox.2023.1177586] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/13/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction: In vitro approaches are an essential tool in screening for toxicity of new chemicals, products and therapeutics. To increase the reproducibility and human relevance of these in vitro assessments, it is advocated to remove animal-derived products such as foetal bovine serum (FBS) from the cell culture system. Currently, FBS is routinely used as a supplement in cell culture medium, but batch-to-batch variability may introduce inconsistency in inter- and intra-lab assessments. Several chemically defined serum replacements (CDSR) have been developed to provide an alternative to FBS, but not every cell line adapts easily and successfully to CDSR-supplemented medium, and the long-term effect on cell characteristics remains uncertain. Aim: The aim of this study was to adapt the TK6 cell line to animal-product free CDSR-supplemented medium and evaluate the long-term effects on cell health, growth, morphology, phenotype, and function. This included a provisional assessment to determine the suitability of the transitioned cell line for standardised genotoxicity testing using the "in vitro mammalian cell micronucleus test" (OECD TG 487). Materials and methods: Gradual adaptation and direct adaptation methodologies were compared by assessing the cell proliferation, size and viability every passage until the cells were fully adapted to animal-free CDSR. The metabolic activity and membrane integrity was assessed every 4-8 passages by PrestoBlue and CytoTox-ONE™ Homogeneous Membrane Integrity Assay respectively. A detailed morphology study by high content imaging was performed and the expression of cell surface markers (CD19 and CD20) was conducted via flow cytometry to assess the potential for phenotypic drift during longer term culture of TK6 in animal-free conditions. Finally, functionality of cells in the OECD TG 487 assay was evaluated. Results: The baseline characteristics of TK6 cells cultured in FBS-supplemented medium were established and variability among passages was used to set up acceptance criteria for CDSR adapted cells. TK6 were adapted to CDSR supplemented medium either via direct or gradual transition reducing from 10% v/v FBS to 0% v/v FBS. The cell growth rate was compromised in the direct adaptation and therefore the gradual adaptation was preferred to investigate the long-term effects of animal-free CDSR on TK6 cells. The new animal cells showed comparable (p > 0.05) viability and cell size as the parent FBS-supplemented cells, with the exception of growth rate. The new animal free cells showed a lag phase double the length of the original cells. Cell morphology (cellular and nuclear area, sphericity) and phenotype (CD19 and CD20 surface markers) were in line (p > 0.05) with the original cells. The new cells cultured in CDSR-supplemented medium performed satisfactory in a pilot OECD TG 487 assay with compounds not requiring metabolic activation. Conclusion: TK6 cells were successfully transitioned to FBS- and animal product-free medium. The new cell cultures were viable and mimicked the characteristics of FBS-cultured cells. The gradual transition methodology utilised in this study can also be applied to other cell lines of interest. Maintaining cells in CDSR-supplemented medium eliminates variability from FBS, which in turn is likely to increase the reproducibility of in vitro experiments. Furthermore, removal of animal derived products from cell culture techniques is likely to increase the human relevance of in vitro methodologies.
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Affiliation(s)
| | | | | | | | - Ann Doherty
- Safety Sciences, Clinical Pharmacology and Safety Sciences R&D, AstraZeneca, Cambridge, United Kingdom
| | - Daniel Ebner
- Nuffield Department of Medicine, Target Discovery Institute, University of Oxford, Oxford, United Kingdom
| | - Joanne Elloway
- Safety Sciences, Clinical Pharmacology and Safety Sciences R&D, AstraZeneca, Cambridge, United Kingdom
| | - Jianan Fu
- PAN-Biotech GmbH, Aidenbach, Germany
| | | | - Val Millar
- Nuffield Department of Medicine, Target Discovery Institute, University of Oxford, Oxford, United Kingdom
| | - Ouarda Saib
- Safety and Environmental Assurance Centre (SEAC), Unilever, Bedford, United Kingdom
| | - Andrew Scott
- Safety and Environmental Assurance Centre (SEAC), Unilever, Bedford, United Kingdom
| | - Ian Woods
- LabCorp Drug Development, Huntington, United Kingdom
| | - Victoria Hutter
- ImmuONE Limited, Hatfield, United Kingdom
- Centre for Topical Drug Delivery and Toxicology School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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Peterson ER, Sajjakulnukit P, Scott A, Heaslip C, Lyssiotis C, Castro MG, Wahl DR. Abstract 2820: Defining the role of purine metabolism in radiation resistance in H3K27M–mutant diffuse midline glioma. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-2820] [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: 04/07/2023]
Abstract
Abstract
Diffuse midline gliomas (DMG) are an aggressive and treatment resistant form of brain cancer in urgent need of new and effective treatment strategies. Radiation therapy (RT) is the standard of care for DMGs, but these tumors often recur locally within the high-dose radiation field. Therefore, it is imperative to discover methods of overcoming RT resistance. DMGs are often characterized by the presence of driving mutation in the tail domain of histone H3 that converts the 27th residue from a lysine to a methionine (termed H3K27M). Using liquid chromatography/mass spectrometry “snapshot” metabolomics, we determined that human H3K27M-expressing cells (referred to as K27M cells going forward) possess altered metabolic profiles distinct from their H3-wildtype (H3WT) counterparts characterized by enrichment in metabolites associated with purine metabolism. RT-treated K27M isogenic-paired cells displayed K27M-specific increases in the abundance of both hypoxanthine and guanine and decreased abundance of guanosine, which can be degraded into guanine from mature guanylate species (GMP/GDP/GTP). Hypoxanthine and guanine are the substrates for HGPRT (encoded by HPRT1), the rate-limiting enzyme in purine salvage. Using publicly available data, pediatric high-grade gliomas (pHGG) expressing K27M were found to have decreased HPRT1 transcript compared to H3WT tumors, and we found decreased HGPRT protein expression in K27M cell lines compared to their isogenic H3WT counterparts. The decreased abundance of guanosine, increased abundance of both purine salvage metabolites following RT, and decreased expression of HGPRT suggest impaired guanylate purine salvage in K27M cells that is exacerbated by RT. We hypothesized that K27M cells are deficient in purine salvage and may rely on de novo purine synthesis (DNPS) for purine production following RT. Consistent with this hypothesis, we found that a clinically available, blood-brain penetrant inhibitor of DNPS increased RT-mediated killing of K27M neurospheres in vitro. Combination RT+DNPS inhibition (DNPSi) increased survival (38d post-implantation) over RT alone (31.5d post-implantation) in Rag1-KO mice bearing orthotopically implanted K27M tumors, but did not cure tumors. To understand potential mechanisms of treatment resistance, we interrogated metabolic pathway utilization with stable isotope tracing. Using 2,8-deuterium-hypoxanthine to interrogate purine salvage and 15N-glutamine to interrogate de novo purine synthesis, we found an RT-mediated increase in purine salvage that could mediate resistance to DNPSi inhibition. Future experiments will determine whether inhibition of purine salvage has efficacy for those tumors that recur or progress following treatment with RT and DNPSi inhibition.
Citation Format: Erik R. Peterson, Peter Sajjakulnukit, Andrew Scott, Caleb Heaslip, Costas Lyssiotis, Maria G. Castro, Daniel R. Wahl. Defining the role of purine metabolism in radiation resistance in H3K27M–mutant diffuse midline glioma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2820.
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Affiliation(s)
| | | | | | - Caleb Heaslip
- 2Massachusetts College of Pharmacy and Health Sciences, Boston, MA
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Mittal A, Scott A, Achreja A, Tarnal V, Al-Holou W, Lyssiotis C, Wahl D, Nagrath D. Abstract 1160: A machine learning based method for in-vivo metabolic flux analysis of patient tumors. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-1160] [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: 04/07/2023]
Abstract
Abstract
Metabolic fluxes likely control cancer phenotypes and treatment responses but cannot be measured in cancers in human patients. Machine learning has become a popular tool to study cancer biology and can identify complex patterns in the data which may not be decipherable by traditional analyses. We propose an approach to combine 13C-tracer analysis with machine learning to quantify the metabolism of purines in glioblastoma patients. In recent years, multiple studies have been conducted on isotope tracing in cancer patients. While the data for the enrichment of metabolites in human tumors has improved our understanding of cancer metabolism, we lack methods to estimate metabolic fluxes from these enrichment values. A significant challenge in estimating the fluxes in human subjects is that we are limited to enrichment data from a single in-vivo measurement at isotopic non-steady state. We overcome this challenge by combining INST-MFA (Isotopic Non-Stationary-Metabolic Flux Analysis) with machine learning methods. We use the enrichment of circulating metabolites as an input and simulate the time-dependent metabolite enrichment profiles for randomized flux vectors. We use this data to train a convolutional neural network (CNN) model to predict the flux ratios. Apart from being able to predict the fluxes from a single time-point, a machine learning model drastically reduces the time required to fit a traditional INST-MFA model. We demonstrate the real-world validity of the model by predicting flux ratios in mice models and comparing them to results from traditional INST-MFA models. We apply the model to decipher the heterogeneity of the purine pathway in eight patients with brain tumors.
Citation Format: Anjali Mittal, Andrew Scott, Abhinav Achreja, Vijay Tarnal, Wajd Al-Holou, Costas Lyssiotis, Daniel Wahl, Deepak Nagrath. A machine learning based method for in-vivo metabolic flux analysis of patient tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1160.
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Chakravarty PD, Ton T, Scott A, Doherty C, Douglas CM, Montgomery J. Outpatient secondary care pathways for head and neck cancer referral result in patient delays for cancer treatment. Ann R Coll Surg Engl 2023; 105:352-356. [PMID: 36260287 PMCID: PMC10066648 DOI: 10.1308/rcsann.2022.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 04/03/2023] Open
Abstract
INTRODUCTION The majority of head and neck cancer referrals are received through primary care. A proportion of cancer referrals are received through secondary care specialties. Local delivery plan (LDP) targets in Scotland for cancer investigation are set at 31 days for diagnosis and 62 days to start treatment. The aim was to audit referrals made through non-primary care pathways compared with the standard primary care pathways against LDP targets. METHODS New head and neck cancer patients between 1 January 2014 and 1 January 2019 were included. Pathway points were recorded between referral to outpatient clinic, time to multidisciplinary team discussion (MDT) and finally MDT to treatment. RESULTS 1,276 new patient referrals were received over a 5-year period. Of these, 136 (10%) were referred via non-primary care pathways. The mean time for urgent suspicion of cancer (USoC) referrals to start treatment was 77 days (15 days over target) and for outpatient secondary care referrals was 102 days (40 days over target) (p<0.05). When treatment intent was considered, 841/1,131 (75%) of patients referred via primary care were treated curatively compared with 49/99 (49%) (p<0.05) of patients referred through the secondary outpatient pathway. CONCLUSION Patients with head and neck cancer referred from other outpatient specialties face delays commencing cancer treatment and are also associated with a greater likelihood of being treated with palliative intent.
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Affiliation(s)
| | - T Ton
- NHS Greater Glasgow and Clyde, UK
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Zaidi SEZ, Zaheer R, Poulin-Laprade D, Scott A, Rehman MA, Diarra M, Topp E, Domselaar GV, Zovoilis A, McAllister TA. Comparative Genomic Analysis of Enterococci across Sectors of the One Health Continuum. Microorganisms 2023; 11:microorganisms11030727. [PMID: 36985300 PMCID: PMC10052687 DOI: 10.3390/microorganisms11030727] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
Enterococci are Gram-positive bacteria that can be isolated from a variety of environments including soil, water, plants, and the intestinal tract of humans and animals. Although they are considered commensals in humans, Enterococcus spp. are important opportunistic pathogens. Due to their presence and persistence in diverse environments, Enterococcus spp. are ideal for studying antimicrobial resistance (AMR) from the One Health perspective. We undertook a comparative genomic analysis of the virulome, resistome, mobilome, and the association between the resistome and mobilome of 246 E. faecium and 376 E. faecalis recovered from livestock (swine, beef cattle, poultry, dairy cattle), human clinical samples, municipal wastewater, and environmental sources. Comparative genomics of E. faecium and E. faecalis identified 31 and 34 different antimicrobial resistance genes (ARGs), with 62% and 68% of the isolates having plasmid-associated ARGs, respectively. Across the One Health continuum, tetracycline (tetL and tetM) and macrolide resistance (ermB) were commonly identified in E. faecium and E. faecalis. These ARGs were frequently associated with mobile genetic elements along with other ARGs conferring resistance against aminoglycosides [ant(6)-la, aph(3′)-IIIa], lincosamides [lnuG, lsaE], and streptogramins (sat4). Study of the core E. faecium genome identified two main clades, clade ‘A’ and ‘B’, with clade A isolates primarily originating from humans and municipal wastewater and carrying more virulence genes and ARGs related to category I antimicrobials. Overall, despite differences in antimicrobial usage across the continuum, tetracycline and macrolide resistance genes persisted in all sectors.
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Affiliation(s)
- Sani-e-Zehra Zaidi
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, Lethbridge, AB T1J 4B1, Canada
- Department of Chemistry and Biochemistry, University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4, Canada
| | - Rahat Zaheer
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, Lethbridge, AB T1J 4B1, Canada
| | - Dominic Poulin-Laprade
- Sherbrooke Research and Development Centre, Agriculture and Agri-Food Canada, Sherbrooke, QC J1M 1Z3, Canada
| | - Andrew Scott
- London Research and Development Centre, Agriculture and Agri-Food Canada, London, ON N5V 4T3, Canada
| | - Muhammad Attiq Rehman
- Guelph Research and Development Centre, Agriculture and Agri-Food Canada, Guelph, ON N1G 5C9, Canada
| | - Moussa Diarra
- Guelph Research and Development Centre, Agriculture and Agri-Food Canada, Guelph, ON N1G 5C9, Canada
| | - Edward Topp
- London Research and Development Centre, Agriculture and Agri-Food Canada, London, ON N5V 4T3, Canada
| | - Gary Van Domselaar
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB R3E 3R2, Canada
| | - Athanasios Zovoilis
- Department of Chemistry and Biochemistry, University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4, Canada
| | - Tim A. McAllister
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, Lethbridge, AB T1J 4B1, Canada
- Correspondence:
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Abstract
Utilizing economic tools, we evaluate the gains from improving the relationship between biological and chronological age in dollar terms. We show that the gains to individuals are substantial because targeting aging exploits synergies between health and life expectancy and the complementarities across different diseases. Gains are boosted by improvements in life expectancy and a rising number of older people. We compute the value of slowing aging in a range of countries and estimate that increasing life expectancy by 1 year has an annual benefit of ∼4%-5% of gross domestic product (GDP). Augmenting GDP with these measures of health gains reveals the growing importance of achieving healthy longevity as a means of boosting welfare, with the need being particularly acute in the United States.
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Affiliation(s)
- Andrew Scott
- London Business School and Research Fellow, Centre for Economic Policy Research, Regent's Park, London NW1 4SA, United Kingdom
| | - Julian Ashwin
- London Business School, Regent's Park, London NW1 4SA, United Kingdom
| | - Martin Ellison
- University of Oxford, Nuffield College, NuCamp, CEPR, Oxford OX1 1NF, United Kingdom
| | - David Sinclair
- Department of Genetics, Blavatnik Institute, Boston, Massachusetts 02115, USA
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Narayan A, Nolan W, Raja A, Nathwani N, Tur SB, Thomas R, Scott A, Martins A, Founti P. Outcomes of newly referred patients with suspected angle closure: Do we need to redefine the clinical pathways? Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0296] [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: 02/11/2023]
Affiliation(s)
- Akshay Narayan
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust London UK
| | - Winnie Nolan
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust London UK
- National Institute for Health and Care Research (NIHR) Biomedical Research Centre Moorfields and UCL Institute of Ophthalmology London UK
| | - Aneela Raja
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust London UK
| | - Neil Nathwani
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust London UK
| | | | - Rachel Thomas
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust London UK
| | - Andrew Scott
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust London UK
| | - Alessandra Martins
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust London UK
| | - Panayiota Founti
- Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust London UK
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Woods T, Palmarini N, Corner L, Barzilai N, Bethell LJ, Cox LS, Eyre H, Ferrucci L, Fried L, Furman D, Kennedy B, Roddam A, Scott A, Siow RC. Quantum Healthy Longevity for healthy people, planet, and growth. Lancet Healthy Longev 2022; 3:e811-e813. [PMID: 36384162 DOI: 10.1016/s2666-7568(22)00267-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Tina Woods
- Collider Health, London, UK; British Society for Research on Ageing, Durham, UK.
| | - Nic Palmarini
- National Innovation Centre for Ageing, Newcastle, UK
| | - Lynne Corner
- National Innovation Centre for Ageing, Newcastle, UK; VOICE Network, Newcastle, UK
| | - Nir Barzilai
- Institute for Aging Research, Albert Einstein College of Medicine, New York, NY, USA; Paul F Glenn Center for the Biology of Human Aging Research, Harvard Medical School, Boston, MA, USA; National Institutes of Health's Nathan Shock Centers of Excellence in the Basic Biology of Aging, New York, NY, USA
| | - Lord James Bethell
- former Parliamentary Under Secretary of State for Technology, Innovation and Life Sciences, London, UK
| | - Lynne S Cox
- Lab of Ageing and Cell Senescence, University of Oxford, Oxford, UK; UK Ageing Networks, Oxford, UK
| | - Harris Eyre
- Brain Capital Alliance, San Francisco, CA, USA; Rice University's Baker Institute for Public Policy, Houston, TX, USA; Meadows Mental Health Policy Institute, Dallas, TX, USA; OECD Neuroscience-inspired Policy Initiative, Paris, France
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Linda Fried
- Mailman School of Public Health, Public Health Practice, and Department of Epidemiology and Medicine, Columbia University Medical Center, New York, NY, USA
| | - David Furman
- Stanford 1000 Immunomes Project, Stanford School of Medicine, Stanford, CA, USA; Buck AI Platform, The Buck Institute for Research on Aging, Novato, CA, USA
| | - Brian Kennedy
- Centre for Healthy Longevity, National University Health System, and Department of Biochemistry and Department of Physiology, National University of Singapore, Singapore
| | | | - Andrew Scott
- Department of Economics, London Business School, London, UK
| | - Richard C Siow
- Department of Ageing Research, Kings College London, London, UK
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Wichmann C, Morgan K, Guo N, Gan H, Burvenich I, Donnelly P, Scott A. Radiosynthesis and in vitro comparison of [225Ac]Ac-DOTA-dhPzPEG4- and [225Ac]Ac-macropa-tzPEG3Sq-conjugated ch806, a tumour-specific anti-EGFR antibody, and preclinical evaluation in a murine glioma model. Nucl Med Biol 2022. [DOI: 10.1016/s0969-8051(22)02129-1] [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: 12/13/2022]
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Ko A, Noel M, Chao J, Sohal D, Crow M, Oberstein P, Scott A, McRee A, Rocha Lima C, Fong L, Keenan B, Filbert E, Hsu F, Shankaran V. 1229P A multicenter phase II study of sotigalimab (CD40 agonist) in combination with neoadjuvant chemoradiation for resectable esophageal and gastroesophageal junction (GEJ) cancers. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1347] [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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Hegi-Johnson F, Akhurst T, Rudd S, Donnelly P, Scott A, Callahan J, Roselt P, John T, Sithara S, Wichmann C, Hanna G, MacManus M. MA09.05 Increased PD-L1 Tracer Uptake in Recently-irradiated Lesions in NSCLC: Preliminary Results of a Phase 0 Trial (ImmunoPET) of a Novel PET Tracer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.127] [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: 11/27/2022]
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Scott A, Call J, Chandana S, Borazanci E, Falchook G, Bordoni R, Richey S, Starodub A, Chung V, Lakhani N, Lam E, Schaffer K, Wang J, Shapiro G, Sachdev J, Beaupre D, Tolcher A. 451O Preliminary evidence of clinical activity from phase I and Ib trials of the CLK/DYRK inhibitor cirtuvivint (CIRT) in subjects with advanced solid tumors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.580] [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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Feng F, Ning Y, Xue Y, Friedl V, Hann D, Gibb B, Bergamaschi A, Guler G, Hazen K, Scott A, Phillips T, McCarthy E, Ellison C, Malta R, Nguyen A, Lopez V, Cavet R, Chowdhury S, Volkmuth W, Levy S. 69MO 5-Hydroxymethycytosine analysis reveals stable epigenetic changes in tumor tissue that enable cfDNA cancer predictions. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Coelho V, Scott A, Bilgic E, Keuhl A, Sibbald M. Understanding Feedback for Learners in Interprofessional Settings: A Scoping Review. Int J Environ Res Public Health 2022; 19:10732. [PMID: 36078451 PMCID: PMC9517787 DOI: 10.3390/ijerph191710732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Interprofessional feedback is becoming increasingly emphasized within health professions' training programs. The objective of this scoping review is to determine what is known about how learners perceive and interact with feedback in an interprofessional context for learning. METHODS A search strategy was developed and conducted in Ovid MEDLINE. Title and abstract screening were performed by two reviewers independently. Next, full texts of selected articles were reviewed by one reviewer to determine the articles included in the review. Data extraction was performed to determine the articles' study population, methodologies and outcomes relevant to the research objective. RESULTS Our analysis of the relevant outcomes yielded four key concepts: (1) issues with the feedback process and the need for training; (2) the perception of feedback providers, affecting how the feedback is utilized; (3) professions of the feedback providers, affecting the feedback process; and (4) learners' own attitude toward feedback, affecting the feedback process. CONCLUSIONS The learner's perception of interprofessional feedback can be an obstacle in the feedback process. Training around interprofessional feedback should be included as part of interprofessional programs. Research is needed to explore how to address barriers in feedback interaction that stem from misguided perceptions of feedback providers' professions.
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Affiliation(s)
- Varun Coelho
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Andrew Scott
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Elif Bilgic
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Amy Keuhl
- Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Matthew Sibbald
- Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
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Deng K, Uhlig S, Goodman LB, Ip HS, Killian ML, Nemser SM, Ulaszek J, Kiener S, Kmet M, Frost K, Hettwer K, Colson B, Nichani K, Schlierf A, Tkachenko A, Mlalazi-Oyinloye M, Scott A, Reddy R, Tyson GH. Second round of an interlaboratory comparison of SARS-CoV2 molecular detection assays used by 45 veterinary diagnostic laboratories in the United States. J Vet Diagn Invest 2022; 34:825-834. [PMID: 35983593 PMCID: PMC9446291 DOI: 10.1177/10406387221115702] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic presents a continued public health challenge. Veterinary diagnostic laboratories in the United States use RT-rtPCR for animal testing, and many laboratories are certified for testing human samples; hence, ensuring that laboratories have sensitive and specific SARS-CoV2 testing methods is a critical component of the pandemic response. In 2020, the FDA Veterinary Laboratory Investigation and Response Network (Vet-LIRN) led an interlaboratory comparison (ILC1) to help laboratories evaluate their existing RT-rtPCR methods for detecting SARS-CoV2. All participating laboratories were able to detect the viral RNA spiked in buffer and PrimeStore molecular transport medium (MTM). With ILC2, Vet-LIRN extended ILC1 by evaluating analytical sensitivity and specificity of the methods used by participating laboratories to detect 3 SARS-CoV2 variants (B.1; B.1.1.7 [Alpha]; B.1.351 [Beta]) at various copy levels. We analyzed 57 sets of results from 45 laboratories qualitatively and quantitatively according to the principles of ISO 16140-2:2016. More than 95% of analysts detected the SARS-CoV2 RNA in MTM at ≥500 copies for all 3 variants. In addition, for nucleocapsid markers N1 and N2, 81% and 92% of the analysts detected ≤20 copies in the assays, respectively. The analytical specificity of the evaluated methods was >99%. Participating laboratories were able to assess their current method performance, identify possible limitations, and recognize method strengths as part of a continuous learning environment to support the critical need for the reliable diagnosis of COVID-19 in potentially infected animals and humans.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gregory H Tyson
- Division of Food Processing Science and Technology, U.S. Food and Drug Administration, Bedford Park, IL, USA
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Bailey D, Scott A. John G. Morris, AO, MBBS (1934-2022). J Nucl Med 2022; 63:14N. [PMID: 35914825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
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Craine A, Scott A, Desai D, Alshawabkeh L, Adler E, Kim N, Contijoch F. 442 Myocardial Work Estimation With Ct Aids Evaluation Of Regional Right Ventricular Function. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.047] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Scott A, Kim P, Tran H, Kligerman S, Adler E, Contijoch F. 465 Free Wall And Septal Wall Right Ventricular Strain With Ct For Postoperative Right Ventricular Failure Risk. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.076] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Glynn DJ, Crampton R, Pesnot T, Scott A, Nassoy AC, Kirk R, Narducci D, Nelson G, Ongiri L, Begum H, Rao V, Bingham M, McPherson R, Turner D. Abstract 419: The development of BRPF1 degraders as a potential treatment for acute myeloid leukemia. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-419] [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: 11/16/2022]
Abstract
Abstract
Acetylation of histones and additional nuclear proteins is a key mechanism in the regulation of gene expression. Aberrant acetylation has been linked to a wide range of diseases including cancer, inflammation, and neurodevelopmental disorders. Histone acetylation is introduced by histone acetyltransferases complexes (HATs), where substrate specificity is dramatically enhanced by scaffolding proteins that activate and target them to specific chromatin sites. A protein of interest with both epigenetic acetyl reader and scaffolding function is the protein Bromodomain and PHD finger-containing protein 1 (BRPF1). The Protein contains domains of two plant homeodomain (PHD) fingers separated by a zinc knuckle (PZP domain), a bromodomain, and a proline-tryptophan-tryptophan-proline (PWWP) Tudor domain. Native BRPF1 complexes can contain either MOZ/MORF or HBO1 as the catalytic MYST-family acetyltransferase subunit and the stable complex with Moz-Tif2 is known to lead to the development of human acute myeloid leukemia (AML). Given this, we chose to pursue the development of BRPF1 degraders to probe cancer disease biology especially in AML, where new therapies are required to overcome several unmet needs such as less-toxic treatments and relapsed/refractory disease paradigms. Here we present the design and synthesis of a range of BRPF1 degraders in highly desirable physicochemical space utilizing in-silico modeling. The prepared degraders which utilize multiple E3 ligases were then screened against cell lines harboring Mixed-lineage leukemia (MLL) translocations specifically the THP-1 cell line. In addition to this, we investigated the ability of the compounds to effectively degrade the target and suitability of our degraders for potential in-vivo exposure through a panel of routine ADMET assays.
Citation Format: Daniel Joseph Glynn, Rosie Crampton, Thomas Pesnot, Andrew Scott, Anne-Chloe Nassoy, Ralph Kirk, Daniele Narducci, Gary Nelson, Lynette Ongiri, Habiba Begum, Vincent Rao, Matilda Bingham, Rhoanne McPherson, Darryl Turner. The development of BRPF1 degraders as a potential treatment for acute myeloid leukemia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 419.
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Affiliation(s)
| | - Rosie Crampton
- 1Concept Life Sciences, Chapel-En-Le-Frith, United Kingdom
| | - Thomas Pesnot
- 1Concept Life Sciences, Chapel-En-Le-Frith, United Kingdom
| | - Andrew Scott
- 2Concept Life Sciences, Edinburgh, United Kingdom
| | | | - Ralph Kirk
- 1Concept Life Sciences, Chapel-En-Le-Frith, United Kingdom
| | | | - Gary Nelson
- 1Concept Life Sciences, Chapel-En-Le-Frith, United Kingdom
| | - Lynette Ongiri
- 1Concept Life Sciences, Chapel-En-Le-Frith, United Kingdom
| | - Habiba Begum
- 1Concept Life Sciences, Chapel-En-Le-Frith, United Kingdom
| | - Vincent Rao
- 2Concept Life Sciences, Edinburgh, United Kingdom
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Ward J, Gill S, Armstrong K, Fogarty T, Tan D, Scott A, Yahya A, Dhaliwal S, Jacques A, Tang C. PO-1384 Simethicone use to Reduce Rectal Variability During Prostate Cancer Radiotherapy, a Randomised Trial. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03348-5] [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: 11/27/2022]
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Lee ST, Emmett LM, Pattison DA, Hofman MS, Bailey DL, Latter M, Francis RJ, Scott A. The Importance of Training, Accreditation and Guidelines for The Practice of Theranostics: The Australian Perspective. J Nucl Med 2022; 63:819-822. [PMID: 35393349 DOI: 10.2967/jnumed.122.263996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/08/2022] [Revised: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
Theranostics is a burgeoning development in nuclear medicine which is being rapidly implemented worldwide. There is an increasing need to provide a multidisciplinary framework to the practice of theranostics, to ensure that patients receive this treatment in a safe manner and are provided with security in the knowledge that the health practitioners providing the service are adequately trained. Nuclear medicine experts in Australia have taken the initiative to produce a set of Theranostic guidelines relevant to Australian medical practice. These guidelines encompass specialist qualifications, patient care, radiopharmaceutical production, radiation safety and dosimetry. We propose these guidelines could be adapted for other countries, and promote standards of practice leading to optimal clinical outcomes for patients receiving theranostic treatments.
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Scott A, Murray R, Tien YC, Topp E. Contamination of hay and haylage with enteric bacteria and selected antibiotic resistance genes following fertilization with dairy manure or biosolids. Can J Microbiol 2022; 68:249-257. [PMID: 35020524 DOI: 10.1139/cjm-2021-0326] [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: 11/22/2022]
Abstract
The present study evaluated if enteric bacteria or antibiotic resistance genes carried in fecal amendments contaminate the hay at harvest, representing a potential route of exposure to ruminants that consume the hay. In field experiments, dairy manure was applied to a hay field for three successive growing seasons, and biosolids applied to a hay field for one growing season. Various enteric bacteria in the amendments were enumerated by viable plate count, and selected gene targets were quantified by qPCR. Key findings include the following: At harvest, hay receiving dairy manure or biosolids did not carry more viable enteric bacteria than did hay from unamended control plots. Fermentation of hay did not result in a detectable increase in viable enteric bacteria. The application of dairy manure or biosolids did result in a few gene targets being more abundant on hay at the first harvest. Fermentation of hay did result in an increase in the abundance of gene targets, but this occurred both with hay from amended and control plots. Overall, application of fecal amendments will result in an increase in the abundance of some gene targets associated with antibiotic resistance on first cut hay.
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Affiliation(s)
- Andrew Scott
- Agriculture and Agri-Food Canada, 6337, London, Ontario, Canada;
| | - Roger Murray
- Agriculture and Agri-Food Canada, 6337, London, Ontario, Canada;
| | - Yuan-Ching Tien
- Agriculture and Agri-Food Canada, 6337, London, Ontario, Canada;
| | - Edward Topp
- Agriculture and Agri-Food Canada, 6337, London, Canada;
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Faniyi AA, Hughes MJ, Scott A, Belchamber KBR, Sapey E. Inflammation, Ageing and Diseases of the Lung: Potential therapeutic strategies from shared biological pathways. Br J Pharmacol 2021; 179:1790-1807. [PMID: 34826882 DOI: 10.1111/bph.15759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/27/2021] [Revised: 10/07/2021] [Accepted: 11/08/2021] [Indexed: 12/15/2022] Open
Abstract
Lung diseases disproportionately affect elderly individuals. The lungs form a unique environment: a highly elastic organ with gaseous exchange requiring the closest proximity of inhaled air containing harmful agents and the circulating blood volume. The lungs are highly susceptible to senescence, with age and "inflammageing" creating a pro-inflammatory environment with a reduced capacity to deal with challenges. Whilst lung diseases may have disparate causes, the burden of ageing and inflammation provides a common process which can exacerbate seemingly unrelated pathologies. However, these shared pathways may also provide a common route to treatment, with increased interest in drugs which target ageing processes across respiratory diseases. In this review, we will examine the evidence for the increased burden of lung disease in older adults, the structural and functional changes seen with advancing age and assess what our expanding knowledge of inflammation and ageing pathways could mean for the treatment of lung disease.
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Affiliation(s)
- A A Faniyi
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, U.K
| | - M J Hughes
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, U.K
| | - A Scott
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, U.K
| | - K B R Belchamber
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, U.K
| | - E Sapey
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, U.K
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Rosenblatt R, Lee H, Liapakis A, Lunsford KE, Scott A, Sharma P, Wilder J. Equitable Access to Liver Transplant: Bridging the Gaps in the Social Determinants of Health. Hepatology 2021; 74:2808-2812. [PMID: 34060678 DOI: 10.1002/hep.31986] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 12/17/2022]
Abstract
The COVID-19 pandemic and social justice movement have highlighted the impact of social determinants of health (SDOH) and structural racism in the United States on both access to care and patient outcomes. With the evaluation for liver transplantation being a highly subjective process, there are multiple ways for SDOH to place vulnerable patients at a disadvantage. This policy corner focuses on three different methods to reverse the deleterious effects of SDOH-identify and reduce implicit bias, expand and optimize telemedicine, and improve community outreach.
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Affiliation(s)
- Russell Rosenblatt
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY
| | - Hannah Lee
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA
| | | | - Keri E Lunsford
- Division of Transplant and Hepatobiliary Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.,Center for Immunity and Inflammation, Rutgers New Jersey Medical School, Newark, NJ
| | | | - Pratima Sharma
- Division of Gastroenterology and Hepatology, Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Julius Wilder
- Division of Gastroenterology, Duke School of Medicine, Durham, NC.,Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
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Vaios E, Grabowski M, Srinivasan E, Huie D, Sankey E, Otvos B, Olufawo M, Scott A, Kim A, Leuthardt E, Barnett G, Mohammadi A, Reitman Z, Floyd S, Kirkpatrick J, Fecci P. Combining Laser Interstitial Thermal Therapy With SRS Improves Time to Progression for Recurrent SRS-Treated Brain Metastases. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1565] [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: 10/20/2022]
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Scott F, Wichmann C, Burvenich I, McDonald A, Guo N, Rigopoulos A, Soikes R, Angelides S, Roemeling RV, Scott A. 324 Preclinical evaluation of anti-VISTA antibody CI-8993 in a syngeneic huVISTA-KI model. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundVISTA (V-domain Ig suppressor of T-cell activation) inhibits anti-tumour immune responses. The Investigational product CI-8993 is a fully human IgG1k monoclonal antibody that binds specifically to this immune checkpoint molecule. Phase I safety has been established in prior trials in patients with advanced cancer (NCT02671955). To assist determining the pharmacokinetics and biodistribution of CI-8993 in patients we aimed to develop a Zirconium-89 (89Zr)-labelled CI-8993 for PET imaging and quantitation, and validate in preclinical models prior to a planned human trial.MethodsConjugation conditions of CI-8993 to the metal ion chelator desferrioxamine B (Df-) were established by optimisation of Df:mAb ratio, reaction temperature, time and purification method. Conjugates were assessed by SE-HPLC, SDS-PAGE, and ELISA. Radiolabelling was performed with 89Zr and the radioconjugate was tested for specific activity, radiochemical purity and binding affinity for huVISTA. The in-vivo biodistribution and properties of 89Zr-Df-CI-8993 and IgG1 isotype control radioconjugates were assessed in huVISTA knock-in female (C57BL/6N-Vsir< sup >tm1.1(VSIR)Geno</sup >) or control C57BL/6 mice bearing syngeneic MB49 bladder cancer tumours. Whole body animal PET/CT imaging was performed on day of radioconjugate synthesis and injection and day 1 and day 3 p.i. Biodistribution was assessed by image analyses, and tissue counting, with IHC analyses performed to verify VISTA antigen expression.ResultsConjugation of Df- to CI-8993 for 60 minutes at room temperature followed by purification via gel filtration resulted in stable constructs with an average chelator-to-antibody ratio of 1.81. SDS-PAGE showed integrity of CI-8993 was maintained after conjugation, and ELISA indicated no impact of conjugation on binding to human VISTA. Radiochemical purity (iTLC) and protein integrity (SE-HPLC) at EOS were > 99% and 93%. PET imaging and biodistribution in MB49 tumour-bearing huVISTA knock-in female mice showed specific localisation of 89Zr-Df-CI-8993 to VISTA expressing organs (liver: 14.98 ± 0.50 %ID/g; spleen: 292.00 ± 14.51 %ID/g; n = 3) compared to 89Zr-Df-IgG1 control (liver: 4.615 ± 0.15 %ID/g; spleen: 6.37 ± 0.22 %ID/g; n = 4) or in the presence of competing unlabelled CI-8993 (liver: 8.14 ± 0.50 %ID/g; spleen: 41.14 ± 3.00 %ID/g; n = 5). Tumour-to-blood ratios indicated specific tumour targeting of 89Zr-Df-CI-8993 in the presence of unlabelled CI-8993 (20.47 ± 3.09) compared to trace dose 89Zr-Df-CI-8993 (0.97 ± 0.12; P = 0.0001) or 89Zr-Df-IgG1 control (1.75 ± 0.11; P < 0.0001).ConclusionsWe have validated 89Zr-Df-CI-8993 for specific binding to huVISTA in-vivo. A clinical trial of 89Zr-Df-CI-8993 is planned in solid tumour patients.Ethics ApprovalAll animal studies were approved by the Austin Health Animal Ethics Committee and were conducted in compliance with the Australian Code for the care anduse of animals for scientific purposes.
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Jones H, George KP, Scott A, Buckley JP, Watson PM, Oxborough DL, Thijssen DH, Graves LEF, Whyte GP, McGregor G, Naylor LH, Rosenberg M, Askew CD, Green DJ. Charter to establish clinical exercise physiology as a recognised allied health profession in the UK: a call to action. BMJ Open Sport Exerc Med 2021; 7:e001158. [PMID: 34631147 PMCID: PMC8458347 DOI: 10.1136/bmjsem-2021-001158] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
The UK population is growing, ageing and becoming increasingly inactive and unfit. Personalised and targeted exercise interventions are beneficial for ageing and the management of chronic and complex conditions. Increasing the uptake of effective exercise and physical activity (PA) interventions is vital to support a healthier society and decrease healthcare costs. Current strategies for exercise and PA at a population level mostly involve self-directed exercise pathways, delivered largely via the fitness industry. Even for those who opt-in and manage to achieve the current recommendations regarding minimum PA, this generic ‘one-size-fits-all’ approach often fails to demonstrate meaningful physiological and health benefits. Personalised exercise prescription and appropriate exercise testing, monitoring and progression of interventions for individuals with chronic disease should be provided by appropriately trained and recognised exercise healthcare professionals, educated in the cognate disciplines of exercise science (eg, physiology, biomechanics, motor control, psychology). This workforce has operated for >20 years in the Australian public and private healthcare systems. Accredited exercise physiologists (AEPs) are recognised allied health professionals, with demonstrable health and economic benefits. AEPs have knowledge of the risks and benefits of distinct forms of exercise, skills in the personalised prescription and optimal delivery of exercise, and competencies to support sustained PA behavioural change, based on the established scientific evidence. In this charter, we propose a road map for the training, accreditation and promotion of a clinical exercise physiology profession in the UK.
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Affiliation(s)
- Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Keith P George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Andrew Scott
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - John P Buckley
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Shrewsbury, UK
| | - Paula M Watson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - David L Oxborough
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Dick H Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,Radboud Institute for Health Sciences, Radboud University Medical Centre, Radboud, The Netherlands
| | - Lee E F Graves
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Greg P Whyte
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Gordon McGregor
- University of Coventry, Coventry, UK.,University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
| | - Michael Rosenberg
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
| | - Christopher D Askew
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia.,Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Sunshine Coast, Queensland, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
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Grimmett C, Bates A, West M, Leggett S, Varkonyi-Sepp J, Campbell A, Davis J, Wootton S, Shaw C, Barlow R, Ashcroft J, Scott A, Moyes H, Hawkins L, Levett DZH, Williams F, Grocott MPW, Jack S. SafeFit Trial: virtual clinics to deliver a multimodal intervention to improve psychological and physical well-being in people with cancer. Protocol of a COVID-19 targeted non-randomised phase III trial. BMJ Open 2021; 11:e048175. [PMID: 34446487 PMCID: PMC8392740 DOI: 10.1136/bmjopen-2020-048175] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The impact of the COVID-19 pandemic (caused by the SARS-CoV-2 virus) on individuals with cancer has been profound. It has led to increased anxiety, distress and deconditioning due to reduced physical activity. We aim to investigate whether SafeFit, a multimodal intervention of physical activity, nutrition and psychological support delivered virtually by cancer exercise specialists (CES), can improve physical and emotional functionings during the COVID-19 pandemic. METHODS AND ANALYSIS A phase III non-randomised intervention trial, target recruitment of 1050 adults with suspected or confirmed diagnosis of cancer. All recruited participants will receive the multimodal intervention delivered by CES for 6 months. Sessions will be delivered 1-to-1 using telephone/video conferencing consultations. CES will work with each participant to devise a personalised programme of (1) physical activity, (2) basic dietary advice and (3) psychological support, all underpinned by behaviour change support. PRIMARY OUTCOME Physical and emotional functioning as measured by the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ-C30). SECONDARY OUTCOMES overall quality of life measured by EORTC-QLQ-C30 and EQ-5D-5L, health economics, patient activation, self-efficacy to self-manage chronic disease, distress, impact of COVID-19 on emotional functioning, self-reported physical activity, functional capacity and nutrition. Adherence to the intervention will also be measured and a process evaluation conducted. ETHICS AND DISSEMINATION Ethical approval was obtained from the Health Research Authority (reference number 20/NW/0254). Results of this trial will be disseminated through publication of peer-reviewed articles, presentations at scientific conferences, and to the public and people with cancer in collaboration with our patient and public involvement representatives and partners. TRIAL REGISTRATION NUMBER NCT04425616.
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Affiliation(s)
- Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Andrew Bates
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Malcolm West
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Samantha Leggett
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Judit Varkonyi-Sepp
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Anna Campbell
- School of Applied Science, Edinburgh Napier University, Edinburgh, UK
| | | | - Stephen Wootton
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Cancer and Nutrition Collaboration, Southampton, UK
| | - Clare Shaw
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust, London, UK
| | - Rachael Barlow
- Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Joanna Ashcroft
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Andrew Scott
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Helen Moyes
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lesley Hawkins
- Critical Care/Anaesthesia and Perioperative Medicine Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Denny Z H Levett
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Michael P W Grocott
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sandy Jack
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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St John ER, Bakri AC, Johanson E, Loughran D, Scott A, Chen ST, Joshi S, Darzi A, Leff DR. Assessment of the introduction of semi-digital consent into surgical practice. Br J Surg 2021; 108:342-345. [PMID: 33783479 DOI: 10.1093/bjs/znaa119] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/10/2020] [Indexed: 11/12/2022]
Abstract
In this study, paper-based surgical consent is demonstrated to have significant errors of omission and legibility. These errors were improved by the introduction of a procedure-specific, patient-bespoke, semi-digital consent form application. Patient-reported experience of their involvement in shared decision-making is described for paper-based consent and the implications of future digital consent are discussed.
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Affiliation(s)
- E R St John
- Department of Breast Surgery, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Concentric Health, Tramshed Tech, Cardiff, Wales, UK.,Academic Surgical Unit, Division of Surgery and Cancer, Imperial College London, St Mary's Hospital Campus, London, UK
| | - A C Bakri
- Academic Surgical Unit, Division of Surgery and Cancer, Imperial College London, St Mary's Hospital Campus, London, UK
| | - E Johanson
- School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - D Loughran
- Concentric Health, Tramshed Tech, Cardiff, Wales, UK
| | - A Scott
- Academic Surgical Unit, Division of Surgery and Cancer, Imperial College London, St Mary's Hospital Campus, London, UK.,Department of General Surgery, Imperial College Healthcare NHS Trust, Charing Cross Hospital and St Mary's Hospital, London, UK
| | - S-T Chen
- Department of General Surgery, Imperial College Healthcare NHS Trust, Charing Cross Hospital and St Mary's Hospital, London, UK
| | - S Joshi
- Department of Breast Surgery, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - A Darzi
- Academic Surgical Unit, Division of Surgery and Cancer, Imperial College London, St Mary's Hospital Campus, London, UK
| | - D R Leff
- Department of Breast Surgery, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Academic Surgical Unit, Division of Surgery and Cancer, Imperial College London, St Mary's Hospital Campus, London, UK
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Waugh CM, Scott A. Substantial Achilles adaptation following strength training has no impact on tendon function during walking. PLoS One 2021; 16:e0255221. [PMID: 34324575 PMCID: PMC8320898 DOI: 10.1371/journal.pone.0255221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 07/12/2021] [Indexed: 11/18/2022] Open
Abstract
Tendons are responsive to mechanical loading and their properties are often the target of intervention programs. The tendon's mechanical properties, particularly stiffness, also govern its function, therefore changes to these properties could have substantial influence on energy-saving mechanisms during activities utilizing the stretch-shortening cycle. We investigated Achilles tendon (AT) function in vivo during walking with respect to a training intervention that elicited significant increases in AT stiffness. 14 men and women completed 12-weeks of isometric plantarflexor strength training that increased AT stiffness, measured during isometric MVC, by ~31%. Before and after the intervention, participants walked shod at their preferred velocity on a fully-instrumented treadmill. Movement kinematics, kinetics and displacement of the gastrocnemius medialis muscle-tendon junction were captured synchronously using 3D motion capture and ultrasound imaging, respectively. A MANOVA test was used to examine changes in AT force, stress, strain, stiffness, Young's modulus, hysteresis and strain energy, measured during walking, before and following strength training. All were non-significant for a main effect of time, therefore no follow-up statistical tests were conducted. Changes in joint kinematics, tendon strain, velocity, work and power and muscle activity during the stance phase were assessed with 1D statistical parametric mapping, all of which also demonstrated a lack of change in response to the intervention. This in vivo examination of tendon function in walking provides an important foundation for investigating the functional consequences of training adaptations. We found substantial increases in AT stiffness did not impact on tendon function during walking. AT stiffness measured during walking, however, was unchanged with training, which suggests that increases in stiffness may not be evident across the whole force-elongation relation, a finding which may help explain previously mixed intervention results and guide future investigations in the functional implications of tendon adaptation.
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Affiliation(s)
- C. M. Waugh
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- * E-mail:
| | - A. Scott
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Scott A, Olack B, Rouch JD, Khalil HA, Kokubun BA, Lei NY, Wang J, Solorzano S, Lewis M, Dunn JCY, Stelzner MG, Niland JC, Martín MG. Comparison of Surgical and Cadaveric Intestine as a Source of Crypt Culture in Humans. Cell Transplant 2021; 29:963689720903709. [PMID: 32907378 PMCID: PMC7784595 DOI: 10.1177/0963689720903709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/17/2022] Open
Abstract
Human small intestinal crypts are the source of intestinal stem cells (ISCs) that are capable of undergoing self-renewal and differentiation to an epithelial layer. The development of methods to expand the ISCs has provided opportunities to model human intestinal epithelial disorders. Human crypt samples are usually obtained from either endoscopic or discarded surgical samples, and are thereby exposed to warm ischemia, which may impair their in vitro growth as three-dimensional culture as spheroids or enteroids. In this study we compared duodenal samples obtained from discarded surgical samples to those isolated from whole-body preserved cadaveric donors to generate in vitro cultures. We also examined the effect of storage solution (phosphate-buffered saline or University of Wisconsin [UW] solution) as well as multiple storage times on crypt isolation and growth in culture. We found that intestinal crypts were successfully isolated from cadaveric tissue stored for up to 144 h post-procurement and also were able to generate enteroids and spheroids in certain media conditions. Surgical samples stored in UW after procurement were sufficiently viable up to 24 h and also allowed the generation of enteroids and spheroids. We conclude that surgical samples stored for up to 24 h post-procurement in UW solution allowed for delayed crypt isolation and viable in vitro cultures. Furthermore, in situ, hypothermic preservation in cadaveric duodenal samples permitted crypt/ISC isolation, and successful culture of spheroids and enteroids from tissues held for up to 6 days post-procurement.
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Affiliation(s)
- Andrew Scott
- Department of Surgery, David Geffen School of Medicine, 12222UCLA, Los Angeles, CA, USA
| | - Barbara Olack
- Department of Diabetes and Cancer Discovery Science, 20220City of Hope, Integrated Islet Distribution Program and Intestinal Stem Cell Consortium, Coordinating Center, Duarte, CA, USA
| | - Joshua D Rouch
- Department of Surgery, David Geffen School of Medicine, 12222UCLA, Los Angeles, CA, USA
| | - Hassan A Khalil
- Department of Surgery, David Geffen School of Medicine, 12222UCLA, Los Angeles, CA, USA
| | - Brent A Kokubun
- Department of Surgery, David Geffen School of Medicine, 12222UCLA, Los Angeles, CA, USA
| | - Nan Ye Lei
- Department of Surgery, David Geffen School of Medicine, 12222UCLA, Los Angeles, CA, USA
| | - Jiafang Wang
- Division of Gastroenterology and Nutrition, Department of Pediatrics, Mattel Children's Hospital and the David Geffen School of Medicine, 12222UCLA Los Angeles, CA, USA
| | - Sergio Solorzano
- Division of Gastroenterology and Nutrition, Department of Pediatrics, Mattel Children's Hospital and the David Geffen School of Medicine, 12222UCLA Los Angeles, CA, USA
| | - Michael Lewis
- Department of Pathology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - James C Y Dunn
- Department of Surgery, 6429Stanford University School of Medicine, Stanford, CA, USA
| | - Matthias G Stelzner
- Department of Surgery, David Geffen School of Medicine, 12222UCLA, Los Angeles, CA, USA.,Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Joyce C Niland
- Department of Diabetes and Cancer Discovery Science, 20220City of Hope, Integrated Islet Distribution Program and Intestinal Stem Cell Consortium, Coordinating Center, Duarte, CA, USA
| | - Martín G Martín
- Division of Gastroenterology and Nutrition, Department of Pediatrics, Mattel Children's Hospital and the David Geffen School of Medicine, 12222UCLA Los Angeles, CA, USA.,Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, 12222UCLA, Los Angeles, CA, USA
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Liew D, Poon A, Mcmaster C, Owen C, Leung J, Frauman A, Cebon J, Scott A, Buchanan R. OP0194 GENERALIZED IMMUNE ACTIVATION IN STRUCTURES RELATED TO PMR OR GCA ON PET/CT ASSESSMENT DOES NOT OCCUR IN IMMUNE CHECKPOINT INHIBITOR-TREATED PATIENTS WHO DO NOT GO ON TO DEVELOP RHEUMATIC IMMUNE-RELATED ADVERSE EVENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The pathogenesis of rheumatic immune-related adverse events (irAEs) from checkpoint inhibitor cancer immunotherapy directed against programmed cell death protein 1 (PD-1) and programmed death ligand 1 (PD-L1) remains unknown, even though they are a consequence of pharmacologic inhibition of a specific immune mechanism. Given that some irAEs resemble polymyalgia rheumatica (PMR) or giant cell arteritis (GCA), a disease whose pathogenesis is poorly understood, observations regarding the pathogenesis of PMR-like or GCA-like irAEs are of significant interest. One proposed pathogenic mechanism involves generalized immune activation leading to a spectrum of subclinical disease. Interrogation of this hypothesis may be aided by PET/CT, which is frequently utilized for oncological staging purposes but is also useful in classical PMR or GCA diagnosis. If PMR or GCA irAEs merely represent a spectrum of generalized immune activation, low-grade subclinical PMR or GCA-related changes on PET/CT might be expected to be seen in patients who receive immunotherapy, irrespective of whether they develop clinically evident rheumatic irAEs.Objectives:This study investigated whether such changes occurred in patients receiving immunotherapy who did not develop clinically evident rheumatic irAEs.Methods:Consecutive patients exposed to PD-1 or PD-L1 inhibitor immunotherapy at a single center had scintigraphic uptake calculated by a nuclear medicine physician experienced in assessment of vasculitis. Patients were included if they had had 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging both within the two weeks prior to immunotherapy initiation and after at least eleven weeks of immunotherapy. Patients who went on to develop a rheumatic irAE were excluded, as were patients with scintigraphic evidence of liver metastases owing to their potential influence on scoring of uptake. Quantification of 18F-FDG uptake by maximum standardized uptake values (maximum standard unit value, SUVmax) was performed at sites relevant to PMR or GCA (17 sites relevant to PMR, 17 sites relevant to GCA) in paired scans, and the difference calculated.Results:Twenty-four patients receiving nivolumab, pembrolizumab or avelumab met the inclusion criteria, primarily for melanoma, non-small cell lung cancer, or lymphoma. The mean age was 67 at the time of the first scan, 71% were male, and 66% had a complete or partial oncological response at best response. No statistically or clinically significant difference in SUVmax was noted at any PMR or GCA-relevant anatomical site interrogated. Latent class analysis did not reveal clusters identifiable by cancer type, best response, or presence of combination therapy.Conclusion:Patients treated with PD-1/PD-L1 inhibitors without clinically evident rheumatic irAEs do not develop subclinical PMR or GCA-like changes on PET/CT. This supports the proposition that PMR-like and GCA-like irAEs are a distinct entity with stochastic onset, and do not simply represent generalized immune activation induced by immunotherapy.Acknowledgements:David Liew is the recipient of the Ronald John Gleghorn Bursary from the University of Melbourne.Disclosure of Interests:David Liew: None declared, Aurora Poon: None declared, Christopher McMaster: None declared, Claire Owen Speakers bureau: Roche, Jessica Leung Speakers bureau: GIlead, Novartis, Albert Frauman: None declared, Jonathan Cebon: None declared, Andrew Scott: None declared, Russell Buchanan: None declared
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Abstract
The NICE Guidelines published in 2015 state that testosterone supplementation can be considered for menopausal women with low sexual desire if hormone replacement therapy alone is not effective. There is however, no detail on what to prescribe, how much to prescribe or whether monitoring is required. At the time of conception of this project, there was no national guideline or official advice from the British Menopause Society. We decided to ask menopause experts from around the UK to see if a consensus could be reached about good prescribing practice. The method and results as discussed below may be helpful in future recommendations and guidance.
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Affiliation(s)
- A Scott
- Essex Private Doctors, Shenfield, Essex, UK
| | - D Holloway
- Guys and St Thomas' NHS Trust, London, UK
| | - J Rymer
- GKT School of Medical Education Faculty of Life Sciences and Medicine, King's College, London, UK
| | - D Bruce
- GKT School of Medical Education Faculty of Life Sciences and Medicine, King's College, London, UK
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Scott A, Hernandez-Hernandez D, Adler E, Kim P, Kligerman S, Contijoch F. Synthesis of CT Imaging and Right Heart Catheterization Enables Single-Beat RV-PA Coupling Estimations in Heart Failure Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.552] [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: 11/25/2022] Open
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Scott A, Zhou W, Wilder-Romans K, Feng J, Wu Z, Andren A, Zhang L, Sajjakulnukit P, Kachman M, Umemura Y, Schmitt M, Qi N, Lawrence T, Lyssiotis C, Wahl D. DDRE-28. MECHANISTIC AND THERAPEUTIC LINKS BETWEEN PURINE BIOSYNTHESIS AND DNA DAMAGE IN GLIOBLASTOMA. Neurooncol Adv 2021. [PMCID: PMC7992234 DOI: 10.1093/noajnl/vdab024.050] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Glioblastoma (GBM) is the most common and aggressive adult brain cancer. Radiation therapy (RT) is a critical treatment modality, and development of RT resistance is the predominant cause of recurrence and mortality in GBM patients. Using cell line models as well as patient-derived xenografts and neurospheres in orthotopic brain tumor models, we have identified increased rates and dependence upon de novo purine biosynthesis as a hallmark of GBM RT resistance. More recently, we have discovered that radiation treatment acutely stimulates flux through de novo purine synthesis in cell line and neurosphere models of GBM. This RT-induced increase in de novo purine synthesis is dependent on signaling through the DNA damage response and thus appears to be an adaptive mechanism to supply purines to repair radiation-induced DNA damage. To determine whether this regulatory mechanism also exists in vivo, we have used advanced metabolomic and metabolic tracing techniques with 13C-labeled glucose and 15N-labeled glutamine in mice bearing RT-resistant GBM patient-derived orthotopic brain tumors. We found that that orthotopic GBM PDXs had elevated activity of de novo purine synthesis that increased further after RT, while normal cortex had little activity even after RT. These observations have therapeutic relevance, as targeting this metabolic pathway with the FDA-approved purine biosynthesis inhibitor mycophenolate mofetil (MMF) overcomes GBM radiation resistance in mouse models in vivo. The lack of de novo purine synthesis in normal cortex suggests that targeting this pathway may be tumor specific. Collectively our data suggest that de novo synthesis of purines mediates RT resistance in GBM and that treatment of brain tumors with MMF in combination with RT may be a promising therapeutic strategy in patients.
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Affiliation(s)
| | | | | | - Jiane Feng
- University of Michigan, Ann Arbor, MI, USA
| | - Zhe Wu
- University of Michigan, Ann Arbor, MI, USA
| | | | - Li Zhang
- University of Michigan, Ann Arbor, MI, USA
| | | | | | | | | | - Nathan Qi
- University of Michigan, Ann Arbor, MI, USA
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Zhou W, Yao Y, Scott A, Wilder-Romans K, Dresser J, Werner C, Sun H, Pratt D, Sajjakulnukit P, Zaho S, Davis M, Nelson B, Halbrook C, Zhang L, Gatto F, Srinivasan S, Jairath N, Correa L, Umemura Y, Walker A, Kachman M, Qi N, Sarkaria J, Xiong J, Morgan M, Rehemtulla A, Castro M, Lowenstein P, Chandrasekaran S, Lawrence T, Lyssiotis C, Wahl D. DDRE-24. TARGETING PURINE METABOLISM TO OVERCOME GLIOBLASTOMA THERAPY RESISTANCE. Neurooncol Adv 2021. [PMCID: PMC7992262 DOI: 10.1093/noajnl/vdab024.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Intratumoral genomic heterogeneity in glioblastoma (GBM) is a barrier to overcoming radiation (RT) resistance. To discover genotype-independent mediators of RT resistance, we correlated RT resistance with the concentration of approximately 700 metabolites across 23 GBM cell lines. Purine metabolites, especially those containing the base guanine, were most correlated with RT resistance. Similarly, increased abundance of tumor purines was associated with decreased survival in GBM patients treated with RT. This relationship is causal. Purine supplementation protected RT-sensitive GBMs from RT and promoted the repair of RT-induced double strand DNA breaks (DSBs). In vitro and in vivo stable isotope tracing confirmed that GBM cell lines and orthotopic patient-derived xenografts primarily generated purines through the de novo synthetic pathway. RT treatment further increased de novo purine synthesis in GBM through signaling via the DNA damage response. Inhibition of de novo GTP synthesis with mycophenolic acid (MPA) sensitized multiple GBM cell lines and neurospheres to RT by slowing the repair of RT-induced DSBs. MPA-induced radiosensitization was GTP-dependent as it was rescued by nucleoside supplementation. Modulating pyrimidine metabolism affected neither RT resistance nor DSB repair, suggesting these GTP-specific effects are due to active signaling rather than its ability to act as a physical substrate for DNA repair and candidate signaling molecules have been identified. These results were recapitulated in vivo with mycophenolate mofetil (MMF), the orally bioavailable FDA-approved prodrug of MPA. MMF potentiated RT efficacy, reduced tumor guanylates and slowed the repair of RT-induced DSBs across multiple models. Because de novo purine synthesis is activated by many of the oncogenic alterations that drive GBM, its inhibition is a promising genotype-independent strategy to overcome GBM RT resistance. We have now begun a clinical trial to determine whether combining MMF and RT is safe and potentially efficacious in patients with GBM.
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Affiliation(s)
| | | | | | | | | | | | - Hanshi Sun
- University of Michigan, Ann Arbor, MI, USA
| | - Drew Pratt
- University of Michigan, Ann Arbor, MI, USA
| | | | | | - Mary Davis
- University of Michigan, Ann Arbor, MI, USA
| | | | | | - Li Zhang
- University of Michigan, Ann Arbor, MI, USA
| | | | | | | | | | | | | | | | - Nathan Qi
- University of Michigan, Ann Arbor, MI, USA
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