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Aberg JA, Mills A, Moreno S, Slater J, Prakash M, Clark A. The evolution of clinical study design in heavily treatment-experienced persons with HIV: A critical review. Antivir Ther 2023; 28:13596535231174774. [PMID: 37212748 DOI: 10.1177/13596535231174774] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Heavily treatment-experienced (HTE) persons with HIV have limited options for antiretroviral therapy and face many challenges, complicating their disease management. There is an ongoing need for new antiretrovirals and treatment strategies for this population. We reviewed the study designs, baseline characteristics, and results of clinical trials that enrolled HTE persons with HIV. A PubMed literature search retrieved articles published between 1995 and 2020, which were grouped by trial start date (1995-2009, N = 89; 2010-2014, N = 3; 2015-2020, N = 2). Clinical trials in HTE participants markedly declined post-2010. Participant characteristics and study designs showed changes in trends over time. As treatment strategies for HTE persons with HIV progress, we must look beyond virologic suppression to consider the broader needs of this complex heterogeneous population.
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Affiliation(s)
- Judith A Aberg
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Santiago Moreno
- Hospital Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain
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2
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Spinelli F, Prakash M, Slater J, van der Kolk M, Bassani N, Grove R, Wynne B, van Wyk J, Clark A. Dolutegravir-based regimens in treatment-naive and treatment-experienced aging populations: analyses of 6 phase III clinical trials. HIV Res Clin Pract 2021; 22:46-54. [PMID: 34180785 DOI: 10.1080/25787489.2021.1941672] [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] [Indexed: 12/15/2022]
Abstract
Background: Older adults living with HIV (OALWH) are a growing population facing unique challenges to successful antiretroviral therapy.Objective: To assess efficacy and safety profiles of antiretroviral regimens, including those containing dolutegravir, in OALWH.Methods: Combined data from 6 phase III/IIIb trials in treatment-naive (ARIA, FLAMINGO, SINGLE, SPRING-2; N = 2634) and treatment-experienced (DAWNING, SAILING; N = 1339) participants receiving dolutegravir- or non-dolutegravir-based regimens were analyzed by age (<50, ≥50 to <65, and ≥65 years). Baseline data included comorbidities and numbers of concomitant medications. Week 48 efficacy outcomes included virologic response (HIV-1 RNA <50 copies/mL) and CD4+ cell count change from baseline. Safety outcomes included incidence of adverse events (AEs), serious AEs, and AE-related withdrawals.Results: Use of ≥5 concomitant medications was more frequently reported among treatment-naive and treatment-experienced participants aged ≥50 to <65 (30% [90/296] and 25% [57/227], respectively) and ≥65 years (43% [10/23] and 29% [4/14]) than among those aged <50 years (13% [310/2315] and 11% [118/1098]). Comorbidities were more prevalent in the older age groups. For dolutegravir-based regimens, Week 48 rates of virologic response and change in CD4+ cell count were similar across age groups (treatment naive, 80-87% and 234-251 cells/mm3; treatment experienced, 70-100% and 105-156 cells/mm3, respectively). There were no major differences in safety outcomes in each age group.Conclusions: In these analyses of combined phase III/IIIb trial data, efficacy and safety of dolutegravir-based regimens were generally similar across age groups in treatment-naive or treatment-experienced participants. Polypharmacy and comorbidities were more common among OALWH than those aged <50 years.
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Affiliation(s)
| | | | - Jill Slater
- ViiV Healthcare, Research Triangle Park, NC, USA
| | | | | | | | - Brian Wynne
- ViiV Healthcare, Research Triangle Park, NC, USA
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Magee M, Slater J, Mannino F, Ackerman P, Llamoso C, Moore K. Effect of Renal and Hepatic Impairment on the Pharmacokinetics of Temsavir, the Active Moiety of Fostemsavir. J Clin Pharmacol 2021; 61:939-953. [PMID: 33368327 DOI: 10.1002/jcph.1810] [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: 11/06/2020] [Accepted: 12/23/2020] [Indexed: 11/10/2022]
Abstract
The oral prodrug fostemsavir (GSK3684394, formerly BMS-663068) is an antiretroviral treatment for HIV-1. Fostemsavir is metabolized to its active moiety, temsavir, a first-in-class HIV-1 attachment inhibitor that binds to the viral envelope glycoprotein 120. Long-term antiretroviral therapy, the resulting longer life expectancy, and/or certain coinfections can increase the risk of chronic liver and kidney disease in HIV-1-infected individuals. Two studies were conducted to collectively evaluate the impact of renal and hepatic impairment on temsavir pharmacokinetics (PK) and safety following a single dose of a 600-mg extended-release fostemsavir tablet. There was no clinically meaningful effect of renal or hepatic impairment on temsavir PK, although renal clearance decreased with increasing renal impairment from moderate to severe, and exposure (maximum concentration and area under the plasma concentration-time curve from time 0 to infinity) tended to increase with increasing severity of hepatic impairment. No clinically meaningful effect of hemodialysis on temsavir PK parameters was observed. Fostemsavir was generally safe and well tolerated by treated subjects. Most adverse events (AEs) were mild, with the exception of 1 patient in the renal impairment study who discontinued due to 2 serious AEs unrelated to the study drug. No other treatment-emergent serious AEs occurred, and no other AEs leading to discontinuation were reported. Overall, these results suggest that fostemsavir can be used without dose modification in subjects with mild to severe renal impairment, including those with end-stage renal disease on hemodialysis, and in subjects with mild to severe hepatic impairment.
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Affiliation(s)
- Mindy Magee
- GlaxoSmithKline, Upper Providence, Pennsylvania, USA
| | - Jill Slater
- ViiV Healthcare, Research Triangle Park, North Carolina, USA
| | - Frank Mannino
- GlaxoSmithKline, Upper Providence, Pennsylvania, USA
| | | | | | - Katy Moore
- ViiV Healthcare, Research Triangle Park, North Carolina, USA
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Teran A, McAuley G, Slater J, Wroe A. PD-0551: Experimental investigation of magnetically focused proton minibeams. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00573-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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McAuley G, Lim C, Teran A, Slater J, Wroe A. PO-1760: Magnetically focused minibeams for proton therapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01778-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Hardefeldt LY, Bailey KE, Slater J. Overview of the use of antimicrobial drugs for the treatment of bacterial infections in horses. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- L. Y. Hardefeldt
- Asia‐Pacific Centre for Animal Health Melbourne Veterinary School Faculty of Veterinary and Agricultural Sciences University of Melbourne Parkville VictoriaAustralia
- National Centre for Antimicrobial Stewardship Peter Doherty Institute Carlton VictoriaAustralia
| | - K. E. Bailey
- Asia‐Pacific Centre for Animal Health Melbourne Veterinary School Faculty of Veterinary and Agricultural Sciences University of Melbourne Parkville VictoriaAustralia
- National Centre for Antimicrobial Stewardship Peter Doherty Institute Carlton VictoriaAustralia
| | - J. Slater
- U‐Vet Melbourne Veterinary School Faculty of Veterinary and Agricultural Sciences University of Melbourne Werribee Victoria Australia
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Slater J, Liu L, Sui D, Weyman E, Chan A. Chemosensory Outcomes in Nasopharyngeal Cancer Patients Treated with Proton Beam Therapy: A Prospective Longitudinal Study. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Genovese S, Epifano F, Preziuso F, Slater J, Nangia-Makker P, Majumdar APN, Fiorito S. Gercumin synergizes the action of 5-fluorouracil and oxaliplatin against chemoresistant human cancer colon cells. Biochem Biophys Res Commun 2019; 522:95-99. [PMID: 31740005 DOI: 10.1016/j.bbrc.2019.11.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 10/25/2019] [Accepted: 11/11/2019] [Indexed: 12/11/2022]
Abstract
Advanced colon cancer is extremely difficult to cure, underscoring the need to develop novel therapeutic agents. Prenylated curcumins that are semisynthetic curcumin derivatives with significant anti-cancer potential have been studied herein to assess their therapeutic potential for colon cancer and tested to this aim in vitro for their growth inhibitory properties against 5-fluorouracil + oxaliplatin resistant human colon cancer CR-HT29 and HCT-116 cells. The resulting most active product, gercumin (mono-O-geranylcurcumin), has been further tested for its synergistic effects with FOLFOX (a combination of 5-fluorouracil and oxaliplatin) on the same cell lines. Activity of this combination on colonosphere formation was also investigated. Gercumin was able to suppress the growth of cancer cells with a potency similar to that of curcumin. A synergistic effect of this compound and FOLFOX was also observed. doses tested for synergy in the colonosphere assays did not show greater suppression of colonosphere formation than independent treatment with either reagent alone. Only one of the combinations was shown to be more effective at suppressing colonosphere formation [gercumin 5 μM + FOLFOX (2x)]. Thus, the growth inhibitory effects of curcumin against human cancer cells can be modulated and enhanced by the introduction of hydrophobic chains, normally found in several natural compounds, like the geranyl one. Such compounds are also able to synergize with known chemotherapeutics.
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Affiliation(s)
- Salvatore Genovese
- Dipartimento di Farmacia, Università"G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Francesco Epifano
- Dipartimento di Farmacia, Università"G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy.
| | - Francesca Preziuso
- Dipartimento di Farmacia, Università"G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Jill Slater
- Department of Biological Sciences, University of Michigan-Flint, Michigan, USA
| | - Pratima Nangia-Makker
- VA Medical Center, Karmanos Cancer Institute, Department of Medicine, Wayne State University, Detroit, MI, USA
| | - Adhip P N Majumdar
- VA Medical Center, Karmanos Cancer Institute, Department of Medicine, Wayne State University, Detroit, MI, USA
| | - Serena Fiorito
- Dipartimento di Farmacia, Università"G. D'Annunzio" Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
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Altamirano J, Salas M, Contreras A, Martínez F, Slater J, Barrera A, Cifuentes J. Ameloblastic fibroodontoma, literature review apropos of a case. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sepúlveda C, Altamirano J, Salas M, Slater J, Figueroa L, Yanine N, Barrera A. Mandibular infected buccal cyst, report of 8 cases. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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11
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Contreras A, Altamirano J, Salas M, Yanine N, Slater J, Barrera A. Necrotizing sialometaplasia, literature review and report of two cases. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.699] [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]
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12
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McColl KA, Sunarto A, Slater J, Bell K, Asmus M, Fulton W, Hall K, Brown P, Gilligan D, Hoad J, Williams LM, Crane MSJ. Cyprinid herpesvirus 3 as a potential biological control agent for carp (Cyprinus carpio) in Australia: susceptibility of non-target species. J Fish Dis 2017; 40:1141-1153. [PMID: 28026008 DOI: 10.1111/jfd.12591] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/20/2016] [Accepted: 10/21/2016] [Indexed: 06/06/2023]
Abstract
Carp (Cyprinus carpio L.) is a pest species in Australian waterways, and cyprinid herpesvirus 3 (CyHV-3) is being considered as a potential biological control (biocontrol) agent. An important consideration for any such agent is its target specificity. In this study, the susceptibility to CyHV-3 of a range of non-target species (NTS) was tested. The NTS were as follows: 13 native Australian, and one introduced, fish species; a lamprey species; a crustacean; two native amphibian species (tadpole and mature stages); two native reptilian species; chickens; and laboratory mice. Animals were exposed to 100-1000 times the approximate minimum amount of CyHV-3 required to cause disease in carp by intraperitoneal and/or bath challenge, and then examined clinically each day over the course of 28 days post-challenge. There were no clinical signs, mortalities or histological evidence consistent with a viral infection in a wide taxonomic range of NTS. Furthermore, there was no molecular evidence of infection with CyHV-3, and, in particular, all RT-PCRs for viral mRNA were negative. As a consequence, the results encourage further investigation of CyHV-3 as a potential biocontrol agent that is specific for carp.
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Affiliation(s)
- K A McColl
- CSIRO-Australian Animal Health Laboratory, Geelong, Vic., Australia
| | - A Sunarto
- CSIRO-Australian Animal Health Laboratory, Geelong, Vic., Australia
| | - J Slater
- CSIRO-Australian Animal Health Laboratory, Geelong, Vic., Australia
| | - K Bell
- K&C Global Fisheries, Sale, Vic., Australia
| | - M Asmus
- Department of Primary Industries, Narrandera Fisheries Centre, Narrandera, NSW, Australia
| | - W Fulton
- Department of Primary Industries, Fisheries Research Branch, Queenscliff, Vic., Australia
| | - K Hall
- Department of Primary Industries, Fisheries Research Branch, Queenscliff, Vic., Australia
| | - P Brown
- The Murray-Darling Freshwater Research Centre and La Trobe University, Mildura, Vic., Australia
| | - D Gilligan
- Department of Primary Industries, Narrandera Fisheries Centre, Narrandera, NSW, Australia
| | - J Hoad
- CSIRO-Australian Animal Health Laboratory, Geelong, Vic., Australia
| | - L M Williams
- CSIRO-Australian Animal Health Laboratory, Geelong, Vic., Australia
| | - M St J Crane
- CSIRO-Australian Animal Health Laboratory, Geelong, Vic., Australia
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Feldman T, Kar S, Lim D, Smalling R, Whisenant B, Rammohan C, Fail P, Rinaldi M, Hermiller J, Herrmann H, Kipperman R, Slater J, Foster E, Weissman N, Glower D. 4176The EVEREST II REALISM continued access non-high risk study: mid- and long-term follow-up in surgical candidates. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.4176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T. Feldman
- Evanston Hospital Northshore, Evanston, United States of America
| | - S. Kar
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - D.S. Lim
- University of Virginia, Charlottesville, United States of America
| | - R. Smalling
- Memorial Hermann Hospital, Houston, United States of America
| | - B. Whisenant
- Intermountain Heart Institute, Murray, United States of America
| | - C. Rammohan
- El Camino Hospital, Mountain View, United States of America
| | - P. Fail
- Terrebonne General Medical Center, Houma, United States of America
| | - M. Rinaldi
- Sanger Heart & Vascular Institute, Charlotte, United States of America
| | - J. Hermiller
- St Vincent's Medical Center of Indiana, Indianapolis, United States of America
| | - H. Herrmann
- University of Pennsylvania, Philadelphia, United States of America
| | - R. Kipperman
- Morristown Medical Center, Morristown, United States of America
| | - J. Slater
- New York University Langone Medical Center, New York, United States of America
| | - E. Foster
- University of California San Francisco, San Francisco, United States of America
| | - N.J. Weissman
- Medstar Research Institute, Washington, United States of America
| | - D. Glower
- Duke University Medical Center, Durham, United States of America
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Abstract
A case is reported of a patient who presented to his family doctor with a short history of cough with signs and symptoms of thyrotoxicosis. Carbimazole treatment had little effect and his symptoms worsened to include severe shortness of breath. He was investigated further and found to have multiple lung and liver metastases from an unknown primary site. Biopsy and subsequent post-mortem investigations revealed a testicular tumour and a grossly elevated serum human chorionic gonadotrophin (hCG) concentration. The biochemical and clinical thyrotoxicosis is presumed to be due to the thyrotrophic activity of excess hCG secretion, in a situation analogous to that seen in hydatidiform mole or in hyperemesis gravidarum.
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Affiliation(s)
- L K Tilbrook
- Department of Clinical Biochemistry, Broomfield Hospital, Mid Essex Hospital Services, NHS Trust Broomfield, Chelmsford CM1 5ET, Essex, UK.
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Lamberton T, Slater J, Wroe A. SU-F-T-212: A Comparison of Treatment Strategies for Intracranial Stereotactic Radiosurgery. Med Phys 2016. [DOI: 10.1118/1.4956350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Slater J, Phillips J, Guo CY, Clark M, Geldhof A, Gearhart N, Nissinen R. FRI0183 Pregnancy Outcomes in Women Exposed To Infliximab (Innovator): Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Nguyen TT, McAuley GA, Heczko S, Slater J, Wroe A. SU-F-T-211: Evaluation of a Dual Focusing Magnet System for the Treatment of Small Proton Targets. Med Phys 2016. [DOI: 10.1118/1.4956349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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18
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Wroe A, McAuley G, Slater J. SU-E-T-239: Design and Evaluation of a Nozzle Shielding System in Passively Scattered Proton Therapy. Med Phys 2015. [DOI: 10.1118/1.4924601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Slater J, Borchers K, Chambers T, Cullinane A, Duggan V, Elton D, Legrand L, Paillot R, Fortier G. Report of the International Equine Influenza Roundtable Expert Meeting at Le Touquet, Normandy, February 2013. Equine Vet J 2014; 46:645-50. [PMID: 25146166 DOI: 10.1111/evj.12302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J Slater
- Royal Veterinary College, London, UK
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McAuley G, Slater J, Wroe A. WE-D-17A-04: Magnetically Focused Proton Irradiation of Small Volume Targets. Med Phys 2014. [DOI: 10.1118/1.4889407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Simpson R, Gordon I, Ghebremedhin A, Wroe A, Schulte R, Bush D, Slater J, Patyal B. SU-E-T-72: Commissioning of a Standardized SRS Cone Set: Determination of the Bolus Gap Factors in a Passively Scattered Proton Beam. Med Phys 2014. [DOI: 10.1118/1.4888402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wroe A, Webster J, Bush D, Schulte R, Patyal B, Slater J. SU-E-T-582: Evaluation of Standard Beam Delivery Devices in Proton Intracranial Radiosurgery. Med Phys 2014. [DOI: 10.1118/1.4888918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Choi D, Gordon I, Ghebremedhin A, Wroe A, Schulte R, Bush D, Slater J, Patyal B. SU-E-T-268: Proton Radiosurgery End-To-End Testing Using Lucy 3D QA Phantom. Med Phys 2014. [DOI: 10.1118/1.4888599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dibden A, Offman J, Parmar D, Jenkins J, Slater J, Binysh K, McSorley J, Scorfield S, Cumming P, Liao XH, Ryan M, Harker D, Stevens G, Rogers N, Blanks R, Sellars S, Patnick J, Duffy SW. Reduction in interval cancer rates following the introduction of two-view mammography in the UK breast screening programme. Br J Cancer 2014; 110:560-4. [PMID: 24366303 PMCID: PMC3915134 DOI: 10.1038/bjc.2013.778] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 11/13/2013] [Accepted: 11/17/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The introduction of two-view mammography at incident (subsequent) screens in the National Health Service Breast Screening Programme (NHSBSP) has led to an increased number of cancers detected at screen. However, the effect of two-view mammography on interval cancer rates has yet to be assessed. METHODS Routine screening and interval cancer data were collated from all screening programmes in the United Kingdom for women aged 50-64, screened between 1 April 2003 and 31 March 2005. Interval cancer rates were compared based on whether two-view mammography was in use at the last routine screen. RESULTS The reduction in interval cancers following screening using two-view mammography compared with one view was 0.68 per 1,000 women screened. Overall, this suggests the introduction of two-view mammography at incident screen was accompanied by a 15-20% reduction in interval cancer rates in the NHSBSP. CONCLUSION The introduction of two-view mammography at incident screens is associated with a reduction in incidence of interval cancers. This is consistent with previous publications on a contemporaneous increase in screen-detected cancers. The results provide further evidence of the benefit of the use of two-view mammography at incident screens.
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Affiliation(s)
- A Dibden
- Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis, Queen Mary, University of London, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| | - J Offman
- Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis, Queen Mary, University of London, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| | - D Parmar
- Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis, Queen Mary, University of London, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
| | - J Jenkins
- East Midlands Quality Assurance Reference Centre (QARC), Nottingham University Hospital City Campus, Hucknall Road, Nottingham NG5 1PB, UK
| | - J Slater
- East of England QARC, 2nd Floor, Compass House, Chivers Way, Vision Park, Histon, Cambridge CB24 9AD, UK
| | - K Binysh
- London QARC, 1st Floor, 51/53 Bartholomew Close, London EC1A 7BE, UK
| | - J McSorley
- Northern Ireland QARC, 18 Ormeau Avenue, Belfast BT2 8HS, UK
| | - S Scorfield
- North East, Yorkshire and the Humber QARC, Waterfront 4, Goldcrest Way, Newburn Riverside Newcastle upon Tyne, NE15 8NY, UK
| | - P Cumming
- North West QARC, Hollinwood Business Centre, Albert Street, Oldham OL8 3QL, UK
| | - X-H Liao
- South Central QARC, 4150 Chancellor Court, Oxford Business Park South, Oxford OX4 2GX, UK
| | - M Ryan
- South East Coast QARC, 77a High Street, Battle, East Sussex TN33 0AG, UK
| | - D Harker
- South West QARC, 1st Floor, Grosvenor House, 149 Whiteladies Road, Clifton, Bristol BS8 2RA, UK
| | - G Stevens
- Public Health Wales, 18 Cathedral Road, Cardiff CF11 9LJ, UK
| | - N Rogers
- West Midlands Breast Screening QARC, Public Health Building, University of Birmingham, Birmingham B15 2TT, UK
| | - R Blanks
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - S Sellars
- NHS Cancer Screening Programmes, Fulwood House, Old Fulwood Road, Sheffield S10 3TH, UK
| | - J Patnick
- NHS Cancer Screening Programmes, Fulwood House, Old Fulwood Road, Sheffield S10 3TH, UK
| | - S W Duffy
- Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis, Queen Mary, University of London, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK
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Slater J, Morhaim H, Rudolph S. Abstract W MP12: Changing Policies for Blood Pressure Management in Spontaneous Intracerebral Hemorrhage. Stroke 2014. [DOI: 10.1161/str.45.suppl_1.wmp12] [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
Background:
Current American Heart Association guidelines for targeted blood pressure management in spontaneous intracerebral hemorrhage (ICH), published in 2010, suggest a target mean arterial pressure of less than 110 or a blood pressure of less than 160/90 in patients without elevated intracranial pressure. These guidelines acknowledge that these recommendations have been based on incomplete efficacy evidence. A lower level recommendation was given for reducing target blood pressure to a systolic of 140, based on the INTERACT trial published in 2008. The INTERACT2 trial, published in May 2013, has been interpreted to establish the safety of rapid blood pressure lowering to 140 systolic.
Purpose:
To determine the current level of adoption by stroke centers of lower targets for blood pressure in patients with spontaneous intracerebral hemorrhage, and whether these targets have changed in 2013.
Methods:
We developed a web-based survey that was distributed via email and professional groups to stroke advanced practice nurses and stroke program coordinators. The survey asked specific questions regarding changes in clinical practice and stroke center policies on blood pressure management in spontaneous ICH. The survey was anonymous, and the survey software was able to exclude multiple entries from the same computer.
Results:
Responses were obtained from academic medical centers, community teaching hospitals, and community non-teaching hospitals. Awareness of the results of INTERACT2 was known by 65%, 50%, and 31% of stroke nurses at these hospitals, respectively. Targets for systolic blood pressure were changed in 2013 at 46%, 44%, and 11% of hospitals by group. A time target to lower blood pressure of less than one hour was adopted by 57%, 46%, and 28% respectively.
Conclusion:
Stroke centers have rapidly adopted changes in blood pressure management in intracerebral hemorrhage in advance of guideline revisions. Non-teaching hospitals were less likely to adopt these changes.
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Cook W, Bryzinski B, Slater J, Frederich R, Allen E. Saxagliptin efficacy and safety in patients with type 2 diabetes mellitus and cardiovascular disease history or cardiovascular risk factors: results of a pooled analysis of phase 3 clinical trials. Postgrad Med 2013; 125:145-54. [PMID: 23748515 DOI: 10.3810/pgm.2013.05.2657] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This post hoc analysis sought to assess the efficacy, safety, and tolerability of saxagliptin in patients with type 2 diabetes mellitus and cardiovascular (CV) risk factors or disease (CVD). METHODS Data from 5 randomized controlled trials were pooled to compare saxagliptin 5 mg with placebo: 2 studies of saxagliptin as monotherapy in drug-naïve patients and 1 each of saxagliptin as add-on therapy to metformin, glyburide, or a thiazolidinedione. Analysis was performed according to the following baseline/trial entry criteria: 1) history/no history of CVD; 2) ≥ 2 versus 0 to 1 CV risk factors; 3) statin use versus no statin use; and 4) hypertension versus no hypertension. Change from baseline glycated hemoglobin (HbA1c), fasting plasma glucose, and postprandial glucose levels; and the proportion of patients achieving an HbA1c level < 7% were analyzed (week 24). Safety was assessed by adverse events, hypoglycemia, and body weight. RESULTS In total, 882 patients received saxagliptin 5 mg and 799 received placebo. Differences in adjusted mean change from baseline HbA1c (95% CI) were greater with saxagliptin compared with placebo in patients with a history of CVD (-0.64% [-0.90 to -0.38]) and no history of CVD (-0.68% [-0.78 to -0.58]); with ≥ 2 CV risk factors (-0.73% [-0.85 to -0.60]) and 0 to 1 CV risk factor (-0.62% [-0.75 to -0.48]); with statin use (-0.70% [-0.89 to -0.52]) and no statin use (-0.66% [-0.77 to -0.56]); and with hypertension (-0.69% [-0.82 to -0.57]) and no hypertension (-0.66% [-0.80 to -0.52]). Saxagliptin was well tolerated, with similar adverse event rates and types compared with placebo. There was a < 1% rate of confirmed hypoglycemia in all groups except in patients with CV history who received placebo (2.1%). CONCLUSION Saxagliptin improved glycemic measures, resulted in low rates of confirmed hypoglycemia, and was well tolerated in patients with or without CVD and CV risk factors.
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Affiliation(s)
- William Cook
- Medical Affairs, AstraZeneca, Wilmington, DE 19850, USA.
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McAuley G, Slater J, Wroe A. SU-E-T-524: Effects On Dose and RBE From High Density Materials in Proton Therapy. Med Phys 2013. [DOI: 10.1118/1.4814954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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29
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Gridley D, Slater J, Yonemoto L, Miller D, Rossi C, Archambeau J, Andres M, Oey M. Pilot study of cytokine profiles in prostate cancer patients undergoing proton or conventional radiotherapy. Int J Oncol 2012; 8:175-81. [PMID: 21544347 DOI: 10.3892/ijo.8.1.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The mechanisms responsible for normal tissue late effects following radiotherapy are largely unknown and currently no method for predicting such risks is available. Abnormal levels of cytokine production induced by radiation has been suggested as a contributing factor by multiple investigators. The purpose of the present study was to evaluate plasma levels of transforming growth factor-beta 1 (TGF-beta 1), basic fibroblast growth factor (bFGF), tumor necrosis factor-alpha (TNF-alpha), and interleukin-1 beta (IL-1 beta) in patients with prostate cancer scheduled for radiotherapy (protons, photons, or combination of both). It has been recently shown that ionizing radiation can increase expression of these cytokines and there are indications that they may be associated with morbidity. Blood samples were obtained from 20 subjects (age 51-80) before, during the first week, and immediately after the end of therapy; 3 healthy volunteers served as controls. Significant positive correlations (p<0.05) were obtained between bFGF, IL-1 beta, and TNF-alpha and the integral dose of radiation during the first week of treatment. Correlations approaching significance (p<0.1) were obtained with bFGF and acute treatment-related morbidity. A higher integral dose (due to larger irradiated volumes) was delivered with conventional photon compared to proton irradiation. No significance was obtained with any of the cytokines and pretreatment prostate specific antigen (PSA) levels, patient age, grade or stage of disease, or the integral dose by the end of radiation treatment. These results show that large changes occur in the plasma levels of certain cytokines early after initiation of radiotherapy and that treatment of larger volumes is more likely to induce these changes. Our data support further investigation of the role of cytokines during radiotherapy.
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Affiliation(s)
- D Gridley
- LOMA LINDA UNIV,SCH MED,DEPT RADIAT MED,LOMA LINDA,CA 92350. LOMA LINDA UNIV,MED CTR,INDEPENTENT ORDER FORESTERS CANC RES LAB,LOMA LINDA,CA 92350
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30
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Kydd JH, Slater J, Osterrieder N, Lunn DP, Antczak DF, Azab W, Balasuriya U, Barnett C, Brosnahan M, Cook C, Damiani A, Elton D, Frampton A, Gilkerson J, Goehring L, Horohov D, Maxwell L, Minke J, Morley P, Nauwynck H, Newton R, Perkins G, Pusterla N, Soboll-Hussey G, Traub-Dargatz J, Townsend H, Van de walle GR, Wagner B. Third International Havemeyer Workshop on Equine Herpesvirus type 1. Equine Vet J 2012; 44:513-7. [DOI: 10.1111/j.2042-3306.2012.00604.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [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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31
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McAuley G, Barnes S, Wroe A, Slater J. SU-E-T-300: Monte Carlo Simulation of Single-Plane Magnetically Focused Narrow Proton Beams. Med Phys 2012; 39:3772. [DOI: 10.1118/1.4735386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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32
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Barnes S, McAuley G, Wroe A, Slater J. SU-E-T-232: Proton Source Modeling for Geant4 Monte Carlo Simulations. Med Phys 2012; 39:3756-3757. [PMID: 28517316 DOI: 10.1118/1.4735295] [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] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To investigate the effect of initial proton beam source placement, distribution and angle on the proton dose distribution in a therapeutic nozzle using Geant4. METHODS We performed Geant4 Monte Carlo simulations of a passively scattered proton treatment nozzle. Accurate geometry including all elements in the treatment room was used. Protons were generated just inside the vacuum pipe using one of two models. First, a standard two dimensional Gaussian distribution of proton starting position was used with a small random angle added to the initial direction. The size of the Gaussian distribution and the random angle were set to match measured beam spot size and angular spread at the exit window. Second, a point source of protons further back in the vacuum pipe with a small random angle was used. The distance of the point source to exit window and the random angle were set to match the spot size and angular deviation used for the Gaussian distribution. Depth dose curves and orthogonal beam profiles were examined to determine changes between the two models. RESULTS Orthogonal beam profiles for large apertures showed changes of up to 6.5% between the two models with the point source showing much better agreement with measured data. Depth dose curves and orthogonal profiles for small apertures were unaffected. For large apertures, the average difference compared to measured data was of 1.9% and 0.7% and the max difference was 5.0% and 1.6% for Gaussian and point sources, respectively. CONCLUSIONS The point source more realistically models the proton distribution in the vacuum pipe by correlating the proton position with the direction. For certain scattering setups and large apertures point source modeling is necessary to accurate match measured data with Monte Carlo simulations.
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Affiliation(s)
- S Barnes
- Loma Linda University, Loma Linda, CA.,Loma Linda University Medical Center, Loma Linda, CA
| | - G McAuley
- Loma Linda University, Loma Linda, CA.,Loma Linda University Medical Center, Loma Linda, CA
| | - A Wroe
- Loma Linda University, Loma Linda, CA.,Loma Linda University Medical Center, Loma Linda, CA
| | - J Slater
- Loma Linda University, Loma Linda, CA.,Loma Linda University Medical Center, Loma Linda, CA
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Khurana T, Collison M, Chew F, Jeong K, Slater J. Allergen Specificity Of 3 Scfv Antibodies Developed For A Multiplex Assay Of Blattella Germanica Extract Potency. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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34
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Rappolee D, Xie Y, Zhou S, Slater J, Puscheck E. cellular and toxicological stress causes adaptive “PRIORITIZED” AND “Compensatory” differentiation of embryonic and placental stem cells of the implanting blastocyst. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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35
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Dagenais G, Lu J, Faxon D, Slater J, Frye R. 680 Do patients with type 2 diabetes and stable coronary artery disease with or without angina have a similar prognosis? a sub-study of the bari 2D trial. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.566] [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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36
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Slater J, Sevenhuysen G, Edginton B, O'neil J. 'Trying to make it all come together': structuration and employed mothers' experience of family food provisioning in Canada. Health Promot Int 2011; 27:405-15. [DOI: 10.1093/heapro/dar037] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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37
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Abstract
The sequence of the Streptococcus equi subspecies equi (S equi) M-like protein (SeM) gene was determined for 105 isolates of S equi from strangles outbreaks in the UK during 2010 and compared with previous data from 2007 to 2008. Twenty-three distinct alleles were identified, including 11 novel alleles. One allele giving rise to a putative truncated M protein was identified from the guttural pouch of an asymptomatic carrier. Allele 9 was the most prevalent, comprising 57.7 per cent of isolates, followed by allele 6 (10.3 per cent). Significant changes in allele prevalence were found between 2007, 2008 and 2010, with an increasing prevalence in SeM-9-related alleles and a corresponding decreasing prevalence in SeM-6-related alleles observed over the period (P<0.001). Geographical proximity of outbreaks caused by some uncommon alleles was apparent between 2007, 2008 and 2010.
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Affiliation(s)
- N J Parkinson
- Centre for Preventive Medicine, Animal Health Trust, Landwades Park, Kentford, Newmarket, Suffolk CB8 7UU
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38
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Wroe A, Ghebremedhin A, Johnson M, Piskulich F, Patyal B, Schulte R, Slater J. SU-E-T-501: Immobilization System Design and Testing for Proton Therapy. Med Phys 2011. [DOI: 10.1118/1.3612454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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39
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Wroe A, Schulte R, Slater J. SU-E-T-296: Dose Delivered to Gantry-Mounted Electronics in Proton Therapy. Med Phys 2011. [DOI: 10.1118/1.3612247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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40
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Kydd JH, Slater J, Osterrieder N, Antczak DF, Lunn DP. Report of the Second Havemeyer EHV-1 Workshop, Steamboat Springs, Colorado, USA, September 2008. Equine Vet J 2010; 42:572-5. [PMID: 20716200 DOI: 10.1111/j.2042-3306.2010.00157.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This report summarises the findings of the Second Havemeyer EHV-1 Workshop, which was held in Steamboat Springs, Colorado, USA in September 2008. A total of 38 delegates, consisting of veterinary clinicians and scientists from academia and industry participated in a series of sessions that focused on equine herpesvirus myeloencephalopathy (EHM). Each session consisted of a review, followed by short presentations on current research topics. The sessions included EHM epidemiology, in vivo and in vitro models for studying EHM, EHV-1 virulence determinants, real-time PCR diagnostics, antiviral medications and new vaccination technologies. The report summarises the key advances identified during and since the meeting. Citations are restricted to selected reviews and papers published since the workshop.
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Affiliation(s)
- J H Kydd
- School of Veterinary Medicine and Science, University of Nottingham, UK
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41
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42
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Xie Y, Abdallah M, Awonuga A, Slater J, Puscheck E, Rappolee D. Benzopyrene causes AMPK-dependent ID2 loss in placental trophoblast stem cells. Fertil Steril 2009. [DOI: 10.1016/j.fertnstert.2009.07.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Awonuga AO, Abdallah ME, Xie Y, Slater J, Zhou S, Proteasa S, Puscheck EE, Rappolee D. Eomesodermin Is Upregulated by Stress in Trophoblast Stem Cells in a Stress Activated Protein Kinase (SAPK)-Dependent Manner. Biol Reprod 2009. [DOI: 10.1093/biolreprod/81.s1.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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44
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Xie Y, Abdallah M, Awonuga N, Slater J, Puscheck E, Rappolee D. Benzo(a)pyrene Activates Stress Enzymes and Regulates Transcription Factors That Favor Differentiation of Trophoblast Stem Cells. Biol Reprod 2009. [DOI: 10.1093/biolreprod/81.s1.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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45
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Rappolee D, Xie Y, Slater J, Zhou S, Awonuga A, Addallah M, Puscheck E. Stress and Stress Enzymes Have Some Shared Functions in Pre-Implantation Embryos and Their Trophoblast Stem Cells. Biol Reprod 2009. [DOI: 10.1093/biolreprod/81.s1.666] [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: 11/12/2022] Open
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46
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Wroe A, Rightnar S, Ghebremedhin A, Schulte R, Lesyna D, Patyal B, Slater J, Gridley D, Slater J. SU-FF-T-312: Dosimetry for Radiobiological Evaluation of the Active Beam Scanning System at Loma Linda University Medical Center. Med Phys 2009. [DOI: 10.1118/1.3181792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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47
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McDonald SE, Slater J, Powell R, Khalil HS, Garth RJN. A randomised controlled trial comparing Rapid Rhino Mannheim and Netcell series 5000 packs following routine nasal surgery. Rhinology 2009; 47:41-44. [PMID: 19382493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To determine whether there is a difference in discomfort between Netcell Series 5000 and Rapid Rhino Mannheim 8.0 cm (Cat. No. 800) packs used after routine nasal surgery, whilst in situ and during removal. This was tested in a single blind, randomised controlled trial at the ENT Department, Royal Devon & Exeter Hospital. PARTICIPANTS Adults aged 16-65 undergoing nasal septal surgery and trimming of inferior turbinates. Patients were excluded if they were undergoing revision surgery, taking anticoagulants, or had a history of sino-nasal disease or trauma. Thirty nine entered and 32 completed the study. The intervention was a different nasal pack in each side of the nose, removed the morning after surgery. MAIN OUTCOMES MEASURES Pain experienced by patients while packs are in situ and on removal as recorded on a standard unmarked 100 mm visual analogue scale. RESULTS There was no difference in the pain scores whilst in situ. Rapid Rhino Mannheim was more painful on removal (difference = 10.6 mm, p < 0.001, Wilcoxon signed ranks test). CONCLUSIONS Rapid Rhino Mannheim packs do not confer a benefit over Netcell Series 5000 packs after routine nasal surgery.
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Affiliation(s)
- S E McDonald
- Torbay Hospital, ENT Department, Torquay, United Kingdom.
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48
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Slater J, Green C, Sevenhuysen G, O'Neil J, Edginton B. Socio-demographic and geographic analysis of overweight and obesity in Canadian adults using the Canadian Community Health Survey (2005). Chronic Dis Can 2009; 30:4-15. [PMID: 20031083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Using the 2005 Canadian Community Health Survey, this study examined how overweight and obesity in Canadian adults are distributed across socio-demographic and geographic groupings. Overweight and obesity prevalence were modeled against socio-demographic indicators using Poisson regression and were assessed geographically using choropleth maps. The Gini coefficient was used to assess the distribution of prevalence across risk groups. The potential impacts of high risk versus population-based prevention approaches on the population prevalence of obesity were also examined. Of adults aged 25 to 64 years, 17% were obese and 53% were overweight or obese, with the highest proportions observed in older age groups, among those who were physically inactive, white or non-immigrant, with low educational levels, and living in the prairie and east coast regions. Recalculation of obesity rates under the different prevention scenarios demonstrated that population-based approaches could achieve a four-fold greater decrease in obesity cases than high risk approaches, highlighting the need for broader population strategies for obesity prevention in Canada.
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Affiliation(s)
- J Slater
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba.
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Huang C, Loewen P, Pelletier T, Slater J, Chung M. Implementation of proven interventions in general medical inpatients: development and evaluation of a new quality indicator for drug therapy. Qual Saf Health Care 2008; 17:269-74. [PMID: 18678724 DOI: 10.1136/qshc.2007.023416] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Among adult general medical inpatients, there are numerous interventions whose benefits outweigh their risks. However, there are no published reports describing the overall use of such proven interventions in this population. OBJECTIVES To determine implementation rates of a broad range of interventions while accounting for valid reasons for non-use, predictors of implementation and feasibility of generating new indices to describe quality of care. METHODS Based on a review of current practice guidelines and clinical trials related to five common conditions, implementation rates of 17 interventions were assessed retrospectively. Subjects were a complete sample of 150 adults with target medical conditions discharged from general medical units at an urban community hospital. RESULTS The Ideal Intervention Index (3I), which described the proportion of ideal intervention opportunities that were implemented, was 0.74 (95% CI 0.70 to 0.78). The Justified Non-Use Index (JNUI), which described the proportion of all the interventions not implemented that were justified by a valid reason for non-use, was 0.49 (95% CI 0.41 to 0.55). Smoking cessation therapy in high-risk patients had the lowest indices (3I 0.30, 95% CI 0.00 to 0.60; JNUI 0.00), and aspirin for secondary stroke prevention had the highest (3I 1.0; JNUI 1.0). CONCLUSIONS Overall, proven interventions are underused among the patients studied, and the reasons for non-use are frequently not readily discernible. There is potential for improvement, but research is required to further investigate reasons for non-use. It is feasible to measure implementation rates of proven interventions as an indicator of quality of care using the indices developed.
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Affiliation(s)
- C Huang
- Vancouver Coastal Health, Vancouver, British Columbia, Canada
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50
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Tilbrook LK, Slater J, Agarwal A, Cyriac J. An unusual cause of interference in a salicylate assay caused by mitochondrial acetoacetyl-CoA thiolase deficiency. Ann Clin Biochem 2008; 45:524-6. [DOI: 10.1258/acb.2008.007202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mitochondrial acetoacetyl-CoA thiolase deficiency (or beta-ketothiolase deficiency) is a rare metabolic disorder characterized by acute episodes of severe acidosis and ketosis. A case is presented of an 18-month-old boy who presented with vomiting and diarrhoea and was found to be markedly acidotic. When the acidosis persisted despite saline fluid boluses and bicarbonate correction, further investigations were undertaken. Routine biochemical investigation revealed detectable salicylate concentrations despite the parents denying its administration, which initially caused some diagnostic confusion. The results of urine organic acid analysis, however, confirmed that the diagnosis of mitochondrial acetoacetyl-CoA thiolase deficiency. The high concentrations of acetoacetate present in the patient's sample resulted in a false-positive reaction in the Trinder assay for salicylate.
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Affiliation(s)
| | - J Slater
- Department of Clinical Biochemistry
| | - A Agarwal
- Department of Paediatrics, Mid Essex Hospital Services NHS Trust, Broomfield Hospital, Chelmsford, Essex CM1 5ET, UK
| | - J Cyriac
- Department of Paediatrics, Mid Essex Hospital Services NHS Trust, Broomfield Hospital, Chelmsford, Essex CM1 5ET, UK
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