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Hum C, Tahir U, Mei SHJ, Champagne J, Fergusson DA, Lalu M, Stewart DJ, Walley K, Marshall J, dos Santos CC, Winston BW, Mendelson AA, Dave C, McIntyre L. Efficacy and Safety of Umbilical Cord-Derived Mesenchymal Stromal Cell Therapy in Preclinical Models of Sepsis: A Systematic Review and Meta-analysis. Stem Cells Transl Med 2024; 13:346-361. [PMID: 38381583 PMCID: PMC11016835 DOI: 10.1093/stcltm/szae003] [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: 07/07/2023] [Accepted: 11/11/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND In preclinical studies, mesenchymal stromal cells (MSCs), including umbilical cord-derived MSCs (UC-MSCs), demonstrate the ability to modulate numerous pathophysiological processes related to sepsis; however, a systematic synthesis of the literature is needed to assess the efficacy of UC-MSCs for treating sepsis. OBJECTIVE To examine the effects of UC-MSCs on overall mortality (primary outcome) as well as on organ dysfunction, coagulopathy, endothelial permeability, pathogen clearance, and systemic inflammation (secondary outcomes) at prespecified time intervals in preclinical models of sepsis. METHODS A systematic search was conducted on Embase, Ovid MEDLINE, and Web of Science up to June 20, 2023. Preclinical controlled studies using in vivo sepsis models with systemic UC-MSC administration were included. Meta-analyses were conducted and expressed as odds ratios (OR) and ratios of the weighted means with 95% CI for categorical and continuous data, respectively. Risk of bias was assessed with the SYRCLE tool. RESULTS Twenty-six studies (34 experiments, n = 1258 animals) were included in this review. Overall mortality was significantly reduced with UC-MSC treatment as compared to controls (OR: 0.26, 95% CI: 0.18-0.36). At various prespecified time intervals, UC-MSCs reduced surrogate measures of organ dysfunction related to the kidney, liver, and lung; reduced coagulopathy and endothelial permeability; and enhanced pathogen clearance from multiple sites. UC-MSCs also modulated systemic inflammatory mediators. No studies were rated as low risk across all SYCLE domains. CONCLUSIONS These results demonstrate the efficacy of UC-MSC treatment in preclinical sepsis models and highlight their potential as a therapeutic intervention for septic shock.
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Affiliation(s)
- Christine Hum
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Usama Tahir
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shirley H J Mei
- Regenerative Medicine Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Josee Champagne
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Dean A Fergusson
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Manoj Lalu
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Regenerative Medicine Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Cell and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - Duncan J Stewart
- Regenerative Medicine Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Cell and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Keith Walley
- Department of Medicine, Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - John Marshall
- Department of Surgery (Critical Care), University of Toronto, Toronto, ON, Canada
| | - Claudia C dos Santos
- Keenan Research Centre for Biomedical Science and Interdepartmental Division of Critical Care, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada
| | - Brent W Winston
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - Asher A Mendelson
- Section of Critical Care Medicine, Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Chintan Dave
- Division of Critical Care Medicine, Department of Medicine, Western University, London, ON, Canada
| | - Lauralyn McIntyre
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Medicine (Division of Critical Care), University of Ottawa, Ottawa, ON, Canada
- Department of Medicine (Critical Care), The Ottawa Hospital, Ottawa Hospital Research Institute, Centre for Transfusion and Critical Care Research, Ottawa, ON, Canada
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Augustyniak M, Lou E, Jacobs G, Fleming M, Marshall J, Coutinho A, Yoshino T. Learning Outcomes of "GetSMART," Education for Diagnostics and Targeted Treatment for HER2+ Metastatic Gastric and Colorectal Cancers. J Cancer Educ 2024; 39:118-125. [PMID: 38135836 PMCID: PMC10995009 DOI: 10.1007/s13187-023-02384-8] [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] [Subscribe] [Scholar Register] [Accepted: 11/11/2023] [Indexed: 12/24/2023]
Abstract
The treatment landscape for patients affected by gastric and colorectal cancer (G&CRC) has significantly broadened over the past decade. Molecular diagnostic methods have improved with a precision oncology-driven approach to the development of treatment options tailored to specific molecular targets, including the human epidermal growth factor 2 (HER2). While scientific evidence on the role of HER2 in G&CRC has improved, there has been a lag in general understanding and applications of testing for HER2+ G&CRC and resulting targeting treatment in the wider oncology community. To better understand and address the root causes of this gap, a needs assessment deployed among 85 oncology care providers was conducted and informed the development of an accredited online educational program entitled "GetSMART." The program consisted of four modules developed and narrated by experts in gastrointestinal oncology. The educational content and assessment metrics were guided by a confidence-based assessment (CBA) model and the Moore, Green, and Gallis outcomes framework. Assessment methods consisted of quantitative pre- and post-activity tests, an evaluation embedded within the education (n = 163), and semi-structured interviews (n = 5) post-activity completion. Findings indicated that "GetSMART" enhanced participants' knowledge, confidence, and intent to change practice in relation to their (1) identification of HER2 aberrations, (2) selection of appropriate treatments for HER2+ G&CRC, and (3) ability to engage patients in shared decision-making and management of adverse events. "GetSMART" can therefore be a valuable educational resource for oncology HCPs caring for patients affected by HER2+ metastatic G&CRC, offering strategies to ensure an optimal team and patient-centered approach to the care being delivered.
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Affiliation(s)
| | - Emil Lou
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ginny Jacobs
- AXDEV Global, Inc, Virginia Beach, Virginia, USA
| | | | - John Marshall
- District of Columbia, Georgetown University, Washington, USA
| | - Anelisa Coutinho
- Multidisciplinary Oncology Institution, Clinica AMO, Salvador, Bahia, Brazil
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Arai H, Yang Y, Baca Y, Millstein J, Denda T, Ou FS, Innocenti F, Takeda H, Kubota Y, Doi A, Horie Y, Umemoto K, Izawa N, Wang J, Battaglin F, Jayachandran P, Algaze S, Soni S, Zhang W, Goldberg RM, Hall MJ, Scott AJ, Hwang JJ, Lou E, Weinberg BA, Marshall J, Goel S, Xiu J, Michael Korn W, Venook AP, Sunakawa Y, Lenz HJ. Predictive value of CDC37 gene expression for targeted therapy in metastatic colorectal cancer. Eur J Cancer 2024; 201:113914. [PMID: 38359495 DOI: 10.1016/j.ejca.2024.113914] [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: 11/11/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND CDC37 is a key determinant of client kinase recruitment to the HSP90 chaperoning system. We hypothesized that kinase-specific dependency on CDC37 alters the efficacy of targeted therapies for metastatic colorectal cancer (mCRC). MATERIAL AND METHODS Two independent mCRC cohorts were analyzed to compare the survival outcomes between CDC37-high and CDC37-low patients (stratified by the median cutoff values): the CALGB/SWOG 80405 trial (226 and 207 patients receiving first-line bevacizumab- and cetuximab-containing chemotherapies, respectively) and Japanese retrospective (50 refractory patients receiving regorafenib) cohorts. A dataset of specimens submitted to a commercial CLIA-certified laboratory was utilized to characterize molecular profiles of CDC37-high (top quartile, N = 5055) and CDC37-low (bottom quartile, N = 5055) CRCs. RESULTS In the bevacizumab-treated group, CDC37-high patients showed significantly better progression-free survival (PFS) (median 13.3 vs 9.6 months, hazard ratio [HR] 0.59, 95% confidence interval [CI] 0.44-0.79, p < 0.01) than CDC37-low patients. In the cetuximab-treated group, CDC37-high and CDC37-low patients had similar outcomes. In the regorafenib-treated group, CDC37-high patients showed significantly better overall survival (median 11.3 vs 6.0 months, HR 0.24, 95% CI 0.11-0.54, p < 0.01) and PFS (median 3.5 vs 1.9 months, HR 0.51, 95% CI 0.28-0.94, p = 0.03). Comprehensive molecular profiling revealed that CDC37-high CRCs were associated with higher VEGFA, FLT1, and KDR expressions and activated hypoxia signature. CONCLUSIONS CDC37-high mCRC patients derived more benefit from anti-VEGF therapies, including bevacizumab and regorafenib, but not from cetuximab. Molecular profiles suggested that such tumors were dependent on angiogenesis-relating pathways.
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Affiliation(s)
- Hiroyuki Arai
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yan Yang
- Department of Population and Public Health Sciences, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Yasmine Baca
- Clinical & Translational Research, Medical Affairs, Caris Life Sciences, Phoenix, AZ, USA
| | - Joshua Millstein
- Department of Population and Public Health Sciences, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tadamichi Denda
- Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Fang-Shu Ou
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA
| | - Federico Innocenti
- UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hiroyuki Takeda
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yohei Kubota
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Ayako Doi
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshiki Horie
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kumiko Umemoto
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Naoki Izawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Jingyuan Wang
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Francesca Battaglin
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Priya Jayachandran
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandra Algaze
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Shivani Soni
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Wu Zhang
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Michael J Hall
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Aaron James Scott
- Department of Medicine, University of Arizona Cancer Center, Tucson, AZ, USA
| | - Jimmy J Hwang
- Department of Solid Tumor Oncology, GI Medical Oncology, Levine Cancer Institute, Charlotte, NC, USA
| | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Benjamin A Weinberg
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - John Marshall
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Joanne Xiu
- Clinical & Translational Research, Medical Affairs, Caris Life Sciences, Phoenix, AZ, USA
| | - W Michael Korn
- Clinical & Translational Research, Medical Affairs, Caris Life Sciences, Phoenix, AZ, USA
| | - Alan P Venook
- University of California, San Francisco, San Francisco, CA, USA
| | - Yu Sunakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Heinz-Josef Lenz
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Shankar-Hari M, Calandra T, Soares MP, Bauer M, Wiersinga WJ, Prescott HC, Knight JC, Baillie KJ, Bos LDJ, Derde LPG, Finfer S, Hotchkiss RS, Marshall J, Openshaw PJM, Seymour CW, Venet F, Vincent JL, Le Tourneau C, Maitland-van der Zee AH, McInnes IB, van der Poll T. Reframing sepsis immunobiology for translation: towards informative subtyping and targeted immunomodulatory therapies. Lancet Respir Med 2024; 12:323-336. [PMID: 38408467 PMCID: PMC11025021 DOI: 10.1016/s2213-2600(23)00468-x] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/27/2023] [Accepted: 12/07/2023] [Indexed: 02/28/2024]
Abstract
Sepsis is a common and deadly condition. Within the current model of sepsis immunobiology, the framing of dysregulated host immune responses into proinflammatory and immunosuppressive responses for the testing of novel treatments has not resulted in successful immunomodulatory therapies. Thus, the recent focus has been to parse observable heterogeneity into subtypes of sepsis to enable personalised immunomodulation. In this Personal View, we highlight that many fundamental immunological concepts such as resistance, disease tolerance, resilience, resolution, and repair are not incorporated into the current sepsis immunobiology model. The focus for addressing heterogeneity in sepsis should be broadened beyond subtyping to encompass the identification of deterministic molecular networks or dominant mechanisms. We explicitly reframe the dysregulated host immune responses in sepsis as altered homoeostasis with pathological disruption of immune-driven resistance, disease tolerance, resilience, and resolution mechanisms. Our proposal highlights opportunities to identify novel treatment targets and could enable successful immunomodulation in the future.
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Affiliation(s)
- Manu Shankar-Hari
- Institute for Regeneration and Repair, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK.
| | - Thierry Calandra
- Service of Immunology and Allergy, Center of Human Immunology Lausanne, Department of Medicine and Department of Laboratory Medicine and Pathology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | | | - Michael Bauer
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - W Joost Wiersinga
- Center for Experimental and Molecular Medicine and Division of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Hallie C Prescott
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Julian C Knight
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Kenneth J Baillie
- Institute for Regeneration and Repair, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Lieuwe D J Bos
- Department of Intensive Care, Academic Medical Center, Amsterdam, Netherlands
| | - Lennie P G Derde
- Intensive Care Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Simon Finfer
- Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Richard S Hotchkiss
- Department of Anesthesiology and Critical Care Medicine, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - John Marshall
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada
| | | | - Christopher W Seymour
- Department of Critical Care Medicine, The Clinical Research, Investigation, and Systems Modeling of Acute illness (CRISMA) Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Fabienne Venet
- Immunology Laboratory, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris-Saclay University, Paris, France
| | - Anke H Maitland-van der Zee
- Department of Pulmonary Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Iain B McInnes
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Tom van der Poll
- Center for Experimental and Molecular Medicine and Division of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
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5
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Muquith M, Espinoza M, Elliott A, Xiu J, Seeber A, El-Deiry W, Antonarakis ES, Graff SL, Hall MJ, Borghaei H, Hoon DSB, Liu SV, Ma PC, McKay RR, Wise-Draper T, Marshall J, Sledge GW, Spetzler D, Zhu H, Hsiehchen D. Tissue-specific thresholds of mutation burden associated with anti-PD-1/L1 therapy benefit and prognosis in microsatellite-stable cancers. Nat Cancer 2024:10.1038/s43018-024-00752-x. [PMID: 38528112 DOI: 10.1038/s43018-024-00752-x] [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] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 02/28/2024] [Indexed: 03/27/2024]
Abstract
Immune checkpoint inhibitors (ICIs) targeting programmed cell death protein 1 or its ligand (PD-1/L1) have expanded the treatment landscape against cancers but are effective in only a subset of patients. Tumor mutation burden (TMB) is postulated to be a generic determinant of ICI-dependent tumor rejection. Here we describe the association between TMB and survival outcomes among microsatellite-stable cancers in a real-world clinicogenomic cohort consisting of 70,698 patients distributed across 27 histologies. TMB was associated with survival benefit or detriment depending on tissue and treatment context, with eight cancer types demonstrating a specific association between TMB and improved outcomes upon treatment with anti-PD-1/L1 therapies. Survival benefits were noted over a broad range of TMB cutoffs across cancer types, and a dose-dependent relationship between TMB and outcomes was observed in a subset of cancers. These results have implications for the use of cancer-agnostic and universal TMB cutoffs to guide the use of anti-PD-1/L1 therapies, and they underline the importance of tissue context in the development of ICI biomarkers.
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Affiliation(s)
- Maishara Muquith
- Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Magdalena Espinoza
- Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | - Andreas Seeber
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
| | - Wafik El-Deiry
- Laboratory of Translational Oncology and Experimental Cancer Therapeutics, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Emmanuel S Antonarakis
- Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Stephanie L Graff
- Lifespan Cancer Institute, Legorreta Cancer Center, Brown University, Providence, RI, USA
| | - Michael J Hall
- Department of Clinical Genetics, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Hossein Borghaei
- Department of Hematology-Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Dave S B Hoon
- Department of Translational Molecular Medicine, Saint John's Cancer Institute, Providence Saint John's Health Center, Santa Monica, CA, USA
| | - Stephen V Liu
- Division of Hematology and Oncology, Georgetown University, Washington, DC, USA
| | | | - Rana R McKay
- Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Trisha Wise-Draper
- Division of Hematology and Oncology, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - John Marshall
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | | | | | - Hao Zhu
- Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David Hsiehchen
- Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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6
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Lee CH, Banoei MM, Ansari M, Cheng MP, Lamontagne F, Griesdale D, Lasry DE, Demir K, Dhingra V, Tran KC, Lee T, Burns K, Sweet D, Marshall J, Slutsky A, Murthy S, Singer J, Patrick DM, Lee TC, Boyd JH, Walley KR, Fowler R, Haljan G, Vinh DC, Mcgeer A, Maslove D, Mann P, Donohoe K, Hernandez G, Rocheleau G, Trahtemberg U, Kumar A, Lou M, Dos Santos C, Baker A, Russell JA, Winston BW. Using a targeted metabolomics approach to explore differences in ARDS associated with COVID-19 compared to ARDS caused by H1N1 influenza and bacterial pneumonia. Crit Care 2024; 28:63. [PMID: 38414082 PMCID: PMC10900651 DOI: 10.1186/s13054-024-04843-0] [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: 12/12/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
RATIONALE Acute respiratory distress syndrome (ARDS) is a life-threatening critical care syndrome commonly associated with infections such as COVID-19, influenza, and bacterial pneumonia. Ongoing research aims to improve our understanding of ARDS, including its molecular mechanisms, individualized treatment options, and potential interventions to reduce inflammation and promote lung repair. OBJECTIVE To map and compare metabolic phenotypes of different infectious causes of ARDS to better understand the metabolic pathways involved in the underlying pathogenesis. METHODS We analyzed metabolic phenotypes of 3 ARDS cohorts caused by COVID-19, H1N1 influenza, and bacterial pneumonia compared to non-ARDS COVID-19-infected patients and ICU-ventilated controls. Targeted metabolomics was performed on plasma samples from a total of 150 patients using quantitative LC-MS/MS and DI-MS/MS analytical platforms. RESULTS Distinct metabolic phenotypes were detected between different infectious causes of ARDS. There were metabolomics differences between ARDSs associated with COVID-19 and H1N1, which include metabolic pathways involving taurine and hypotaurine, pyruvate, TCA cycle metabolites, lysine, and glycerophospholipids. ARDSs associated with bacterial pneumonia and COVID-19 differed in the metabolism of D-glutamine and D-glutamate, arginine, proline, histidine, and pyruvate. The metabolic profile of COVID-19 ARDS (C19/A) patients admitted to the ICU differed from COVID-19 pneumonia (C19/P) patients who were not admitted to the ICU in metabolisms of phenylalanine, tryptophan, lysine, and tyrosine. Metabolomics analysis revealed significant differences between C19/A, H1N1/A, and PNA/A vs ICU-ventilated controls, reflecting potentially different disease mechanisms. CONCLUSION Different metabolic phenotypes characterize ARDS associated with different viral and bacterial infections.
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Affiliation(s)
- Chel Hee Lee
- Department of Critical Care Medicine, University of Calgary, Alberta, Canada
| | - Mohammad M Banoei
- Department of Critical Care Medicine, University of Calgary, Alberta, Canada
| | - Mariam Ansari
- Department of Critical Care Medicine, University of Calgary, Alberta, Canada
| | - Matthew P Cheng
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | | | - Donald Griesdale
- Critical Care Medicine, Vancouver General Hospital and University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada
| | - David E Lasry
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | - Koray Demir
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | - Vinay Dhingra
- Critical Care Medicine, Vancouver General Hospital and University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada
| | - Karen C Tran
- Division of General Internal Medicine, Vancouver General Hospital and University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada
| | - Terry Lee
- Centre for Health Evaluation and Outcome Science (CHEOS), St. Paul's Hospital and University of British Columbia, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Kevin Burns
- Department of Medicine, Division of Nephrology, Ottawa Hospital Research Institute, and University of Ottawa, 1967 Riverside Dr., Rm. 535, Ottawa, ON, K1H 7W9, Canada
| | - David Sweet
- Critical Care Medicine and Emergency Medicine, Vancouver General Hospital and University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada
| | - John Marshall
- Department of Surgery, St. Michael's Hospital and University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Arthur Slutsky
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Srinivas Murthy
- British Columbia Children's Hospital, University of British Columbia, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Joel Singer
- Centre for Health Evaluation and Outcome Science (CHEOS), St. Paul's Hospital and University of British Columbia, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - David M Patrick
- British Columbia Centre for Disease Control (BCCDC) and School of Population and Public Health, University of British Columbia, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
| | - Todd C Lee
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | - John H Boyd
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Keith R Walley
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Robert Fowler
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Greg Haljan
- Department of Medicine and Critical Care Medicine, Surrey Memorial Hospital, 13750 96th Avenue, Surrey, BC, V3V 1Z2, Canada
| | - Donald C Vinh
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | - Alison Mcgeer
- Mt. Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada
| | - David Maslove
- Department of Critical Care, Kingston General Hospital and Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada
| | | | | | | | | | - Uriel Trahtemberg
- Department of Critical Care, Galilee Medical Center, Nahariya, Israel
- Bar Ilan University, Ramat Gan, Israel
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Anand Kumar
- Departments of Medicine and Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Ma Lou
- Departments of Medicine and Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Claudia Dos Santos
- Department of Medicine and Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada
| | - Andrew Baker
- Departments of Critical Care and Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - James A Russell
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Brent W Winston
- Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology, University of Calgary, Health Research Innovation Center (HRIC), Room 4C64, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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Khushman MM, Toboni MD, Xiu J, Manne U, Farrell A, Lou E, Shields AF, Philip PA, Salem ME, Abraham J, Spetzler D, Marshall J, Jayachandran P, Hall MJ, Lenz HJ, Sahin IH, Seeber A, Powell MA. Differential responses to immune checkpoint inhibitors are governed by diverse mismatch repair gene alterations. Clin Cancer Res 2024:734268. [PMID: 38350001 DOI: 10.1158/1078-0432.ccr-23-3004] [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] [Received: 10/03/2023] [Revised: 11/23/2023] [Accepted: 02/09/2024] [Indexed: 02/15/2024]
Abstract
PURPOSE The response to immune checkpoint inhibitors (ICIs) in deficient mismatch repair (dMMR) colorectal cancer (CRC) and endometrial cancer (EC) is variable. Here, we explored the differential response to ICIs according to different MMR alterations. EXPERIMENTAL DESIGN CRC (N=13701) and EC (N=3315) specimens were tested at Caris Life Sciences. Median overall survival (mOS) was estimated using Kaplan-Meier. The prediction of high, intermediate and low affinity epitopes by tumor mutation burden (TMB) values was conducted using R-squared (R2) Results: Compared to mutL (MLH1 and PMS2) co-loss, the mOS was longer in mutS (MSH2 and MSH6) co-loss in all CRC (54.6m vs. 36m; p=0.0.025) and EC (81.5m vs. 48.2m; p<0.001) patients. In ICIs-treated patients, the mOS was longer in mutS co-loss in CRC (not reached (NR) vs. 36m; p=0.011). In EC, the mOS was NR vs. 42.2m; p=0.711). The neoantigen load (NAL) in mutS co-loss compared to mutL co-loss was higher in CRC (high-affinity epitopes: 25.5 vs 19; q=0.017, intermediate: 39 vs. 32; q=0.004, low: 87.5 vs. 73; q<0.001) and EC (high-affinity epitopes: 15 vs. 11; q=0.002, intermediate: 27.5 vs. 19; q<0.001, low: 59 vs. 41; q<0.001) respectively. R2 ranged from 0.25 in mutS co-loss CRC to 0.95 in mutL co-loss EC. CONCLUSIONS Patients with mutS co-loss experienced longer mOS in CRC and EC and better response to ICIs in CRC. Among all explored biomarkers, NAL was higher in mutS co-loss and may be a potential driving factor for the observed better outcomes. TMB did not reliably predict NAL.
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Affiliation(s)
| | - Michael D Toboni
- The University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Joanne Xiu
- Caris Life Sciences (United States), Phoenix, AZ, United States
| | - Upender Manne
- University of Alabama at Birmingham, BIRMINGHAM, Alabama, United States
| | - Alex Farrell
- Caris Life Sciences (United States), United States
| | - Emil Lou
- University of Minnesota, Minneapolis, MN, United States
| | | | - Philip A Philip
- Wayne State University School of Medicine, Karmanos Cancer Institute, Detroit, mi, United States
| | | | - Jim Abraham
- Caris Life Sciences (United States), Dallas, TX, United States
| | - David Spetzler
- Caris Life Sciences (United States), Phoenix, Az, United States
| | - John Marshall
- Georgetown University, Washington, DC, United States
| | | | - Michael J Hall
- Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Heinz-Josef Lenz
- University of Southern California, Los Angeles, CA, United States
| | | | - Andreas Seeber
- Medical University of Innsbruck, Comprehensive Cancer Center Innsbruck, Innsbruck, Austria
| | - Matthew A Powell
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
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8
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Abratenko P, Alterkait O, Andrade Aldana D, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow D, Barrow J, Basque V, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Brunetti MB, Camilleri L, Cao Y, Caratelli D, Cavanna F, Cerati G, Chappell A, Chen Y, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Cross R, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Djurcic Z, Dorrill R, Duffy K, Dytman S, Eberly B, Englezos P, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Franco D, Furmanski AP, Gao F, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Gramellini E, Green P, Greenlee H, Gu L, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hilgenberg C, Horton-Smith GA, Imani Z, Irwin B, Ismail M, James C, Ji X, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Liu H, Louis WC, Luo X, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Martynenko S, Mastbaum A, Mawby I, McConkey N, Meddage V, Micallef J, Miller K, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Moudgalya MM, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Pophale I, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Safa I, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, St John J, Strauss T, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. Search for Heavy Neutral Leptons in Electron-Positron and Neutral-Pion Final States with the MicroBooNE Detector. Phys Rev Lett 2024; 132:041801. [PMID: 38335355 DOI: 10.1103/physrevlett.132.041801] [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] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024]
Abstract
We present the first search for heavy neutral leptons (HNLs) decaying into νe^{+}e^{-} or νπ^{0} final states in a liquid-argon time projection chamber using data collected with the MicroBooNE detector. The data were recorded synchronously with the NuMI neutrino beam from Fermilab's main injector corresponding to a total exposure of 7.01×10^{20} protons on target. We set upper limits at the 90% confidence level on the mixing parameter |U_{μ4}|^{2} in the mass ranges 10≤m_{HNL}≤150 MeV for the νe^{+}e^{-} channel and 150≤m_{HNL}≤245 MeV for the νπ^{0} channel, assuming |U_{e4}|^{2}=|U_{τ4}|^{2}=0. These limits represent the most stringent constraints in the mass range 35
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - O Alterkait
- Tufts University, Medford, Massachusetts 02155, USA
| | - D Andrade Aldana
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - L Arellano
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - D Barrow
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - J Barrow
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - V Basque
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | | | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
- Michigan State University, East Lansing, Michigan 48824, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Bhat
- University of Chicago, Chicago, Illinois 60637, USA
| | - M Bhattacharya
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - B Bogart
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - M B Brunetti
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - Y Cao
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - D Caratelli
- University of California, Santa Barbara, California 93106, USA
| | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Chappell
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Y Chen
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | | | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - R Cross
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - P Detje
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- Universität Bern, Bern CH-3012, Switzerland
| | - Z Djurcic
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | - P Englezos
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - A Ereditato
- University of Chicago, Chicago, Illinois 60637, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O G Finnerud
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Foreman
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - B T Fleming
- University of Chicago, Chicago, Illinois 60637, USA
| | - D Franco
- University of Chicago, Chicago, Illinois 60637, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - F Gao
- University of California, Santa Barbara, California 93106, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - E Gramellini
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Green
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Gu
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- University of Chicago, Chicago, Illinois 60637, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - C Hilgenberg
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - Z Imani
- Tufts University, Medford, Massachusetts 02155, USA
| | - B Irwin
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - M Ismail
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Nankai University, Nankai District, Tianjin 300071, China
| | - J H Jo
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - D Kalra
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - M B Leibovitch
- University of California, Santa Barbara, California 93106, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - J-Y Li
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - H Liu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Viriginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N Martinez
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - S Martynenko
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - I Mawby
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N McConkey
- University College London, London WC1E 6BT, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Micallef
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tufts University, Medford, Massachusetts 02155, USA
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Mogan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
- Indiana University, Bloomington, Indiana 47405, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M M Moudgalya
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | | | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Nayak
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Nebot-Guinot
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - N Oza
- Columbia University, New York, New York 10027, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - N Pallat
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - H B Parkinson
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - N Patel
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Piasetzky
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - I Pophale
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Rafique
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - M Reggiani-Guzzo
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - M Rosenberg
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Ross-Lonergan
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | | | - I Safa
- Columbia University, New York, New York 10027, USA
| | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - N Taniuchi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - D Torbunov
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Tyler
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - A J White
- University of Chicago, Chicago, Illinois 60637, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - W Wu
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L E Yates
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - H W Yu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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9
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Gilbert DC, Nankivell M, Rush H, Clarke NW, Mangar S, Al-Hasso A, Rosen S, Kockelbergh R, Sundaram SK, Dixit S, Laniado M, McPhail N, Shaheen A, Brown S, Gale J, Deighan J, Marshall J, Duong T, Macnair A, Griffiths A, Amos CL, Sydes MR, James ND, Parmar MKB, Langley RE. A Repurposing Programme Evaluating Transdermal Oestradiol Patches for the Treatment of Prostate Cancer Within the PATCH and STAMPEDE Trials: Current Results and Adapting Trial Design. Clin Oncol (R Coll Radiol) 2024; 36:e11-e19. [PMID: 37973477 DOI: 10.1016/j.clon.2023.10.054] [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: 07/03/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
AIMS Androgen deprivation therapy (ADT), usually achieved with luteinising hormone releasing hormone analogues (LHRHa), is central to prostate cancer management. LHRHa reduce both testosterone and oestrogen and are associated with significant long-term toxicity. Previous use of oral oestrogens as ADT was curtailed because of cardiovascular toxicity. Transdermal oestrogen (tE2) patches are a potential alternative ADT, supressing testosterone without the associated oestrogen-depletion toxicities (osteoporosis, hot flushes, metabolic abnormalities) and avoiding cardiovascular toxicity, and we here describe their evaluation in men with prostate cancer. MATERIALS AND METHODS The PATCH (NCT00303784) adaptive trials programme (incorporating recruitment through the STAMPEDE [NCT00268476] platform) is evaluating the safety and efficacy of tE2 patches as ADT for men with prostate cancer. An initial randomised (LHRHa versus tE2) phase II study (n = 251) with cardiovascular toxicity as the primary outcome measure has expanded into a phase III evaluation. Those with locally advanced (M0) or metastatic (M1) prostate cancer are eligible. To reflect changes in both management and prognosis, the PATCH programme is now evaluating these cohorts separately. RESULTS Recruitment is complete, with 1362 and 1128 in the M0 and M1 cohorts, respectively. Rates of androgen suppression with tE2 were equivalent to LHRHa, with improved metabolic parameters, quality of life and bone health indices (mean absolute change in lumbar spine bone mineral density of -3.0% for LHRHa and +7.9% for tE2 with an estimated difference between arms of 9.3% (95% confidence interval 5.3-13.4). Importantly, rates of cardiovascular events were not significantly different between the two arms and the time to first cardiovascular event did not differ between treatment groups (hazard ratio 1.11, 95% confidence interval 0.80-1.53; P = 0.54). Oncological outcomes are awaited. FUTURE Efficacy results for the M0 cohort (primary outcome measure metastases-free survival) are expected in the final quarter of 2023. For M1 patients (primary outcome measure - overall survival), analysis using restricted mean survival time is being explored. Allied translational work on longitudinal samples is underway.
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Affiliation(s)
- D C Gilbert
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK; University Hospitals Sussex NHS Foundation Trust, Royal Sussex County Hospital, Brighton, UK.
| | - M Nankivell
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - H Rush
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - N W Clarke
- The Christie and Salford Royal Hospitals, Manchester, UK
| | - S Mangar
- Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - A Al-Hasso
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - S Rosen
- National Heart and Lung Institute, Imperial College, London, UK
| | - R Kockelbergh
- Department of Urology, University Hospitals of Leicester, Leicester, UK
| | - S K Sundaram
- Mid-Yorkshire Teaching NHS Trust, Pinderfields Hospital, Wakefield, UK
| | - S Dixit
- Scunthorpe General Hospital, Scunthorpe, UK
| | | | | | | | - S Brown
- Airedale General Hospital, Keighley, UK
| | - J Gale
- Queen Alexandra Hospital, Portsmouth, UK
| | - J Deighan
- Patient Representative, MRC Clinical Trials Unit at UCL, London, UK
| | - J Marshall
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - T Duong
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - A Macnair
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK; Guys and St Thomas' NHS Foundation Trust, London, UK
| | - A Griffiths
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - C L Amos
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - M R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - N D James
- Institute of Cancer Research, Sutton, UK
| | - M K B Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - R E Langley
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
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10
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Naik MT, Naik N, Hu T, Wang SH, Marshall J. Structure-based design of peptidomimetic inhibitors of PSD-95 with improved affinity for the PDZ3 domain. FEBS Lett 2024; 598:233-241. [PMID: 37904289 PMCID: PMC10842001 DOI: 10.1002/1873-3468.14767] [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: 08/09/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 11/01/2023]
Abstract
Aberrant brain-derived neurotrophic factor (BDNF) signaling has been proposed to contribute to the pathophysiology of depression and other neurological disorders such as Angelman syndrome. We have previously shown that targeting the tropomyosin receptor kinase B/postsynaptic density protein-95 (PSD-95) nexus in the BDNF signaling pathway by peptidomimetic inhibitors is a promising approach for therapeutic intervention. Here, we used structure-based knowledge to develop a new Syn3 peptidomimetic compound series that fuses peptides derived from the PSD-95-binding protein SynGAP to our prototype compound CN2097. The new compounds target the PSD-95 PDZ3 domain and adjoining αC helix to achieve bivalent binding that results in up to 7-fold stronger affinity compared to CN2097. These compounds were designed to improve CN2097 specificity for the PSD-95 PDZ3 domain, and structure-activity relationship studies were performed to improve their resistance to proteolysis.
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Affiliation(s)
- Mandar T. Naik
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island, 02912, United States of America
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
| | - Nandita Naik
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island, 02912, United States of America
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
| | - Tony Hu
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
| | - Szu-Huan Wang
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island, 02912, United States of America
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
| | - John Marshall
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island, 02912, United States of America
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
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11
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Heels-Ansdell D, Billot L, Thabane L, Alhazzani W, Deane A, Guyatt G, Finfer S, Lauzier F, Myburgh J, Young P, Arabi Y, Marshall J, English S, Muscedere J, Ostermann M, Venkatesh B, Zytaruk N, Hardie M, Hammond N, Knowles S, Saunders L, Poole A, Al-Fares A, Xie F, Hall R, Cook D. REVISE: re-evaluating the inhibition of stress erosions in the ICU-statistical analysis plan for a randomized trial. Trials 2023; 24:796. [PMID: 38057875 PMCID: PMC10701941 DOI: 10.1186/s13063-023-07794-z] [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: 05/23/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The REVISE (Re-Evaluating the Inhibition of Stress Erosions in the ICU) trial will evaluate the impact of the proton pump inhibitor pantoprazole compared to placebo in invasively ventilated critically ill patients. OBJECTIVE To outline the statistical analysis plan for the REVISE trial. METHODS REVISE is a randomized clinical trial ongoing in intensive care units (ICUs) internationally. Patients ≥ 18 years old, receiving invasive mechanical ventilation, and expected to remain ventilated beyond the calendar day after randomization are allocated to either 40 mg pantoprazole intravenously or placebo while mechanically ventilated. RESULTS The primary efficacy outcome is clinically important upper GI bleeding; the primary safety outcome is 90-day mortality. Secondary outcomes are ventilator-associated pneumonia, Clostridioides difficile infection, new renal replacement therapy, ICU and hospital mortality, and patient-important GI bleeding. Tertiary outcomes are total red blood cells transfused, peak serum creatinine concentration, and duration of mechanical ventilation, ICU, and hospital length of stay. Following an interim analysis of results from 2400 patients (50% of 4800 target sample size), the data monitoring committee recommended continuing enrolment. CONCLUSIONS This statistical analysis plan outlines the statistical analyses of all outcomes, sensitivity analyses, and subgroup analyses. REVISE will inform clinical practice and guidelines worldwide. TRIAL REGISTRATION www. CLINICALTRIALS gov NCT03374800. November 21, 2017.
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Affiliation(s)
- Diane Heels-Ansdell
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Laurent Billot
- The George Institute for Global Health, University of New South Wales, University of New South Wales Medicine & Health, Sydney, New South Wales, Australia
| | - Lehana Thabane
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Waleed Alhazzani
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Adam Deane
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Gordon Guyatt
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Simon Finfer
- Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - François Lauzier
- Division of Critical Care, Department of MedicineDepartment of Anesthesiology and Critical CareFaculty of Medicine, at l`Université LavalLaval UniversityUniversite Laval Faculte de medicine, Quebec, Canada
| | - John Myburgh
- Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Paul Young
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Yaseen Arabi
- King Saud bin Abdulaziz University for Health Sciences, Riyad, Saudi Arabia
| | - John Marshall
- Department of Surgery and Critical Care Medicine, Unity Health Toronto, University of Toronto, Toronto, Canada
| | - Shane English
- Department of Medicine (Critical Care), Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - John Muscedere
- Department of Critical Care Medicine, Queens University| Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | | | - Bala Venkatesh
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole Zytaruk
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Academic Critical Care Office Room D176, Critical Care Medicine, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario, Canada
| | - Miranda Hardie
- The George Institute for Global Health, Newton, Australia
| | - Naomi Hammond
- University of New South Wales, Sydney, New South Wales, Australia
| | - Serena Knowles
- The George Institute for Global Health, Newton, Australia
| | - Lois Saunders
- Academic Critical Care Office Room D176, Critical Care Medicine, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario, Canada
| | | | - Abdulrahman Al-Fares
- Interdepartment Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Feng Xie
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Richard Hall
- Dalhousie University Faculty of Medicine, Halifax, Canada
| | - Deborah Cook
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
- Academic Critical Care Office Room D176, Critical Care Medicine, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario, Canada.
- Department of Medicine, McMaster University, Hamilton, ON, Canada.
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12
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Banoei MM, McIntyre LA, Stewart DJ, Mei SHJ, Courtman D, Watpool I, Granton J, Marshall J, dos Santos C, Walley KR, Schlosser K, Fergusson DA, Winston BW. Metabolomics Analysis of Mesenchymal Stem Cell (MSC) Therapy in a Phase I Clinical Trial of Septic Shock: An Exploratory Study. Metabolites 2023; 13:1142. [PMID: 37999238 PMCID: PMC10673547 DOI: 10.3390/metabo13111142] [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: 10/03/2023] [Revised: 10/19/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023] Open
Abstract
Sepsis is the result of an uncontrolled host inflammatory response to infection that may lead to septic shock with multiorgan failure and a high mortality rate. There is an urgent need to improve early diagnosis and to find markers identifying those who will develop septic shock and certainly a need to develop targeted treatments to prevent septic shock and its high mortality. Herein, we explore metabolic alterations due to mesenchymal stromal cell (MSC) treatment of septic shock. The clinical findings for this study were already reported; MSC therapy was well-tolerated and safe in patients in this phase I clinical trial. In this exploratory metabolomics study, 9 out of 30 patients received an escalating dose of MSC treatment, while 21 patients were without MSC treatment. Serum metabolomics profiling was performed to detect and characterize metabolite changes due to MSC treatment and to help determine the sample size needed for a phase II clinical trial and to define a metabolomic response to MSC treatment. Serum metabolites were measured using 1H-NMR and HILIC-MS at times 0, 24 and 72 h after MSC infusion. The results demonstrated the significant impact of MSC treatment on serum metabolic changes in a dose- and time-dependent manner compared to non-MSC-treated septic shock patients. This study suggests that plasma metabolomics can be used to assess the response to MSC therapy and that treatment-related metabolomics effects can be used to help determine the sample size needed in a phase II trial. As this study was not powered to detect outcome, how the treatment-induced metabolomic changes described in this study of MSC-treated septic shock patients are related to outcomes of septic shock in the short and long term will need to be explored in a larger adequately powered phase II clinical trial.
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Affiliation(s)
- Mohammad M. Banoei
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada;
| | - Lauralyn A. McIntyre
- Department of Medicine (Division of Critical Care), University of Ottawa, Ottawa, ON K1H 8L6, Canada;
- Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada; (D.J.S.); (S.H.J.M.); (D.C.); (I.W.); (K.S.); (D.A.F.)
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Duncan J. Stewart
- Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada; (D.J.S.); (S.H.J.M.); (D.C.); (I.W.); (K.S.); (D.A.F.)
- Department of Cell and Molecular Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Shirley H. J. Mei
- Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada; (D.J.S.); (S.H.J.M.); (D.C.); (I.W.); (K.S.); (D.A.F.)
- Department of Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada
| | - David Courtman
- Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada; (D.J.S.); (S.H.J.M.); (D.C.); (I.W.); (K.S.); (D.A.F.)
- Department of Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada
| | - Irene Watpool
- Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada; (D.J.S.); (S.H.J.M.); (D.C.); (I.W.); (K.S.); (D.A.F.)
| | - John Granton
- Department of Medicine, University of Toronto, Toronto, ON M5G 2N2, Canada;
| | - John Marshall
- Department of Surgery and Critical Care Medicine, Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, The University of Toronto, Toronto, ON M5B 1W8, Canada; (J.M.); (C.d.S.)
| | - Claudia dos Santos
- Department of Surgery and Critical Care Medicine, Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, The University of Toronto, Toronto, ON M5B 1W8, Canada; (J.M.); (C.d.S.)
| | - Keith R. Walley
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada;
| | - Kenny Schlosser
- Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada; (D.J.S.); (S.H.J.M.); (D.C.); (I.W.); (K.S.); (D.A.F.)
- Department of Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada
| | - Dean A. Fergusson
- Ottawa Hospital Research Institute, Ottawa, ON K1H 8M5, Canada; (D.J.S.); (S.H.J.M.); (D.C.); (I.W.); (K.S.); (D.A.F.)
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Brent W. Winston
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada;
- Departments of Medicine and Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
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13
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Görlitz M, Justen L, Rochette PJ, Buonanno M, Welch D, Kleiman NJ, Eadie E, Kaidzu S, Bradshaw WJ, Javorsky E, Cridland N, Galor A, Guttmann M, Meinke MC, Schleusener J, Jensen P, Söderberg P, Yamano N, Nishigori C, O'Mahoney P, Manstein D, Croft R, Cole C, de Gruijl FR, Forbes PD, Trokel S, Marshall J, Brenner DJ, Sliney D, Esvelt K. Assessing the safety of new germicidal far-UVC technologies. Photochem Photobiol 2023. [PMID: 37929787 DOI: 10.1111/php.13866] [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: 07/25/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023]
Abstract
The COVID-19 pandemic underscored the crucial importance of enhanced indoor air quality control measures to mitigate the spread of respiratory pathogens. Far-UVC is a type of germicidal ultraviolet technology, with wavelengths between 200 and 235 nm, that has emerged as a highly promising approach for indoor air disinfection. Due to its enhanced safety compared to conventional 254 nm upper-room germicidal systems, far-UVC allows for whole-room direct exposure of occupied spaces, potentially offering greater efficacy, since the total room air is constantly treated. While current evidence supports using far-UVC systems within existing guidelines, understanding the upper safety limit is critical to maximizing its effectiveness, particularly for the acute phase of a pandemic or epidemic when greater protection may be needed. This review article summarizes the substantial present knowledge on far-UVC safety regarding skin and eye exposure and highlights research priorities to discern the maximum exposure levels that avoid adverse effects. We advocate for comprehensive safety studies that explore potential mechanisms of harm, generate action spectra for crucial biological effects and conduct high-dose, long-term exposure trials. Such rigorous scientific investigation will be key to determining safe and effective levels for far-UVC deployment in indoor environments, contributing significantly to future pandemic preparedness and response.
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Affiliation(s)
- Maximilian Görlitz
- Massachusetts Institute of Technology, Media Lab, Cambridge, Massachusetts, USA
- SecureBio, Inc., Cambridge, Massachusetts, USA
| | - Lennart Justen
- Massachusetts Institute of Technology, Media Lab, Cambridge, Massachusetts, USA
- SecureBio, Inc., Cambridge, Massachusetts, USA
| | - Patrick J Rochette
- Centre de recherche du CHU de Québec-Université Laval, Axe Médecine Régénératrice Quebec, Quebec City, Quebec, Canada
| | - Manuela Buonanno
- Center for Radiological Research, Columbia University Medical Center, New York City, New York, USA
| | - David Welch
- Center for Radiological Research, Columbia University Medical Center, New York City, New York, USA
| | - Norman J Kleiman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Ewan Eadie
- Photobiology Unit, Ninewells Hospital, Dundee, UK
| | - Sachiko Kaidzu
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan
| | - William J Bradshaw
- Massachusetts Institute of Technology, Media Lab, Cambridge, Massachusetts, USA
- SecureBio, Inc., Cambridge, Massachusetts, USA
| | - Emilia Javorsky
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts, USA
- Future of Life Institute, Cambridge, Massachusetts, USA
| | - Nigel Cridland
- Radiation, Chemicals and Environment Directorate, UK Health Security Agency, Didcot, UK
| | - Anat Galor
- Miami Veterans Affairs Medical Center, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, USA
| | | | - Martina C Meinke
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Schleusener
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Paul Jensen
- Final Approach Inc., Port Orange, Florida, USA
| | - Per Söderberg
- Ophthalmology, Department of Surgical Sciences, Uppsala Universitet, Uppsala, Sweden
| | - Nozomi Yamano
- Division of Dermatology, Department of Internal Related, Kobe University, Kobe, Japan
| | - Chikako Nishigori
- Division of Dermatology, Department of Internal Related, Kobe University, Kobe, Japan
- Japanese Red Cross Hyogo Blood Center, Kobe, Japan
| | - Paul O'Mahoney
- Optical Radiation Effects, UK Health Security Agency, Chilton, UK
| | - Dieter Manstein
- Department of Dermatology, Cutaneous Biology Research Center, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rodney Croft
- International Commission on Non-Ionizing Radiation Protection (ICNIRP), Chair, Wollongong, New South Wales, Australia
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Curtis Cole
- Sun & Skin Consulting LLC, New Holland, Pennsylvania, USA
| | - Frank R de Gruijl
- Department of Dermatology, Universiteit Leiden, Leiden, South Holland, The Netherlands
| | | | - Stephen Trokel
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, USA
| | - John Marshall
- Institute of Ophthalmology, University College London, London, UK
| | - David J Brenner
- Center for Radiological Research, Columbia University Medical Center, New York City, New York, USA
| | - David Sliney
- IES Photobiology Committee, Chair, Fallston, Maryland, USA
- Consulting Medical Physicist, Fallston, Maryland, USA
| | - Kevin Esvelt
- Massachusetts Institute of Technology, Media Lab, Cambridge, Massachusetts, USA
- SecureBio, Inc., Cambridge, Massachusetts, USA
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14
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Lau KA, Yang X, Rioult-Pedotti MS, Tang S, Appleman M, Zhang J, Tian Y, Marino C, Yao M, Jiang Q, Tsuda AC, Huang YWA, Cao C, Marshall J. A PSD-95 peptidomimetic mitigates neurological deficits in a mouse model of Angelman syndrome. Prog Neurobiol 2023; 230:102513. [PMID: 37536482 DOI: 10.1016/j.pneurobio.2023.102513] [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: 04/13/2023] [Revised: 07/26/2023] [Accepted: 07/30/2023] [Indexed: 08/05/2023]
Abstract
Angelman Syndrome (AS) is a severe cognitive disorder caused by loss of neuronal expression of the E3 ubiquitin ligase UBE3A. In an AS mouse model, we previously reported a deficit in brain-derived neurotrophic factor (BDNF) signaling, and set out to develop a therapeutic that would restore normal signaling. We demonstrate that CN2097, a peptidomimetic compound that binds postsynaptic density protein-95 (PSD-95), a TrkB associated scaffolding protein, mitigates deficits in PLC-CaMKII and PI3K/mTOR pathways to restore synaptic plasticity and learning. Administration of CN2097 facilitated long-term potentiation (LTP) and corrected paired-pulse ratio. As the BDNF-mTORC1 pathway is critical for inhibition of autophagy, we investigated whether autophagy was disrupted in AS mice. We found aberrantly high autophagic activity attributable to a concomitant decrease in mTORC1 signaling, resulting in decreased levels of synaptic proteins, including Synapsin-1 and Shank3. CN2097 increased mTORC1 activity to normalize autophagy and restore hippocampal synaptic protein levels. Importantly, treatment mitigated cognitive and motor dysfunction. These findings support the use of neurotrophic therapeutics as a valuable approach for treating AS pathology.
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Affiliation(s)
- Kara A Lau
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
| | - Xin Yang
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
| | - Mengia S Rioult-Pedotti
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
| | - Stephen Tang
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
| | - Mark Appleman
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
| | - Jianan Zhang
- Institute of Neuroscience, Soochow University, Suzhou 215000, China.
| | - Yuyang Tian
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
| | - Caitlin Marino
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
| | - Mudi Yao
- The Fourth School of Clinical Medicine, The Affiliated Eye Hospital, Nanjing Medical University, Nanjing 210029, China.
| | - Qin Jiang
- The Fourth School of Clinical Medicine, The Affiliated Eye Hospital, Nanjing Medical University, Nanjing 210029, China.
| | - Ayumi C Tsuda
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
| | - Yu-Wen Alvin Huang
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
| | - Cong Cao
- Institute of Neuroscience, Soochow University, Suzhou 215000, China.
| | - John Marshall
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI 02912, United States.
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15
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Shaw JF, Ouyang Y, Fergusson DA, McArdle T, Martin C, Cook D, Graham ID, Hawken S, McCartney CJL, Menon K, Saginur R, Seely A, Stiell I, Fox-Robichaud A, English S, Marshall J, Thavorn K, Taljaard M, McIntyre LA. A Hospital-Wide Open-Label Cluster Crossover Pragmatic Comparative Effectiveness Randomized Trial Comparing Normal Saline to Ringer's Lactate: Protocol and Statistical Analysis Plan of The FLUID Trial. JMIR Res Protoc 2023; 12:e51783. [PMID: 37801356 PMCID: PMC10589831 DOI: 10.2196/51783] [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: 08/12/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Normal saline (NS) and Ringer's lactate (RL) are the most common crystalloids given to hospitalized patients. Despite concern about possible harm associated with NS (eg, hyperchloremic metabolic acidosis, impaired kidney function, and death), few large multicenter randomized trials focused on critically ill patients have compared these fluids. Uncertainty exists about the effects of these fluids on clinically important outcomes across all hospitalized patients. OBJECTIVE The FLUID trial is a pragmatic, multicenter, 2×2 cluster crossover comparative effectiveness randomized trial that aims to evaluate the effectiveness of a hospital-wide policy that stocks either NS or RL as the main crystalloid fluid in 16 hospitals across Ontario, Canada. METHODS All hospitalized adult and pediatric patients (anticipated sample size 144,000 patients) with an incident admission to the hospital over the course of each study period will be included. Either NS or RL will be preferentially stocked throughout the hospital for 12 weeks before crossing to the alternate fluid for the subsequent 12 weeks. The primary outcome is a composite of death and hospital readmission within 90 days of hospitalization. Secondary outcomes include death, hospital readmission, dialysis, reoperation, postoperative reintubation, length of hospital stay, emergency department visits, and discharge to a facility other than home. All outcomes will be obtained from health administrative data, eliminating the need for individual case reports. The primary analysis will use cluster-level summaries to estimate cluster-average treatment effects. RESULTS The statistical analysis plan has been prepared "a priori" in advance of receipt of the trial data set from ICES and any analyses. CONCLUSIONS We describe the protocol and statistical analysis plan for the evaluation of primary and secondary outcomes for the FLUID trial. TRIAL REGISTRATION ClinicalTrials.gov NCT04512950; https://classic.clinicaltrials.gov/ct2/show/NCT04512950. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51783.
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Affiliation(s)
- Julia F Shaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Yongdong Ouyang
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Dean A Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Tracy McArdle
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Claudio Martin
- Division of Critical Care Medicine, London Health Sciences Centre, Western University, London, ON, Canada
| | - Deborah Cook
- Departments of Medicine, Clinical Epidemiology and Biostatistics, St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Steven Hawken
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- ICES, University of Ottawa, Ottawa, ON, Canada
| | | | - Kusum Menon
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
| | - Raphael Saginur
- Department of Medicine, Infectious Diseases, The Ottawa Hospital, Ottawa, ON, Canada
| | - Andrew Seely
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | - Ian Stiell
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Alison Fox-Robichaud
- Department of Medicine and Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Shane English
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, Division of Critical Care, University of Ottawa, Ottawa, ON, Canada
| | - John Marshall
- Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- ICES, University of Ottawa, Ottawa, ON, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Lauralyn A McIntyre
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, Division of Critical Care, University of Ottawa, Ottawa, ON, Canada
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16
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Lombardo S, Seedat F, Elliman D, Marshall J. Policy-making and implementation for newborn bloodspot screening in Europe: a comparison between EURORDIS principles and UK practice. Lancet Reg Health Eur 2023; 33:100714. [PMID: 37954001 PMCID: PMC10636270 DOI: 10.1016/j.lanepe.2023.100714] [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: 05/24/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 11/14/2023]
Abstract
Newborn bloodspot screening (NBS) policy is a contentious area in Europe. Variation in the screening panels on offer, in the approach to evidence assessment and in the use of health economic modelling are some of the issues which are debated on the topic. In this paper we focus on a set of patient-driven principles for newborn screening published by EURORDIS and use these as a reference point for exploration and comparison with NBS policy development and screening practice in the UK. In doing so, we share UK practice; we note the UK is generally well aligned with many of the recommended principles, but we also discuss areas of controversy and challenges. Some of these, like 'actionability', will undoubtedly continue to be debated and may never reach consensus. For others, such as patient and public voice participation in newborn screening systems, there are opportunities to continue improving existing processes and developing new mechanisms for stakeholder participation. Screening bodies in other European countries should also compare their policy-making and implementation practices with the EURORDIS principles to stimulate further discussion on the challenges and opportunities of newborn screening and provide a cross-European baseline.
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Affiliation(s)
- Silvia Lombardo
- UK National Screening Committee, Department of Health and Social Care, 39 Victoria Street, London SW1H 0EU, UK
| | - Farah Seedat
- St. George’s, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - David Elliman
- UK National Screening Committee, Department of Health and Social Care, 39 Victoria Street, London SW1H 0EU, UK
| | - John Marshall
- UK National Screening Committee, Department of Health and Social Care, 39 Victoria Street, London SW1H 0EU, UK
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17
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Abratenko P, Alterkait O, Andrade Aldana D, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow J, Basque V, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Cohen EO, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Djurcic Z, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hicks R, Hilgenberg C, Horton-Smith GA, Irwin B, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Miller K, Mills J, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Pophale I, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, John JS, Strauss T, Sword-Fehlberg S, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Double-Differential Measurement of Kinematic Imbalance in Neutrino Interactions with the MicroBooNE Detector. Phys Rev Lett 2023; 131:101802. [PMID: 37739352 DOI: 10.1103/physrevlett.131.101802] [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] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/09/2023] [Accepted: 07/14/2023] [Indexed: 09/24/2023]
Abstract
We report the first measurement of flux-integrated double-differential quasielasticlike neutrino-argon cross sections, which have been made using the Booster Neutrino Beam and the MicroBooNE detector at Fermi National Accelerator Laboratory. The data are presented as a function of kinematic imbalance variables which are sensitive to nuclear ground-state distributions and hadronic reinteraction processes. We find that the measured cross sections in different phase-space regions are sensitive to different nuclear effects. Therefore, they enable the impact of specific nuclear effects on the neutrino-nucleus interaction to be isolated more completely than was possible using previous single-differential cross section measurements. Our results provide precision data to help test and improve neutrino-nucleus interaction models. They further support ongoing neutrino-oscillation studies by establishing phase-space regions where precise reaction modeling has already been achieved.
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - O Alterkait
- Tufts University, Medford, Massachusetts 02155, USA
| | - D Andrade Aldana
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - J Anthony
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - L Arellano
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - J Barrow
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - V Basque
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - O Benevides Rodrigues
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
- Syracuse University, Syracuse, New York 13244, USA
| | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M Bhattacharya
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - B Bogart
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - D Caratelli
- University of California, Santa Barbara, California 93106, USA
| | - I Caro Terrazas
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y Chen
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - E O Cohen
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - L Cooper-Troendle
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - P Detje
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- Universität Bern, Bern CH-3012, Switzerland
| | - Z Djurcic
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | | | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O G Finnerud
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Foreman
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - B T Fleming
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - N Foppiani
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - D Franco
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - O Goodwin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - E Gramellini
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - P Green
- The University of Manchester, Manchester M13 9PL, United Kingdom
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - R Hicks
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - C Hilgenberg
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - B Irwin
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Itay
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - L Jiang
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J H Jo
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - D Kalra
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - M B Leibovitch
- University of California, Santa Barbara, California 93106, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - J-Y Li
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N Martinez
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - K Mason
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - N McConkey
- The University of Manchester, Manchester M13 9PL, United Kingdom
- University College London, London WC1E 6BT, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - J Mills
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mogan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Mousseau
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | | | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Nayak
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Nebot-Guinot
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - N Oza
- Columbia University, New York, New York 10027, USA
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - N Pallat
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - H B Parkinson
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - N Patel
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Piasetzky
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - I D Ponce-Pinto
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - I Pophale
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - S Prince
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Rafique
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - M Reggiani-Guzzo
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - M Rosenberg
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Ross-Lonergan
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | | | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Sword-Fehlberg
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - N Taniuchi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - D Torbunov
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Tyler
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - A J White
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Z Williams
- University of Texas, Arlington, Texas 76019, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - N Wright
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - W Wu
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L E Yates
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - H W Yu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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18
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Dennis BB, Thabane L, Heels-Ansdell D, Dionne JC, Binnie A, Tsang J, Guyatt G, Ahmed A, Lauzier F, Deane A, Arabi Y, Marshall J, Zytaruk N, Saunders L, Finfer S, Myburgh J, Muscedere J, English S, Ostermann M, Hardie M, Knowles S, Cook D. Proton pump inhibitors in critically ill mechanically ventilated patients with COVID-19: protocol for a substudy of the Re-EValuating the Inhibition of Stress Erosions (REVISE) Trial. Trials 2023; 24:561. [PMID: 37644556 PMCID: PMC10466724 DOI: 10.1186/s13063-023-07589-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Critically ill patients commonly receive proton pump inhibitors (PPIs) to prevent gastrointestinal (GI) bleeding from stress-induced ulceration. Despite widespread use in the intensive care unit (ICU), observational data suggest that PPIs may be associated with adverse outcomes in patients with COVID-19 infection. This preplanned study is nested within a large randomized trial evaluating pantoprazole versus placebo in invasively ventilated patients. The 3 objectives are as follows: (1) to describe the characteristics of patients with COVID-19 in terms of demographics, biomarkers, venous thromboembolism, tracheostomy incidence and timing, and other clinical outcomes; (2) to evaluate the impact of COVID-19 infection on clinically important GI bleeding, 90-day mortality, and other outcomes compared to a propensity-matched non-infected cohort; and (3) to explore whether pantoprazole has a differential treatment effect on clinically important GI bleeding, 90-day mortality, and other outcomes in patients with and without COVID-19 infection. METHODS The ongoing trial Re-EValuating the Inhibition of Stress Erosions (REVISE) compares pantoprazole 40 mg IV to placebo on the primary efficacy outcome of clinically important GI bleeding and the primary safety outcome of 90-day mortality. The protocol described in this report is for a substudy focused on patients with COVID-19 infection that was not in the original pre-pandemic trial protocol. We developed a one-page case report form to characterize these patients including data related to biomarkers, venous thromboembolism, COVID-19 therapies, tracheostomy incidence and timing, duration of mechanical ventilation, and ICU and hospital stay. Our analysis will describe the trajectory of patients with COVID-19 infection, a propensity-matched analysis of infected and non-infected patients, and an extended subgroup analysis comparing the effect of PPI among patients with and without COVID-19 infection. DISCUSSION Prophylactic acid suppression in invasively ventilated critically ill patients with COVID-19 infection has unknown consequences. The results of these investigations will inform practice, guidelines, and future research. TRIAL REGISTRATION REVISE Trial [NCT03374800 December 15, 2017], COVID-19 Cohort Study [NCT05715567 February 8, 2023].
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Affiliation(s)
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
- Biostatistics Unit, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
- Division of Critical Care, Research Institute, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
| | - Joanna C. Dionne
- Departments of Medicine and Health Research Methods, Evidence, and Impact, McMaster University, McMaster University Health Sciences Center, Room 2C11, 1200 Main Street West, Hamilton, ON L8N 3Z5 Canada
| | - Alexandra Binnie
- Department of Critical Care Medicine, Niagara Health System, St. Catharines, ON Canada
| | - Jennifer Tsang
- Department of Medicine, McMaster University, Hamilton, ON Canada
- Department of Critical Care Medicine, Niagara Health System, St. Catharines, ON Canada
| | - Gordon Guyatt
- Departments of Medicine and Health Research Methods, Evidence, and Impact, McMaster University, McMaster University Health Sciences Center, Room 2C11, 1200 Main Street West, Hamilton, ON L8N 3Z5 Canada
| | - Aijaz Ahmed
- Department of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA USA
| | - François Lauzier
- Departments of Anesthesiology and Medicine and Critical Care Medicine, Université Laval, Québec, Québec Canada
| | - Adam Deane
- Department of Critical Care Medicine, University of Melbourne, Melbourne Medical School, Parkville, VIC Australia
| | - Yaseen Arabi
- Intensive Care Department, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
| | - John Marshall
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON Canada
| | - Nicole Zytaruk
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
- Division of Critical Care, Research Institute, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Lois Saunders
- Division of Critical Care, Research Institute, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Simon Finfer
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW Australia
| | - John Myburgh
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW Australia
- Intensive Care Unit, St. George Hospital, Sydney, Australia
| | - John Muscedere
- Department of Critical Care Medicine, Queen’s University, Kingston, ON Canada
| | - Shane English
- Department of Medicine, University of Ottawa, Ottawa, ON Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Marlies Ostermann
- Department of Critical Care, King’s College London, Guy’s & St Thomas’ Hospital, London, UK
| | - Miranda Hardie
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW Australia
| | - Serena Knowles
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW Australia
| | - Deborah Cook
- Division of Critical Care, Research Institute, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
- Departments of Medicine and Health Research Methods, Evidence, and Impact, McMaster University, McMaster University Health Sciences Center, Room 2C11, 1200 Main Street West, Hamilton, ON L8N 3Z5 Canada
| | - For the REVISE Investigators the Canadian Critical Care Trials Group
- Department of Medicine, McMaster University, Hamilton, ON Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
- Biostatistics Unit, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
- Division of Critical Care, Research Institute, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
- Departments of Medicine and Health Research Methods, Evidence, and Impact, McMaster University, McMaster University Health Sciences Center, Room 2C11, 1200 Main Street West, Hamilton, ON L8N 3Z5 Canada
- Department of Critical Care Medicine, Niagara Health System, St. Catharines, ON Canada
- Department of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA USA
- Departments of Anesthesiology and Medicine and Critical Care Medicine, Université Laval, Québec, Québec Canada
- Department of Critical Care Medicine, University of Melbourne, Melbourne Medical School, Parkville, VIC Australia
- Intensive Care Department, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON Canada
- Critical Care Program, The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW Australia
- Intensive Care Unit, St. George Hospital, Sydney, Australia
- Department of Critical Care Medicine, Queen’s University, Kingston, ON Canada
- Department of Medicine, University of Ottawa, Ottawa, ON Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
- Department of Critical Care, King’s College London, Guy’s & St Thomas’ Hospital, London, UK
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Naik MT, Naik N, Hu T, Wang SH, Marshall J. Structure-based development of new cyclic compounds targeting PSD-95 PDZ3 domain. bioRxiv 2023:2023.08.10.552828. [PMID: 37609345 PMCID: PMC10441386 DOI: 10.1101/2023.08.10.552828] [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] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Aberrant BDNF signaling has been proposed to contribute to the pathophysiology of depression and other neurological disorders such as Angelman syndrome. We have previously shown that targeting the TrkB / PSD-95 nexus by peptidomimetic inhibitors is a promising approach for therapeutic intervention. Here we used structure-based knowledge to develop a new peptidomimetic compound series that fuses SynGAP-derived peptides to our prototype compound CN2097. These compounds target the PSD-95 PDZ3 domain and adjoining αC helix to achieve bivalent binding that results in up to 7-fold stronger affinity compared to CN2097. These compounds were designed to improve CN2097 specificity for the PDZ3 domain and limited SAR studies have been performed to improve their resistance to proteolysis.
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Affiliation(s)
- Mandar T. Naik
- Department of Molecular Biology, Cell Biology and Biochemistry
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
| | - Nandita Naik
- Department of Molecular Biology, Cell Biology and Biochemistry
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
| | - Tony Hu
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
| | - Szu-Huan Wang
- Department of Molecular Biology, Cell Biology and Biochemistry
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
| | - John Marshall
- Department of Molecular Biology, Cell Biology and Biochemistry
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, Rhode Island, 02912, United States of America
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20
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Abratenko P, Andrade Aldana D, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow J, Basque V, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Djurcic Z, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hicks R, Hilgenberg C, Horton-Smith GA, Irwin B, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Miller K, Mills J, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Nunes M, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Pophale I, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, John JS, Strauss T, Sword-Fehlberg S, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Measurement of Quasielastic Λ Baryon Production in Muon Antineutrino Interactions in the MicroBooNE Detector. Phys Rev Lett 2023; 130:231802. [PMID: 37354393 DOI: 10.1103/physrevlett.130.231802] [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] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/07/2023] [Accepted: 04/28/2023] [Indexed: 06/26/2023]
Abstract
We present the first measurement of the cross section of Cabibbo-suppressed Λ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the main injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to 2.2×10^{20} protons on target running in neutrino mode, and 4.9×10^{20} protons on target running in anti-neutrino mode. An automated selection is combined with hand scanning, with the former identifying five candidate Λ production events when the signal was unblinded, consistent with the GENIE prediction of 5.3±1.1 events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of 3.7±1.0 events. Restricting the phase space to only include Λ baryons that decay above MicroBooNE's detection thresholds, we obtain a flux averaged cross section of 2.0_{-1.7}^{+2.2}×10^{-40} cm^{2}/Ar, where statistical and systematic uncertainties are combined.
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - D Andrade Aldana
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - J Anthony
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - L Arellano
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - J Barrow
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - V Basque
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | | | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M Bhattacharya
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - B Bogart
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - D Caratelli
- University of California, Santa Barbara, California 93106, USA
| | - I Caro Terrazas
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y Chen
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - L Cooper-Troendle
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - P Detje
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- Universität Bern, Bern CH-3012, Switzerland
| | - Z Djurcic
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | | | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O G Finnerud
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Foreman
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - B T Fleming
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - N Foppiani
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - D Franco
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - O Goodwin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - E Gramellini
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - P Green
- The University of Manchester, Manchester M13 9PL, United Kingdom
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - R Hicks
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - C Hilgenberg
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - B Irwin
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Itay
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - L Jiang
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J H Jo
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - D Kalra
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - M B Leibovitch
- University of California, Santa Barbara, California 93106, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - J-Y Li
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N Martinez
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - K Mason
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - N McConkey
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - J Mills
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mogan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Mousseau
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | | | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Nayak
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Nebot-Guinot
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - M Nunes
- Syracuse University, Syracuse, New York 13244, USA
| | - N Oza
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - N Pallat
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - H B Parkinson
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - N Patel
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Piasetzky
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - I D Ponce-Pinto
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - I Pophale
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - S Prince
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Rafique
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - M Reggiani-Guzzo
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - M Rosenberg
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Ross-Lonergan
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | | | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Sword-Fehlberg
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - N Taniuchi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - D Torbunov
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Tyler
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - A J White
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Z Williams
- University of Texas, Arlington, Texas 76019, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - N Wright
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - W Wu
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L E Yates
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - H W Yu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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21
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Vaghefi E, Yang S, Xie L, Han D, Yap A, Schmeidel O, Marshall J, Squirrell D. A multi-centre prospective evaluation of THEIA™ to detect diabetic retinopathy (DR) and diabetic macular oedema (DMO) in the New Zealand screening program. Eye (Lond) 2023; 37:1683-1689. [PMID: 36057664 PMCID: PMC10219993 DOI: 10.1038/s41433-022-02217-w] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/09/2022] [Accepted: 08/12/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To validate the potential application of THEIA™ as clinical decision making assistant in a national screening program. METHODS A total of 900 patients were recruited from either an urban large eye hospital, or a semi-rural optometrist led screening provider, as they were attending their appointment as part of New Zealand Diabetic Eye Screening Programme. The de-identified images were independently graded by three senior specialists, and final results were aggregated using New Zealand grading scheme, which was then converted to referable/non-referable and Healthy/mild/more than mild/sight threatening categories. RESULTS THEIA™ managed to grade all images obtained during the study. Comparing the adjudicated images from the specialist grading team, "ground truth", with the grading by the AI platform in detecting "sight threatening" disease, at the patient level THEIA™ achieved 100% imageability, 100% [98.49-100.00%] sensitivity and [97.02-99.16%] specificity, and negative predictive value of 100%. In other words, THEIA™ did not miss any patients with "more than mild" or "sight threatening" disease. The level of agreement between the clinicians and the aggregated results was (k value: 0.9881, 0.9557, and 0.9175), and the level of agreement between THEIA™ and the aggregated labels was (k value: 0.9515). CONCLUSION This multi-centre prospective trial showed that THEIA™ did not miss referable disease when screening for diabetic retinopathy and maculopathy. It also had a very high level of granularity in reporting the disease level. As THEIA™ has been tested on a variety of cameras, operating in a range of clinics (rural/urban, ophthalmologist-led\optometrist-led), we believe that it will be a suitable addition to a public diabetic screening program.
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Affiliation(s)
- Ehsan Vaghefi
- Toku Eyes®, Auckland, New Zealand.
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand.
| | | | - Li Xie
- Toku Eyes®, Auckland, New Zealand
| | | | - Aaron Yap
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Ole Schmeidel
- Department of Diabetes, Auckland District Health Board, Auckland, New Zealand
| | - John Marshall
- Institute of Ophthalmology, University College of London, London, UK
| | - David Squirrell
- Toku Eyes®, Auckland, New Zealand
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
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22
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Hammer A, Heeren TFC, Angunawela R, Marshall J, Saha K. A Novel Role for Corneal Pachymetry in Planning Cataract Surgery by Determining Changes in Spherical Equivalent Resulting from a Previous LASIK Treatment. J Ophthalmol 2023; 2023:2261831. [PMID: 37483313 PMCID: PMC10362985 DOI: 10.1155/2023/2261831] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/22/2023] [Accepted: 04/27/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives To provide a metric to differentiate between hyperopic and myopic ablation of a prior LASIK treatment based on the corneal pachymetry profile after laser vision correction (LVC). Methods Pachymetry data were retrospectively recovered from patients who had previous LASIK for refractive purposes between 2019 and 2020. Patients with any corneal disorder were excluded. Ablation spherical equivalent was predicted from the central to semiperipheral corneal thickness (CPT) ratio, both values were provided by using the Pentacam user interface software (UI), and values were computed from extracted raw pachymetry data. Results Data of 157 eyes of 81 patients were collected, of which data were analysed for 73 eyes of 73 patients to avoid concurrence of measurements in both eyes per subject (42% female; mean age 40.9; SD 12.8). The CPT ratio cutoff for distinction between myopic and hyperopic LASIK was 0.86 for Pentacam UI data. Sensitivity and specificity were 0.7 and 0.95, respectively. Accuracy increased with computation of the CPT ratio based on extracted raw data with sensitivity and specificity of 0.87 and 0.99, respectively. There was a marked linear correlation between the CPT ratio and the ablation spherical equivalent (R2 = 0.93). Conclusions CPT ratio cutoffs can correctly classify if a cornea previously had a hyperopic versus myopic LASIK surgery and estimate the ablation spherical equivalent of such treatment. This could prove useful for increased accuracy of intraocular lens (IOL) calculations for patients with no historical data of their prior LVC surgery at the time of cataract surgery planning.
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Affiliation(s)
- Arthur Hammer
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Romesh Angunawela
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- OCL Vision, London, UK
| | - John Marshall
- University College London, Institute of Ophthalmology, London, UK
| | - Kamran Saha
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
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23
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Marshall J. Laser ablation of tree-ring isotopes: pinpoint precision. Tree Physiol 2023; 43:691-693. [PMID: 36807985 PMCID: PMC10177000 DOI: 10.1093/treephys/tpad017] [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] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/22/2023] [Indexed: 05/13/2023]
Affiliation(s)
- John Marshall
- Forest Ecology and Management, Swedish University of Agricultural Sciences, Skogmarksgränd 17, 90183 Umeå, Sweden
- Leibniz-Centre for Agricultural Landscape Research (ZALF) e.V., Eberswalder Str. 84, 15374 Müncheberg, Germany
- Global Change Research Institute CAS, Bělidla 986/4a, 60300 Brno, Czechia
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24
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Henriksson N, Marshall J, Högberg MN, Högberg P, Polle A, Franklin O, Näsholm T. Re-examining the evidence for the mother tree hypothesis - resource sharing among trees via ectomycorrhizal networks. New Phytol 2023. [PMID: 37149889 DOI: 10.1111/nph.18935] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/19/2023] [Indexed: 05/09/2023]
Abstract
Seminal scientific papers positing that mycorrhizal fungal networks can distribute carbon (C) among plants have stimulated a popular narrative that overstory trees, or 'mother trees', support the growth of seedlings in this way. This narrative has far-reaching implications for our understanding of forest ecology and has been controversial in the scientific community. We review the current understanding of ectomycorrhizal C metabolism and observations on forest regeneration that make the mother tree narrative debatable. We then re-examine data and conclusions from publications that underlie the mother tree hypothesis. Isotopic labeling methods are uniquely suited for studying element fluxes through ecosystems, but the complexity of mycorrhizal symbiosis, low detection limits, and small carbon discrimination in biological processes can cause researchers to make important inferences based on miniscule shifts in isotopic abundance, which can be misleading. We conclude that evidence of a significant net C transfer via common mycorrhizal networks that benefits the recipients is still lacking. Furthermore, a role for fungi as a C pipeline between trees is difficult to reconcile with any adaptive advantages for the fungi. Finally, the hypothesis is neither supported by boreal forest regeneration patterns nor consistent with the understanding of physiological mechanisms controlling mycorrhizal symbiosis.
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Affiliation(s)
- Nils Henriksson
- Department of Forest Ecology and Management, Swedish University of Agricultural Sciences, SE-901 83, Umeå, Sweden
| | - John Marshall
- Department of Forest Ecology and Management, Swedish University of Agricultural Sciences, SE-901 83, Umeå, Sweden
| | - Mona N Högberg
- Department of Forest Ecology and Management, Swedish University of Agricultural Sciences, SE-901 83, Umeå, Sweden
| | - Peter Högberg
- Department of Forest Ecology and Management, Swedish University of Agricultural Sciences, SE-901 83, Umeå, Sweden
| | - Andrea Polle
- Forest Botany and Tree Physiology, Georg-August University of Göttingen, Büsgenweg 2, 37077, Göttingen, Germany
| | - Oskar Franklin
- Department of Forest Ecology and Management, Swedish University of Agricultural Sciences, SE-901 83, Umeå, Sweden
- International Institute for Applied Systems Analysis, Schlossplatz 1, Laxenburg, A-2361, Austria
| | - Torgny Näsholm
- Department of Forest Ecology and Management, Swedish University of Agricultural Sciences, SE-901 83, Umeå, Sweden
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25
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Stanga PE, Valentin Bravo FJ, Reinstein UI, Stanga SFE, Marshall J, Archer TJ, Reinstein DZ. New Terminology and Methodology for the Assessment of the Vitreous, Its Floaters and Opacities, and Their Effect on Vision: Standardized and Kinetic Anatomical and Functional Testing of Vitreous Floaters and Opacities (SK VFO Test). Ophthalmic Surg Lasers Imaging Retina 2023; 54:306-315. [PMID: 37184989 DOI: 10.3928/23258160-20230412-02] [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: 05/17/2023]
Abstract
OBJECTIVE To introduce VFO and SK VFO Test: new, more representative terminology for symptoms of vitreous floaters/opacities (VFO) and new standardized kinetic (SK) anatomical-functional assessment. MATERIALS AND METHODS Eight eyes underwent before-after limited vitrectomy (LV): best-corrected visual acuity, low-luminance visual acuity, Minnesota Low Vision Reading Chart near visual acuity in logMAR, contrast sensitivity function (CV1000E), and straylight measurements (SM) (HDA/LDA/C-Quant). SK infrared confocal scanning laser ophthalmoscopy (SK IRcSLO) and swept-source widefield optical coherence tomography (SS-WF-OCT) identified VFO and posterior vitreous detachment (PVD). SK IRcSLO was performed with gaze directed towards the extreme superior, inferior, and lateral directions. RESULTS Anatomical-functional results after LV improved in 7 eyes (87.5%): objective scatter index (27.34%), disturbance index (47.97%) and C-Quant Log units (2.26%). Pre-LV SK IRcSLO and SS-WFOCT imaging identified dynamic well-defined VFO and PVD status (100%). A residual asymptomatic anterior cortical vitreous-induced shadowing ripple effect was detected post-LV. CONCLUSIONS This is the first objective-standardized test accounting for VFO kinesis and intermittent effect. There is potential for personalizing treatment and establishing best candidates for laser or surgery. [Ophthalmic Surg Lasers Imaging Retina 2023;54:306-315.].
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26
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Akbari O, Li M, Kandul N, Sun R, Yang T, Dalla Benetta E, Brogan D, Antoshechkin I, Sánchez C H, Zhan YP, DeBeaubien N, Loh Y, Su M, Montell C, Marshall J. Targeting Sex Determination to Suppress Mosquito Populations. Res Sq 2023:rs.3.rs-2834069. [PMID: 37162925 PMCID: PMC10168471 DOI: 10.21203/rs.3.rs-2834069/v1] [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] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Each year, hundreds of millions of people are infected with arboviruses such as dengue, yellow fever, chikungunya, and Zika, which are all primarily spread by the notorious mosquito Aedes aegypti. Traditional control measures have proven insuficient, necessitating innovations. In response, here we generate a next generation CRISPR-based precision-guided sterile insect technique (pgSIT) for Aedes aegypti that disrupts genes essential for sex determination and fertility, producing predominantly sterile males that can be deployed at any life stage. Using mathematical models and empirical testing, we demonstrate that released pgSIT males can effectively compete with, suppress, and eliminate caged mosquito populations. This versatile species-specific platform has the potential for field deployment to control wild populations, safely curtailing disease transmission.
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Affiliation(s)
- Omar Akbari
- School of Biological Sciences, Department of Cell and Developmental Biology, University of California
| | - Ming Li
- University of California, San Diego
| | | | | | | | | | | | | | - Héctor Sánchez C
- Divisions of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley
| | - Yin Peng Zhan
- Institute of Biophysics, Chinese Academy of Sciences
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27
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Macnair A, Nankivell M, Murray ML, Rosen SD, Appleyard S, Sydes MR, Forcat S, Welland A, Clarke NW, Mangar S, Kynaston H, Kockelbergh R, Al-Hasso A, Deighan J, Marshall J, Parmar M, Langley RE, Gilbert DC. Healthcare systems data in the context of clinical trials - A comparison of cardiovascular data from a clinical trial dataset with routinely collected data. Contemp Clin Trials 2023; 128:107162. [PMID: 36933612 DOI: 10.1016/j.cct.2023.107162] [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: 11/18/2022] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Routinely-collected healthcare systems data (HSD) are proposed to improve the efficiency of clinical trials. A comparison was undertaken between cardiovascular (CVS) data from a clinical trial database with two HSD resources. METHODS Protocol-defined and clinically reviewed CVS events (heart failure (HF), acute coronary syndrome (ACS), thromboembolic stroke, venous and arterial thromboembolism) were identified within the trial data. Data (using pre-specified codes) was obtained from NHS Hospital Episode Statistics (HES) and National Institute for Cardiovascular Outcomes Research (NICOR) HF and myocardial ischaemia audits for trial participants recruited in England between 2010 and 2018 who had provided consent. The primary comparison was trial data versus HES inpatient (APC) main diagnosis (Box-1). Correlations are presented with descriptive statistics and Venn diagrams. Reasons for non-correlation were explored. RESULTS From 1200 eligible participants, 71 protocol-defined clinically reviewed CVS events were recorded in the trial database. 45 resulted in a hospital admission and therefore could have been recorded by either HES APC/ NICOR. Of these, 27/45 (60%) were recorded by HES inpatient (Box-1) with an additional 30 potential events also identified. HF and ACS were potentially recorded in all 3 datasets; trial data recorded 18, HES APC 29 and NICOR 24 events respectively. 12/18 (67%) of the HF/ACS events in the trial dataset were recorded by NICOR. CONCLUSION Concordance between datasets was lower than anticipated and the HSD used could not straightforwardly replace current trial practices, nor directly identify protocol-defined CVS events. Further work is required to improve the quality of HSD and consider event definitions when designing clinical trials incorporating HSD.
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Affiliation(s)
- Archie Macnair
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK; Health Data Research, UK; Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Matthew Nankivell
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK
| | - Macey L Murray
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK; Health Data Research, UK; NHS DigiTrials, NHS Digital, 7 and 8 Wellington Place, Leeds, West Yorkshire LS1 4AP, UK
| | - Stuart D Rosen
- National Heart and Lung Institute, Imperial College, London, UK
| | - Sally Appleyard
- University Hospitals Sussex NHS Foundation Trust, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK
| | - Matthew R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK; Health Data Research, UK; BHF Data Science Centre, Health Data Research UK (Central Office), Gibbs Building, 215 Euston Road, London NW1 2BE, UK
| | - Sylvia Forcat
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK
| | - Andrew Welland
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK
| | - Noel W Clarke
- The Christie and Salford Royal Hospitals, Manchester, UK
| | - Stephen Mangar
- Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Howard Kynaston
- Division of Cancer and Genetics, Cardiff University Medical School, Cardiff, UK
| | - Roger Kockelbergh
- Department of Urology, University Hospitals of Leicester, Leicester, UK
| | | | - John Deighan
- Patient representative, MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK
| | - John Marshall
- Patient representative, MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK
| | - Mahesh Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK
| | - Ruth E Langley
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK
| | - Duncan C Gilbert
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK; University Hospitals Sussex NHS Foundation Trust, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK.
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28
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Olivera P, Martinez-Lozano H, Leibovitzh H, Xue M, Xu W, Espin-Garcia O, Madsen K, Meddings J, Guttman D, Griffiths A, Huynh H, Turner D, Panancionne R, Steinhart H, Aumais G, Jacobson K, Mack D, Marshall J, Moayyedi P, Lee SH, Turpin W, Croitoru K. A39 HEALTHY FIRST-DEGREE RELATIVES FROM MULTIPLEX FAMILIES VERSUS SIMPLEX HARBOR A HIGHER RISK OF DEVELOPING CROHN'S DISEASE AND ARE ASSOCIATED WITH SUBCLINICAL INFLAMMATION AND ALTERED MICROBIOME COMPOSITION. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991131 DOI: 10.1093/jcag/gwac036.039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Healthy individuals within families with multiple affected members (multiplex families) with Crohn’s disease (CD) have a notably high risk of developing CD. No large prospective pre-disease cohort has assessed differences in preclinical intestinal inflammation, permeability, fecal microbiome, and genetics in healthy at-risk subjects from multiplex families. Purpose We aimed to assess differences in subclinical gut inflammation, genetic risk, gut barrier function, and fecal microbiota composition between first-degree relatives (FDRs) from families with 2 or more affected members (multiplex) and families with only one affected member (simplex). Also, we aimed to assess the risk of future CD onset in subjects from multiplex versus simplex families. Method We utilized the GEM Project cohort of healthy FDRs of CD patients. Subclinical gut inflammation was assessed using fecal calprotectin (FCP) at recruitment. Gut barrier function was assessed using the lactulose-to-mannitol ratio (LMR). For assessment of the CD-related genetic risk, CD-polygenic risk scores (CD-PRS) were calculated. Microbiome composition was assessed by sequencing fecal 16S ribosomal RNA. Generalized estimating equations logistic regression and LEfSe (PMID: 21702898) were used to assess the associations between multiplex status and different outcomes. A Cox proportional hazards model was used to assess time-related risk of future onset of CD. Result(s) 4385 subjects were included. Median age was 17 [IQR 12-24] years, 52.9% were female, 69.4% were siblings and 30.6% were offspring. 4052 (92.4%) and 333 (7.6 %) were simplex and multiplex subjects, respectively. After adjusting for age, sex, family size, and relation to proband, multiplex status was significantly associated with higher baseline FCP (p=0.038), but was not associated with either baseline LMR or CD-PRS (p=0.19 and p=0.33, respectively). We found no significant differences in alpha diversity (Shannon index) (p=0.57) between simplex and multiplex subjects. Beta diversity analysis assessed by the Bray-Curtis dissimilarity index did not reveal significant differences (R2=3e-04, p=0.607). The genera Eisenbergiella, Eggerthellaceae uncultured, and Morganella, were significantly more abundant in multiplex subjects, whereas Lachnospira, Sutterella, Lachnospiraceae_NK4A136_group, and Lachnospiraceae_UCG_004 less abundant. The risk of CD onset was significantly higher in multiplex subjects. In multivariable analysis, multiplex status at recruitment was associated with increased risk of CD onset (adjusted HR 3.41, 95% CI 1.70-6.87, p=0.00055), after adjusting for demographics, FCP, LMR, and CD-PRS. Conclusion(s) Multiplex status compared to simplex is associated with a 3.4-fold increased risk of CD onset, a higher FCP, and fecal bacterial composition. A comprehensive assessment of environmental factors that increase CD risk in multiplex families remains to be elucidated in future studies. Disclosure of Interest None Declared
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Affiliation(s)
- P Olivera
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - H Martinez-Lozano
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - H Leibovitzh
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - M Xue
- Temerty Faculty of Medicine
| | - W Xu
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto
| | - O Espin-Garcia
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto
| | | | - J Meddings
- Department of Medicine, Cumming School of Medicine, Calgary
| | - D Guttman
- Department of Cell & Systems Biology,Centre for the Analysis of Genome Evolution & Function
| | - A Griffiths
- IBD Center, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto
| | - H Huynh
- Division of Gastroenterology and Nutrition, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - D Turner
- The Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - R Panancionne
- Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology of Gastroenterology, University of Calgary, Calgary
| | - H Steinhart
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - G Aumais
- Department of Medicine, Hôpital Maisonneuve-Rosemont, Montreal University, Montreal
| | - K Jacobson
- British Columbia Children's Hospital, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver
| | - D Mack
- Division of Gastroenterology, Hepatology & Nutrition, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa
| | - J Marshall
- Department of Medicine, McMaster University, Hamilton, Canada
| | - P Moayyedi
- Department of Medicine, McMaster University, Hamilton, Canada
| | - S -H Lee
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - W Turpin
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - K Croitoru
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
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29
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Novak D, Masoudi A, Shaukat B, Kabariti S, Drapkin J, Christian M, Kogan R, Marshall J, Motov S. MeMed BV testing in emergency department patients presenting with febrile illness concerning for respiratory tract infection. Am J Emerg Med 2023; 65:195-199. [PMID: 36437179 DOI: 10.1016/j.ajem.2022.11.022] [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] [Received: 11/07/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
| | | | | | | | | | - Manan Christian
- Department of Pathology and Laboratory Medicine, Maimonides Medical Center, 4802 10(th) Ave, Brooklyn, NY 11219, USA
| | - Rita Kogan
- Department of Pathology and Laboratory Medicine, Maimonides Medical Center, 4802 10(th) Ave, Brooklyn, NY 11219, USA
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30
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McIntyre LA, Fergusson DA, McArdle T, Fox-Robichaud A, English SW, Martin C, Marshall J, Cook DJ, Graham ID, Hawken S, McCartney C, Menon K, Saginur R, Seely A, Stiell I, Thavorn K, Weijer C, Iyengar A, Muscedere J, Forster AJ, Taljaard M. FLUID trial: a hospital-wide open-label cluster cross-over pragmatic comparative effectiveness randomised pilot trial comparing normal saline to Ringer's lactate. BMJ Open 2023; 13:e067142. [PMID: 36737087 PMCID: PMC9900065 DOI: 10.1136/bmjopen-2022-067142] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Normal saline (NS) and Ringer's lactate (RL) are the most common crystalloids used for fluid therapy. Despite evidence of possible harm associated with NS (eg, hyperchloremic metabolic acidosis, impaired kidney function and death), few large multi-centre randomised trials have evaluated the effect of these fluids on clinically important outcomes. We conducted a pilot trial to explore the feasibility of a large trial powered for clinically important outcomes. DESIGN FLUID was a pragmatic pilot cluster randomised cross-over trial. SETTING Four hospitals in the province of Ontario, Canada PARTICIPANTS: All hospitalised adult and paediatric patients with an incident admission to the hospital over the course of each study period. INTERVENTIONS A hospital wide policy/strategy which stocked either NS or RL throughout the hospital for 12 weeks before crossing over to the alternate fluid for the subsequent 12 weeks. PRIMARY AND SECONDARY OUTCOME MEASURES The primary feasibility outcome was study fluid protocol adherence. Secondary feasibility outcomes included time to Research Ethics Board (REB) approval and trial initiation. Primary (composite of death or re-admission to hospital in first 90 days of index hospitalisation) and secondary clinical outcomes were analysed descriptively. RESULTS Among 24 905 included patients, mean age 59.1 (SD 20.5); 13 977 (56.1%) were female and 21 150 (85.0%) had medical or surgical admitting diagnoses. Overall, 96 821 L were administered in the NS arm, and 78 348 L in the RL arm. Study fluid adherence to NS and RL was 93.7% (site range: 91.6%-98.0%) and 79.8% (site range: 72.5%-83.9%), respectively. Time to REB approval ranged from 2 to 48 days and readiness for trial initiation from 51 to 331 days. 5544 (22.3%) patients died or required hospital re-admission in the first 90 days. CONCLUSIONS The future large trial is feasible. Anticipating and addressing logistical challenges during the planning stages will be imperative. TRIAL REGISTRATION NUMBER NCT02721485.
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Affiliation(s)
- Lauralyn Ann McIntyre
- Department of Medicine (Critical Care), Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada
- Critical Care, Ottawa Hospital General Campus, Ottawa, Ontario, Canada
| | - Dean A Fergusson
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Tracy McArdle
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - Shane W English
- Medicine (Critical Care), University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Claudio Martin
- Medicine (Critical Care), London Health Sciences Centre, London, Ontario, Canada
| | - John Marshall
- Surgery/Critical Care Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Deborah J Cook
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Clinical Epidemiology, University of Ottawa, Ottawa, Ontario, Canada
| | - Steven Hawken
- ICES @uOttawa, Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada
- Clinical Epidemiology, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Colin McCartney
- Anesthesiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Kusum Menon
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Raphael Saginur
- Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Andrew Seely
- Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Surgery, Ottawa Hospital, Ottawa, Ontario, Canada
| | - Ian Stiell
- Department of Emergency Medicine, Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Charles Weijer
- Rotman Institute of Philospohy, Western University Faculty of Science, London, Ontario, Canada
| | - Akshai Iyengar
- Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - John Muscedere
- Critical Care, Kingston General Hospital, Kingston, Ontario, Canada
| | - Alan J Forster
- Internal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Xie L, Vaghefi E, Yang S, Han D, Marshall J, Squirrell D. Automation of Macular Degeneration Classification in the AREDS Dataset, Using a Novel Neural Network Design. Clin Ophthalmol 2023; 17:455-469. [PMID: 36755888 PMCID: PMC9901462 DOI: 10.2147/opth.s396537] [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] [Received: 11/16/2022] [Accepted: 01/12/2023] [Indexed: 02/04/2023] Open
Abstract
Purpose To create an ensemble of Convolutional Neural Networks (CNNs), capable of detecting and stratifying the risk of progressive age-related macular degeneration (AMD) from retinal photographs. Design Retrospective cohort study. Methods Three individual CNNs are trained to accurately detect 1) advanced AMD, 2) drusen size and 3) the presence or otherwise of pigmentary abnormalities, from macular centered retinal images were developed. The CNNs were then arranged in a "cascading" architecture to calculate the Age-related Eye Disease Study (AREDS) Simplified 5-level risk Severity score (Risk Score 0 - Risk Score 4), for test images. The process was repeated creating a simplified binary "low risk" (Scores 0-2) and "high risk" (Risk Score 3-4) classification. Participants There were a total of 188,006 images, of which 118,254 images were deemed gradable, representing 4591 patients, from the AREDS1 dataset. The gradable images were split into 50%/25%/25% ratios for training, validation and test purposes. Main Outcome Measures The ability of the ensemble of CNNs using retinal images to predict an individual's risk of experiencing progression of their AMD based on the AREDS 5-step Simplified Severity Scale. Results When assessed against the 5-step Simplified Severity Scale, the results generated by the ensemble of CNN's achieved an accuracy of 80.43% (quadratic kappa 0.870). When assessed against a simplified binary (Low Risk/High Risk) classification, an accuracy of 98.08%, sensitivity of ≥85% and specificity of ≥99% was achieved. Conclusion We have created an ensemble of neural networks, trained on the AREDS 1 dataset, that is able to accurately calculate an individual's score on the AREDS 5-step Simplified Severity Scale for AMD. If the results presented were replicated, then this ensemble of CNNs could be used as a screening tool that has the potential to significantly improve health outcomes by identifying asymptomatic individuals who would benefit from AREDS2 macular supplements.
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Affiliation(s)
- Li Xie
- Toku Eyes Limited, Auckland, New Zealand
| | - Ehsan Vaghefi
- Toku Eyes Limited, Auckland, New Zealand,School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand,Correspondence: Ehsan Vaghefi, Tel +6493737599, Email
| | - Song Yang
- Toku Eyes Limited, Auckland, New Zealand
| | - David Han
- Toku Eyes Limited, Auckland, New Zealand,School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | | | - David Squirrell
- Toku Eyes Limited, Auckland, New Zealand,Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand
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Rerolle F, Dantzer E, Phimmakong T, Lover A, Hongvanthong B, Phetsouvanh R, Marshall J, Sturrock H, Bennett A. Characterizing mobility patterns of forest goers in southern Lao PDR using GPS loggers. Malar J 2023; 22:38. [PMID: 36732769 PMCID: PMC9893532 DOI: 10.1186/s12936-023-04468-8] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 01/24/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND In the Greater Mekong Subregion (GMS), forest-going populations are considered high-risk populations for malaria and are increasingly targeted by national control programmes' elimination efforts. A better understanding of forest-going populations' mobility patterns and risk associated with specific types of forest-going trips is necessary for countries in the GMS to achieve their objective of eliminating malaria by 2030. METHODS Between March and November 2018, as part of a focal test and treat intervention (FTAT), 2,904 forest-goers were recruited in southern Lao PDR. A subset of forest-goers carried an "i-Got-U" GPS logger for roughly 2 months, configured to collect GPS coordinates every 15 to 30 min. The utilization distribution (UD) surface around each GPS trajectory was used to extract trips to the forest and forest-fringes. Trips with shared mobility characteristics in terms of duration, timing and forest penetration were identified by a hierarchical clustering algorithm. Then, clusters of trips with increased exposure to dominant malaria vectors in the region were further classified as high-risk. Finally, gradient boosting trees were used to assess which of the forest-goers' socio-demographic and behavioural characteristics best predicted their likelihood to engage in such high-risk trips. RESULTS A total of 122 forest-goers accepted carrying a GPS logger resulting in the collection of 803 trips to the forest or forest-fringes. Six clusters of trips emerged, helping to classify 385 (48%) trips with increased exposure to malaria vectors based on high forest penetration and whether the trip happened overnight. Age, outdoor sleeping structures and number of children were the best predictors of forest-goers' probability of engaging in high-risk trips. The probability of engaging in high-risk trips was high (~ 33%) in all strata of the forest-going population. CONCLUSION This study characterized the heterogeneity within the mobility patterns of forest-goers and attempted to further segment their role in malaria transmission in southern Lao People's Democratic Republic (PDR). National control programmes across the region can leverage these results to tailor their interventions and messaging to high-risk populations and accelerate malaria elimination.
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Affiliation(s)
- Francois Rerolle
- grid.266102.10000 0001 2297 6811Malaria Elimination Initiative, The Global Health Group, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA
| | - Emily Dantzer
- grid.266102.10000 0001 2297 6811Malaria Elimination Initiative, The Global Health Group, University of California, San Francisco, CA USA
| | - Toula Phimmakong
- grid.415768.90000 0004 8340 2282Center for Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao People’s Democratic Republic
| | - Andrew Lover
- grid.266683.f0000 0001 2166 5835Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA USA
| | - Bouasy Hongvanthong
- grid.415768.90000 0004 8340 2282Center for Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao People’s Democratic Republic
| | - Rattanaxay Phetsouvanh
- grid.415768.90000 0004 8340 2282Center for Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao People’s Democratic Republic
| | - John Marshall
- grid.47840.3f0000 0001 2181 7878Divisions of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA USA
| | - Hugh Sturrock
- grid.266102.10000 0001 2297 6811Malaria Elimination Initiative, The Global Health Group, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA
| | - Adam Bennett
- grid.266102.10000 0001 2297 6811Malaria Elimination Initiative, The Global Health Group, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA ,grid.415269.d0000 0000 8940 7771Malaria and Neglected Tropical Diseases, PATH, Seattle, WA USA
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Mukherji R, Suguru S, Xiao J, Geng X, Wang H, Noel MS, He AR, Weinberg BA, Marshall J, Agarwal S. Success rates and clinicopathologic associations with experimental outcomes of a novel circulating tumor cell (CTC) technology in advanced colon cancer (CC) and pancreatic cancer (PC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.805] [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: 01/26/2023] Open
Abstract
805 Background: Studying CTC cultures (cx) ex-vivo can provide valuable insights into cancer metastases (mets). However, current immunoaffinity- and size-based-methods used to isolate and expand these cells have low success rates for culturing CTCs (6-20%). Here, we report our experience using a novel technology developed at Georgetown for culturing CTCs from patients (pts) with metastatic (m) CC, mPC, and locally advanced PC (LAPC). Methods: 44 peripheral blood samples were prospectively collected from 35 pts with adenocarcinoma across 3 cohorts (18 samples from 15 mCC pts, 21 samples from 15 mPC pts, and 5 samples from 5 LAPC pts). Pts were previously treated, treatment-naïve, or actively undergoing treatment. FiColl-Paque-based separation of red blood cells was performed, plasma and buffy coat cells were resuspended in cx medium, and successfully grown CTC cxs were processed and injected subcutaneously (subQ) in the flanks of mice. A single predetermined sample from each pt was used in assessing the clinicopathologic associations with experiment outcomes and survival analyses. Results: CTC cxs were successfully grown from 81.8% (36/44) of all samples. Cxs grew from 72.2% (13/18) of mCC, 85.7% (18/21) of mPC, and 100% (5/5) of LAPC samples. At the time of analysis, 25 injected mice were evaluable for subQ tumor growth. 4 mice failed to grow tumor, 10 were still under monitoring, and 11 grew tumor, 9 of which also developed mets. These were mostly macro-mets and partially mirrored the met pattern seen in the matched pt. Across all cohorts, samples were predominantly collected from pts during systemic treatment (79.5%), during 2nd- (36.4%) and 1st-line treatment (20.5%), at a median of 15 (0-111) and 5 (1-20) months after diagnosis in mPC/mCC and LAPC pts, respectively, after scans with new/progressing disease (72.7%), and with a median of 3 (1-9) sites of disease on scans done within 2 months of collection . In all pts, no clinicopathologic or genomic factor predicted for cx growth. In the mCC subgroup, female sex (p=0.044), longer time from diagnosis to CTC collection (p=0.033), and presence of lung mets (p=0.022) were associated with cx growth. With cohorts combined, the median pt progression-free survival was 174 days (95% CI 97-220) and median overall survival was not reached. There was no statistically significant relationship between cx growth and pt survival. Conclusions: This novel platform demonstrated historically high rates of successful CTC cx and xenograft tumor growth using samples from advanced CC and PC pts. Studies to elucidate reasons for mice failing to grow tumor and others with matched tumor-CTC molecular analyses are ongoing to validate this promising technology to ultimately use to identify biomarkers for metastases, uncover novel therapeutic targets, and inform clinical decisions.
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Affiliation(s)
| | | | - Jerry Xiao
- Georgetown University Medical Center, Washington, DC
| | - Xue Geng
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | - Hongkun Wang
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | | | - Aiwu Ruth He
- Georgetown University Medical Center, Washington, DC
| | | | - John Marshall
- Lombardi Cancer Center, Georgetown University, Washington, DC
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Lou E, Marshall J, Jacobs G, Fleming M, Coutinho AK, Yoshino T, Augustyniak M, McFadden P. Diagnostics and treatment for HER2+ mG&CRC: Learning outcomes of GetSMART. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.82] [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: 01/26/2023] Open
Abstract
82 Background: Gastric/colorectal cancer (G&CRC) are among the most prevalent cancers. Efforts are ongoing to better assess their clinical/genomic factors. HER2 (human epidermal growth factor receptor 2) testing is strongly recommended in clinical practice to guide treatment. An accredited education program (GetSMART) was launched online (January 2021–April 2022) to equip healthcare providers (HCPs) with knowledge, skills, and confidence to accurately assess/apply molecular testing and therapy options for metastatic G&CRC patients. Methods: A knowledge/confidence-based assessment was embedded in four modules to measure learners’ knowledge mastery (% answering correctly with confidence) pre/post-activity. Self-reported confidence and anticipated performance in clinical practice were measured before/after each module. At the end of program, HCPs were asked about their commitment to change. McNemar’s test was applied to assess statistical significance in pre-post for paired items, and descriptive analysis for non-paired items. Results: Overall, 925 unique HCPs engaged in GetSMART, 31% (n=284) completed all modules, of which 57% (n=163) consented analysis of their data. A statistically significant increase (p<0.05) was measured in percentage of HCPs demonstrating knowledge mastery, confidence, and commitment to change their practice from pre to post across four competencies, except for percentage of HCPs “often”/“always” engaging patients in shared decision-making (SDM) (3, Performance). Largest gains in knowledge mastery/confidence were noted for HCPs’ ability to anticipate/manage adverse events (AE) ( 4A); and for anticipated performance, in HCPs considering appropriate treatment. Post-activity, 66% (98/149) of HCPs intended to change practice based on module content, 83% (70/84) of whom were “highly”/“somewhat” confident to make changes. The activity’s anticipated impact on patients was rated “major”/“moderate” by 69% (103/149) of HCPs. Conclusions: Identification of HER2 aberrations in mG&CRC and its appropriate treatment selection remains challenging in oncology care. This evaluation demonstrated that GetSMART positively impacted HCPs’ knowledge, confidence, and anticipated performance in clinical practice to enhance health outcomes of HER2+ mG&CRC patients. [Table: see text]
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Affiliation(s)
- Emil Lou
- Masonic Cancer Center/ University of Minnesota School of Medicine, Minneapolis, MN
| | - John Marshall
- Lombardi Cancer Center, Georgetown University, Washington, DC
| | | | | | | | - Takayuki Yoshino
- National Cancer Center Hospital East, Japan, Kashiwa, Chiba, Japan
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Lenz HJ, Nicolaides T, Elliott A, Goldberg RM, Marshall J, Lou E, Shields AF, Sohal D, Weinberg BA, Spetzler D, Abraham J, Xiu J, Korn WM. Analysis of HLA gene expression in patients with dMMR/MSI-H colorectal carcinoma resistant to immune checkpoint inhibitors. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.202] [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: 01/25/2023] Open
Abstract
202 Background: Large studies have identified immune checkpoint inhibitors (ICI) as an effective therapy for deficient mismatch repair/microsatellite instability high (dMMR/MSI-H) colorectal cancer (CRC). However, a subset of dMMR/MSI-H CRC patients exist that do not benefit from ICI and show rapid cancer progression within the first 6 months of therapy. Genetic alterations of the host immune system, including loss of β2M and single copy loss of HLA molecules, can contribute to innate resistance to ICI. In this study, we sought to analyze the role of expression of HLA genes and β2M as determinants of innate resistance to ICI by analyzing an extensive clinico-genomic database. Methods: Next-generation sequencing (NGS) of DNA (592-gene or whole exome) and RNA (whole transcriptome) was performed on CRC patient samples (n = 24,394) submitted to a CLIA-certified laboratory (Caris Life Sciences, Phoenix, AZ). dMMR/MSI-H was assessed by IHC/NGS. PD-L1 expression was tested by IHC (SP142; positive (+): ≥2+, ≥%5). Real world overall survival and treatment data were obtained from insurance claims data. Time-To-Next-treatment (TTNT) was calculated from start of ICI monotherapy to the start of next therapy, or death. Kaplan-Meier estimates were used for comparison. A composite signature of MHC II gene expression was tested for molecular associations. Immune cell infiltration was estimated by RNA deconvolution using quanTIseq. Statistical significance was determined using Fisher’s Exact/Mann Whitney/X2 tests. Results: We identified 1549 patients with dMMR/MSI-H CRC; 242 patients of these had received pembrolizumab or nivolumab. Using TTNT as a proxy for progression on treatment, we divided the patients into two cohorts: >180 days TTNT and <180 days TTNT. Following manual curation of the cases by two oncologists and limiting the patients to those who had received ≥ 2 doses of either ICI and at least 180 days of recorded follow up, we generated cohorts of 77 patients (>180 days TTNT; good responders) and 34 patients (<180 days TTNT; poor responders). High expression of HLA genes (HLA-DRB1, HLA-B, HLA-DQB1, HLA-DPB1, HLA-DPA1- p<0.02; fold change 2.1-3) was found in the good responder group. No β2M alterations were detected in either subgroup. After dividing the entire cohort into quartiles, patients in the highest quartile of expression for either CD74, HLA-DQA1, HLA-DQB1, HLA-DPB1 or HLA-DRB1 had improved survival when compared to lower expressors (p< 0.05). High MHC II signature expression was associated with an increased rate of PD-L1+ (34 vs 8%, p<0.0001) and infiltration of M1 macrophages (9.1 vs 4.9%, p<0.0001). Conclusions: We identify elevated expression of HLA genes involved in formation of the MHC-II complex as a potential biomarker of improved response to immunotherapy that could, if further validated, optimize patient selection for ICI in CRC.
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Affiliation(s)
- Heinz-Josef Lenz
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | | | | | - Richard M. Goldberg
- West Virginia University Cancer Institute and the Mary Babb Randolph Cancer Center, Morgantown, WV
| | - John Marshall
- Lombardi Cancer Center, Georgetown University, Washington, DC
| | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
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Battaglin F, Krause H, Elliot A, Abraham J, Soni S, Algaze S, Jayachandran P, Arai H, Zhang W, Lo JH, Mittal P, Weinberg BA, Lou E, Shields AF, Goldberg RM, Goel S, Marshall J, Liang G, Korn WM, Lenz HJ. SETD2 gene expression and the molecular landscape of colorectal cancer (CRC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.184] [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: 01/26/2023] Open
Abstract
184 Background: SETD2, a key methyltransferase modulating histone 3 gene transcription, has been shown to act as a tumor suppressor gene by reducing oxidative stress, colonic inflammation and tumorigenesis in animal models. SETD2 gene expression has been reported to be significantly downregulated in CRC and linked with poorer patient survival. Additionally, SETD2 plays an important role in DNA repair and loss of function mutations have been associated with increased tumor mutational burden (TMB), mismatch repair (MMR) deficiency, and benefit from immunotherapy. Hence, we aimed to characterize the molecular features associated with SETD2 gene expression in CRC. Methods: 15,425 CRC tumors tested at Caris Life Sciences (Phoenix, AZ) with NextGen Sequencing on DNA (592 genes or whole exome sequencing), RNA (whole transcriptome sequencing), and IHC were analyzed. SETD2-high and -low expression were defined as ≥ top and < bottom quartile of SETD2 transcripts per million (TPM), respectively. Cell infiltration in the tumor microenvironment (TME) was estimated by QuantiSEQ. Mann-Whitney U and X2/Fisher-Exact tests were applied where appropriate, with P-values adjusted for multiple comparisons ( q < .05). Gene expression profiles were analyzed for transcriptional signatures predictive of response to immunotherapy (T cell-inflamed) and MAPK pathway activation (MPAS). Real-world overall survival information was obtained from insurance claims data and Kaplan-Meier estimates were calculated for molecularly defined patients. Results: SETD2 expression was significantly increased in left-sided/rectal compared to right-sided tumors (median TPM [mTPM] 55.8 vs 51.1, q < .001). SETD2 mutations were associated with reduced SETD2 expression in pMMR/MSS CRC (mTPM 37.9 vs 54.3 in WT, q < .001), although not statistically significant in dMMR/MSI-H CRC (mTPM 43.6 vs 51.7 in WT, P = .17). Compared to SETD2-high tumors, SETD2-low was associated with increased rates of TMB-high (10.4% vs 8.2%, P = .009), dMMR/MSI-H (7.3% vs 5.6%, P = .02), and PD-L1 IHC levels (4.4% vs 2.5%, q < .002). Only minor differences in gene mutation and copy number rates were observed between SETD2-high and -low tumors , whereas SETD2-high TME was associated with increased immune cell infiltration, including neutrophils, B cells, NK cells, M2 macrophages, and dendritic cells ( q < .05). SETD2-high was also associated with increased T cell-inflamed and MPAS signatures (152% and 159% median increase, respectively, q < .001), regardless of tumor MMR status. Among dMMR/MSI-H CRC, SETD2-high tumors receiving immune checkpoint inhibitors had longer time-on-treatment (HR: 0.39, 95% CI: 0.2-0.76, P = .005) and a trend towards longer OS (HR: 0.29, 95% CI: 0.07-1.2, P = .069). Conclusions: Our data show distinct immune biomarkers and TME cell infiltration associated with SETD2 gene expression in CRC. These findings support a key role for SETD2 in modulating anti-tumor immunity and TME.
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Affiliation(s)
- Francesca Battaglin
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | | | | | | | - Shivani Soni
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Sandra Algaze
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Priya Jayachandran
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Hiroyuki Arai
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Wu Zhang
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Jae Ho Lo
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Pooja Mittal
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Benjamin Adam Weinberg
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | | | - Richard M. Goldberg
- West Virginia University Cancer Institute and the Mary Babb Randolph Cancer Center, Morgantown, WV
| | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - John Marshall
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Gangning Liang
- Urology, Keck School of Medicine, University of Southern California, LOS Angeles, CA
| | | | - Heinz-Josef Lenz
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
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Ringenbach S, Shah SM, Demidova E, Faezov B, Andrake MD, Mur P, Xiu J, Korn WM, Goel S, Lenz HJ, Marshall J, Shields AF, Oberley MJ, Spetzler D, Valle L, Dunbrack R, Hall MJ, Arora S. Tumor mutation burden in colorectal cancers with POLE exonuclease and non-exonuclease domain variants. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.224] [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: 01/25/2023] Open
Abstract
224 Background: Driver mutations in the exonuclease domain (ExoD) of DNA polymerase epsilon ( POLE) have been associated with high tumor mutation burden (TMB). High TMB is an important marker for immunotherapy, and thus understanding the mechanisms that lead to high TMB is an area of active investigation. Many tumors with POLE ExoD driver mutations have additional POLE variants of uncertain significance (VUS). Some of these VUS lie within the ExoD, while most lie outside the ExoD. This study investigates the role of such POLE VUS on TMB and POLE functionality of ExoD-mutated tumors. Methods: Retrospective colorectal cancer (CRC) genomic profiles from Caris Life Sciences (n=1,870) were separated into groups based on the presence of POLE ExoD mutations and the TMB status. Groups were defined as: ‘TMB-high (TMB-H) POLE ExoD driver without additional POLE VUS’, ‘TMB-H POLE ExoD driver plus POLE VUS’, and ‘TMB-low (TMB-L) POLE variant(s) without ExoD driver’. An additional group with ‘TMB-H POLE variant(s) without ExoD driver’ was identified as potentially novel drivers for future study. The microsatellite instability status (MSI or MSS) was also considered. The level of TMB, the presence of polymerase proofreading-associated mutational signatures and POLE stability/functionality analyzed using AlphaFold2 models and Rosetta Molecular Modeling Suite, were evaluated. Results: POLE variants were identified in 4.9% of the CRCs studied (92/1870). In all, 52.2% (48/92) of those tumors were TMB-H, and 38.0% (35/92) of them contained POLE ExoD drivers. The highest median TMB (mTMB) was found in the ‘TMB-H POLE ExoD driver plus POLE VUS’ group, and this was significantly different from the ‘TMB-H POLE ExoD driver without additional POLE VUS’ and the ‘TMB-L POLE variant without ExoD driver’ group, even when MSI tumors were excluded (p<0.001, Mann-Whitney). These results were validated in TCGA CRC tumors and in other tumor types. Within the ‘TMB-H POLE ExoD driver plus POLE VUS’ group, the mTMB increased with the number of accumulated POLE VUS (p<0.001, Mann Whitney). The nucleotide sequence context of 77.8% of the POLE VUS matched mutational spectra associated with POLE ExoD defects, suggesting that most of the POLE VUS are secondary to the ExoD driver mutation. Finally, the majority of POLE VUS within ‘TMB-H POLE ExoD driver plus POLE VUS’ group have a predicted effect on POLE stability and/or function. Conclusions: Our results suggest that the presence of secondary POLE non-driver variants increase TMB in POLE ExoD-mutated tumors. Although still preliminary, these data could impact prognosis and response to immune checkpoint inhibitors in patients. [Table: see text]
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Affiliation(s)
| | | | | | | | | | - Pilar Mur
- Catalan Institute of Oncology, IDIBELL, L'hospitalet De Llobregat, Spain
| | | | | | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Heinz-Josef Lenz
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - John Marshall
- Lombardi Cancer Center, Georgetown University, Washington, DC
| | | | | | | | - Laura Valle
- Catalan Institute of Oncology, IDIBELL, L'hospitalet De Llobregat, Spain
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Mukherji R, Yin C, Weinberg BA, Alqahtani A, Hameed R, Barcellos A, Connole M, Perelgut C, Fortuin J, Marshall J. Continuous maintenance (Maint) capecitabine (Cape) dosing for colorectal (CRC) and pancreatic cancers (PC): A single-institution, retrospective, real-world study. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.789] [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: 01/26/2023] Open
Abstract
789 Background: Cape is an oral fluoropyrimidine (FP) used as maint therapy in CRC and PC. While the standard FDA dosing is 1250 mg/m2 twice daily (BID) for 14 days followed by 7 days off in a 21-day cycle, there are variations across institutions as to the preferred schedule. To improve tolerability and convenience, our institution adopted a “continuous” dosing schedule where cape is taken BID Monday-Friday (M-F) with a treatment break on Saturday and Sunday. Here, we describe our institution’s experience with continuous maint dosing in advanced CRC and PC patients (pts) and explore real-world outcomes. Methods: Pts ≥ 18 years of age treated with continuous maint cape (+/- bevacizumab) after any line of therapy for stage 4 CRC/PC or locally advanced PC between 1/2016-12/2020 were identified in the COTA real-world database. The final study population included 35 PC and 85 CRC pts. Pt characteristics were analyzed descriptively and progression-free survival (PFS) was calculated using Kaplan Meier methods. Results: Among the 35 PC pts, the median age was 66 years (IQR: 61-73), 57.1% were females, and 65.7% were Caucasian. Among the 85 CRC pts, the median age was 54 years (IQR: 47-66), 47.1% were females, and 55.3% were Caucasian. Most PC (71.4%) and CRC (57.7%) pts were initially prescribed a total daily cape dose of 2 g (range 0.5-4 g). Dose adjustments, including dosage/schedule changes, occurred 11 times amongst PC and 36 times amongst CRC pts, and the leading cause was toxicity (72.7% in PC, 55.6% in CRC). Among PC pts, 14.3% had a dose reduction, 3% had a dose increase, and 11.4% switched to an alternative dosing schedule. Among CRC pts, these rates were 32.9%, 12.9%, and 9.4%, respectively. The leading cause of maint discontinuation was progression of disease (POD) (55.6% in PC, 59.3% in CRC). Additional outcomes are summarized in the table. Conclusions: Although maint FP is an established standard of care, it is often underutilized due to inherent inconveniences and toxicities associated with FDA cape dosing or intravenous FP therapy. The PFS reported here using a continuous cape dosing (predominantly starting at 2 g daily dosing) was in range with those previously reported in PC/CRC 1st-line maint studies using FDA cape dosing or intravenous FP. The rates of cape discontinuation attributed to toxicity we report may be confounded by not controlling for the treatment setting. We argue fixed cape dosing (1 g BID) M-F should be considered a standard maint regimen based on efficacy, convenience, tolerability, and feasibility of dose adjustments.[Table: see text]
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Affiliation(s)
| | - Chao Yin
- Georgetown University, Washington, DC
| | | | - Ali Alqahtani
- MedStar Georgetown University Hospital, Washington, DC
| | | | | | | | | | | | - John Marshall
- Lombardi Cancer Center, Georgetown University, Washington, DC
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Alqahtani A, Baca Y, Xiu J, Hall MJ, Kim D, Goel S, Mukherji R, Yin C, Lenz HJ, Battaglin F, Arai H, Lou E, Shields AF, Walker P, Korn WM, Abraham J, Oberley MJ, Goldberg RM, Marshall J, Weinberg BA. Comparative analysis of the molecular profile and tumor immune microenvironment (TIME) of human epidermal growth factor receptor 2 (HER2) low (L)- versus high (H)-expressing gastroesophageal cancers (GEC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.287] [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: 01/25/2023] Open
Abstract
287 Background: Addition of immune checkpoint blockade to anti-HER2 therapy has improved outcomes in HER2-positive GEC. Anti-HER2 antibody-drug conjugates have shown activity in some HER2-L tumors in other tumor types. We aimed to compare the molecular profile and TIME of HER2-L and HER-H GEC. Methods: 8678 GEC (gastric, GE junction, and esophageal) adenocarcinoma and squamous cell carcinoma samples were analyzed by next-generation sequencing (NGS) of RNA (whole transcriptome, NovaSeq), DNA (592 genes, NextSeq, or whole exome sequencing, NovaSeq), and immunohistochemistry (IHC, Caris Life Sciences, Phoenix, AZ). Cohorts were stratified by IHC HER2 values of 0 (non-expressors), 1-2+ (HER2-L), or 3+ (HER2-H) and compared using X2 or Fisher-Exact. Statistical significance was determined as P-value adjusted for multiple comparisons (q < 0.05). Microenvironment cell population (MCP) counter was used to quantify immune cell infiltration. Results: Tumor were grouped into HER2 non-expressors (N = 5217), L (N = 2660), and H (N = 801). Mutations of TP53 (72% vs 92%) and amplification of MYC (4% vs 7%), CCNE1 (7% vs 12%), CCND3 (2% vs 4%), CDK6 (3% vs 6%), SMARCE1 (2% vs 25%) and RARA (3% vs 24%) were significantly lower in HER2-L compared to HER2-H (q < 0.05). ARID1A (14% vs 9%), PIK3CA (8% vs 3%), KRAS (9% vs 2%), GNAS (2% vs 0.3%), KMT2D (6% vs 1%), CDH1 (5% vs 1%), and ATM (4% vs 1%) mutations were significantly higher in HER2-L compared to HER2-H (q < 0.05). HER2-L was associated with more TMB-H (9.3% vs. 5%; q<0.05), MSI-H (4.7% vs. 0.6%; q<0.05), and a trend towards higher PD-L1 expression than in HER2-H (80.8% vs 76.1%, p < 0.05 but q > 0.05). Immuno-oncology (IO)-related gene expression inversely correlated with HER2 expression with lowest expression of PDCD1LG2, CD274, CTLA4, PDCD1, HAVCR2, CD80, IFNG, LAG3, and CD86 in HER2-H (q < 0.05). HER2-L had significantly higher median immune infiltration of B cells (fold change [FC]: 1.22), T cells (FC: 1.16), CD8+ T cells (FC: 1.56), NK cells (FC: 1.12), neutrophils (FC: 1.10), cytotoxic lymphocytes (FC: 1.36), and myeloid dendritic cells (FC: 1.34), compared to HER2-H (q < 0.05). HER2 non-expressors showed similar immune cell infiltrates compared to HER2-H. HER2-H was associated with lower T-cell inflamed scores and IFN gamma signature when compared to HER2-L and non-expressors (q < 0.05). Conclusions: To our knowledge, this study is the first and largest comparison of molecular profile and TIME in HER2-expressing GEC. We demonstrated distinct molecular and TIME profiles with higher immunogenic profiles in HER-L as compared to HER2-H. IO-related gene expression and TIME cell distribution differences in HER2-H GEC suggest that response to IO and HER2 therapy combinations is likely related to HER2-targeted treatment effect on TIME rather than baseline immunogenicity of the tumor.
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Affiliation(s)
- Ali Alqahtani
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | | | | | | | - Dong Kim
- Fox Chase Cancer Center, Philadelphia, PA
| | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Reetu Mukherji
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Chao Yin
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Heinz-Josef Lenz
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Francesca Battaglin
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Hiroyuki Arai
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | | | | | | | | | | | - Richard M. Goldberg
- West Virginia University Cancer Institute and the Mary Babb Randolph Cancer Center, Morgantown, WV
| | - John Marshall
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Benjamin Adam Weinberg
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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Battaglin F, Baca Y, Walker P, Xiu J, Soni S, Lo JH, Jayachandran P, Algaze S, Mittal P, Zhang W, Wong A, Goldberg RM, Weinberg BA, Lou E, Shields AF, Marshall J, Goel S, Nasertorabi F, Korn WM, Lenz HJ. Molecular correlates of DSCR1 expression in colorectal cancer (CRC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.185] [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: 01/25/2023] Open
Abstract
185 Background: Down syndrome (DS), a genetic disorder caused by trisomy of chr 21, is associated with a considerably lower risk for solid tumors and other angiogenesis related diseases. DSCR1 belongs to a family of evolutionary conserved protein-coding genes located on chr 21 and is highly upregulated in DS patients. Its product, calcipressin-1, has been shown to reduce cancer risk by suppressing angiogenesis. We previously reported that a germline polymorphism in DSCR1 was associated with time to recurrence in resected CRC and anti-VEGF treatment outcomes in metastatic CRC. Here, we analyzed the molecular landscape of CRC according to DSCR1 expression levels. Methods: 20,237 samples from CRC tested at Caris Life Sciences (Phoenix, AZ) with WTS (Illumina NovaSeq) and NextGen DNA sequencing (NextSeq, 592 Genes and NovaSEQ, WES) were analyzed. Top quartile transcripts per million (TPM) for DSCR1 expression were considered high (Q4) while bottom quartile low (Q1). Cell infiltration (CI) in the tumor microenvironment (TME) was estimated by RNA deconvolution analysis using QuantiSEQ. Interferon-gamma and T-cell inflamed signatures were also calculated from RNA data. X2 and Fisher-Exact tests were used and statistical significance was determined as P-value adjusted for multiple comparisons ( q < 0.05). Results: DSCR1 expression was higher in primary tumors than metastases (10.5 vs 8.1 median TPM, q < 0.05). No significant difference was observed in right- versus left-sided tumors, however rectal tumors showed the highest DSCR1 expression ( P < 0.05). Overall, high DSCR1 TPM were associated with TMB-high (11.3% vs 9.3%), dMMR/MSI-H (7.9% vs 5.9%), and PD-L1 (4.7% vs 3.1%) ( q < 0.01); the association with TMB-H was not significant in pMMR/MSS. DSCR1 high was associated with lower mutation rates of APC, KRAS, TP53 and amplification of FLT1/ FLT3, while higher mutation rates of KMT2C/D, BRAF, PTEN, RNF43, and RSPO3 fusions ( q < 0.0001). Gene set enrichment analysis showed that high DSCR1 expressing tumors were enriched in alterations of several pathways including hypoxia, apoptosis, DNA repair, KRAS signaling, inflammatory response, and oxidative stress-related pathways (all P < 0.05, FDR < 0.25). B cells, macrophages, neutrophils, NK cells, Tregs, cancer associated fibroblasts and endothelial cells were more abundant in the TME of tumors with high DSCR1 while myeloid dendritic cells were lower, regardless of MMR status (all q < 0.001). DSCR1 expression was associated with a higher T-cell inflamed signature and IFN score ( q < 0.05). Conclusions: This is the first and most extensive profiling study to investigate DSCR1 expression in CRC. Our data show a strong association between tumor DSCR1 gene expression and distinct molecular features and TME cell infiltration. These findings suggest that DSCR1 holds potential as a novel therapeutic target for CRC and may be an important player in TME modulation.
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Affiliation(s)
- Francesca Battaglin
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | | | | | | | - Shivani Soni
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Jae Ho Lo
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Priya Jayachandran
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Sandra Algaze
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Pooja Mittal
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Wu Zhang
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Alexandra Wong
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Richard M. Goldberg
- West Virginia University Cancer Institute and the Mary Babb Randolph Cancer Center, Morgantown, WV
| | - Benjamin Adam Weinberg
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | | | - John Marshall
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Fariborz Nasertorabi
- Department of Biological Sciences and Chemistry, Bridge Institute, Michelson Center for Convergent Bioscience, University of Southern California, LOS Angeles, CA
| | | | - Heinz-Josef Lenz
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
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41
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Algaze S, Elliott A, Walker P, Battaglin F, Yang Y, Millstein J, Jayachandran P, Arai H, Soni S, Zhang W, Goldberg RM, Weinberg BA, Lou E, Goel S, Abraham J, Marshall J, Korn WM, Liebman H, Lenz HJ. Tissue factor expression in colorectal cancer. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.250] [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: 01/25/2023] Open
Abstract
250 Background: Tissue factor (TF), a component of the coagulation cascade, transmembrane receptor, and cofactor for factor VII/VIIa is expressed by subendothelial cells and critical to hemostasis, thrombosis, cell proliferation, angiogenesis, and metastasis. TF is suggested to have a critical role in colorectal cancer (CRC). Here we assessed the clinico-molecular features associated with TF expression (exp) in CRC. Methods: Tumor molecular profiling was performed for 14,0786 samples by NextGen Sequencing on DNA (592 genes or WES) and RNA (WTS) and immunohistochemistry (IHC) at Caris Life Sciences (Phoenix, AZ). TF-high (TF-H) and TF-low (TF-L) RNA exp were defined as ≥ 75th- and < 25th-percetile of TF transcripts per million (TPM), respectively. X2/Fisher-exact and Mann Whitney U tests were used for comparison, and P-values were adjusted for multiple comparisons. Cell infiltration in the tumor microenvironment (TME) was estimated by quanTIseq. Real-world overall survival (OS) information was obtained from insurance claims data and Kaplan-Meier estimates were calculated for molecularly defined patients (pts). Results: TF exp was higher in primary tumors compared to metastatic sites (2.3-fold, P < 0.001); higher in lung vs. liver metastases (0.6-fold and 0.3-fold, p < 0.001); higher in rectal (1.4-fold), right-sided (1.3-fold), and transverse (1.2-fold) compared to left-sided (P < 0.001); and highest in CMS1 tumors (CMS2 0.4-fold, CMS3 0.7-fold, CMS4 0.8-fold, P < 0.001). TF exp was higher in tumors with high TMB (TMB ≥ 10 Mut/Mb) (1.6-fold), dMMR/MSI-H (1.9-fold), and PD-L1 exp (1.8-fold) (P < 0.001 each). Compared to WT tumors, mutations in KRAS (1.2-fold, P < 0.001), BRAF (1.5-fold, P < 0.001) and ERBB2 (1.2-fold, P < 0.01) were associated with higher TF exp. In pMMR/MSS CRC, TF-L tumors were associated with TP53, APC, and NRAS mutations, and TF-H was associated with KRAS, PIK3CA, SMAD4, FBXW7, BRAF, ARID1A, GNAS, SMAD2, RNF43, KMT2D and BRCA1 mutations. TF exp was positively associated with most immune cell populations, most strongly with endothelial cells. In pMMR/MSS KRAS WT CRC, TF-H was associated with worse OS than TF-L. TF-H was also associated with worse OS for pMMR/MSS CRC pts treated with FOLFOX (HR: 1.5, CI:1.2-1.8, p < 0.0001), FOLFIRI (HR:1.7, CI:1.3-2.1, p < 0.0001), VEGF (HR:1.3, CI:1.1-1.6, p = 0.002) and EGFR inhibitors (HR:1.6, CI:1.1-2.3, p = 0.009) than TF-L. TF-H was associated with greater median days on pembrolizumab compared to TF-L in dMMR/MSI-H CRC (HR: 0.6, CI: 0.4-0.9, p = 0.018). Conclusions: Our data show TF exp is associated with distinct clinical and molecular features, including tumor sidedness and metastatic pattern, as well as CMS subtype and KRAS, BRAF and ERBB2 mutations. TME cell infiltration and IO-related biomarkers were enriched in TF-H, with TF exp correlating with endothelial cell abundance. These findings and associations with patient outcomes suggest that TF may be a relevant biomarker and target in CRC.
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Affiliation(s)
- Sandra Algaze
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | | | | | - Francesca Battaglin
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Yan Yang
- Department of Preventive Medicine, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Joshua Millstein
- Department of Preventive Medicine, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | | | - Hiroyuki Arai
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Shivani Soni
- University of Southern California, Los Angeles, CA
| | - Wu Zhang
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Richard M. Goldberg
- West Virginia University Cancer Institute and the Mary Babb Randolph Cancer Center, Morgantown, WV
| | | | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | - John Marshall
- Lombardi Cancer Center, Georgetown University, Washington, DC
| | - Wolfgang Michael Korn
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - Howard Liebman
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Heinz-Josef Lenz
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
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Arai H, Gandhi N, Battaglin F, Algaze S, Jayachandran P, Soni S, Wu Z, Lo JH, Sohal DP, Goldberg RM, Hall MJ, Scott AJ, Hwang JJ, Lou E, Weinberg BA, Marshall J, Goel S, Korn WM, Lenz HJ. The role of gene expression of CD47 in colorectal cancer (CRC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.240] [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: 01/25/2023] Open
Abstract
240 Background: CD47 belongs to the immunoglobulin superfamily and is overexpressed in many tumor types. CD47 plays an important role in suppressing phagocytosis through binding to transmembrane protein SIRP-alpha on macrophages. Targeting CD47 is a novel strategy for cancer immunotherapy and is being evaluated in ongoing clinical trials. However, molecular characteristics of CD47-overexpressed colorectal cancer (CRC) are largely unknown. Methods: We retrospectively reviewed CRC patient samples (n = 14786) submitted to a commercial CLIA-certified laboratory (Caris Life Sciences, Phoenix AZ). Next-generation sequencing of DNA and RNA (whole-transcriptome sequencing) and immunohistochemistry were performed. Correlation of CD47 expression with danger-associated molecular pattern (DAMP)-related genes ( HMGB1, CALR, ANXA1, HSP90AA1, HSPA1A, and CXCL10) expressions was tested. DAMP signature calculated as composite z-score of the DAMP related genes was compared between CD47-high and -low patients classified according to the median level of CD47 expression. Distributions of KRAS and BRAF mutations, consensus molecular subtype (CMS), and signatures of oncogenic signaling pathways were compared between CD47-high and -low patients. In addition, overall survival (OS) was compared between CD47-high and -low patients available for survival data. Results: CD47 expression level was significantly higher in metastatic compared to primary lesions (1.07-fold, q < 0.05) and microsatellite instability high tumors compared to microsatellite stable tumors (1.15-fold, q < 0.05). CD47 expression was positively correlated with DAMP genes expression except for HSPA1A, and the DAMP signature (median score [MS]: 2.66 vs -2.29, q < 0.05) was significantly increased in CD47-high patients. KRAS mutations were less prevalent (45.87% vs 50.05%) and CMS1(17.72% vs 14.42%) and CMS4 (40.33% vs 27.28%) were more prevalent in CD47-high patients, while no difference was observed in the prevalence of BRAF mutations between CD47-high and -low patients. Signatures of EMT (MS:2.91 vs -3.19), TGF-beta (MS:3.72 vs -3.52), angiogenesis (MS:2.95 vs -2.78), MAPK (MS:4.99 vs -4.12), PI3K (MS:2.41 vs -2.03), and immune-related signaling pathways (MS:1.20 vs -2.51) were significantly enriched in CD47-high patients (all q < 0.05). CD47-high patients (n = 4873) showed significantly worse OS than CD47-low patients (n = 4898) (median OS, 32.4 vs 37.6 months; hazard ratio = 1.158, p< 0.01). Conclusions: Highly CD47-expressed CRC harbored activation of DAMPs and oncogenic signaling pathways that linked to aberrant tumor microenvironment and worse prognosis. Our results support intensive treatment strategies using CD47 inhibitors combined with cytotoxic agents and molecular targeted agents (such as anti-VEGF agents) in CD47-overexpressed CRC.
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Affiliation(s)
- Hiroyuki Arai
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | | | - Francesca Battaglin
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | | | - Priya Jayachandran
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Shivani Soni
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Zhang Wu
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Jae Ho Lo
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | | | | | | | | | | | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | | | - John Marshall
- Lombardi Cancer Center, Georgetown University, Washington, DC
| | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | - Heinz-Josef Lenz
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Arai H, Baca Y, Battaglin F, Algaze S, Jayachandran P, Soni S, Wu Z, Lo JH, Sohal DP, Goldberg RM, Hall MJ, Scott AJ, Hwang JJ, Lou E, Weinberg BA, Marshall J, Goel S, Xiu J, Lenz HJ. The role of gene expression of CDC37 in colorectal cancer (CRC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.237] [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: 01/25/2023] Open
Abstract
237 Background: CDC37-HSP90 axis is an essential chaperoning system for stabilization of kinases. CDC37 determines selectivity of client kinases recognized by HSP90. We previously showed patients with CDC37-dependent ( CDC37 high expression) colorectal cancer (CRC) derived more benefit from regorafenib and bevacizumab both of which target HSP90 client kinases or signaling pathway, but not from cetuximab which targets HSP90 non-client kinase. However, molecular characteristics and interaction with relevant signaling pathways in CDC37-dependent CRC are largely unknown. Methods: We retrospectively reviewed CRC patient samples submitted to a commercial CLIA-certified laboratory (Caris Life Sciences, Phoenix AZ). Next-generation sequencing of DNA and RNA (whole-transcriptome sequencing) and immunohistochemistry were performed. Molecular profiles between top quartile transcripts per million for CDC37 expression (Q4, CDC37-high: n = 5056) and bottom quartile (Q1, CDC37-low: n = 5056) were compared for gene mutations, microsatellite instability (MSI) status, PD-L1 expression, co-expression of HSP90 genes ( HSP90AA1 and HSP90AB1), MAPK pathway activity score (MPAS), T-cell inflamed signature, and cell infiltration in the tumor microenvironment (TME) assessed by QuantiSEQ. Gene set enrichment analysis (GSEA) was performed between CDC37-high (Q4) and CDC37-low (Q1) tumors. Results: KRAS mutations trended higher in CDC37-high tumors compared to CDC37-low tumors (49.5% vs 47.1%) while APC (76.9% vs 72.3%), TP53 (75.5% vs 71.8%) and TCF7L2 (5.0% vs 3.5%) mutations were significantly higher in CDC37-high tumors compared to CDC37-low tumors (q < 0.05). No significance in expression quartiles were observed for dMMR/MSI-H or PD-L1 expression. HSP90AA1 and HSP90AB1 expression levels were significantly higher in CDC37-high tumors (2.9-fold and 2.6-fold in median, respectively; both q< 0.05). Both MPAS and T-cell inflamed signatures were significantly higher in CDC37-high tumors ( q< 0.05). Infiltration of NK cells, Tregs, neutrophils, M1 macrophages, and B-cells were greater in CDC37-high tumors (q < 0.05). GSEA showed several signaling pathways, such as KRAS, TGF-beta, hypoxia, WNT-beta catenin, and PI3K-AKT-MTOR, were enriched in CDC37-high tumors. Conclusions: Highly CDC37-expressed (CDC37-dependent) CRC was associated with aberrant TME where abundance of immune cell infiltrate and broad activation of kinase-related signaling pathways were evident. Our results support the kinase-stabilizing function of CDC37 in CRC. Further investigations combined with survival data are warranted to address the prognostic and predictive values of CDC37 expression in targeted therapies of CRC.
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Affiliation(s)
- Hiroyuki Arai
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | | | - Francesca Battaglin
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Sandy Algaze
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Priya Jayachandran
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Shivani Soni
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Zhang Wu
- Division of Medical Oncology, USC Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA
| | - Jae Ho Lo
- Norris Comprehensive Cancer Center, University of Southern Carilfornia, Los Angeles, CA
| | | | | | | | | | | | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | | | - John Marshall
- Lombardi Cancer Center, Georgetown University, Washington, DC
| | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | - Heinz-Josef Lenz
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Weinberg BA, Wang H, Noel MS, He AR, Marshall J, Weiner LM, Fishbein TM, Winslow ER, Jackson PG, Guerra JF, Aguila F, Unger KR. Phase I study of proton therapy in adjuvant pancreatic cancer (PROTON-PANC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.709] [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: 01/25/2023] Open
Abstract
709 Background: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival rate of 10%. The current standard of care for patients with resectable disease is surgical resection followed by 6 months of adjuvant mFOLFIRINOX (mFFX) chemotherapy. As survival outcomes and distant recurrence rates improve with the use of mFFX, locoregional recurrence remains a significant cause of morbidity and mortality. We sought to integrate short-course proton radiation therapy (PRT) to the operative bed between cycles of adjuvant chemotherapy in patients with resected PDAC of the pancreatic head. Methods: Between 2019 and 2022, patients with resected PDAC with an R0 or R1 resection on adjuvant mFFX were enrolled in a phase I trial using a 3+3 dose-escalation schema (NCT03885284). Patients received mFFX as used in the PRODIGE 24 study and also received short-course PRT delivered over 1 week in 5 fractions (5 GyE each) between cycles 6 and 7 of mFFX. In dose level 1 (DL1), patients received PRT on days 15-19 in a 28-day cycle before starting cycle 7, and in dose level 2 (DL2) patients received PRT on days 8-12 in a 21-day cycle before starting cycle 7. Results: Nine patients were enrolled on the trial, median age 66 (range 52-78). Five had R0 resections, 4 had R1 resections, and 5 had node-positive disease. No patients received preoperative therapy, and none underwent vein reconstruction. Three patients were enrolled on DL1 and 6 patients on DL2. One dose limiting toxicity (DLT) occurred at DL2 (prolonged grade 3 neutropenia resulting in discontinuation of mFFX after cycle 7). No other DLTs were observed. Four patients completed the planned 12 cycles of mFFX (range 7-12, median 11). None of the patients have had local recurrence. Five of 9 patients had recurrence: 3 in the liver, 1 in the peritoneum, and 1 in the bone. Six patients are still alive, 4 of whom are recurrence free. With a median follow up from date of chemotherapy start of 12.5 months, median time to disease recurrence was 12 months (95% confidence interval [CI] 4-not reached [NR]), and median overall survival has not been reached (95% CI 6-NR, 2-year survival rate 57%). Conclusions: PRT integrated within adjuvant mFFX was well-tolerated and no local recurrence was observed for patients with resected PDAC. These findings warrant being confirmed in a phase II trial. Clinical trial information: NCT03885284 .
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Affiliation(s)
- Benjamin Adam Weinberg
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Hongkun Wang
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | - Marcus Smith Noel
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Aiwu Ruth He
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - John Marshall
- Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Louis M. Weiner
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Thomas M. Fishbein
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Emily R. Winslow
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Patrick G. Jackson
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Juan F. Guerra
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Francisco Aguila
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Keith Robert Unger
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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Cornish SB, Muilwijk M, Scott JR, Marson JM, Myers PG, Zhang W, Wang Q, Kostov Y, Johnson HL, Marshall J. Impact of sea ice transport on Beaufort Gyre liquid freshwater content. Clim Dyn 2023; 61:1139-1155. [PMID: 37457371 PMCID: PMC10338613 DOI: 10.1007/s00382-022-06615-4] [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] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/29/2022] [Indexed: 07/18/2023]
Abstract
The Arctic Ocean's Beaufort Gyre (BG) is a wind-driven reservoir of relatively fresh seawater, situated beneath time-mean anticyclonic atmospheric circulation, and is covered by mobile pack ice for most of the year. Liquid freshwater accumulation in and expulsion from this gyre is of critical interest due to its potential to affect the Atlantic meridional overturning circulation and due to the importance of freshwater in modulating vertical fluxes of heat, nutrients and carbon in the ocean, and exchanges of heat and moisture with the atmosphere. Here, we investigate the hypothesis that wind-driven sea ice transport into/from the BG region influences the freshwater content of the gyre and its variability. To test this hypothesis, we use the results of a coordinated climate response function experiment with four ice-ocean models, in combination with targeted experiments using a regional setup of the MITgcm, in which we rotate the surface wind forcing vectors (thereby changing the ageostrophic component of these winds). Our results show that, via an effect on the net thermodynamic growth rate, anomalies in sea ice transport into the BG affect liquid freshwater adjustment. Specifically, increased ice import increases freshwater retention in the gyre, whereas ice export decreases freshwater in the gyre. Our results demonstrate that uncertainty in the ageostrophic component of surface winds, and in the dynamic sea ice response to these winds, has important implications for ice thermodynamics and freshwater. This sensitivity may explain some of the observed inter-model spread in simulations of Beaufort Gyre freshwater and its adjustment in response to wind forcing.
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Affiliation(s)
- Sam B. Cornish
- Department of Earth Sciences, University of Oxford, Oxford, UK
| | - Morven Muilwijk
- Geophysical Institute, University of Bergen and Bjerknes Centre for Climate Research, Bergen, Norway
- Norwegian Polar Institute, Tromsø, Norway
| | | | - Juliana M. Marson
- Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, Canada
- Centre for Earth Observation Science, University of Manitoba, Winnipeg, Canada
| | - Paul G. Myers
- Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, Canada
| | - Wenhao Zhang
- Institute of Oceanology, Chinese Academy of Sciences, Qingdao, China
- Alfred Wegener Institute, Helmholtz Center for Polar and Marine Research (AWI), Bremerhaven, Germany
| | - Qiang Wang
- Alfred Wegener Institute, Helmholtz Center for Polar and Marine Research (AWI), Bremerhaven, Germany
| | - Yavor Kostov
- College of Life and Environmental Science, University of Exeter, Exeter, UK
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Gravestock P, Clark E, Morton M, Sharma S, Fisher H, Walker J, Wood R, Hancock H, Waugh N, Cooper A, Maier R, Marshall J, Chandler R, Bahl A, Crabb S, Jain S, Pedley I, Jones R, Staffurth J, Heer R. Using the AR-V7 biomarker to determine treatment in metastatic castrate resistant prostate cancer, a feasibility randomised control trial, conclusions from the VARIANT trial. NIHR Open Res 2023; 2:49. [PMID: 37035713 PMCID: PMC7614403 DOI: 10.3310/nihropenres.13284.2] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 04/05/2023]
Abstract
Background Prostate cancer is the most commonly diagnosed malignancy in the UK. Castrate resistant prostate cancer (CRPC) can be difficult to manage with response to next generation hormonal treatment variable. AR-V7 is a protein biomarker that can be used to predict response to treatment and potentially better inform management in these patients. Our aim was to establish the feasibility of conducting a definitive randomised controlled trial comparing the clinical utility of AR-V7 biomarker assay in personalising treatments for patients with metastatic CRPC within the United Kingdom (UK) National Health Service (NHS). Due to a number of issues the trial was not completed successfully, we aim to discuss and share lessons learned herein. Methods We conducted a randomised, open, feasibility trial, which aimed to recruit 70 adult men with metastatic CRPC within three secondary care NHS trusts in the UK to be run over an 18-month period. Participants were randomised to personalised treatment based on AR-V7 status (intervention) or standard care (control). The primary outcome was feasibility, which included: recruitment rate, retention and compliance. Additionally, a baseline prevalence of AR-V7 expression was to be estimated. Results Fourteen participants were screened and 12 randomised with six into each arm over a nine-month period. Reliability issues with the AR-V7 assay meant prevalence was not estimated. Due to limited recruitment the study did not complete to target. Conclusions Whilst the trial did not complete to target, we have ascertained that men with advanced cancer are willing to take part in trials utilising biomarker guided treatment. A number of issues were identified that serve as important learning points in future clinical trials.
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Affiliation(s)
- Paul Gravestock
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Tyne and Wear, NE3 3HD, UK
| | - Emma Clark
- Translational and Clinical Research Institute, NU Cancer, Newcastle upon Tyne, Tyne and Wear, NE1 7RU, UK
| | - Miranda Morton
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, Tyne and Wear, NE2 4AE, UK
| | - Shirya Sharma
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, Tyne and Wear, NE2 4AE, UK
| | - Holly Fisher
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, Tyne and Wear, NE1 7RU, UK
| | - Jenn Walker
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, Tyne and Wear, NE2 4AE, UK
| | - Ruth Wood
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, Tyne and Wear, NE2 4AE, UK
| | - Helen Hancock
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, Tyne and Wear, NE2 4AE, UK
| | - Nichola Waugh
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, Tyne and Wear, NE2 4AE, UK
| | | | - Rebecca Maier
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, Tyne and Wear, NE2 4AE, UK
| | - John Marshall
- Trial Management Group, VARIANT Trial, Newcastle upon Tyne, Tyne and Wear, NE1 7RU, UK
| | - Robert Chandler
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Tyne and Wear, NE3 3HD, UK
| | - Amit Bahl
- University Hospitals Bristol NHS Foundation Trust, Bristol, BS1 3NU, UK
| | - Simon Crabb
- University of Southampton, Southampton, Hampshire, SO17 1BJ, UK
| | - Suneil Jain
- Queens University Belfast, Belfast, BT7 1NN, UK
| | - Ian Pedley
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Tyne and Wear, NE3 3HD, UK
| | - Rob Jones
- Institute of Cancer Services, University of Glasgow, Glasgow, G12 0YN, UK
| | - John Staffurth
- Velindre University NHS Trust, Cardiff, CF15 7QZ, UK
- Division of Cancer and Genetics, Cardiff University, Cardiff, CF14 4XN, UK
| | - Rakesh Heer
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, Tyne and Wear, NE3 3HD, UK
- Translational and Clinical Research Institute, NU Cancer, Newcastle upon Tyne, Tyne and Wear, NE1 7RU, UK
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47
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Abratenko P, Andrade Aldana D, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow J, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hicks R, Hilgenberg C, Horton-Smith GA, Irwin B, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Miller K, Mills J, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Nunes M, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Pophale I, Prince S, Qian X, Raaf JL, Radeka V, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, St John J, Strauss T, Sword-Fehlberg S, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Constraints on Light Sterile Neutrino Oscillations from Combined Appearance and Disappearance Searches with the MicroBooNE Detector. Phys Rev Lett 2023; 130:011801. [PMID: 36669216 DOI: 10.1103/physrevlett.130.011801] [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] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
We present a search for eV-scale sterile neutrino oscillations in the MicroBooNE liquid argon detector, simultaneously considering all possible appearance and disappearance effects within the 3+1 active-to-sterile neutrino oscillation framework. We analyze the neutrino candidate events for the recent measurements of charged-current ν_{e} and ν_{μ} interactions in the MicroBooNE detector, using data corresponding to an exposure of 6.37×10^{20} protons on target from the Fermilab booster neutrino beam. We observe no evidence of light sterile neutrino oscillations and derive exclusion contours at the 95% confidence level in the plane of the mass-squared splitting Δm_{41}^{2} and the sterile neutrino mixing angles θ_{μe} and θ_{ee}, excluding part of the parameter space allowed by experimental anomalies. Cancellation of ν_{e} appearance and ν_{e} disappearance effects due to the full 3+1 treatment of the analysis leads to a degeneracy when determining the oscillation parameters, which is discussed in this Letter and will be addressed by future analyses.
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - D Andrade Aldana
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - J Anthony
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - L Arellano
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - J Barrow
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - V Basque
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | | | | | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M Bhattacharya
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - B Bogart
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - D Caratelli
- University of California, Santa Barbara, California 93106, USA
| | - I Caro Terrazas
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y Chen
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - L Cooper-Troendle
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - P Detje
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- Universität Bern, Bern CH-3012, Switzerland
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | | | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O G Finnerud
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Foreman
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - B T Fleming
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - N Foppiani
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - D Franco
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - O Goodwin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - E Gramellini
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - P Green
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - R Hicks
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - C Hilgenberg
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - B Irwin
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Itay
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - L Jiang
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J H Jo
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - D Kalra
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - M B Leibovitch
- University of California, Santa Barbara, California 93106, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - J-Y Li
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - K Manivannan
- Syracuse University, Syracuse, New York 13244, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N Martinez
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - K Mason
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - N McConkey
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - J Mills
- Tufts University, Medford, Massachusetts 02155, USA
| | - A Mogan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Mousseau
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | | | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Nayak
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Nebot-Guinot
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - M Nunes
- Syracuse University, Syracuse, New York 13244, USA
| | - N Oza
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - N Pallat
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - H B Parkinson
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - N Patel
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Piasetzky
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - I D Ponce-Pinto
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - I Pophale
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - S Prince
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Reggiani-Guzzo
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - M Rosenberg
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Ross-Lonergan
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | | | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Smith
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S Sword-Fehlberg
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - N Taniuchi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - D Torbunov
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Tyler
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - A J White
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Z Williams
- University of Texas, Arlington, Texas 76019, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - N Wright
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - W Wu
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L E Yates
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - H W Yu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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48
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Ruban-Fell B, Attilakos G, Haskins-Coulter T, Hyde C, Kusel J, Mackie A, Rivero-Arias O, Thilaganathan B, Thomson N, Visintin C, Marshall J. The impact of ultrasound-based antenatal screening strategies to detect vasa praevia in the United Kingdom: An exploratory study using decision analytic modelling methods. PLoS One 2022; 17:e0279229. [PMID: 36538562 PMCID: PMC9767376 DOI: 10.1371/journal.pone.0279229] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
The objective of this exploratory modelling study was to estimate the effects of second-trimester, ultrasound-based antenatal detection strategies for vasa praevia (VP) in a hypothetical cohort of pregnant women. For this, a decision-analytic tree model was developed covering four discrete detection pathways/strategies: no screening; screening targeted at women undergoing in-vitro fertilisation (IVF); screening targeted at women with low-lying placentas (LLP); screening targeted at women with velamentous cord insertion (VCI) or a bilobed or succenturiate (BL/S) placenta. Main outcome measures were the number of referrals to transvaginal sonography (TVS), diagnosed and undiagnosed cases of VP, overdetected cases of VCI, and VP-associated perinatal mortality. The greatest number of referrals to TVS occurred in the LLP-based (2,083) and VCI-based screening (1,319) pathways. These two pathways also led to the highest proportions of pregnancies diagnosed with VP (VCI-based screening: 552 [78.9% of all pregnancies]; LLP-based: 371 [53.5%]) and the lowest proportions of VP leading to perinatal death (VCI-based screening: 100 [14.2%]; LLP-based: 196 [28.0%]). In contrast, the IVF-based pathway resulted in 66 TVS referrals, 50 VP diagnoses (7.1% of all VP pregnancies), and 368 (52.6%) VP-associated perinatal deaths which was comparable to the no screening pathway (380 [54.3%]). The VCI-based pathway resulted in the greatest detection of VCI (14,238 [99.1%]), followed by the IVF-based pathway (443 [3.1%]); no VCI detection occurred in the LLP-based or no screening pathways. In conclusion, the model results suggest that a targeted LLP-based approach could detect a substantial proportion of VP cases, while avoiding VCI overdetection and requiring minimal changes to current clinical practice. High-quality data is required to explore the clinical and cost-effectiveness of this and other detection strategies further. This is necessary to provide a robust basis for future discussion about routine screening for VP.
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Affiliation(s)
| | - George Attilakos
- Fetal Medicine Unit, University College London Hospital, London, United Kingdom
| | | | - Christopher Hyde
- Exeter Test Group, Institute of Health Research, College of Medicine and Health, University of Exeter, St. Luke’s Campus, Exeter, United Kingdom
| | | | - Anne Mackie
- National Screening Committee, Public Health England, London, United Kingdom
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Basky Thilaganathan
- Fetal Medicine Unit, St George’s University Hospital NHS Foundation Trust and Molecular & Clinical Sciences Research Institute, St George’s University of London, London, United Kingdom
| | - Nigel Thomson
- The Society and College of Radiographers, London, United Kingdom
| | | | - John Marshall
- UK National Screening Committee, London, United Kingdom
- * E-mail:
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49
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Petros BA, Paull JS, Tomkins-Tinch CH, Loftness BC, DeRuff KC, Nair P, Gionet GL, Benz A, Brock-Fisher T, Hughes M, Yurkovetskiy L, Mulaudzi S, Leenerman E, Nyalile T, Moreno GK, Specht I, Sani K, Adams G, Babet SV, Baron E, Blank JT, Boehm C, Botti-Lodovico Y, Brown J, Buisker AR, Burcham T, Chylek L, Cronan P, Dauphin A, Desreumaux V, Doss M, Flynn B, Gladden-Young A, Glennon O, Harmon HD, Hook TV, Kary A, King C, Loreth C, Marrs L, McQuade KJ, Milton TT, Mulford JM, Oba K, Pearlman L, Schifferli M, Schmidt MJ, Tandus GM, Tyler A, Vodzak ME, Krohn Bevill K, Colubri A, MacInnis BL, Ozsoy AZ, Parrie E, Sholtes K, Siddle KJ, Fry B, Luban J, Park DJ, Marshall J, Bronson A, Schaffner SF, Sabeti PC. Multimodal surveillance of SARS-CoV-2 at a university enables development of a robust outbreak response framework. Med 2022; 3:883-900.e13. [PMID: 36198312 PMCID: PMC9482833 DOI: 10.1016/j.medj.2022.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Universities are vulnerable to infectious disease outbreaks, making them ideal environments to study transmission dynamics and evaluate mitigation and surveillance measures. Here, we analyze multimodal COVID-19-associated data collected during the 2020-2021 academic year at Colorado Mesa University and introduce a SARS-CoV-2 surveillance and response framework. METHODS We analyzed epidemiological and sociobehavioral data (demographics, contact tracing, and WiFi-based co-location data) alongside pathogen surveillance data (wastewater and diagnostic testing, and viral genomic sequencing of wastewater and clinical specimens) to characterize outbreak dynamics and inform policy. We applied relative risk, multiple linear regression, and social network assortativity to identify attributes or behaviors associated with contracting SARS-CoV-2. To characterize SARS-CoV-2 transmission, we used viral sequencing, phylogenomic tools, and functional assays. FINDINGS Athletes, particularly those on high-contact teams, had the highest risk of testing positive. On average, individuals who tested positive had more contacts and longer interaction durations than individuals who never tested positive. The distribution of contacts per individual was overdispersed, although not as overdispersed as the distribution of phylogenomic descendants. Corroboration via technical replicates was essential for identification of wastewater mutations. CONCLUSIONS Based on our findings, we formulate a framework that combines tools into an integrated disease surveillance program that can be implemented in other congregate settings with limited resources. FUNDING This work was supported by the National Science Foundation, the Hertz Foundation, the National Institutes of Health, the Centers for Disease Control and Prevention, the Massachusetts Consortium on Pathogen Readiness, the Howard Hughes Medical Institute, the Flu Lab, and the Audacious Project.
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Affiliation(s)
- Brittany A Petros
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Harvard-MIT Program in Health Sciences and Technology, Cambridge, MA 02139, USA; Harvard/MIT MD-PhD Program, Boston, MA 02115, USA; Systems, Synthetic, and Quantitative Biology PhD Program, Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Jillian S Paull
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Systems, Synthetic, and Quantitative Biology PhD Program, Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA.
| | - Christopher H Tomkins-Tinch
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA.
| | - Bryn C Loftness
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Department of Computer Science and Engineering, Colorado Mesa University, Grand Junction, CO 81501, USA; Complex Systems and Data Science PhD Program, University of Vermont, Burlington, VT 05405, USA; Vermont Complex Systems Center, University of Vermont, Burlington, VT 05405, USA.
| | | | - Parvathy Nair
- Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA
| | | | - Aaron Benz
- Degree Analytics, Inc., Austin, TX 78758, USA
| | | | | | - Leonid Yurkovetskiy
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
| | - Shandukani Mulaudzi
- Harvard Program in Bioinformatics and Integrative Genomics, Harvard Medical School, Boston, MA 02115, USA
| | | | - Thomas Nyalile
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
| | - Gage K Moreno
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Ivan Specht
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Kian Sani
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Gordon Adams
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Simone V Babet
- Department of Civil, Environmental, and Architectural Engineering, University of Colorado, Boulder, CO 80309, USA
| | - Emily Baron
- COVIDCheck Colorado, LLC, Denver, CO 80202, USA
| | - Jesse T Blank
- Colorado Mesa University, Grand Junction, CO 81501, USA
| | - Chloe Boehm
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Princeton University Molecular Biology Department, Princeton, NJ 08544, USA
| | | | - Jeremy Brown
- Colorado Mesa University, Grand Junction, CO 81501, USA
| | | | | | - Lily Chylek
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Paul Cronan
- Fathom Information Design, Boston, MA 02114, USA
| | - Ann Dauphin
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
| | - Valentine Desreumaux
- Department of Civil, Environmental, and Architectural Engineering, University of Colorado, Boulder, CO 80309, USA
| | - Megan Doss
- Warrior Diagnostics, Inc., Loveland, CO 80538, USA
| | - Belinda Flynn
- Colorado Mesa University, Grand Junction, CO 81501, USA
| | | | | | | | - Thomas V Hook
- Department of Civil, Environmental, and Architectural Engineering, University of Colorado, Boulder, CO 80309, USA
| | - Anton Kary
- Department of Biological Sciences, Colorado Mesa University, Grand Junction, CO 81501, USA
| | - Clay King
- Department of Mathematics and Statistics, Colorado Mesa University, Grand Junction, CO 81501, USA
| | | | - Libby Marrs
- Fathom Information Design, Boston, MA 02114, USA
| | - Kyle J McQuade
- Department of Biological Sciences, Colorado Mesa University, Grand Junction, CO 81501, USA
| | - Thorsen T Milton
- Department of Civil, Environmental, and Architectural Engineering, University of Colorado, Boulder, CO 80309, USA
| | - Jada M Mulford
- Department of Biological Sciences, Colorado Mesa University, Grand Junction, CO 81501, USA
| | - Kyle Oba
- Fathom Information Design, Boston, MA 02114, USA
| | - Leah Pearlman
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | | | | | - Grace M Tandus
- Department of Civil, Environmental, and Architectural Engineering, University of Colorado, Boulder, CO 80309, USA
| | - Andy Tyler
- Colorado Mesa University, Grand Junction, CO 81501, USA
| | - Megan E Vodzak
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Kelly Krohn Bevill
- Department of Computer Science and Engineering, Colorado Mesa University, Grand Junction, CO 81501, USA
| | - Andres Colubri
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; University of Massachusetts Medical School, Worcester, MA 01655, USA
| | | | - A Zeynep Ozsoy
- Department of Biological Sciences, Colorado Mesa University, Grand Junction, CO 81501, USA
| | - Eric Parrie
- COVIDCheck Colorado, LLC, Denver, CO 80202, USA
| | - Kari Sholtes
- Department of Computer Science and Engineering, Colorado Mesa University, Grand Junction, CO 81501, USA; Department of Civil, Environmental, and Architectural Engineering, University of Colorado, Boulder, CO 80309, USA
| | - Katherine J Siddle
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - Ben Fry
- Fathom Information Design, Boston, MA 02114, USA
| | - Jeremy Luban
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA; Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, MA 01655, USA; Massachusetts Consortium on Pathogen Readiness, Boston, MA 02115, USA
| | - Daniel J Park
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - John Marshall
- Colorado Mesa University, Grand Junction, CO 81501, USA
| | - Amy Bronson
- Physician Assistant Program, Department of Kinesiology, Colorado Mesa University, Grand Junction, CO 81501, USA
| | | | - Pardis C Sabeti
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA; Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA; Massachusetts Consortium on Pathogen Readiness, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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50
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Salman A, Kailani O, Marshall J, Ghabra M, Balamoun AA, Darwish TR, Badla AA, Alhaji H. Evaluation of Anterior and Posterior Corneal Higher Order Aberrations for the Detection of Keratoconus and Suspect Keratoconus. Tomography 2022; 8:2864-2873. [PMID: 36548532 PMCID: PMC9782471 DOI: 10.3390/tomography8060240] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/20/2022] [Accepted: 11/28/2022] [Indexed: 12/07/2022] Open
Abstract
AIM To investigate the application of anterior and posterior corneal higher-order aberrations (HOAs) in detecting keratoconus (KC) and suspect keratoconus (SKC). METHOD A retrospective, case-control study evaluating non-ectatic (normal) eyes, SKC eyes, and KC eyes. The Sirius Scheimpfug (CSO, Italy) analyses was used to measure HOAs of the anterior and posterior corneal surfaces. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated. RESULTS Two-hundred and twenty eyes were included in the analysis (normal n = 108, SKC n = 42, KC n = 70). Receiver operating characteristic (ROC) curve analysis revealed a high predictive ability for anterior corneal HOAs parameters: the root mean square (RMS) total corneal HOAs, RMS trefoil, and RMS coma to detect keratoconus (AUC > 0.9 for all). RMS Coma (3, ±1) derived from the anterior corneal surface was the parameter with the highest ability to discriminate between suspect keratoconus and normal eyes (AUC = 0.922; cut-off > 0.2). All posterior corneal HOAs parameters were unsatisfactory in discriminating between SKC and normal eyes (AUC < 0.8 for all). However, their ability to detect KC was excellent with AUC of >0.9 for all except RMS spherical aberrations (AUC = 0.846). CONCLUSIONS Anterior and posterior corneal higher-order aberrations can differentiate between keratoconus and normal eyes, with a high level of certainty. In suspect keratoconus disease, however, only anterior corneal HOAs, and in particular coma-like aberrations, are of value. Corneal aberrometry may be of value in screening for keratoconus in populations with a high prevalence of the disease.
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Affiliation(s)
- Abdelrahman Salman
- Department of Ophthalmology, Tishreen University, Latakia P.O. Box 25, Syria
- Correspondence:
| | - Obeda Kailani
- King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | - John Marshall
- Institute of Ophthalmology, University College London in Association with Moorfield Eye Hospital, London WC1E 6BT, UK
| | - Marwan Ghabra
- Whipps Cross University Hospital, Leytonstone, London E11 1NR, UK
| | | | - Taym R. Darwish
- Department of Ophthalmology, Tishreen University, Latakia P.O. Box 25, Syria
| | - Abdul Aziz Badla
- Department of Ophthalmology, Suliman Al-Habib Hospital, Dubai 41516, United Arab Emirates
| | - Hala Alhaji
- Department of Ophthalmology, Tishreen University, Latakia P.O. Box 25, Syria
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