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Erenso D, Tran L, Abualrob I, Bushra M, Hengstenberg J, Muhammed E, Endale I, Endale N, Endale E, Mayhut S, Torres N, Sheffield P, Vazquez C, Crogman H, Nichols C, Dang T, Hach EE. Observation of magnet-induced star-like radiation of a plasma created from cancer cells in a laser trap. Eur Biophys J 2024; 53:123-131. [PMID: 38451329 DOI: 10.1007/s00249-024-01701-3] [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] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/06/2023] [Accepted: 01/20/2024] [Indexed: 03/08/2024]
Abstract
We present a new phenomenon resulting from the interaction of magnetic beads with cancer cells in a laser trap formed on a slide containing a depression 16.5 mm in diameter and 0.78 mm of maximum depth. This phenomenon includes the apparent formation and expansion of a dark bubble that attracts and incinerates surrounding matter when it explodes, which leads to a plasma emitting intense radiation that has the appearance of a star on a microscopic scale. We have observed the star-like phenomenon for more than 4 years, and the intensity depends on the laser's power. Measuring the laser power of the dark bubble shows the entrapment of electromagnetic energy as it expands.
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Affiliation(s)
- D Erenso
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA.
| | - L Tran
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - I Abualrob
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - M Bushra
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - J Hengstenberg
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - E Muhammed
- Department of Physics, Addis Ababa University, Addis Ababa, Ethiopia
| | - I Endale
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - N Endale
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - E Endale
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - S Mayhut
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - N Torres
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - P Sheffield
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - C Vazquez
- Department of Physics, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - H Crogman
- Department of Physics, California State University Dominguez Hills, Carson, CA, 90747, USA
| | - C Nichols
- Department of Physics, California State University Dominguez Hills, Carson, CA, 90747, USA
| | - T Dang
- Department of Physics, California State University Dominguez Hills, Carson, CA, 90747, USA
| | - E E Hach
- School of Physics and Astronomy, Rochester Institute of Technology, 85 Lomb Memorial Drive, Rochester, NY, 14623, USA
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Bianchi A, Agosteo S, Bortot D, Cirrone GAP, Colautti P, La Tessa C, Mazzucconi D, Missiaggia M, Petringa G, Rosenfeld AB, Selva A, Tran L, Verona C, Verona Rinati G, Conte V. Microdosimetry of a 62-MeV clinical proton beam with five detectors. Radiat Prot Dosimetry 2023; 199:1968-1972. [PMID: 37819306 DOI: 10.1093/rpd/ncac231] [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: 07/07/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 10/13/2023]
Abstract
In proton therapy, most treatment planning systems (TPS) use a fixed relative biological effectiveness (RBE) of 1.1 all along the depth-dose profile. Innovative TPS are now investigated considering the variability of RBE with radiation quality. New TPS need an experimental verification in the quality assurance (QA) routine in clinics, but RBE data are usually obtained with radiobiological measurements that are time consuming and not suitable for daily QA. Microdosimetry is a useful tool based on physical measurements which can monitor the radiation quality. Several microdosimeters are available in different research institutions, which could potentially be used for the QA in TPS. In this study, the response functions of five detectors in the same 62-MeV proton Spread Out Bragg Peak is compared in terms of spectral distributions and their average values and microdosimetric RBE. Their different response function has been commented and must be considered in the clinical practice.
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Affiliation(s)
- A Bianchi
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - S Agosteo
- Politecnico di Milano, Dipartimento di Energia, 20156 Milano, Italy
- INFN-Milano, 20133 Milano, Italy
| | - D Bortot
- Politecnico di Milano, Dipartimento di Energia, 20156 Milano, Italy
- INFN-Milano, 20133 Milano, Italy
| | - G A P Cirrone
- INFN-Laboratori Nazionali del Sud, 95125 Catania, Italy
| | - P Colautti
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - C La Tessa
- University of Trento, Dipartimento di Fisica, 38123 Povo, Trento, Italy
- Trento Institute of Fundamental Physics and Applications, 38123 Povo, Trento, Italy
| | - D Mazzucconi
- Politecnico di Milano, Dipartimento di Energia, 20156 Milano, Italy
- INFN-Milano, 20133 Milano, Italy
| | - M Missiaggia
- University of Trento, Dipartimento di Fisica, 38123 Povo, Trento, Italy
- Trento Institute of Fundamental Physics and Applications, 38123 Povo, Trento, Italy
| | - G Petringa
- INFN-Laboratori Nazionali del Sud, 95125 Catania, Italy
- ELI Beamlines Center, Institute of Physics, Czech Academy of Sciences, 252 41 Dolní Břežany, Czech Republic
| | - A B Rosenfeld
- Centre for Medical Radiation Physics, University of Wollongong, 2522 Wollongong, Australia
| | - A Selva
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
| | - L Tran
- Centre for Medical Radiation Physics, University of Wollongong, 2522 Wollongong, Australia
| | - C Verona
- INFN-Roma2, Dipartimento di Ingegneria Industriale, Università di Roma "Tor Vergata", 00133 Roma, Italy
| | - G Verona Rinati
- INFN-Roma2, Dipartimento di Ingegneria Industriale, Università di Roma "Tor Vergata", 00133 Roma, Italy
| | - V Conte
- INFN-Laboratori Nazionali di Legnaro, 35020 Legnaro, Italy
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Tran L, Klainguti G, Hoeckele N, Kaeser PF. Torsional strabismus and vertical rectus muscle surgery in thyroid eye disease. J Fr Ophtalmol 2023; 46:49-56. [PMID: 36496294 DOI: 10.1016/j.jfo.2022.05.026] [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: 04/01/2022] [Revised: 05/21/2022] [Accepted: 05/30/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To assess the torsional component in patients with vertical strabismus due to thyroid eye disease (TED) and its course after vertical rectus muscle surgery. PATIENTS AND METHODS Retrospective chart review of patients undergoing vertical strabismus surgery for TED between 1998 and 2017, having undergone pre- and postoperative Harms tangent screen examination. RESULTS Forty patients (27 women) were identified. A torsional component was present in all patients. Thirty-three patients had a mean excyclotorsion of 4.5° in primary position, increasing to 8.2° in upgaze, associated with restricted elevation. Inferior rectus muscle recession (n=29) reduced the excyclotorsion in all cases. A 4.4° mean incyclotorsion was present in primary position in 7 cases, increasing to 7.1° in downgaze. Superior rectus muscle recession reduced the incyclotorsion in 5/6 cases. The torsional surgical dose-effect relationship was correlated with the amount of preoperative torsion. The field of binocular single vision improved from 6.5% preoperatively to 71.1% after surgery. CONCLUSIONS Ocular torsion is common in vertical strabismus secondary to TED and is significantly improved by vertical rectus muscle surgery alone. Surgery should be planned according to vertical deviation and motility limitation, and vertical rectus muscles surgery should be considered the first line of treatment, with selective oblique muscle surgery as a second-line option, which was unnecessary in our series.
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Affiliation(s)
- L Tran
- Hôpital ophtalmique Jules-Gonin, service d'ophtalmologie de l'université de Lausanne, 15, avenue de France, 1004 Lausanne, Switzerland
| | - G Klainguti
- Hôpital ophtalmique Jules-Gonin, service d'ophtalmologie de l'université de Lausanne, 15, avenue de France, 1004 Lausanne, Switzerland
| | - N Hoeckele
- Hôpital ophtalmique Jules-Gonin, service d'ophtalmologie de l'université de Lausanne, 15, avenue de France, 1004 Lausanne, Switzerland
| | - P-F Kaeser
- Hôpital ophtalmique Jules-Gonin, service d'ophtalmologie de l'université de Lausanne, 15, avenue de France, 1004 Lausanne, Switzerland.
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Gakis GP, Krikas A, Neofytou P, Tran L, Charitidis C. Modelling the biodistribution of inhaled gold nanoparticles in rats with interspecies extrapolation to humans. Toxicol Appl Pharmacol 2022; 457:116322. [PMID: 36414120 DOI: 10.1016/j.taap.2022.116322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/21/2022]
Abstract
The increasing intentional and non-intentional exposure to nanoparticles (NPs) has raised the interest concerning their fate and biodistribution in the body of animals and humans after inhalation. In this context, Physiologically Based (pharmaco)Kinetic (PBK) modelling has emerged as an in silico approach that simulates the biodistribution kinetics of NPs in the body using mathematical equations. Due to restrictions in data availability, such models are first developed for rats or mice. In this work, we present the interspecies extrapolation of a PBK model initially developed for rats, in order to estimate the biodistribution of inhaled gold NPs (AuNPs) in humans. The extrapolation framework is validated by comparing the model results with experimental data from a clinical study performed on humans for inhaled AuNPs of two different sizes, namely 34 nm and 4 nm. The novelty of this work lies in the extrapolation of a PBK model for inhaled AuNPs to humans and comparison with clinical data. The extrapolated model is in good agreement with the experimental data, and provides insights for the mechanisms of inhaled AuNP translocation to the blood circulation, after inhalation. Finally, the biodistribution of the two sizes of AuNPs in the human body after 28 days post-exposure is estimated by the model and discussed.
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Affiliation(s)
- G P Gakis
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - A Krikas
- Thermal Hydraulics and Multiphase Flow Laboratory, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - P Neofytou
- Thermal Hydraulics and Multiphase Flow Laboratory, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - L Tran
- Institute of Occupational Medicine, Edinburgh, UK
| | - C Charitidis
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece.
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Krikas A, Neofytou P, Gakis GP, Xiarchos I, Charitidis C, Tran L. Modeling of clearance, retention, and translocation of inhaled gold nanoparticles in rats. Inhal Toxicol 2022; 34:361-379. [PMID: 36053230 DOI: 10.1080/08958378.2022.2115592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: The increasing exposure to gold nanoparticles (AuNPs), due to their wide range of applications, has led to the need for thorough understanding of their biodistribution, following exposure. The objective of this paper is to develop a PBK model in order to study the clearance, retention and translocation of inhaled gold nanoparticles in rats, providing a basis for the understanding of the absorption, distribution, metabolism and elimination (ADME) mechanisms of AuNPs in various organs.Materials and methods: A rat PBK computational model was developed, connected to a detailed respiratory model, including the olfactory, tracheobronchial, and alveolar regions. This model was coupled with a Multiple Path Particle Dosimetry (MPPD) model to appropriately simulate the exposure to AuNPs. Three existing in vivo experimental datasets from scientific literature for the biodistribution of inhaled AuNPs for different AuNP sizes and exposure scenarios were utilized for model calibration and validation.Results and Discussion: The model was calibrated using two individual datasets for nose only inhaled and intratracheally instilled AuNPs, while an independent dataset for nose only inhaled AuNPs was used as external validation. The overall fitting over the three datasets was proved acceptable as shown by the relevant statistical metrics. The influence of several physiological parameters is also studied via a sensitivity analysis, providing useful insights into the mechanisms of NP pharmacokinetics. The key aspects of the inhaled AuNPs biodistribution are discussed, revealing the key mechanisms for the AuNPs absorption routes, the AuNP uptake by secondary organs and the influence of the AuNP size on the translocation from the lungs to blood circulation.Conclusions: The model results together with the model sensitivity analysis clarified the key mechanisms for the inhaled AuNPs biodistribution to secondary organs. It was observed that nose-only inhaled AuNPs of smaller size can enter the blood circulation through secondary routes, such as absorption through the gastrointestinal (GI) lumen, showing that such translocations should not be underestimated in biodistribution modelling. Finally, the computational framework presented in this study can be used as a basis for a more wide investigation of inhaled nanoparticles biodistribution, including interspecies extrapolation of the resulting PBK model for the inhalation and subsequent biodistribution of AuNPs in humans.
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Affiliation(s)
- A Krikas
- Thermal Hydraulics and Multiphase Flow Laboratory, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - P Neofytou
- Thermal Hydraulics and Multiphase Flow Laboratory, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - G P Gakis
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - I Xiarchos
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - C Charitidis
- Research Lab of Advanced, Composite, Nano-Materials and Nanotechnology, Materials Science and Engineering Department, School of Chemical Engineering, National Technical University of Athens, Athens, Greece
| | - L Tran
- Institute of Occupational Medicine, Edinburgh, UK
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Bui V, Hsu L, Sun A, Tran L, Shanbhag S, Chang L, Zhou W, Mehta N, Chen M. 401 Deepheartct: A Fully Automatic Hybrid Structure Segmentation Framework Based On Atlas, Reverse Ranking, And Convolutional Neural Network For Computed Tomography Angiography. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Tran L, Meng S, Wang P, Pan I, Yi T, Wang R, Jiao Z, Bai H. Abstract No. 240 Automated outcome prediction in mechanical thrombectomy for acute large vessel ischemic stroke using 3D convolutional neural networks applied to CT angiography. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Patel P, Nallandhighal S, Scoville D, Tran L, Cotta B, Udager AM, Rao A, Palapattu GS, Dadhania V, Pitchiaya S, Salami S. The role of spatial transcriptomic profiling to determine androgen receptor signaling and immune infiltration in prostate cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
272 Background: Prostate cancer (PCa) in the transition zone (TZ) accounts for approximately 30% of disease and tends to present with higher PSAs with a lower risk of seminal vesicle invasion, extra-capsular extension, and risk of biochemical recurrence compared with peripheral zone (PZ) tumors. The underlying biological mechanism for these differences is poorly understood. Here, we performed spatial transcriptomic profiling to elucidate the molecular differences between TZ and PZ PCa. Methods: We identified three patients who underwent radical prostatectomy for PCa (one each with PZ only, TZ only, and both PZ and TZ tumors) and used the NanoString’s Digital Spatial Profiling (DSP) platform to quantify whole transcriptomic gene expression data (17,128 genes) in multiple regions of interest (ROI) per patient (42 cancer and 8 normal samples). Four morphology markers to facilitate ROI selection in both cancer and normal areas (SYTO13 for nucleus, PanCK for epithelium, SMA for stroma and CD45 for immune cells) were selected. Raw counts for 17,128 genes were imported to R v.4.1.0 for downstream data analyses. Counts were Q3 normalized and scaled (Z-score) to enable plotting of all genes on the same axes. Differential gene expression analysis using a linear model fit by empirical Bayes moderation, gene set enrichment analysis (GSEA) by cancer hallmarks, XCell gene sets for pathway enrichment and immune cell deconvolution using CIBERSORT was performed. Results: There were grade group (GG) 4 (n=10) and 5 (n=10) tumors in PZ and GG 3 (n=10), 4 (n=11) and 5 (n=1) cancers in TZ regions. We observed distinct gene expression profiles between PZ (n = 20) and TZ (n=22) tumors. Interestingly, androgen receptor (AR) signaling was significantly higher in TZ PCa ROIs compared to PZ ROIs in both GSEA (false discovery rate < 5%) and the androgen subcomponent of the genomic prostate score (p<0.001), regardless of grade, epithelial, stromal or immune component of the region. To standardize the comparison, CIBERSORT’s absolute immune signature scores were only computed for GG4 tumors and found to be significantly higher in PZ GG4 tumors compared to TZ GG4 tumors. Notably, CD4+ memory T cells were significantly higher in PZ GG4 regions compared to TZ GG4 tumor regions (p<0.05). Conclusions: Here, we demonstrate distinct gene expression profiles of PZ and TZ PCa. Specifically, we observed higher AR signaling in TZ cancers and higher levels of immune infiltration on PZ cancers. This is in concordance with prior knowledge that TZ tumors may be associated with higher serum PSA and PZ tumors may be associated with inflammation. Further studies are needed to discern the biological and clinical significance of the different molecular features of PZ and TZ PCa.
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Affiliation(s)
- Parth Patel
- University of Michigan Department of Urology, Ann Arbor, MI
| | | | | | - Lynn Tran
- Medical College of Georgia, Augusta, GA
| | - Brittney Cotta
- University of Michigan Department of Urology, Ann Arbor, MI
| | - Aaron M. Udager
- University of Michigan Department of Pathology, Ann Arbor, MI
| | - Arvind Rao
- University of Michigan Department of Computational Biology, Ann Arbor, MI
| | | | | | | | - Simpa Salami
- University of Michigan Department of Urology, Ann Arbor, MI
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Patel P, Nallandhighal S, Scoville D, Tran L, Cotta B, Udager A, Rao A, Palapattu G, Dadhania V, Pitchiaya S, Salami S. Spatial transcriptomic profiling of prostate cancer reveals zone specific androgen receptor signaling and immune infiltration. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00509-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bailey C, Ghamande S, Tran L, Rungruang B, Wheatley D, Higgins R. The COVID-19 pandemic did not adversely affect clinical trial enrollment in gynecologic oncology trials at a single academic institution. Gynecol Oncol 2022. [DOI: 10.1016/j.ygyno.2021.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Matrana D, Smith E, Marble M, Tran L, Meddaugh H, Heifner A, McKernan A, Wall L. M159 OMENN SYNDROME ASSOCIATED WITH DNA LIGASE 1. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tran L, Tuite M, Michaela Serpa S, Kunnirickal S, Esposito T, Pfau SE, Shah SM. Developing a multi-disciplinary program for routine acetylcholine vasoreactivity testing in the cardiac catheterization laboratory. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Of the patients who are referred for invasive coronary angiography 30–50% are found to have no obstructive coronary artery disease. Current ESC Guidelines for chronic coronary syndromes have a class IIa recommendation for intracoronary provocative testing with acetylcholine in patients with ischemia and no obstructive coronary artery disease (INOCA). However, there is limited guidance for pharmacy and nursing teams for the support of provocative testing in the cardiac catheterization laboratory.
Purpose
To demonstrate feasibility and safety of acetylcholine vasoreactivity testing in the cardiac catheterization laboratory.
Methods
The inpatient pharmacy developed an adapted protocol based on available evidence and facilitated a multi-disciplinary operational workflow for the assessment of vasospastic angina. 3mL acetylcholine aliquots of 1mcg/mL, 10 mcg/mL, 25 mcg/mL, 50 mcg/mL, and 100 mcg/mL were prepared by pharmacy following sterile compounding standards. The transition from provider or nursing staff compounding to pharmacy compounding provided quality assurance following United States Pharmacopeia compounding standards for improved sterility and patient safety, especially with a complicated micro-dilution recipe. Pharmacy supported the necessary guidance with optimized clinical decision support in the form of a customized order panel embedded in the electronic health record system and compounding software as another layer of standardization and quality assurance. Syringes were made available to the interventional cardiologist in the cardiac catheterization laboratory suite immediately prior to a scheduled case. Eleven orders of acetylcholine were placed with five dilution syringes per order (total 55 compounded syringes) from the customized acetylcholine provoked coronary vasospasm procedure order panel.
Results
From January 2020 to March 2021, 11 patients underwent acetylcholine vasoreactivity testing for clinical indications. One patient developed atrial fibrillation with a rapid ventricular rate during provocative testing of the right coronary artery which required elective cardioversion the following day. Of 11 patients, 9 were outpatients and 2 were inpatients. 1 patient received intravenous atropine and ondansetron due to profound bradycardia and nausea after 100mcg acetylcholine administration. No other safety events occurred.
Conclusion(s)
Provocative testing with intracoronary acetylcholine administration is safe and feasible. For clinical assessment, sterile compounding and customized order panels facilitate routine clinical assessment for patients with suspected vasospastic angina. Nursing protocols should include cardiac monitoring, medications to reverse adverse effects, and possible outcomes of provocative testing. We provide a practical description of our workflow for pharmacists, catheterization laboratory staff, and providers for routine acetylcholine provocation for the evaluation of INOCA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L Tran
- Yale New Haven Hospital, New Haven, United States of America
| | - M Tuite
- Yale New Haven Hospital, New Haven, United States of America
| | | | - S Kunnirickal
- Yale New Haven Hospital, New Haven, United States of America
| | - T Esposito
- Yale New Haven Hospital, New Haven, United States of America
| | - S E Pfau
- Yale New Haven Hospital, New Haven, United States of America
| | - S M Shah
- Yale New Haven Hospital, New Haven, United States of America
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Lisberg A, Liu B, Salehi-Rad R, Lee J, Tran L, Kostyantyn K, Lim R, Dumitras C, Jing Z, Abtin F, Suh R, Genshaft S, Fishbein G, Kaul A, Kahlon K, Ashouri S, Goldman J, Elashoff D, Garon E, Dubinett S. P11.01 Phase I Trial of in Situ Vaccination With Autologous CCL21-Modified Dendritic Cells (CCL21-DC) Combined With Pembrolizumab for Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bhave P, Ahmed T, Shoushtari A, Zaremba A, Versluis J, Mangana J, Weichenthal M, Si L, Lesimple T, Robert C, Trojaniello C, Wicky A, Heywood R, Tran L, Batty K, Stansfeld A, Lebbe C, Schwarze J, Mooradian M, Carlino M. 1047P Efficacy of checkpoint inhibitors (CPIs) in acral melanoma (AM). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Lisberg A, Liu B, Salehi-Rad R, Lee J, Tran L, Krysan K, Li R, Lin Y, Abtin F, Suh R, Oh S, Aberle D, Winter L, Wallace W, Elashoff D, Garon E, Sharma S, Dubinett S. P15.08 Phase I Trial of in situ Vaccination With Autologous CCL21-Modified Dendritic Cells (CCL21-DC) Combined With Pembrolizumab for Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wynne R, Ferguson C, Williams-Spence J, Tran L, Reid C. Australian Risk Factors for 30-day Readmission After Isolated Coronary Artery Bypass Grafts. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mysona DP, Tran L, Bai S, dos Santos B, Ghamande S, Chan J, She JX. Tumor-intrinsic and -extrinsic (immune) gene signatures robustly predict overall survival and treatment response in high grade serous ovarian cancer patients. Am J Cancer Res 2021; 11:181-199. [PMID: 33520368 PMCID: PMC7840710] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 09/14/2020] [Indexed: 06/12/2023] Open
Abstract
In the present study, we developed a transcriptomic signature capable of predicting prognosis and response to primary therapy in high grade serous ovarian cancer (HGSOC). Proportional hazard analysis was performed on individual genes in the TCGA RNAseq data set containing 229 HGSOC patients. Ridge regression analysis was performed to select genes and develop multigenic models. Survival analysis identified 120 genes whose expression levels were associated with overall survival (OS) (HR = 1.49-2.46 or HR = 0.48-0.63). Ridge regression modeling selected 38 of the 120 genes for development of the final Ridge regression models. The consensus model based on plurality voting by 68 individual Ridge regression models classified 102 (45%) as low, 23 (10%) as moderate and 104 patients (45%) as high risk. The median OS was 31 months (HR = 7.63, 95% CI = 4.85-12.0, P < 1.0-10) and 77 months (HR = ref) in the high and low risk groups, respectively. The gene signature had two components: intrinsic (proliferation, metastasis, autophagy) and extrinsic (immune evasion). Moderate/high risk patients had more partial and non-responses to primary therapy than low risk patients (odds ratio = 4.54, P < 0.001). We concluded that the overall survival and response to primary therapy in ovarian cancer is best assessed using a combination of gene signatures. A combination of genes which combines both tumor intrinsic and extrinsic functions has the best prediction. Validation studies are warranted in the future.
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Affiliation(s)
- David P Mysona
- University of North CarolinaChapel Hill, NC 27517, USA
- Jinfiniti Precision Medicine, Inc.Augusta, GA 30907, USA
| | - Lynn Tran
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia at Augusta UniversityAugusta, GA 30912, USA
| | - Shan Bai
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia at Augusta UniversityAugusta, GA 30912, USA
| | | | - Sharad Ghamande
- Department of OBGYN, Medical College of Georgia at Augusta UniversityAugusta, GA 30912, USA
| | - John Chan
- Palo Alto Medical Foundation Research InstitutePalo Alto, CA 94301, USA
| | - Jin-Xiong She
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia at Augusta UniversityAugusta, GA 30912, USA
- Department of OBGYN, Medical College of Georgia at Augusta UniversityAugusta, GA 30912, USA
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O'Brien J, Dawson L, Chowdhury E, Tran L, Baker R, Newcomb A, Smith J, Reid C, Duffy S. Long-term Outcomes in Indigenous Australians Following Coronary Artery Bypass Surgery. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Conte V, Agosteo S, Bianchi A, Bolst D, Bortot D, Catalano R, Cirrone GAP, Colautti P, Cuttone G, Guatelli S, James B, Mazzucconi D, Rosenfeld AB, Selva A, Tran L, Petringa G. Microdosimetry of a therapeutic proton beam with a mini-TEPC and a MicroPlus-Bridge detector for RBE assessment. Phys Med Biol 2020; 65:245018. [PMID: 33086208 DOI: 10.1088/1361-6560/abc368] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Proton beams are widely used worldwide to treat localized tumours, the lower entrance dose and no exit dose, thus sparing surrounding normal tissues, being the main advantage of this treatment modality compared to conventional photon techniques. Clinical proton beam therapy treatment planning is based on the use of a general relative biological effectiveness (RBE) of 1.1 along the whole beam penetration depth, without taking into account the documented increase in RBE at the end of the depth dose profile, in the Bragg peak and beyond. However, an inaccurate estimation of the RBE can cause both underdose or overdose, in particular it can cause the unfavourable situation of underdosing the tumour and overdosing the normal tissue just beyond the tumour, which limits the treatment success and increases the risk of complications. In view of a more precise dose delivery that takes into account the variation of RBE, experimental microdosimetry offers valuable tools for the quality assurance of LET or RBE-based treatment planning systems. The purpose of this work is to compare the response of two different microdosimetry systems: the mini-TEPC and the MicroPlus-Bridge detector. Microdosimetric spectra were measured across the 62 MeV spread out Bragg peak of CATANA with the mini-TEPC and with the Bridge microdosimeter. The frequency and dose distributions of lineal energy were compared and the different contributions to the spectra were analysed, discussing the effects of different site sizes and chord length distributions. The shape of the lineal energy distributions measured with the two detectors are markedly different, due to the different water-equivalent sizes of the sensitive volumes: 0.85 μm for the TEPC and 17.3 μm for the silicon detector. When the Loncol's biological weighting function is applied to calculate the microdosimetric assessment of the RBE, both detectors lead to results that are consistent with biological survival data for glioma U87 cells. Both the mini-TEPC and the MicroPlus-Bridge detector can be used to assess the RBE variation of a 62 MeV modulated proton beam along its penetration depth. The microdosimetric assessment of the RBE based on the Loncol's weighting function is in good agreement with radiobiological results when the 10% biological uncertainty is taken into account.
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Affiliation(s)
- V Conte
- INFN Laboratori Nazionali di Legnaro, viale dell'Università 2 35020 Legnaro, Italy
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Igbinosa I, Lee K, Oakeson A, Riley E, Melchor S, Birdsong J, Tran L, Weng Y, Collins W, Abir G, Bianco Y, He Z, Desai M, Mathew R, Lee G, Ahuja N, Lyell D, Gibbs R, Aziz N. Health disparities among pregnant women with sars-cov-2 infection at a university medical center in northern California. Am J Obstet Gynecol 2020. [PMCID: PMC7683952 DOI: 10.1016/j.ajog.2020.08.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Mysona DP, Ghamande S, She JX, Tran L, Tran P, Rungruang BJ, Chan JK, Bae-Jump V, Gehrig PA. Are There Survival Differences Between Women with Equivalent Residual Disease After Interval Cytoreductive Surgery Compared with Primary Cytoreductive Surgery for Advanced Ovarian and Peritoneal Cancer? Ann Surg Oncol 2020; 28:3605-3615. [PMID: 33155151 DOI: 10.1245/s10434-020-09304-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/15/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to investigate survival differences between equivalent residual disease [complete gross resection (CGR), minimal residual disease (MRD), suboptimal] at the time of primary debulking surgery (PDS) and interval debulking surgery (IDS). METHODS The National Cancer Database was used to identify patients from 2010 to 2015 with stage IIIC/IV primary peritoneal or ovarian cancer who had residual disease recorded. Propensity score matching (PSM) was used to correct for differences in characteristics between the PDS and IDS groups. RESULTS Of 8683 patients with advanced ovarian cancer, 4493 (52%), 2546 (29%), and 1644 (19%) had CGR, MRD, or suboptimal resection, respectively. From 2010 to 2015, the number of patients undergoing IDS increased 27% (ptrend < 0.001), and there was an 18% increase in CGRs (ptrend = 0.005). The increased use of IDS from 2010 to 2015 was associated with increased CGRs (ptrend = 0.02) and decreased MRD (ptrend = 0.001), but not with decreased suboptimal resections (ptrend = 0.18). IDS, even after PSM, was associated with inferior overall survival [OS; hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.03-1.22, p = 0.008]. A CGR at PDS had prolonged median OS compared with a CGR at IDS (51 vs. 44 months, p < 0.001). Additionally, MRD at PDS had worse median OS compared with a CGR at IDS (41 vs. 44 months, p = 0.03), but improved median OS compared with MRD at IDS (median OS 35 months, p = 0.05). CONCLUSION The use of IDS continues to rise in the US, and is associated with improved surgical outcomes but not necessarily similar oncologic outcomes. There should be continued efforts to improve cytoreductive outcomes in women with advanced ovarian and peritoneal malignancies.
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Affiliation(s)
- David Pierce Mysona
- Obstetrics and Gynecology, University of North Carolina Hospitals, Women's Hospital, Chapel Hill, NC, USA.
| | | | - Jin-Xiong She
- Medical College of Georgia, Augusta, GA, USA.,Jinfinti Precision Medicine, Inc., Augusta, GA, USA
| | - Lynn Tran
- Medical College of Georgia, Augusta, GA, USA
| | - Paul Tran
- Medical College of Georgia, Augusta, GA, USA
| | | | - John K Chan
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.,California Pacific and Palo Alto Medical Foundation/Sutter Health Research Institute, San Francisco, CA, USA
| | - Victoria Bae-Jump
- Obstetrics and Gynecology, University of North Carolina Hospitals, Women's Hospital, Chapel Hill, NC, USA.,University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Paola A Gehrig
- Obstetrics and Gynecology, University of North Carolina Hospitals, Women's Hospital, Chapel Hill, NC, USA.,University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
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Zahradnik I, Pomorski M, Tran L, Kada W, De Marzi L, Tromson D, Barberet P, Pastuovic Z, Vohradsky J, Salvador S, Leterrier L, Prezado Y, Pourcher T, Herault J, Rosenfeld A. PH-0045: Characterization of proton, carbon and silicon ion beams using scCVD diamond-based microdosimeters. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00071-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Zhu J, Tran L, Zheng F, James J, Guthridge J, Chong B. 717 Enhanced molecular signatures in cutaneous lupus erythematosus patients support distinct pathogenic pathways in African American patients. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Merrill JT, Guthridge J, Zack D, Foster P, Burington B, Tran L, Smith M, James JA. SAT0187 DISCRIMINATION OF SYSTEMIC LUPUS (SLE) PATIENTS WITH CLINICAL RESPONSE TO OBEXELIMAB (XMAB®5871) BASED ON A PATTERN OF IMMUNOLOGIC MARKERS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:We recently reported Phase 2 SLE trial results of obexelimab, an FcγRIIb agonist (suppressor of B cell activation). Obexelimab did not meet the primary endpoint (% of patients without flare at Day 225) (p=0.183) but other endpoints such as time to flare (p=0.025) were met.Objectives:1. To assign SLE patients to phenotypic subsets based on patterns of gene expression in immune-related pathways.12. To explore the association of immune patterns and clinical response to obexelimab.Methods:This analysis included 71 of the 104 participants in the obexelimab study, those who either completed the protocol or terminated for disease flare, if there were adequate blood samples (biomarker subset). At screening, patients were assigned to clusters based on 41 SLE co-expression signature modules from the Human Immune Phenotyping Consortium via unsupervised random forest and K-means clustering.2Other markers of SLE disease were also examined. TheBOLD3study design mandated withdrawal of background immunosuppressants, supporting less ambiguous pharmacodynamic analysis as the trial progressed.Results:Immune pathway expression patterns of 7 patient clusters (Fig 1a) confirmed our prior characterization of 200 non-overlapping SLE patients.2The biomarker subset retained a trend of longer time to first flare in patients receiving obexelimab (n=38) vs placebo (n=33) (Fig1b, HR 0.61, p=0.11). A smaller set of only Clusters 3 and 6 demonstrated marked increased time to flare in the obexelimab group (n=13) compared to placebo (n=14) (Fig 1c, HR 0.22, p=0.025). Obexelimab had no effect on other clusters (Fig 1d). The responder clusters shared low expression of inflammation modules (p < 0.001) compared to other clusters and high expression of T Cell, immune response, cell cycle, mitochondrial modules (all p < 0.001) and B Cell modules (p=0.006). We therefore sorted patients by these specific features regardless of cluster assignment. Figure 2 shows significant impact of obexelimab on time to flare in 64 patients with B Cell pathway activation (HR 0.5, p=0.038), although less robust by itself than found in Clusters 3 and 6. In a group with high B or plasma cell modules but low inflammation (n=46), treatment effect increased (HR 0.35, p=0.019). Between Screening and Baseline, as brief steroids were given and background treatments withdrawn, expression of B Cell and Plasma Cell pathways increased. Both then decreased after treatment with obexelimab but not placebo (p< 0.0001 and p< 0.001 respectively), an effect not seen with other immune pathway modules.Conclusion:Precision medicine for SLE has been hampered by heterogenous immune signals with variable expression. Clustering of patients by gene co-expression pathways enabled an efficient, hierarchical array that reduplicated results of a prior SLE cohort, suggesting these are not random phenotypes. Of these 7 reproducible SLE subsets, the combination of clusters 3 and 6 distinguished an obexelimab responder population of 27 out of 71 subjects (38%) with high expression of B and T Cell modules and cell activation pathways. Focus on the defining features shared by these clusters revealed specific factors associated with response, enabling inclusion of some patients from other clusters in an optimized responder population of 46/71 (65% of subjects). B Cell and Plasma Cell pathways demonstrated mechanism-related pharmacodynamic effects of obexelimab. Lack of responders with high expression of inflammation modules could implicate inhibitory factors to obexelimab within inflammatory pathways, potentially targetable by complementary treatments.References:[1]Banchereau Cell 165:1548 2016[2]Lu ACR Abstract #2977 2017[3]Merrill Arthritis Rheumatol 69: 1257 2017Disclosure of Interests: :Joan T Merrill Grant/research support from: Xencor, Bristol Myers Squibb, Glaxo Smith Kline, Consultant of: Xencor, Abbvie, UCB, Glaxo Smith Kline, EMD Serono, Astellas, Remegen, Celgene/Bristol Myers Squibb, Exagen, Astra Zeneca, Amgen, Jannsen, Servier, ILTOO, Daitchi Sankyo, Lilly, Paid instructor for: Abbvie, Bristol Myers Squibb, Joel Guthridge Grant/research support from: Xencor, Bristol Myers Squibb, DXterity, Debra Zack Shareholder of: Xencor, Employee of: Xencor, Paul Foster Shareholder of: Xencor Inc, Employee of: Xencor Inc, Bart Burington Shareholder of: Xencor Inc, Employee of: Xencor Inc, Ly Tran: None declared, Miles Smith: None declared, Judith A. James Grant/research support from: Progentec Diagnostics, Inc, Consultant of: Abbvie, Novartis, Jannsen
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Tran L, Jeon B, Chasens E. 0829 Sleep, Chronic Pain, and Global Health in Adults Ages 65 or Older. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Understanding the association of sleep and pain in older adults can help improve their global health. The purpose of the study was to describe the associations between sleep, chronic pain, and global health in adults ages 65 or older.
Methods
This study was a secondary analysis of data from adults over 65 years in the 2015 Sleep in America Poll - Sleep and Pain by the National Sleep Foundation (NSF). The survey included demographics (age, race, marital status, education), sleep (duration, quality, insomnia symptoms), and pain (type [none, chronic, fleeting], intensity, location). Global health derived from general health, physical health, mental health, and quality of life with a potential range of 4-20; higher score=better health. The survey also queried fatigue and stress.
Results
The sample (N=248) was 65-91 years (mean age=72.8±5.9), male (53.6%), White (82.7%), married (65.7%), and with post-highschool education (54.4%). Average sleep duration was 425±74 minutes. “No pain” was reported by 38.7% of the sample (n=96), “fleeting pain” by 32.7% (n= 81), and “chronic pain” by 28.6% (n=71). The most common locations for chronic pain were shoulder or neck (63.2%) and back (69.4%). Average global health score was 9.8±2.9. There was no significant difference in time in bed, sleep duration, bedtime, or wake-up time between groups. Persons with chronic pain had higher average pain intensity, worst pain intensity, and current pain; they reported significantly lower sleep quality with significantly more restlessness, trouble staying asleep, and worry about getting a good night sleep (all p-values<.02), there was no significant difference in difficulty falling asleep compared to persons with no pain. Persons with chronic pain had significantly worse general health, physical health, mental health, global health, fatigue, and stress (all p-values<.02); but no significant difference in quality of life compared to persons with no pain.
Conclusion
We conclude that chronic pain has a significant negative impact on sleep and global health in the sample of adults ages 65 or older from the 2015 Sleep in America Poll - Sleep and Pain by the NSF.
Support
Undergraduate Research Mentoring Program, University of Pittsburgh School of Nursing.
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Affiliation(s)
- L Tran
- University of Pittsburgh School of Nursing, Pittsburgh, PA
| | - B Jeon
- University of Pittsburgh School of Nursing, Pittsburgh, PA
| | - E Chasens
- University of Pittsburgh School of Nursing, Pittsburgh, PA
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Aljarod T, Tran L, Al Ikhwan M, Prasad B. 0640 Initial Sleep Center Evaluation and Follow Up Improves Positive Airway Pressure (PAP) Therapy Adherence When Compared to Direct Referrals Without Sleep Physician Follow Up: A Retrospective Study. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Obstructive sleep apnea (OSA) affects 26% of adults and positive airway pressure (PAP) is the gold-standard of therapy. Factors affecting PAP adherence—use >4 hours in a 24-hour period—have been studied extensively. We compared of the three months (or other time frame) PAP adherence between patients seen by a sleep specialist prior to OSA diagnosis versus patients referred directly for OSA testing by non-sleep specialist providers. The goal of the study was to understand the impact of sleep consultation on PAP adherence.
Methods
Direct referral (DR) patients underwent polysomnography (PSG) and received PAP devices prior to the sleep clinic visit. In contrast, sleep center patients (SC) had a sleep clinic visit with a sleep physician or APRN prior to PSG.
Eighty-four patients were included in this study, 42 DR and 42 SC patients. Exclusion criteria were age <18 years old, absence of baseline PSG, and lack of 90-day compliance data. Covariates included demographics, body mass index (BMI), AHI, nadir oxygen saturation, demographics, and Epworth Sleepiness Scale (ESS) score. Objective PAP adherence for first 90 days was the primary outcome.
Results
Age (p=0.1), ESS (p=0.3), BMI (p=0.6), and AHI (p=0.9) were not significantly different between the groups. SC patients had greater PAP adherence (4.77 hours, 95%CI: 4.1 to 5.4) compared to DR patients (3.61 hours, 95%CI: 2.88 to 4.33, p=0.02). SC patients were also 8 times more likely to follow up in clinic within 1 year of starting PAP treatment (Likelihood Ratio 8.25, p=0.004).
Conclusion
While possibly more time-efficient for patients, direct referrals may ultimately result in lower PAP adherence due to missed opportunities for receiving education about OSA and PAP therapy. This is consistent with findings from a previous meta-analysis demonstrating that educational interventions improve PAP adherence. Moving forward, we will continue encouraging directly referred patients to follow up in the sleep center after PSG.
Support
None
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Affiliation(s)
- T Aljarod
- University of Illinois at chicago, Chicago, IL
| | - L Tran
- Universitry of Illinois at Chicago, Chicago, IL
| | - M Al Ikhwan
- University of Illinois at Chicago, Chicago, IL
| | - B Prasad
- University of Illinois at Chicago, Chicago, IL
- University of Illinois at Chicago, Chicago, IL
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Williams H, Tarallo C, Tran L, Griswold L, Bailey C, Patel K, Ghamande S, Rungruang B. Factors Influencing Survival and Survivorship Outcomes in Vulvar Cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Salehi-Rad R, Li R, Lim R, Tran L, Abascal J, Ong S, Liu B, Dubinett S. A35 Dendritic Cell in Situ Vaccination Potentiates Anti-PD-1 Efficacy and Induces Immunoediting in a Murine Model of NSCLC. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Brunnström H, Staaf J, Tran L, Söderlund L, Nodin B, Jirström K, Vidarsdottir H, Planck M, Mattsson J, Botling J, Micke P. MA18.05 Diagnostic Difference Between Neuroendocrine Markers in Pulmonary Cancers: A Comprehensive Study and Review of the Literature. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Williams H, Wang J, Tran L, Mobley S, Rungruang BJ, Ghamande SA. Use of nivolumab as salvage therapy in heavily pretreated patients with gynecologic malignancies. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5593 Background: There are limited effective treatments for gynecologic cancer patients who have been previously treated with multiple lines of chemotherapy. Immune checkpoint inhibitor (ICI) therapy has demonstrated significant activity in certain cancers but has been inconclusive in most gynecologic malignancies. The objective of this study was to determine the impact of salvage ICI therapy in heavily pretreated gynecologic oncology patients. Methods: An IRB approved retrospective study was performed of women with gynecologic cancer treated with nivolumab on a compassionate use program between October 2015 and January 2018. Patient demographics, disease characteristics, pathology and treatment history were collected. Survival probabilities were calculated. Results: Twenty-eight women were identified. Median age at start of treatment was 63 years with a median of 4 prior lines of chemotherapy. Median ECOG status was 2. Disease site was evenly distributed among uterus, ovary and cervix. 67.9% of patients completed 3 or more cycles of treatment. Median PFS of all patients was only 2.6 months however when comparing patients who received 2-3 cycles (n = 13) with those who received 4 or more (n = 9), median PFS was statistically significant 2.4 months vs 6.4 months (p = 0.0005). When looking at treatment response, 7 patients had partial response/stable disease after 3 cycles (25%). Median PFS of the 7 “responders” was 6.6 months vs 2.5 months of the non-responders (p < 0.001). Only 1 of 9 patients with uterine cancer had a disease response and that patient’s tumor was MSI high. Five patients had low grade serous ovarian cancer. Four of them had a treatment response with a median PFS of 6.1 months (range 3.8 – 25 months). Adverse events were experienced by 68% of patients; most commonly being fatigue (46.4%), arthralgia (25%), and anemia (21.4%). Only 1 patient experienced a grade 3-4 event (a diffuse maculopapular rash). Conclusions: In patients with heavily pretreated gynecologic malignancies with suboptimal performance status, immune checkpoint inhibitor therapy may prolong survival without significant toxicity. Also, there may be a role for ICI in patients with historically chemo resistant low grade serous ovarian cancers.
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Affiliation(s)
| | - Jennifer Wang
- Medical College of Georgia at Augusta University, Augusta, GA
| | - Lynn Tran
- Medical College of Georgia, Augusta, GA
| | - Sara Mobley
- Georgia Cancer Center at Augusta University, Augusta, GA
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Debrot E, Tran L, Chartier L, Bolst D, Guatelli S, Vandevoorde C, de Kock E, Beukes P, Symons J, Nieto-Camero J, Prokopovich DA, Chiriotti S, Parisi A, De Saint-Hubert M, Vanhavere F, Slabbert J, Rosenfeld AB. SOI microdosimetry and modified MKM for evaluation of relative biological effectiveness for a passive proton therapy radiation field. Phys Med Biol 2018; 63:235007. [PMID: 30468682 DOI: 10.1088/1361-6560/aaec2f] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
With more patients receiving external beam radiation therapy with protons, it becomes increasingly important to refine the clinical understanding of the relative biological effectiveness (RBE) for dose delivered during treatment. Treatment planning systems used in clinics typically implement a constant RBE of 1.1 for proton fields irrespective of their highly heterogeneous linear energy transfer (LET). Quality assurance tools that can measure beam characteristics and quantify or be indicative of biological outcomes become necessary in the transition towards more sophisticated RBE weighted treatment planning and for verification of the Monte Carlo and analytical based models they use. In this study the RBE for the CHO-K1 cell line in a passively delivered clinical proton spread out Bragg peak (SOBP) is determined both in vitro and using a silicon-on-insulator (SOI) microdosimetry method paired with the modified microdosimetric kinetic model. The RBE along the central axis of a SOBP with 2 Gy delivered at the middle of the treatment field was found to vary between 1.11-1.98 and the RBE for 10% cell survival between 1.07-1.58 with a 250 kVp x-ray reference radiation and between 1.19-2.34 and 0.95-1.41, respectively, for a Co60 reference. Good agreement was found between RBE values calculated from the SOI-microdosimetry-MKM approach and in vitro. A strong correlation between proton lineal energy and RBE was observed particularly in the distal end and falloff of the SOBP.
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Affiliation(s)
- E Debrot
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia
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Torrey H, Khodadoust M, Tran L, Baum D, Defusco A, Kim YH, Faustman DL. Targeted killing of TNFR2-expressing tumor cells and T regs by TNFR2 antagonistic antibodies in advanced Sézary syndrome. Leukemia 2018; 33:1206-1218. [PMID: 30356161 PMCID: PMC6756055 DOI: 10.1038/s41375-018-0292-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 01/08/2023]
Abstract
Sézary syndrome (SS) is a rare form of cutaneous T-cell lymphoma often refractory to treatment. SS is defined as adenopathy, erythroderma with high numbers of atypical T cells. This offers an opportunity for new interventions and perhaps antibody-based therapeutic by virtue of its high expression of the TNFR2 oncogene on the tumor cells and on T-regulatory cells (Tregs). Potent human-directed TNFR2 antagonistic antibodies have been created that preferentially target the TNFR2 oncogene and tumor-infiltrating TNFR2+ Tregs. Here we test the therapeutic potential of TNFR2 antagonists on freshly isolated lymphocytes from patients with Stage IVA SS and from healthy controls. SS patients were on a variety of end-stage multi-drug therapies. Baseline burden Treg/T effector (Teff) ratios and the responsiveness of tumor and infiltrating Tregs to TNFR2 antibody killing was studied. We show dose-escalating concentrations of a dominant TNFR2 antagonistic antibody killed TNFR2+ SS tumor cells and thus restored CD26- subpopulations of lymphocyte cell numbers to normal. The abundant TNFR2+ Tregs of SS subjects are also killed with TNFR2 antagonism. Beneficial and rapid expansion of Teff was observed. The combination of Treg inhibition and Teff expansion brought the high Treg/Teff ratio to normal. Our findings suggest a marked responsiveness of SS tumor cells and Tregs, to targeting with TNFR2 antagonistic antibodies. These results show TNFR2 antibodies are potent and efficacious in vitro.
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Affiliation(s)
- H Torrey
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA
| | - M Khodadoust
- Stanford University School of Medicine/Cancer Institute, 94305, Palo Alto, CA, USA
| | - L Tran
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA
| | - D Baum
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA
| | - A Defusco
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA
| | - Y H Kim
- Stanford University School of Medicine/Cancer Institute, 94305, Palo Alto, CA, USA
| | - D L Faustman
- Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Rm 3602, 02129, Boston, MA, USA.
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Litton E, Bass F, Delaney A, Hillis G, Marasco S, McGuinness S, Myles PS, Reid CM, Smith JA, Bagshaw SM, Keri-Anne Cowdrey HB, Frengley R, Ferrier J, Gilder E, Henderson S, Larobina M, Merthens J, Morgan M, Navarra L, Rudas M, Turner L, Reid K, Wise M, Young N, Young P, McGiffin D, Duncan J, Kaczmarek M, Seevanayagam S, Shaw M, Shardey G, Skillington P, Chorley T, Baker L, Zhang B, Bright C, Baker R, Canning N, Gilfillan, Kruger R, Fayers T, Kyte M, Doran C, Smith J, Baxter H, Seah P, Scaybrook S, James A, Goodwin K, Dignan R, Hewitt N, Gerrard K, Curtis L, Smith J, Baxter H, Tiruvoipati R, Broukal N, Wolfenden H, Muir, Worthington M, Wong C, Tatoulis J, Wynne R, Marshman D, Sze D, Wilson M, Turner L, Passage J, Kolybaba M, Fermanis G, Newbon P, Passage J, Kolybaba M, Newcomb A, Mack J, Duve K, Jansz P, Hunter T, Bissaker P, Dennis N, Burke N, Yadav S, Cooper K, Chard R, Halaka M, Tran L, Huq M, Billah B, Reid CM. Six-Month Outcomes After High-Risk Coronary Artery Bypass Graft Surgery and Preoperative Intra-aortic Balloon Counterpulsation Use: An Inception Cohort Study. J Cardiothorac Vasc Anesth 2018; 32:2067-2073. [DOI: 10.1053/j.jvca.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Indexed: 11/11/2022]
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Yuen WWY, Lee A, Chan PKS, Tran L, Sayko E. Uptake of human papillomavirus (HPV) vaccination in Hong Kong: Facilitators and barriers among adolescent girls and their parents. PLoS One 2018; 13:e0194159. [PMID: 29543839 PMCID: PMC5854366 DOI: 10.1371/journal.pone.0194159] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/26/2018] [Indexed: 12/31/2022] Open
Abstract
The present study is aimed at assessing the feasibility of delivering the HPV (human papillomavirus) vaccine to girls through a school-based program in Hong Kong, as well as to examine the facilitators and barriers associated with their participation. We approached 1,229 eligible girls aged 9 to 14 at eight schools in Hong Kong to join the program and then delivered the bivalent HPV vaccine at 0 and 6 months over the course of one school year. The students and their parents completed separate questionnaires to indicate their decision on whether or not to participate, and to assess their knowledge of cervical cancer and the HPV vaccine. The overall vaccine uptake was 81.4% (1,000/1,229) for the first dose and 80.8% (993/1,229) for the second dose. Parents and students were given separate questionnaires and asked whether or not they would like to participate in the vaccination program. 87.1% (1,010/1,160) of parents and 84.9% (974/1,147) of students indicated that they would join the program. The reasons associated with parents’ decision not to vaccinate their daughters primarily included concerns around side effects and safety. Multivariate regression analysis showed that parents who thought that the vaccine would protect their daughter from getting cervical cancer (OR = 3.16, 95% CI = 1.39–7.15, p < .01), and those who reported having a doctor’s recommendation (OR = 4.54, 95% CI = 1.05–19.57, p < .05) were more likely to join the program. In contrast, parents who had never heard of the vaccine (OR = .15, 95% CI = .03–.71, p < .02), those who were willing to pay more than HK$2,000 for the vaccine (OR = .39, 95% CI = .19–.81, p < .05), or had a preference to access it through a private clinic (OR = .44, 95% CI = .26–.75, p < .01) were significantly less likely to allow their daughter to join the program. Delivery of the HPV vaccine with high uptake rate in a school setting is feasible in Hong Kong. Engaging key stakeholders including school administrators, teachers and community physicians, and providing relevant information on safety and vaccine effectiveness to parents were important to the success of the program.
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Affiliation(s)
| | - Albert Lee
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - Paul K S Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - Lynn Tran
- Karen Leung Foundation Limited, Hong Kong SAR, China
| | - Erica Sayko
- Karen Leung Foundation Limited, Hong Kong SAR, China
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Wu NC, Wong E, Acca B, Birkmeier J, Tran L, Zhao S, Wong W, Chu VC, Ho K, Malek M, Lu C, Ge G, David K, Quigley NB, Beqaj SS, Davenport S, Weidler J, Bates M, Press M. Abstract P2-03-03: A multicenter clinical study of Xpert® breast cancer STRAT4 demonstrates high concordance with central lab ER, PgR, HER2, and Ki67 IHC and HER2 FISH tests in FFPE breast tumor tissues. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-03-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The Xpert® Breast Cancer STRAT4 (STRAT4) is a CE-IVD marked, semi-quantitative, cartridge-based RT-qPCR assay for the detection of ESR1, PGR, ERBB2 (HER2), and MKi67 mRNAs from formalin fixed, paraffin embedded (FFPE) breast tumors. The assay is fast (< 2 hrs), reproducible, robust, and easy to perform.
The aim of this multicenter clinical study was to assess the performance characteristics of the STRAT4 assay relative to central lab immunohistochemistry (IHC) for ER, PgR, HER2, and Ki67 and to fluorescence in situ hybridization (FISH) for HER2 gene amplification.
Methods: A total of 200 archived primary invasive breast cancer FFPE blocks were sourced from Indivumed for this study. From each block, twelve (12) adjacent tissue sections (4-µm thickness) on slides were prepared for pathological H&E confirmation to define tumor area, and for testing by STRAT4, IHC (ER, PgR, HER2,Ki67), and HER2 FISH. Standard STRAT4 lysate preparation using a single unstained slide per specimen and testing on N=84, N=68, and N=48 samples was performed at 3 independent sites, respectively (2 US and 1 EU). A single slide from each specimen was also processed using the recommended concentrated lysate procedure for STRAT4 testing at Cepheid. All IHC and FISH testing was performed by a central academic reference laboratory in the US. For a given sample, STRAT4 data generated using the standard lysate procedure was included for concordance analysis when all target gene test results were valid. In cases where the standard lysate preparation yielded indeterminate test results for any target, data from the concentrated lysate preparation was used for the data analysis. Receiver Operating Characteristic (ROC) analysis, overall percent agreement (OPA), positive percent agreement (PPA), and negative percent agreement (NPA) between STRAT4 and IHC (IHC/FISH for HER2) were determined for ESR1,PGR, ERBB2, and MKi67.
Results: Of the 200 samples tested by STRAT4, all samples generated valid results for ESR1 and ERBB2, 199 of 200 samples were valid for PGR, and 198 of 200 samples were valid for MKi67 using the standard or concentrated lysate preparation protocol. One sample failed to generate results for both ER and PgR IHC. Twelve samples failed to yield HER2 FISH results.
The STRAT4 success rate and results concordance with IHC were comparable across study sites. OPA between STRAT4 and IHC was 97% for ESR1, 88.9% for PGR, 93.3% for HER2 (92.4% for IHC and FISH), and 90.7% for MKi67 (excluding IHC 10-20% staining). Areas under the ROC curves were 0.9922 for ESR1, 0.9509 for PGR, 0.9958 for ERBB2, and 0.9395 for MKi67.
Conclusion: STRAT4 measurements for ESR1, PGR, ERBB2 and MKi67 mRNA expression are robust and highly concordant with IHC (IHC/FISH for HER2). The technical portion of the assay is easily performed in < 2 hrs including hands-on time using standard FFPE tissue sections. Xpert STRAT4 offers local pathology labs an alternative to centralized, subjective IHC/FISH tests that require a higher level of expertise. Further investigations correlating STRAT4 markers directly with clinical outcomes in independent cohorts are in progress.
Citation Format: Wu NC, Wong E, Acca B, Birkmeier J, Tran L, Zhao S, Wong W, Chu VC, Ho K, Malek M, Lu C, Ge G, David K, Quigley NB, Beqaj SS, Davenport S, Weidler J, Bates M, Press M. A multicenter clinical study of Xpert® breast cancer STRAT4 demonstrates high concordance with central lab ER, PgR, HER2, and Ki67 IHC and HER2 FISH tests in FFPE breast tumor tissues [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-03-03.
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Affiliation(s)
- NC Wu
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - E Wong
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - B Acca
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - J Birkmeier
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - L Tran
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - S Zhao
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - W Wong
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - VC Chu
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - K Ho
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - M Malek
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - C Lu
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - G Ge
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - K David
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - NB Quigley
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - SS Beqaj
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - S Davenport
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - J Weidler
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - M Bates
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
| | - M Press
- Cepheid, Sunnyvale, CA; University of Southern California, Los Angeles, CA; Indivumed GmbH, Hamburg, Germany; Molecular Pathology Labrotory Network, Maryville, TN; Molecular Testing Lab, Vancouver, WA
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Evans M, Choi K, Ogurek I, Tran L, Howard D. 102: A systematic review of case reports of organ damage secondary to intrauterine device perforation. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dieleman J, Peelen L, Coulson T, Tran L, Reid C, Smith J, Myles P, Pilcher D. Age and other perioperative risk factors for postoperative systemic inflammatory response syndrome after cardiac surgery. Br J Anaesth 2017; 119:637-644. [DOI: 10.1093/bja/aex239] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2017] [Indexed: 02/05/2023] Open
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Vandevoorde C, Beukes P, Miles X, de Kock E, Symons J, Nieto-Camero J, Tran L, Chartier L, Debrot E, Propokovic D, Chiriotti S, Parisi A, De Saint-Hubert M, Vanhavere F, Rozenfeld A, Slabbert J. Assessment of out-of-field DNA damage and the impact of neutron RBE on secondary cancer risk in paediatric proton therapy. Phys Med 2017. [DOI: 10.1016/s1120-1797(17)30314-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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O’Connor E, Jackson R, Tran L, Lakshminarayanan B. WITHDRAWN: A late diagnosis of a complicated Meckel’s diverticulum - The first case of an enterocolic fistula secondary to a Meckel’s diverticulum in a paediatric patient and review of the literature. Journal of Pediatric Surgery Case Reports 2017. [DOI: 10.1016/j.epsc.2017.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Coulson TG, Bailey M, Reid CM, Tran L, Mullany DV, Smith JA, Pilcher D. The association between peri-operative acute risk change (ARC) and long-term survival after cardiac surgery. Anaesthesia 2017; 72:1467-1475. [DOI: 10.1111/anae.13967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 01/23/2023]
Affiliation(s)
- T. G. Coulson
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - M. Bailey
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - C. M. Reid
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
- School of Public Health; Curtin University; Perth Western Australia Australia
| | - L. Tran
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - D. V. Mullany
- Critical Care Research Group; University of Queensland; Brisbane Queensland Australia
| | - J. A. Smith
- Department of Surgery; Monash University; Melbourne Victoria Australia
| | - D. Pilcher
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
- Department of Intensive Care; The Alfred Hospital; Melbourne Victoria Australia
- ANZICS Centre for Outcome and Resource Evaluation; Carlton, Melbourne Victoria Australia
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Hattay P, Prusator DK, Tran L, Greenwood-Van Meerveld B. Psychological stress-induced colonic barrier dysfunction: Role of immune-mediated mechanisms. Neurogastroenterol Motil 2017; 29. [PMID: 28300333 DOI: 10.1111/nmo.13043] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/09/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Evidence suggests that patients with irritable bowel syndrome (IBS) exhibit increases in gut permeability and alterations in tight junction (TJ) protein expression. Although psychological stress worsens IBS symptoms, the mechanisms by which stress enhances gut permeability and affects TJ protein expression remain to be determined. Here, we test the hypothesis that chronic intermittent psychological stress activates the release of proinflammatory cytokines to alter TJ proteins and promotes increased gut permeability. METHODS Male Fischer-344 rats were subjected to 1 hour of water avoidance stress (WAS) or SHAM stress per day for 7 days. Following the stress protocol, colonic permeability was measured via transepithelial electrical resistance (TEER) and macromolecular flux of horseradish peroxidase (HRP). In tissue isolated from rats exposed to the WAS or SHAM stress, TJ proteins claudin-2, junctional adhesion molecule-A (JAM-A) and zonula occluden-1 (ZO-1) were measured via Western blotting, histological appearance of the colonic segments was assessed via hematoxylin and eosin staining, and an inflammatory cytokine panel was quantified via quantitative reverse transcription-polymerase chain reaction. KEY RESULTS Repetitive daily exposure to WAS decreased the TEER, increased the macromolecular flux of HRP, and altered the expression of claudin-2, JAM-A and ZO-1 proteins within colonic tissue compared to SHAM controls. In the absence of a histologically defined inflammation, the cytokine profiles of WAS-treated animals revealed an increase in interleukin-1β and tumor necrosis factor (TNF)-α. Subsequent analysis revealed a significant positive correlation between TNF-α and expression of TJ protein claudin-2. CONCLUSIONS & INFERENCES Our findings suggest that chronic stress increases colonic permeability via sub-inflammatory cytokine-mediated remodeling of TJ protein expression.
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Affiliation(s)
- P Hattay
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - D K Prusator
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - L Tran
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - B Greenwood-Van Meerveld
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,VA Medical Center, Oklahoma City, OK, USA.,Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Brouard J, Tran L, Flammang A, Dupont C, Vabret A. Vaccination antigrippale de l’enfant : vaccins inactivés ou vivants atténués ? Arch Pediatr 2017; 24:211-214. [DOI: 10.1016/j.arcped.2016.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 12/19/2016] [Indexed: 10/20/2022]
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Daskalakis A, Zomorrodi R, Tran L, Ziluk A, Blumberger D, Rajji T. Impairment of median nerve somatosensory evoked potentials in schizophrenia. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Chin R, Tran L, Thomas M, Siegel B, Dehdashti F, Kidd E, Schwarz J, Grigsby P. Changes in Cervical Cancer FDG Uptake Heterogeneity After Chemoradiation: Association With Tumor Recurrence and Survival. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wong WCW, Cheng S, Holroyd E, Chen J, Loper KA, Tran L, Miu HYH. A lost tribe in the city: health status and needs of African asylum seekers and refugees in Hong Kong. Int J Equity Health 2016; 15:158. [PMID: 27677957 PMCID: PMC5039797 DOI: 10.1186/s12939-016-0451-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hong Kong's resistance to be a signatory of the 1951 Geneva Convention and lack of domestic policies in this area has resulted in restrictions on access to healthcare amongst asylum seekers and refugees (ASRs). Using social determinants of health framework this study sought to identify health practices, problems and needs of African ASRs in Hong Kong. METHODS A cross-sectional survey comprising of six domains including health status, health-seeking behaviour and social experience targeted at adult African ASRs in Hong Kong was conducted through three local non-governmental organisations between February and April 2013. Outpatient care and inpatient care in the past 12 months were used as proxy measures of general and severe ill health respectively. Associations between the determinants of health factors with general or severe health was explored through logistic regressions. RESULTS Majority of 374 participants were young, single, educated males having been in Hong Kong for over 5 years. A third of ARS (36.1 %) screened positive for depression. Most reported problems related to basic necessities (64.7-78.6 %) and access to health services (72.2 %). ASRs with relatively less education, health awareness or higher risk behaviours were less likely to have obtained outpatient or inpatient services. African ASRs reporting problems with case officers (aOR = 2.80; 95 % CI = 1.35-5.79) or illness in the past 30 days (aOR = 6.00; 95 % CI = 2.94-12.25) were more likely to report general ill health. Similarly, problems with the case officers (aOR = 3.76; 95 % CI = 1.97-7.18) and self-reported illness in the past 30 days (aOR = 3.32; 95 % CI= 1.68-6.57) were also significantly associated with severe ill health. At the health system level, those who reported experiencing difficulties accessing the medical services in Hong Kong are 3.29 (95 % CI = 1.48-7.31) and 4.12 (95 % CI = 1.73-9.79) times as likely to report general and severe ill health respectively. CONCLUSION The host government should have moral and ethical obligations to attend to the health needs of ASRs. Evidently a number of structural and health system factors have significantly impacted the health of African ASRs in Hong Kong. Changes to current policies regarding how African ASRs are handled whilst in Hong Kong but, more immediately, improvements in healthcare access are needed.
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Affiliation(s)
- William Chi Wai Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau Clinic, Rm 3/F., 161 Main Street, Ap Lei Chau, Hong Kong.
| | - Sealing Cheng
- The Anthropology Department, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Eleanor Holroyd
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Julie Chen
- Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau Clinic, Rm 3/F., 161 Main Street, Ap Lei Chau, Hong Kong.,Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong, Hong Kong
| | - Kelley Ann Loper
- The Department of Law, The University of Hong Kong, Hong Kong, Hong Kong
| | - Lynn Tran
- Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau Clinic, Rm 3/F., 161 Main Street, Ap Lei Chau, Hong Kong
| | - Heidi Yin Hai Miu
- Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau Clinic, Rm 3/F., 161 Main Street, Ap Lei Chau, Hong Kong
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Coulson T, Bailey M, Reid C, Tran L, Mullany D, Parker J, Hicks P, Pilcher D. Acute risk change (ARC) identifies outlier institutions in perioperative cardiac surgical care when the standardized mortality ratio cannot. Br J Anaesth 2016; 117:164-71. [DOI: 10.1093/bja/aew180] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 11/12/2022] Open
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Dusinska M, Boland S, Saunders M, Juillerat-Jeanneret L, Tran L, Pojana G, Marcomini A, Volkovova K, Tulinska J, Knudsen LE, Gombau L, Whelan M, Collins AR, Marano F, Housiadas C, Bilanicova D, Halamoda Kenzaoui B, Correia Carreira S, Magdolenova Z, Fjellsbø LM, Huk A, Handy R, Walker L, Barancokova M, Bartonova A, Burello E, Castell J, Cowie H, Drlickova M, Guadagnini R, Harris G, Harju M, Heimstad ES, Hurbankova M, Kazimirova A, Kovacikova Z, Kuricova M, Liskova A, Milcamps A, Neubauerova E, Palosaari T, Papazafiri P, Pilou M, Poulsen MS, Ross B, Runden-Pran E, Sebekova K, Staruchova M, Vallotto D, Worth A. Towards an alternative testing strategy for nanomaterials used in nanomedicine: lessons from NanoTEST. Nanotoxicology 2016; 9 Suppl 1:118-32. [PMID: 25923349 DOI: 10.3109/17435390.2014.991431] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In spite of recent advances in describing the health outcomes of exposure to nanoparticles (NPs), it still remains unclear how exactly NPs interact with their cellular targets. Size, surface, mass, geometry, and composition may all play a beneficial role as well as causing toxicity. Concerns of scientists, politicians and the public about potential health hazards associated with NPs need to be answered. With the variety of exposure routes available, there is potential for NPs to reach every organ in the body but we know little about the impact this might have. The main objective of the FP7 NanoTEST project ( www.nanotest-fp7.eu ) was a better understanding of mechanisms of interactions of NPs employed in nanomedicine with cells, tissues and organs and to address critical issues relating to toxicity testing especially with respect to alternatives to tests on animals. Here we describe an approach towards alternative testing strategies for hazard and risk assessment of nanomaterials, highlighting the adaptation of standard methods demanded by the special physicochemical features of nanomaterials and bioavailability studies. The work has assessed a broad range of toxicity tests, cell models and NP types and concentrations taking into account the inherent impact of NP properties and the effects of changes in experimental conditions using well-characterized NPs. The results of the studies have been used to generate recommendations for a suitable and robust testing strategy which can be applied to new medical NPs as they are developed.
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Affiliation(s)
- M Dusinska
- Health Effects Laboratory-MILK, NILU - Norwegian Institute for Air Research , Kjeller , Norway
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Brouard J, Dupont C, Tran L, Ribault M, Vabret A. [Rhinovirus during childhood: Asthma at adolescence? The chicken or the egg causality dilemma]. Arch Pediatr 2016; 23:557-60. [PMID: 27021809 PMCID: PMC7133363 DOI: 10.1016/j.arcped.2016.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 02/23/2016] [Indexed: 11/27/2022]
Affiliation(s)
- J Brouard
- Service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen, France; EA 4655 U2RM, équipe E3 : « virologie respiratoire comparée », 14032 Caen, France.
| | - C Dupont
- Service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - L Tran
- Service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - M Ribault
- Service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - A Vabret
- Laboratoire de virologie, CHU de Caen, avenue Clemenceau, 14033 Caen, France; EA 4655 U2RM, équipe E3 : « virologie respiratoire comparée », 14032 Caen, France
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Yuen WWY, Tran L, Wong CKH, Holroyd E, Tang CSK, Wong WCW. Psychological health and HIV transmission among female sex workers: a systematic review and meta-analysis. AIDS Care 2016; 28:816-24. [PMID: 26837316 DOI: 10.1080/09540121.2016.1139038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Current HIV prevention interventions for female sex workers (FSWs) have tended to target the cognitive factors in changing their behaviors, yet little attention has been paid to the psychological factors that influence the behavior of women in sex work. This review aimed to explore the associations between the psychological health of FSWs and HIV risk. A total of eight studies published in English before July 2013 were identified and reviewed. FSWs had reported psychological issues, including depression, suicidal thoughts as well as lower quality of life, and the pooled prevalence of probable depression was as high as 62.4%. The majority of studies showed that higher scores in psychological health problems were associated with increased HIV risk behavior, in particular inconsistent condom use, or sexually transmitted infections. Among the five studies which measured symptoms of depression, four documented that higher depression scores were significantly associated with inconsistent condom use among FSWs with their clients and/or partners. Meta-analysis using a fixed-effects model was performed to examine the association between depression and inconsistent condom use and found that higher scores in depression were significantly associated with inconsistent condom use (odds ratio = 2.57, p < .001). This review contends that future HIV preventive interventions should take psychological health of FSWs into consideration.
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Affiliation(s)
- Winnie Wing-Yan Yuen
- a Department of Family Medicine and Primary Care , The University of Hong Kong , Hong Kong, Ap Lei Chau , Hong Kong
| | - Lynn Tran
- a Department of Family Medicine and Primary Care , The University of Hong Kong , Hong Kong, Ap Lei Chau , Hong Kong
| | - Carlos King-Ho Wong
- a Department of Family Medicine and Primary Care , The University of Hong Kong , Hong Kong, Ap Lei Chau , Hong Kong
| | - Eleanor Holroyd
- b School of Health Sciences , RMIT University , Melbourne , Victoria , Australia
| | - Catherine So-Kum Tang
- c Department of Psychology, Faculty of Arts and Social Sciences , National University of Singapore , Singapore
| | - William Chi-Wai Wong
- a Department of Family Medicine and Primary Care , The University of Hong Kong , Hong Kong, Ap Lei Chau , Hong Kong
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Pao SA, Tran L. Evaluation of Patient Characteristics Associated With Mode of Hysterectomy and Conversion Rate. J Minim Invasive Gynecol 2015; 22:S96. [DOI: 10.1016/j.jmig.2015.08.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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