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Landy R, Killcoyne S, Tang C, Juniat S, O’Donovan M, Goel N, Gehrung M, Fitzgerald RC. Real-world implementation of non-endoscopic triage testing for Barrett's oesophagus during COVID-19. QJM 2023; 116:659-666. [PMID: 37220898 PMCID: PMC10497181 DOI: 10.1093/qjmed/hcad093] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/27/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The Coronavirus pandemic (COVID-19) curtailed endoscopy services, adding to diagnostic backlogs. Building on trial evidence for a non-endoscopic oesophageal cell collection device coupled with biomarkers (Cytosponge), an implementation pilot was launched for patients on waiting lists for reflux and Barrett's oesophagus surveillance. AIMS (i) To review reflux referral patterns and Barrett's surveillance practices. (ii) To evaluate the range of Cytosponge findings and impact on endoscopy services. DESIGN AND METHODS Cytosponge data from centralized laboratory processing (trefoil factor 3 (TFF3) for intestinal metaplasia (IM), haematoxylin & eosin for cellular atypia and p53 for dysplasia) over a 2-year period were included. RESULTS A total of 10 577 procedures were performed in 61 hospitals in England and Scotland, of which 92.5% (N = 9784/10 577) were sufficient for analysis. In the reflux cohort (N = 4074 with gastro-oesophageal junction sampling), 14.7% had one or more positive biomarkers (TFF3: 13.6% (N = 550/4056), p53: 0.5% (21/3974), atypia: 1.5% (N = 63/4071)), requiring endoscopy. Among samples from individuals undergoing Barrett's surveillance (N = 5710 with sufficient gland groups), TFF3-positivity increased with segment length (odds ratio = 1.37 per cm (95% confidence interval: 1.33-1.41, P < 0.001)). Some surveillance referrals (21.5%, N = 1175/5471) had ≤1 cm segment length, of which 65.9% (707/1073) were TFF3 negative. Of all surveillance procedures, 8.3% had dysplastic biomarkers (4.0% (N = 225/5630) for p53 and 7.6% (N = 430/5694) for atypia), increasing to 11.8% (N = 420/3552) in TFF3+ cases with confirmed IM and 19.7% (N = 58/294) in ultra-long segments. CONCLUSIONS Cytosponge-biomarker tests enabled targeting of endoscopy services to higher-risk individuals, whereas those with TFF3 negative ultra-short segments could be reconsidered regarding their Barrett's oesophagus status and surveillance requirements. Long-term follow-up will be important in these cohorts.
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Affiliation(s)
- R Landy
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - S Killcoyne
- Cyted Ltd, 22 Station Road, Cambridge CB1 2JD, UK
| | - C Tang
- Cyted Ltd, 22 Station Road, Cambridge CB1 2JD, UK
| | - S Juniat
- Cyted Ltd, 22 Station Road, Cambridge CB1 2JD, UK
| | - M O’Donovan
- Cyted Ltd, 22 Station Road, Cambridge CB1 2JD, UK
- Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - N Goel
- Cyted Ltd, 22 Station Road, Cambridge CB1 2JD, UK
| | - M Gehrung
- Cyted Ltd, 22 Station Road, Cambridge CB1 2JD, UK
| | - R C Fitzgerald
- Department of Oncology, Early Cancer Institute, University of Cambridge, Cambridge CB2 0XZ, UK
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Shah PL, Orton CM, Grinsztejn B, Donaldson GC, Crabtree Ramírez B, Tonkin J, Santos BR, Cardoso SW, Ritchie AI, Conway F, Riberio MPD, Wiseman DJ, Tana A, Vijayakumar B, Caneja C, Leaper C, Mann B, Samson A, Bhavsar PK, Boffito M, Johnson MR, Pozniak A, Pelly M, Shabbir N, Connolly S, Cartier A, Jaffer S, Winpenny C, Daby D, Pepper S, Adamson C, Carungcong J, Nundlall K, Fedele S, Samson-Fessale P, Schoolmeesters A, Gomes de Almeida Martins L, Bull R, Correia Da Costa P, Bautista C, Eleanor Flores M, Maheswaran S, Macabodbod L, Houseman R, Svensson ML, Sayan A, Fung C, Garner J, Lai D, Nelson M, Moore L, Gidwani S, Davies G, Ouma B, Salinos C, Salha J, Yassein R, Abbasi A, Oblak M, Steward A, Thankachen M, Barker A, Fernandes C, Beatriz V, Flores L, Soler-Carracedo A, Rocca A, Maheswaran S, Martella C, Lloyd C, Nolan C, Horsford L, Martins L, Thomas L, Winstanley M, Bourke M, Branch N, Orhan O, Morton R, Saunder S, Patil S, Hughes S, Zhe W, De Leon A, Farah A, Rya G, Alizadeh K, Leong K, Trepte L, Goel N, McGown P, Kirwan U, Vilela Baião T, Marins L, Nazer S, Malaguthi de Souza R, Feitosa M, Lessa F, Silva de Magalhães E, Costenaro J, de Cassia Alves Lira R, Carolina A, Cauduro de Castro A, Machado Da Silva A, Kliemann D, De Cassia Alves Lira R, Walker G, Norton D, Lowthorpe V, Ivan M, Lillie P, Easom N, Sierra Madero J, López Iñiguez Á, Patricia Muñuzuri Nájera G, Paola Alarcón Murra C, Alanis Vega A, Muñoz Trejo T, Pérez Rodríguez O. Favipiravir in patients hospitalised with COVID-19 (PIONEER trial): a multicentre, open-label, phase 3, randomised controlled trial of early intervention versus standard care. Lancet Respir Med 2023; 11:415-424. [PMID: 36528039 PMCID: PMC9891737 DOI: 10.1016/s2213-2600(22)00412-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND COVID-19 has overwhelmed health services globally. Oral antiviral therapies are licensed worldwide, but indications and efficacy rates vary. We aimed to evaluate the safety and efficacy of oral favipiravir in patients hospitalised with COVID-19. METHODS We conducted a multicentre, open-label, randomised controlled trial of oral favipiravir in adult patients who were newly admitted to hospital with proven or suspected COVID-19 across five sites in the UK (n=2), Brazil (n=2) and Mexico (n=1). Using a permuted block design, eligible and consenting participants were randomly assigned (1:1) to receive oral favipiravir (1800 mg twice daily for 1 day; 800 mg twice daily for 9 days) plus standard care, or standard care alone. All caregivers and patients were aware of allocation and those analysing data were aware of the treatment groups. The prespecified primary outcome was the time from randomisation to recovery, censored at 28 days, which was assessed using an intention-to-treat approach. Post-hoc analyses were used to assess the efficacy of favipiravir in patients aged younger than 60 years, and in patients aged 60 years and older. The trial was registered with clinicaltrials.gov, NCT04373733. FINDINGS Between May 5, 2020 and May 26, 2021, we assessed 503 patients for eligibility, of whom 499 were randomly assigned to favipiravir and standard care (n=251) or standard care alone (n=248). There was no significant difference between those who received favipiravir and standard care, relative to those who received standard care alone in time to recovery in the overall study population (hazard ratio [HR] 1·06 [95% CI 0·89-1·27]; n=499; p=0·52). Post-hoc analyses showed a faster rate of recovery in patients younger than 60 years who received favipiravir and standard care versus those who had standard care alone (HR 1·35 [1·06-1·72]; n=247; p=0·01). 36 serious adverse events were observed in 27 (11%) of 251 patients administered favipiravir and standard care, and 33 events were observed in 27 (11%) of 248 patients receiving standard care alone, with infectious, respiratory, and cardiovascular events being the most numerous. There was no significant between-group difference in serious adverse events per patient (p=0·87). INTERPRETATION Favipiravir does not improve clinical outcomes in all patients admitted to hospital with COVID-19, however, patients younger than 60 years might have a beneficial clinical response. The indiscriminate use of favipiravir globally should be cautioned, and further high-quality studies of antiviral agents, and their potential treatment combinations, are warranted in COVID-19. FUNDING LifeArc and CW+.
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Affiliation(s)
- Pallav L Shah
- Chelsea & Westminster NHS Foundation Trust, London, UK,Department of Respiratory Medicine, Royal Brompton Hospital, London, UK,National Heart and Lung Institute, Imperial College London, London, UK,Correspondence to: Prof Pallav L Shah, Chelsea & Westminster NHS Foundation Trust, London SW10 9NH, UK
| | - Christopher M Orton
- Chelsea & Westminster NHS Foundation Trust, London, UK,Department of Respiratory Medicine, Royal Brompton Hospital, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | - Gavin C Donaldson
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - James Tonkin
- Chelsea & Westminster NHS Foundation Trust, London, UK,Department of Respiratory Medicine, Royal Brompton Hospital, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | - Breno R Santos
- Departamento de Infectología, Hospital Nossa Senhora da Conceição–Grupo Hospitalar Conceição, Porto Alegre, Brazil
| | - Sandra W Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | - Andrew I Ritchie
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | - Francesca Conway
- Chelsea & Westminster NHS Foundation Trust, London, UK,Department of Respiratory Medicine, Royal Brompton Hospital, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | - Maria P D Riberio
- Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | - Dexter J Wiseman
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | - Anand Tana
- Chelsea & Westminster NHS Foundation Trust, London, UK,Department of Respiratory Medicine, Royal Brompton Hospital, London, UK
| | - Bavithra Vijayakumar
- Chelsea & Westminster NHS Foundation Trust, London, UK,Department of Respiratory Medicine, Royal Brompton Hospital, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | - Cielito Caneja
- Chelsea & Westminster NHS Foundation Trust, London, UK,Department of Respiratory Medicine, Royal Brompton Hospital, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | - Craig Leaper
- Chelsea & Westminster NHS Foundation Trust, London, UK
| | - Bobby Mann
- Chelsea & Westminster NHS Foundation Trust, London, UK
| | - Anda Samson
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Pankaj K Bhavsar
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Marta Boffito
- Chelsea & Westminster NHS Foundation Trust, London, UK,National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Anton Pozniak
- Chelsea & Westminster NHS Foundation Trust, London, UK,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Michael Pelly
- Chelsea & Westminster NHS Foundation Trust, London, UK
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Goel N, Saroya AS, Morya AK, Tejaswini A. What makes a resident a great resident? Indian J Ophthalmol 2023; 71:1045-1046. [PMID: 36872744 PMCID: PMC10229921 DOI: 10.4103/ijo.ijo_3051_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Affiliation(s)
- Nupur Goel
- Anterior segment and Oculoplasty, Icare Eye Hospital and PG Institute, Noida, Uttar Pradesh, India
| | - Arnav Singh Saroya
- Cataract, Cornea and Refractive Surgery, Dr Agarwals Eye Hospital, Chennai, Tamil Nadu, India
| | - Arvind Kumar Morya
- Cataract, Glaucoma, Refractive, Squint, Paediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Antarvedi Tejaswini
- Cataract, Glaucoma, Refractive, Squint, Paediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
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Pennington J, Contini S, Brown M, Goel N, Chen T. Efficacy of intrathecal morphine administration in pediatric patients undergoing selective dorsal rhizotomy. J Pediatr Rehabil Med 2023; 16:109-114. [PMID: 36806525 DOI: 10.3233/prm-220048] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the effectiveness of intrathecal morphine following selective dorsal rhizotomy in pediatric patients previously diagnosed with cerebral palsy. METHODS This was a retrospective, cohort analysis over the course of four years. The analysis consisted of a treatment group which received intrathecal morphine (5 mcg/kg) injection and a control group that did not receive the injection prior to dural closure. All patients underwent multilevel laminectomies for selective dorsal rhizotomy at Akron Children's Hospital. The effectiveness of the treatment was measured by total dose of hydromorphone administered on patient-controlled analgesia (PCA), number of days on oral narcotics, and cumulative dose of oral narcotic. RESULTS Of the analyzed 15 pediatric patients, seven patients received intrathecal morphine injection while the other eight did not receive the treatment prior to dural closure. There was a difference of 1135 mcg in total PCA dose between the study group (3243 mcg) and the control group (4378 mcg). The total PCA dose based on weight was lower in the study group (163 mcg/kg) than in the control group (171 mcg/kg). CONCLUSION Based on these findings, the administration of intrathecal morphine clinically reduces the opiate need in the first 96 hours post-operatively.
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Affiliation(s)
| | | | | | - Nupur Goel
- Northeast Ohio Medical University, Rootstown, OH, USA
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Goel N, Needham M, Soler-Ferran D, Cotreau MM, Escobar J, Greenberg S. POS1342 DEPLETION OF KLRG1+ T CELLS IN A FIRST-IN-HUMAN CLINICAL TRIAL OF ABC008 IN INCLUSION BODY MYOSITIS (IBM). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundInclusion body myositis (IBM), a relentlessly progressive autoimmune skeletal muscle disease, has no effective available pharmacological therapy. A prominent feature of IBM on microscopy is highly differentiated effector CD8+ cytotoxic T (Tc) cells invading non-necrotic myofibers [1]. These Tc cells, known to be relatively resistant to apoptosis, express markers including killer cell lectin-like receptor G1 (KLRG1) [2]. ABC008, a first-in-class humanized, afucosylated monoclonal antibody (mAb) specific for KLRG1, selectively depletes these highly differentiated Tc cells while sparing other blood cell populations, e.g., naïve, central memory, and regulatory T cells and B cells. ABC008 has been designed to treat diseases mediated by these Tc cells, including IBM and T-cell large granular lymphocytic leukemia (T-LGLL). IBM and rheumatoid arthritis overlap clinically with T-LGLL and share similar expansions of large granular lymphocytes (LGLs), which also express KLRG1. We report here our preliminary data from our ongoing trial of ABC008 in IBM (NCT04659031).ObjectivesEvaluate the safety, pharmacodynamics (PD), and pharmacokinetics (PK) of ABC008 administered subcutaneously (SC) in adults with IBM.MethodsIn this first-in-human, open-label, single ascending dose trial with 3 + 3 design evaluating ABC008 SC, eligible participants must have clinicopathologically defined, clinically defined, or probable IBM according to the European Neuromuscular Centre 2011 research diagnostic criteria [3] and an IBM Functional Rating Scale (IBMFRS) score ≤38. Four dose cohorts are planned: ABC008 0.1, 0.5, 2.0, and 5.0 mg/kg. PD, PK, safety, and disease severity assessments are performed pre-dose (Day 0) and during the 6-month follow-up period.ResultsFive of the 6 (83.3%) participants were male with baseline mean age = 65.7 years, mean IBM disease duration = 6.8 years, and mean IBMFRS score = 27.5 (Table 1). Each received a single dose of ABC008 SC: Cohorts 1 (C1) and 2 (C2) received 0.1 and 0.5 mg/kg and have completed 168 and 56 days of follow-up, respectively.Table 1.Baseline DemographicsBaseline CharacteristicsABC008 SC Treatment GroupsCohort 10.1 mg/kg SC (n=3)Cohort 20.5 mg/kg SC (n=3)ABC008 Overall (N=6)Age (years), mean ± SD64.0 ± 11.3667.3 ± 6.6665.7 ± 8.52Male sex, n (%)3 (100)2 (66.7)5 (83.3)Caucasian3 (100)3 (100)6 (100)Body Mass Index (kg/m2)28.5 ± 3.5828.3 ± 4.2528.4 ± 3.52Disease Duration (years), mean ± SD9.7 ± 5.973.9 ± 4.486.8 ± 5.70IBMFRS score, mean ± SD30.0 ± 4.0825.0 ± 6.1627.5 ± 5.80Abbreviations: IBMFRS, Inclusion Body Myositis Functional Rating Scale; n or N, number; SC, subcutaneous; SD, standard deviation.Maximum depletion of CD8+KLRG1+ cells for C1 and C2 ranged from 46-96% and 98-99%, respectively (Figure 1A), with depletion evident by the next assessment on Day 1. Recovery in C1 began at Day 84 with Day 168 depletion at 29-71%. Other hematologic parameters generally were stable (e.g., T regulatory and B cells). CD8+CD57+ LGLs, mostly KLRG1+, were also depleted (Figure 1B). Preliminary PK showed that ABC008 SC displays a long absorption phase and slow clearance properties typical of mAb therapies. No severe adverse events (AEs) or discontinuations due to AEs have been reported. One unrelated serious AE of fall with muscle tear in a C1 participant with a prior history of falls occurred.Figure 1.Key pharmacodynamic parameters in Study ABC008-IBM-101. Baseline and change (A) of KLRG1+CD8+ T cells and (B) CD8+CD57+ large granular lymphocytes (LGLs). C1 and C2 are Cohorts 1 and 2; P1, P2, and P3 are Participants 1, 2, and 3.ConclusionIn study participants with IBM, single SC doses of 0.1 and 0.5 mg/kg of ABC008 resulted in the depletion of CD8+KLRG1+ cells and CD8+CD57+ LGLs with clear evidence of a dose response for KLRG1+ T cell depletion and no apparent safety signals. Based on these results, a study evaluating ABC008 for the treatment of T-LGLL is planned.References[1]Engel AG, et al. Ann Neurol. 1984;16:209-15.[2]Greenberg SA, et al. Brain. 2016;139:1348-60.[3]Rose MR, et al. Neuromuscul Disord. 2013;23:1044-55.Disclosure of InterestsNiti Goel Shareholder of: UCB, Abcuro, Inc, Employee of: Abcuro, Inc, Merrilee Needham Consultant of: Abcuro, Inc, Grant/research support from: Abcuro, Inc, Dulce Soler-Ferran Shareholder of: Abcuro, Inc, Employee of: Abcuro, Inc, Monette M. Cotreau Consultant of: Abcuro, Inc, Jorge Escobar Shareholder of: Abcuro, Employee of: Abcuro, Steven Greenberg Shareholder of: Abcuro, Inc, Consultant of: Abcuro, Inc
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Goel N. AB0953 Lack of Racial Diversity in Clinical Trials of Psoriatic Arthritis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundParticipant diversity in clinical trials of therapeutics in rheumatology is important to understand how persons of different races and ethnicities might respond differently to therapeutics. Specifically, for psoriatic arthritis (PsA), although people of color (POC) have lower disease prevalence, prevalence still ranges from 0.04-0.19% in Blacks, 0.13-0.19% in Asians, and 0.09-0.30% in Hispanics versus 0.19-0.34% in Whites in the insured population of the US1. Literature on the diversity of PsA clinical trials remains limited, though data suggest that minorities are underrepresented in clinical trials2. This analysis aims to evaluate the diversity of participants in randomized clinical trials (RCTs) of US Food and Drug Administration approved targeted therapies for PsA.ObjectivesTo evaluate the reporting of race and ethnicity in published RCTs of targeted therapeutics approved for the treatment of PsA in the US.MethodsTargeted therapies approved for use in the treatment of PsA in the US were identified. Package inserts and ClinicalTrials.gov (CT.gov) were used to identify the pivotal double blind, RCTs in PsA which supported the approval of the identified therapeutics in the US. The articles reporting the primary endpoint data were obtained. Race and ethnicity data were extracted from the published data. Countries in which the studies were conducted were identified from the publications or CT.gov. Descriptive analyses were performed.ResultsTwenty-nine pivotal RCTs in PsA evaluating targeted therapeutics, published from 2002 – 2022, were identified; 24 reported race; non-White race was reported in only 13 (45%) (Table 1 and Figure 1). In the latter, people of Black race comprised <1% of the overall population in 12 RCTs and 2.7% in the remaining RCT. People of Asian race comprised 6.1% of the overall population reflecting <10% of the population in 11 studies and 11.3% and 19.0% in the remaining 2 studies. Overall, 19 (65.6%) trials recruited participants from Asia Pacific countries. Hispanic/Latinx ethnicity was not reported in any study. Studies published from 2017-2022 reported non-White race (n=7 of 15 [47%]) no more frequently than studies published from 2004-2016 (n=6 of 14 [43%]). Although the 13 RCTs reporting non-White race may not reflect unique individuals, the total number of people included across these RCTs was 7261, of which 48 (0.7%), 441 (6.1%), and 6598 (90.9%) were Black, Asian, and White, respectively.Table 1.Race Reporting in Psoriatic Arthritis Pivotal Clinical Trials of Targeted TherapeuticsRace Reporting StatusTotal Trials (N)Trials which recruited in AP countries(n [% of N])Total Participants (N)White (n [% of N])Black (n [% of N])Asian (n [% of N])Other* (n [% of N])Not reported51 (20.0)1572----Non-White race reported1313 (44.8)72616598 (90.9)48 (0.7)441 (6.1)172 (2.4)Non-White race not reported115 (45.5)65885803 (88.1)---Total (N)2919 (65.5)15421----Abbreviations: AP, Asia Pacific; N and n, number.*Other also includes American Indian/Alaskan Native, mixed race, unknown raceNote: Numbers across rows may not add up to 0, and the total number of individuals reported in any one group may not be unique. Dashes reflect data not provided or able to be calculated.ConclusionOur data show under-reporting of race and ethnicity in publications of pivotal PsA RCTs, and no evidence of improved reporting over time. Whites were overrepresented in pivotal trials of PsA, especially when considering 72 and 62% of the US population was White in 2010 and 2020 (US Census data), respectively, and the reported prevalence of PsA by race in the insured population of the US1. Improved reporting of race/ethnicity and increased representation of racial/ethnic minorities in PsA RCTs are needed.References[1]Ogdie A, et al. Rheumatol Ther. 2021;8(4):1725-39.[2]https://trialfacts.com/diversity-inclusion/ accessed 22 Aug 2021Disclosure of InterestsNiti Goel Shareholder of: UCB, Abcuro, Employee of: Abcuro
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McConnell D, Goel N, Eschbach E, Hickey S, Beattie B, Rozehnal J, Leibner E, Mathews K. 50 Emergency Department Management and Outcomes of COVID-19 Acute Hypoxemic Respiratory Failure During the New York City Surge. Ann Emerg Med 2021. [PMCID: PMC8335511 DOI: 10.1016/j.annemergmed.2021.07.051] [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: 11/19/2022]
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Coates LC, Soriano E, Corp N, Bertheussen H, Callis-Duffin K, Barbosa Campanholo C, Chau J, Eder L, Fernandez D, Fitzgerald O, Garg A, Gladman DD, Goel N, Grieb S, Helliwell P, Husni ME, Jadon D, Katz A, Laheru D, Latella J, Leung YY, Lindsay C, Lubrano E, Mazzuoccolo L, Mcdonald R, Mease PJ, O’sullivan D, Ogdie A, Olsder W, Schick L, Steinkoenig I, De Wit M, Van der Windt D, Kavanaugh A. OP0229 THE GROUP FOR RESEARCH AND ASSESSMENT OF PSORIASIS AND PSORIATIC ARTHRITIS (GRAPPA) TREATMENT RECOMMENDATIONS 2021. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4091] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Since the 2015 GRAPPA treatment recommendations were published, therapeutic options and management strategies for psoriatic arthritis (PsA) have advanced considerably.Objectives:The goal of the GRAPPA recommendations update is to develop high quality, evidence-based recommendations for the treatment of PsA, including related conditions and comorbidities.Methods:GRAPPA rheumatologists, dermatologists and patient research partners (PRPs) updated overarching principles for the management of adults with PsA by consensus. Principles considering use of biosimilars and tapering/discontinuing of therapy were added to this update. Systematic literature searches based on data publicly available from three databases (MEDLINE, EMBASE, and Cochrane CENTRAL) were conducted from the end of the previous recommendations’ searches through August 2020. Additional abstract searches were performed for conference presentations in 2017-2020. Searches covered PsA treatments (peripheral arthritis, axial arthritis, enthesitis, dactylitis, skin, and nail disease). Additional searches were performed for related conditions (uveitis and IBD) and comorbidities evaluating their impact on safety and treatment outcomes. Individual groups assessed the risk of bias and applied the GRADE system to generate strong or conditional recommendations for therapies within the domain groups and for the management of comorbidities and related conditions. These recommendations were then incorporated into an overall treatment schema.Results:Updated, evidence-based treatment recommendations are shown (Table 1). Since 2015, many new medications have been incorporated. Additional results for older medications, such as methotrexate, have been published across PsA domains. Based on the evidence, the treatment recommendations developed by individual groups were incorporated into the overall schema including principles for management of arthritis, spondylitis, enthesitis, dactylitis, skin, and nail disease in PsA, and associated conditions (Figure 1). Choice of therapy for an individual should ideally address all of the domains that impact on that patient, supporting shared decision making with the patient involved. Additional consideration in the recommendations was given to key associated conditions and comorbidities as these often impact on therapy choice.Conclusion:These GRAPPA treatment recommendations provide up to date, evidence-based guidance to providers who manage and treat adult patients with PsA. These recommendations are based on domain-based strategy for PsA and supplemented by overarching principles developed by consensus of GRAPPA members.IndicationStrongForConditional ForConditionalAgainstStrongAgainstInsufficient evidencePeripheral Arthritis DMARD NaïvecsDMARDs, TNFi, PDE4i, IL-12/23i, IL-17i, IL-23i, JAKiNSAIDs, oral CS, IA CS,IL-6i,Peripheral Arthritis DMARD IRTNFi, IL-12/23i, IL-17i, IL-23i, JAKiPDE4i, other csDMARD, NSAIDs, oral CS, IA CS,IL-6i,Peripheral ArthritisbDMARD IRTNFi, IL-17i, IL-23i, JAKi,NSAIDs, oral CS, IA CS, IL-12/23i, PDE4i, CTLA-4-IgIL-6i,Axial arthritis, Biologic NaïveNSAIDs, Physiotherapy, simple analgesia, TNFi, IL-17i, JAKiCS SIJ injections, bisphosphonatescsDMARDs, IL-6i,IL-12/23i, IL-23iAxial PsA, Biologic IRNSAIDs, Physiotherapy, simple analgesia, TNFi, IL-17i, JAKi csDMARDs, IL-6i,IL-12/23i, IL-23iEnthesitisTNFi, IL-12/23i, IL-17i, PDE4i, IL-23i, JAKiNSAIDs, physiotherapy, CS injections, MTXIL-6i,Other csDMARDsDactylitisTNFi IL-12/23i, IL-17i, IL-23i, JAKi, PDE4iNSAIDs, CS injections, MTXOther csDMARDsPsoriasisTopicals, phototherapy, csDMARDs, TNFi, IL-12/23i, IL-17i, IL-23i, PDE4i, JAKi AcitretinNail psoriasisTNFi, IL12/23i, IL17i, IL23i, PDE4iTopical CS, tacrolimus and calcipotriol combination or individual therapies, Pulsed dye laser, csDMARDs, acitretin, JAKiTopical Cyclosporine / Tazarotene, Fumarate, Fumaric Acid Esters, UVA and UVB Phototherapy, AlitretinoinIBDTNFi (not ETN), IL-12/23i, JAKiIL-17iUveitisTNFi (not ETN)Disclosure of Interests:Laura C Coates Speakers bureau: AbbVie, Amgen, Biogen, Celgene, Gilead, Eli Lilly, Janssen, Medac, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Pfizer, and Novartis, Enrique Soriano Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb,GSK, Genzyme, Janssen, Lilly, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb,GSK, Genzyme, Janssen, Lilly, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Grant/research support from: AbbVie, Janssen, Novartis Pharma, Pfizer, Roche, and UCB, Nadia Corp: None declared, Heidi Bertheussen Consultant of: Pfizer, Kristina Callis-Duffin Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Lilly, Janssen, Novartis, Pfizer, Sienna Biopharmaceuticals, Stiefel Laboratories, UCB, Ortho Dermatologics, Inc, Regeneron Pharmaceuticals, Inc., Anaptys Bio, Boehringer Ingelheim., Cristiano Barbosa Campanholo Speakers bureau: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Jeffrey Chau: None declared, Lihi Eder Consultant of: Abbvie, UCB, Janssen, Eli Lily, Pfizer, Novartis, Grant/research support from: Abbvie, UCB, Janssen, Eli Lily, Pfizer, Novartis, Daniel Fernandez Consultant of: Abbvie, UCB, Roche, Janssen, Pfizer, Amgen and Brystol, Grant/research support from: Abbvie, UCB, Roche, Janssen, Pfizer, Amgen and Brystol, Oliver FitzGerald Speakers bureau: AbbVie, Janssen and Pfizer Inc, Consultant of: BMS, Celgene, Eli Lilly, Janssen and Pfizer Inc, Grant/research support from: AbbVie, BMS, Eli Lilly, Novartis and Pfizer Inc, Amit Garg Consultant of: Abbvie, Amgen, Asana Biosciences, Bristol Myers Squibb, Boehringer Ingelheim, Incyte, InflaRx, Janssen, Pfizer, UCB, Viela Biosciences, Grant/research support from: Abbvie, Dafna D Gladman Consultant of: Abbvie, Amgen, BMS, Eli Lilly, Galapagos, Gilead, Jansen, Novartis, Pfizer and UCB, Grant/research support from: Abbvie, Amgen, Eli Lilly, Jansen, Novartis, Pfizer and UCB, Niti Goel: None declared, Suzanne Grieb: None declared, Philip Helliwell Speakers bureau: Janssen, Novartis, Pfizer, Consultant of: Eli Lilly, M Elaine Husni Consultant of: Abbvie, Amgen, Janssen, Novartis, Lilly, UCB, Regeneron, and Pfizer, Deepak Jadon Speakers bureau: AbbVie, Amgen, Celgene, Eli Lilly, Gilead, Healthcare Celltrion, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Gilead, Healthcare Celltrion, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Gilead, Healthcare Celltrion, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Arnon Katz: None declared, Dhruvkumar Laheru: None declared, John Latella: None declared, Ying Ying Leung Speakers bureau: Novartis, AbbVie, Eli Lilly, Janssen, Consultant of: Pfizer and Boehringer Ingelheim, Grant/research support from: Pfizer and conference support from AbbVie, Christine Lindsay Shareholder of: Amgen, Employee of: Aurinia pharmaceuticals, Ennio Lubrano Speakers bureau: Alfa-Sigma, Abbvie, Galapagos, Janssen Cilag, Lilly., Consultant of: Alfa-Sigma, Abbvie, Galapagos, Janssen Cilag, Lilly., Luis Mazzuoccolo Speakers bureau: Abbvie, Amgen, Novartis, Elli Lilly, Jansen, Consultant of: Abbvie, Amgen, Novartis, Elli Lilly, Jansen, Roland McDonald: None declared, Philip J Mease Speakers bureau: AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, Galapagos, Gilead Sciences, GlaxoSmithKline, Janssen, Novartis, Pfizer, SUN and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead Sciences, Janssen, Novartis, Pfizer, SUN and UCB, Denis O’Sullivan: None declared, Alexis Ogdie Consultant of: AbbVie, Amgen, BMS, Celgene, Corrona, Gilead, Janssen, Lilly, Novartis, and Pfizer, Grant/research support from: Novartis and Pfizer and Amgen, Wendy Olsder: None declared, Lori Schick: None declared, Ingrid Steinkoenig: None declared, Maarten de Wit Consultant of: AbbVie, BMS, Celgene, Janssen, Lilly, Novartis, Pfizer, Roche, Danielle van der Windt: None declared, Arthur Kavanaugh Speakers bureau: AbbVie, Amgen, BMS, Eli Lilly, Gilead Janssen, Novartis, Pfizer, UCB, Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Gilead Janssen, Novartis, Pfizer, UCB
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Sharma P, Goel N, Dogar K, Bhalla M, Thami GP, Punia K. Adverse skin reactions related to PPE among healthcare workers managing COVID-19. J Eur Acad Dermatol Venereol 2021; 35:e481-e483. [PMID: 33866611 PMCID: PMC8251062 DOI: 10.1111/jdv.17290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/13/2021] [Indexed: 11/29/2022]
Affiliation(s)
- P Sharma
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
| | - N Goel
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
| | - K Dogar
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
| | - M Bhalla
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
| | - G P Thami
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
| | - K Punia
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
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Vaideeswar P, Bhuvan M, Goel N. Pulmonary ossifying carcinoid - MEN in a male? J Postgrad Med 2021; 68:44-47. [PMID: 33533747 PMCID: PMC8860124 DOI: 10.4103/jpgm.jpgm_8_20] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Pulmonary carcinoid tumors are considered as low-grade neoplasms, seen as centrally located endobronchial masses or as peripheral circumscribed nodules. Calcification or ossification is a known phenomenon, but presentation as large bony mass is extremely uncommon. Herein, we report a case of ossifying bronchial carcinoid along with nodular Hashimoto's thyroiditis as incidental autopsy findings in a 32-year-old patient with a prior recent excision of pituitary macroadenoma. This association suggests the possibility of multiple endocrine neoplasia in this young male.
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Affiliation(s)
- P Vaideeswar
- Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - M Bhuvan
- Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - N Goel
- Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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11
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Goel N, Peng K, Lu Y. Neuromodulation by mGluRs in Sound Localization Circuits in the Auditory Brainstem. Front Neural Circuits 2020; 14:599600. [PMID: 33224028 PMCID: PMC7674593 DOI: 10.3389/fncir.2020.599600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/05/2020] [Indexed: 11/15/2022] Open
Abstract
The ability of humans and animals to localize the source of a sound in a complex acoustic environment facilitates communication and survival. Two cues are used for sound localization at horizontal planes, interaural time and level differences (ITD and ILD), which are analyzed by distinct neural circuits in the brainstem. Here, we review the studies on metabotropic glutamate receptor (mGluR)-mediated neuromodulation of both intrinsic and synaptic properties of brainstem neurons in these circuits. Both mammalian and avian animal models have been used, with each having their advantages that are not present in the other. For the mammalian model, we discuss mGluR neuromodulation in the ILD circuit, with an emphasis on the recent discovery of differential modulation of synaptic transmission of different transmitter release modes. For the avian model, we focus on reviewing mGluR neuromodulation in the ITD pathway, with an emphasis on tonotopic distribution and synaptic plasticity of mGluR modulation in coincidence detector neurons. Future works are proposed to further investigate the functions and mechanisms of mGluRs in the sound localization circuits.
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Affiliation(s)
- Nupur Goel
- Department of Anatomy and Neurobiology, Hearing Research Group, College of Medicine, Northeast Ohio Medical University, Rootstown, OH, United States
| | - Kang Peng
- Department of Anatomy and Neurobiology, Hearing Research Group, College of Medicine, Northeast Ohio Medical University, Rootstown, OH, United States
| | - Yong Lu
- Department of Anatomy and Neurobiology, Hearing Research Group, College of Medicine, Northeast Ohio Medical University, Rootstown, OH, United States
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Patel A, Abdulaal A, Ariyanayagam D, Killington K, Denny SJ, Mughal N, Hughes S, Goel N, Davies GW, Moore LSP, Charani E. Investigating the association between ethnicity and health outcomes in SARS-CoV-2 in a London secondary care population. PLoS One 2020; 15:e0240960. [PMID: 33112892 PMCID: PMC7592846 DOI: 10.1371/journal.pone.0240960] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Black, Asian and minority ethnic (BAME) populations are emerging as a vulnerable group in the severe acute respiratory syndrome coronavirus disease (SARS-CoV-2) pandemic. We investigated the relationship between ethnicity and health outcomes in SARS-CoV-2. METHODS AND FINDINGS We conducted a retrospective, observational analysis of SARS-CoV-2 patients across two London teaching hospitals during March 1 -April 30, 2020. Routinely collected clinical data were extracted and analysed for 645 patients who met the study inclusion criteria. Within this hospitalised cohort, the BAME population were younger relative to the white population (61.70 years, 95% CI 59.70-63.73 versus 69.3 years, 95% CI 67.17-71.43, p<0.001). When adjusted for age, sex and comorbidity, ethnicity was not a predictor for ICU admission. The mean age at death was lower in the BAME population compared to the white population (71.44 years, 95% CI 69.90-72.90 versus, 77.40 years, 95% CI 76.1-78.70 respectively, p<0.001). When adjusted for age, sex and comorbidities, Asian patients had higher odds of death (OR 1.99: 95% CI 1.22-3.25, p<0.006). CONCLUSIONS BAME patients were more likely to be admitted younger, and to die at a younger age with SARS-CoV-2. Within the BAME cohort, Asian patients were more likely to die but despite this, there was no difference in rates of admission to ICU. The reasons for these disparities are not fully understood and need to be addressed. Investigating ethnicity as a clinical risk factor remains a high public health priority. Studies that consider ethnicity as part of the wider socio-cultural determinant of health are urgently needed.
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Affiliation(s)
- Aatish Patel
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
| | - Ahmed Abdulaal
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
| | | | - Kieran Killington
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
| | - Sarah J. Denny
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
| | - Nabeela Mughal
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
- Imperial College London, Kensington, London, United Kingdom
- North West London Pathology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Stephen Hughes
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
| | - Nupur Goel
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
- North West London Pathology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Gary W. Davies
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
- Imperial College London, Kensington, London, United Kingdom
| | - Luke S. P. Moore
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
- North West London Pathology, Imperial College Healthcare NHS Trust, London, United Kingdom
- Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Hammersmith Campus, London, United Kingdom
| | - Esmita Charani
- Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Hammersmith Campus, London, United Kingdom
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Roane B, Ostby S, Wall J, Londono A, Goel N, Leath C, Arend R. How do uterine cancer NGS results impact patient outcomes? Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.031] [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: 11/29/2022]
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Murthy SI, Das S, Deshpande P, Kaushik S, Dave TV, Agashe P, Goel N, Soni A. Differential diagnosis of acute ocular pain: Teleophthalmology during COVID-19 pandemic - A perspective. Indian J Ophthalmol 2020; 68:1371-1379. [PMID: 32587167 PMCID: PMC7574141 DOI: 10.4103/ijo.ijo_1267_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Ocular pain is a common complaint which forces the patient to seek immediate medical attention. It is the primeval first response of the body to any severe condition of the eye such as trauma, infections and inflammation. The pain can be due to conditions directly affecting the eye and ocular adnexa; or indirect which would manifest as referred pain from other organ structures such as the central nervous system. Paradoxically, there are several minor and non-sight threatening conditions, which also leads to ocular pain and does not merit urgent hospital visits. In this perspective, we intend to provide guidelines to the practising ophthalmologist for teleconsultation when a patient complains of pain with focus on how to differentiate the various diagnoses that can be managed over teleconsultation and those requiring emergency care in the clinic. These guidelines can decrease unnecessary hospital visits, which is the need of the hour in the pandemic era and also beyond. Patients who are under quarantine and those who are unable to travel would be benefitted, and at the same time, the burden of increased patient load in busy hospital systems can be reduced.
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Affiliation(s)
- Somasheila I Murthy
- Department of Cornea, The Cornea Institute, L.V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Sujata Das
- Department of Cornea and Anterior Segment, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | | | - Sushmita Kaushik
- Department of Glaucoma, Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarjani Vivek Dave
- Department of Ophthalmic Plastic Surgery, L.V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Prachi Agashe
- Department of Pediatric Ophthalmology, Strabismus and Neurophthalmology K.B. Haji Bachooali Eye Hospital and Agashe Hospital, Mumbai, Maharashtra, India
| | - Nupur Goel
- Crystal Clear Eye Institute and Apex, Mumbai, Maharashtra, India
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Antony A, Holland R, Mokkink W, D’agostino MA, Maksymowych WP, Bertheussen H, Schick L, Goel N, Ogdie A, Orbai AM, Hoejgaard P, Coates LC, Strand V, Gladman DD, Christensen R, Leung YY, Mease PJ, Tillett W. AB0737 MEASUREMENT PROPERTIES OF RADIOGRAPHIC OUTCOME MEASURES IN PSORIATIC ARTHRITIS: A SYSTEMATIC REVIEW FROM THE GRAPPA-OMERACT INITIATIVE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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:Structural damage was identified as an important outcome domain in the Psoriatic Arthritis (PsA) Core Domain Set and should be assessed at least once in the development of a new therapeutic.Objectives:To conduct a systematic literature review (SLR) to identify studies addressing the measurement properties (MPs) for ROIs and appraise the evidence through the OMERACT Filter 2.1 Framework Instrument Selection Algorithm (OFISA). [1]Methods:An SLR was conducted in EMBASE and MEDLINE to identify full-text English studies developing or assessing MPs of ROIs in PsA. Determination of eligibility, data extraction and methodology asssessment were performed by 2 reviewers. MPs were rated according to the ‘Provisional Standards’ and assigned a Red/Amber/White/Green (RAWG) rating (Figure 1). [1, 2]Results:3621 references were screened, 531 full-text articles reviewed, and 12 were included (Figure 2). Nine instruments assessing peripheral radiographs and six assessing axial radiographs were identified (Table 1). Three of the nine peripheral radiographic instruments had adequate evidence for reliability and some evidence for construct validity: the modified Steinbrocker, Ratingen, and modified Sharp van der Heijde scores. There was scant evidence for reliability, construct validity and responsiveness for the axial ROIs, compounded by the lack of a standardized definition of axial PsA.Conclusion:This SLR summarizes the MPs of ROIs and identifies relevant knowledge gaps that need to be addressed prior to endorsement of an instrument for the PsA Core Domain Set.References:[1]Richards P and De Wit M, editors. The OMERACT Handbook (March 2019)[2]Mokkink LB and D’Agostino MA. Protocol for performing a systematic review on imaging techniques (unpublished)Figure 1.Criteria for the RAWG RatingFigure 2.PRISMA DiagramTable 1.Summary of Measurement PropertiesROIDomain MatchFeasibilityConstruct ValidityDiscriminationReliabilityResponsivenessInter-raterIntra-raterMeasurement ErrorLongitudinal Construct ValidityClinical Trial DiscriminationThresholds of MeaningOriginal Steinbrocker ScoreA[1]A[1]R[1]Modified Steinbrocker Score#G[2]G[2]A[1]A[2]Modified Larsen ScoreA[1]A[1]A[1]*Ratingen Score#A[1]G[3]G[3]A[3]A[1]mTSS-AA[1]A[1]A[1]mTSS-B#A[1]A[1]A[1]A[1]*mSvdHs#A[2]G[2]G[2]A[1]A[1]*ReXPsAR[0]SPARS#A[1]A[1]A[1]Axial PsA Definition 1MSASSS#A[2]R[0]BASRI - Total#A[2]R[0]PASRI#A[2]R[0]Axial PsA Definition 2MSASSS#A[1]R[1]A[1]A[1]BASRI - Spine#R[1]A[1]A[1]PASRI#A[1]A[1]A[1]Modified NYC#R[1]A[1]RASSS#R[1]A[1]A[1]A = Amber, R = Red, G = Green[Total available studies for synthesis following excluding studies with poor methodology]* RCT data available but no published effect sizes# Feasibility data availableDisclosure of Interests:Anna Antony: None declared, Richard Holland: None declared, Wieneke Mokkink: None declared, Maria-Antonietta d’Agostino: None declared, Walter P Maksymowych Grant/research support from: Received research and/or educational grants from Abbvie, Novartis, Pfizer, UCB, Consultant of: WPM is Chief Medical Officer of CARE Arthritis Limited, has received consultant/participated in advisory boards for Abbvie, Boehringer, Celgene, Eli-Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, UCB, Speakers bureau: Received speaker fees from Abbvie, Janssen, Novartis, Pfizer, UCB., Heidi Bertheussen: None declared, Lori Schick: None declared, Niti Goel Shareholder of: UCB and Galapagos, Consultant of: VielaBio, Mallinckrodt, and IMMVention, Alexis Ogdie Grant/research support from: Pfizer, Novartis, Consultant of: Abbvie, Amgen, BMS, Celgene, Corrona, Janssen, Lilly, Pfizer, Novartis, Ana-Maria Orbai Grant/research support from: Abbvie, Eli Lilly and Company, Celgene, Novartis, Janssen, Horizon, Consultant of: Eli Lilly; Janssen; Novartis; Pfizer; UCB. Ana-Maria Orbai was a private consultant or advisor for Sun Pharmaceutical Industries, Inc, not in her capacity as a Johns Hopkins faculty member and was not compensated for this service., Pil Hoejgaard: None declared, Laura C Coates: None declared, Vibeke Strand Consultant of: AbbVie, Amgen, Biogen, Celltrion, Consortium of Rheumatology Researchers of North America, Crescendo Bioscience, Eli Lilly, Genentech/Roche, GlaxoSmithKline, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron Pharmaceuticals, Inc., Sanofi, UCB, Dafna D Gladman Grant/research support from: AbbVie, Amgen Inc., BMS, Celgene Corporation, Janssen, Novartis, Pfizer, UCB – grant/research support, Consultant of: AbbVie, Amgen Inc., BMS, Celgene Corporation, Janssen, Novartis, Pfizer, UCB – consultant, Robin Christensen: None declared, Ying Ying Leung Speakers bureau: Novartis, Janssen, Eli Lilly, Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau, William Tillett Grant/research support from: AbbVie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer Inc, UCB, Consultant of: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, MSD, Pfizer Inc, UCB, Speakers bureau: AbbVie, Amgen, Celgene, Lilly, Janssen, Novartis, Pfizer Inc, UCB
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Leung YY, Holland R, Mathew A, Lindsay C, Goel N, Ogdie A, Orbai AM, Hoejgaard P, Chau J, Coates LC, Strand V, Gladman DD, Christensen R, Tillett W, Mease PJ. AB0794 CLINICAL TRIAL DISCRIMINATION OF PHYSICAL FUNCTION INSTRUMENTS FOR PSORIATIC ARTHRITIS: A SYSTEMATIC REVIEW. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Physical function is a core domain to be measured in randomized controlled trials (RCTs) of psoriatic arthritis (PsA). The discriminative performance of patient reported outcome measures (PROMs) for physical function (PF) in RCTs has not been evaluated systematically.Objectives:In this systematic review, the GRAPPA-OMERACT working group aimed to evaluate the clinical trial discrimination of PF-PROMs in PsA RCTs.Methods:We searched PubMed and Scopus databases in English to identify all original RCTs conducted in PsA. We limited the review to RCTs of biologic and targeted synthetic DMARDs. Groups of two researchers extracted data independently for PF-PROMs. We assessed quality in each article using the OMERACT good method checklist. Effect sizes (ES) for the PF-PROMs were calculated and appraised usinga priorihypotheses. Evidence supporting clinical trial discrimination for each PF-PROM was summarized to derive recommendations.Results:32 articles were included (Figure 1). Four PF-PROMs had data for evaluation: HAQ-Disability Index (DI), HAQ-Spondyloarthritis (S), Short Form 36-item Health Survey Physical Component Summary (SF-36 PCS), and the Physical Functioning domain (SF-36 PF) (Table 1). The ES for intervention versus (vs.) control arms for HAQ-DI ranged from -0.55 to -1.81 vs. 0.24 to -0.52; and for SF-36 PCS ranged from 0.30 to 1.86 vs. -0.02 to 0.63.Table 1.Summary of Measurement Properties Table for clinical trial discriminationArticlesHAQ-DIHAQ-SSF-36 PCSSF-36 PFAntoni 2005 (IMPACT); Gottlieb 2009 (UST)+Antoni 2005 (IMPACT2)++Kavanaugh 2006 (IMPACT2)+Mease 2005 (ADEPT); Genovese 2007 (ADA); Mease 2010 (ETN); Kavanaugh 2009 (GO-REVEAL); Kavanaugh 2017 (GO-VIBRANT); Gladman 2014 (RAPID-PsA); Mease 2015 (FUTURE1); McInnes 2015 (FUTURE2); Kavanaugh, 2016 (FUTURE2)-subgroup; Nash 2018 (FUTURE3); Mease 2017 (SPIRIT-P1); Nash 2017 (SPIRIT-P2); Deodhar 2018 (GUS); Mease 2016 (CLZ)++Mease 2000 (ETN); McInne, 2013 (PSUMMIT 1); Ritchlin 2014 (PSUMMIT 2); Araugo 2019 (ECLIPSA)++Gniadecki 2012 (PRESTA)+Mease 2019 (SEAM-PsA)+/-+McInnes 2014 (SEC)++Mease 2014 (BRO)++Mease 2011 (ABT)+/-+Mease 2017 (ASTRAEA)++Mease 2006 (ALC)+/-Mease 2017 (OPAL Broaden); Gladman 2017 (OPAL Beyond)++Mease 2018 (EQUATOR)++Mease 2018 (ABT-122)+Total available articles311244Total articles for evidence synthesis291232Overall rating+++Color code in each box indicate study quality by OMERACT good methods. GREEN: “likely low risk of bias”; AMBER: “some cautions but can be used as evidence”; RED: “don’t use as evidence”. WHITE (empty boxes): absence of information from that study. (+): findings had adequate performance of the instrument; (+/-): equivocal performance; (-): poor performance (less than adequate).Conclusion:Clinical trial discrimination was supported for HAQ-DI and SF-36 PCS in PsA with low risk of bias; and for SF-36 PF with some caution. More studies are required for HAQ-S.Disclosure of Interests:Ying Ying Leung Speakers bureau: Novartis, Janssen, Eli Lilly, Richard Holland: None declared, Ashish Mathew: None declared, Christine Lindsay Employee of: Previously employed (worked) for pharmaceutical company., Niti Goel Shareholder of: UCB and Galapagos, Consultant of: VielaBio, Mallinckrodt, and IMMVention, Alexis Ogdie Grant/research support from: Novartis, Pfizer – grant/research support, Consultant of: AbbVie, BMS, Eli Lilly, Novartis, Pfizer, Takeda – consultant, Ana-Maria Orbai Grant/research support from: Abbvie, Eli Lilly and Company, Celgene, Novartis, Janssen, Horizon, Consultant of: Eli Lilly; Janssen; Novartis; Pfizer; UCB. Ana-Maria Orbai was a private consultant or advisor for Sun Pharmaceutical Industries, Inc, not in her capacity as a Johns Hopkins faculty member and was not compensated for this service., Pil Hoejgaard: None declared, Jeffrey Chau: None declared, Laura C Coates: None declared, Vibeke Strand: None declared, Dafna D Gladman Grant/research support from: AbbVie, Amgen Inc., BMS, Celgene Corporation, Janssen, Novartis, Pfizer, UCB – grant/research support, Consultant of: AbbVie, Amgen Inc., BMS, Celgene Corporation, Janssen, Novartis, Pfizer, UCB – consultant, Robin Christensen: None declared, William Tillett: None declared, Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau
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Yamazaki EM, Rosendahl-Garcia KM, MacMullen LE, Ecker AJ, Kirkpatrick JN, Goel N. 0042 Stroke Volume and Cardiac Index are Differentially Altered by Total Sleep Deprivation and Psychological Stress in Resilient vs. Vulnerable Individuals and Predict Cognitive Performance. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.041] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Individuals show robust resilience and vulnerability in neurobehavioral performance to sleep loss and stress. For the first time, we investigated the time course of two cardiovascular measurements, stroke volume (SV) and cardiac index (CI), both derived from echocardiography, across baseline, total sleep deprivation (TSD), the combination of TSD+psychological stress, and recovery. We also determined whether these variables differ in resilient vs. vulnerable individuals and whether they predict differential vulnerability in cognitive performance.
Methods
Thirty-one healthy adults (ages 27–53; mean±SD, 35.4±7.1y; 14 females) participated in a five-day experiment consisting of two 8h time-in-bed (TIB) baseline nights, 39h TSD, and two 8h-10h TIB recovery nights. A modified Trier Social Stress Test (TSST) was conducted on the TSD day to induce psychological stress. Echocardiographic measures of SV and CI were obtained at six time points (pre-study, baseline, during TSD, during TSD after the TSST, after recovery, and post-study). A median split of TSD performance [total lapses (>500 ms response time) and errors] on the 10-minute Psychomotor Vigilance Test (PVT), defined cognitively resilient (n=15) and vulnerable (n=16) groups. Repeated measures ANOVA and post-hoc comparisons corrected for multiple testing, examined SV and CI across time points between groups.
Results
There was a significant time*group interaction for SV: cognitively resilient individuals had greater SV during the five-day experiment. In addition, in both resilient and vulnerable individuals, SV increased with TSD and with TSD+psychological stress compared with baseline. Like SV, there was a significant time*group interaction for CI: resilient individuals had greater CI at all points of the experiment.
Conclusion
SV and CI differed between resilient and vulnerable individuals across TSD, psychological stress and recovery sleep. Greater SV and greater CI at baseline predicted resilience to TSD and TSD+psychological stress. CI and SV are novel physiological biomarkers of sleep loss, stress, and individual differences in cognitive performance.
Support
NASA NNX14AN49G.
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Affiliation(s)
- E M Yamazaki
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | | | - L E MacMullen
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - A J Ecker
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - J N Kirkpatrick
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA
| | - N Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
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Galli O, Goel N, Basner M, Detre J, Thase M, Sheline Y, Rao H, Dinges D, Gehrman P. 1100 Self-Monitoring Of PVT Performance In Healthy Adults And Individuals With MDD. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1095] [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
Negativity bias in depression has been repeatedly demonstrated in the judgment and decision-making literature. Research investigating the impact of sleep deprivation on self-evaluation of performance in healthy or depressed populations is limited. We examined 1) whether individuals with Major Depressive Disorder (MDD) exhibit a negativity bias in subjective ratings of performance on the Psychomotor Vigilance Task (PVT) as compared with healthy adults, and 2) the impact of total sleep deprivation (TSD) on these ratings.
Methods
N=33 individuals with MDD and n=9 healthy adults completed a 5-day study protocol including two baseline nights (B1-B2, 9h TIB), 36 hours of TSD, and one night of recovery sleep opportunity (Rec). The PVT was administered every 2-4 hours. A brief questionnaire was administered immediately prior to (PRE) and following (POST) the PVT, asking participants to estimate their average reaction time (RT) using a 9-point Likert-type scale. Mixed-effects models examined the impact of group (MDD, Control), protocol day (B1, B2, SD, Rec), and their interaction on objective PVT performance (mean RT) and subjective performance estimates (PRE and POST ratings).
Results
Mean RT was significantly slower during TSD (p<0.001) for all participants. Individuals with MDD and healthy adults did not differ in objective PVT performance (p=0.25) across days. There was no significant interaction between group and protocol day (p=0.96). Both groups predicted slower RTs during TSD as compared with baseline or recovery days (PRE-PVT, p=0.006). Individuals with MDD anticipated slower RTs as compared with healthy adults (p=0.001). On POST-PVT estimates, all participants reported subjective poorer performance during TSD (p<0.008). Individuals with MDD reported slower RTs as compared with healthy adults (p=0.002). Interaction effects between group and protocol day on PRE- and POST- performance ratings were not significant.
Conclusion
This project is the first to investigate subjective estimates of PVT performance in healthy and depressed individuals. Individuals with MDD subjectively reported slower response times as compared with control participants, despite similar objective performance. Depressive symptoms may be a potential confounder of subjective, but not objective, PVT performance.
Support
5R01MH107571
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Affiliation(s)
- O Galli
- University of Pennsylvania, Philadelphia, PA
| | - N Goel
- Rush University Medical Center, Chicago, IL
| | - M Basner
- University of Pennsylvania, Philadelphia, PA
| | - J Detre
- University of Pennsylvania, Philadelphia, PA
| | - M Thase
- University of Pennsylvania, Philadelphia, PA
| | - Y Sheline
- University of Pennsylvania, Philadelphia, PA
| | - H Rao
- University of Pennsylvania, Philadelphia, PA
| | - D Dinges
- University of Pennsylvania, Philadelphia, PA
| | - P Gehrman
- University of Pennsylvania, Philadelphia, PA
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Yamazaki EM, Rosendahl-Garcia KM, MacMullen LE, Ecker AJ, Kirkpatrick JN, Goel N. 0041 Heart Rate Variability Differs in Resilient vs. Vulnerable Adults from Total Sleep Deprivation and Psychological Stress and Predicts Cognitive Performance. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.040] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
There are substantial individual differences (resilience and vulnerability) in neurobehavioral performance from psychosocial stress and sleep loss. However, the time course of heart rate variability (HRV) across baseline, total sleep deprivation (TSD), the combination of TSD + psychological stress, and recovery has not been investigated; in addition, it remains unknown whether HRV and blood pressure (BP) differ in resilient vs. vulnerable individuals and predict individual differences in cognitive performance.
Methods
Thirty-one healthy adults (ages 27–53; mean±SD, 35.4±7.1y; 14 females) participated in a five-day experiment consisting of two 8h time-in-bed (TIB) baseline nights, 39h TSD, and two 8h-10h TIB recovery nights. A modified Trier Social Stress Test (TSST) induced psychological stress on the TSD day. Systolic and diastolic BP and HRV (derived from echocardiographic R-R interval) were obtained at six time points (pre-study, baseline, during TSD, during TSD after the TSST, after recovery, and post-study). Cognitively resilient (n=15) and vulnerable (n=16) groups were defined by a median split on 10-minute Psychomotor Vigilance Test (PVT) TSD performance [total lapses (>500ms response time) and errors]. Repeated measures ANOVA and post-hoc comparisons corrected for multiple testing, examined BP and HRV across time points between groups.
Results
HRV showed a significant time*group interaction: while resilient individuals had significantly lower HRV at pre-study compared to vulnerable individuals, their HRV increased above that of vulnerable individuals with TSD and with TSD + psychological stress. By contrast, systolic and diastolic BP did not show significant time*group interactions and did not predict cognitive vulnerability during TSD.
Conclusion
HRV differed between resilient and vulnerable individuals across TSD, psychological stress and recovery sleep and predicted individual differences in cognitive performance, whereby lower HRV during full-rested conditions predicted resilience to TSD and TSD + psychological stress. HRV, but not BP, is a reliable biomarker of sleep deprivation, psychological stress, and neurobehavioral vulnerability.
Support
NASA NNX14AN49G.
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Affiliation(s)
- E M Yamazaki
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | | | - L E MacMullen
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - A J Ecker
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - J N Kirkpatrick
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA
| | - N Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
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20
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Titone MK, McArthur B, Ng TH, Burke TA, McLaughlin LE, MacMullen LE, Alloy LB, Goel N. 0364 Sex and Race Influence Objective and Self-Report Sleep and Circadian Measures in Emerging Adults at Risk for Bipolar Spectrum Disorder. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.361] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
There is a critical need to understand key factors that impact sleep and circadian rhythm function for emerging adults at risk for bipolar spectrum disorder (BSD). Sex and race are common demographic factors contributing to differences in health outcomes; however, the influence of these variables on sleep and circadian rhythm patterns for emerging adults at risk for BSD has not been characterized.
Methods
Multiple objective and self-report facets of sleep and circadian function, including dim light melatonin onset (DLMO), and measures derived from actigraphy and sleep diaries, were assessed in a 20-day ecological momentary assessment (EMA) study of 150 emerging adults (mean ± SD, 21.8 ± 2.1y; 58.7% female; 57.9% White, 23.4% Black, 10.3% Asian or Pacific Islander, 8.0% Other ethnicity) at-risk for BSD. Bivariate Pearson correlations (two-tailed, p <.05) were conducted between the sleep and circadian measures. ANCOVAs, controlling for BSD status, were conducted to evaluate differences on sleep and circadian characteristics by sex and race.
Results
Males exhibited better actigraphic sleep efficiency and later DLMO phase than females, whereas females exhibited more actigraphic discrete sleep periods. White participants exhibited more actigraphy-measured total sleep time, better sleep efficiency, and fewer sleep periods, and self-reported more total sleep time and better sleep efficiency than Black participants.
Conclusion
We show for the first time that sex and race are significant predictors of objective and self-reported sleep and circadian rhythm measures in a large sample of emerging adults at risk for BSD participating in an EMA study. Our findings extend the existing literature to a novel clinical population and to a naturalistic setting and inform ongoing research on sex and racial health disparities in sleep and circadian rhythms.
Support
This work was supported by NIH R01 MH77908 and R01 MH102310; a Banting Postdoctoral Fellowship from the Social Sciences and Humanities Research Council; and a National Science Foundation Graduate Student Research Fellowship.
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Affiliation(s)
- M K Titone
- Department of Psychology, Temple University, Philadelphia, PA
| | - B McArthur
- Department of Psychology, University of Calgary, Calgary, AB, CANADA
| | - T H Ng
- Department of Psychology, Temple University, Philadelphia, PA
| | - T A Burke
- Department of Psychiatry and Human Behavior, Alpert Medical School Brown University, Providence, RI
| | - L E McLaughlin
- Department of Psychology, Temple University, Philadelphia, PA
| | - L E MacMullen
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - L B Alloy
- Department of Psychology, Temple University, Philadelphia, PA
| | - N Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
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21
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Goel N, Yamazaki EM, MacMullen LE, Ecker AJ. 0265 Cortisol and C-Reactive Protein Fail to Predict Individual Differences in Neurobehavioral Performance Responses to Total Sleep Deprivation and Psychological Stress. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.263] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Individuals show marked differential vulnerability in neurobehavioral deficits from psychosocial stress and sleep deprivation. Although changes in salivary cortisol and C-reactive protein (CRP) typically occur across total sleep deprivation (TSD) and recovery sleep, whether these biological markers during fully rested conditions predict individual differences in cognitive performance during TSD and stress remains unknown.
Methods
Thirty-one healthy adults (ages 27–53; mean ± SD, 35.4 ± 7.1y; 14 females) participated in a five-day experiment consisting of two 8h time-in-bed (TIB) baseline nights, followed by 39h TSD, and two 8h-10h TIB recovery nights. A modified Trier Social Stress Test (TSST) was conducted on the day of TSD to induce psychological stress. Salivary cortisol and CRP from blood were obtained at six time points during the study (pre-study, baseline, during TSD, during TSD after the TSST, after recovery, and post-study). A median split of TSD performance [total lapses (>500 ms response time) and errors] on the 10-minute Psychomotor Vigilance Test (PVT) defined cognitively resilient (n=15) and cognitively vulnerable (n=16) groups. Repeated measures ANOVA and post-hoc comparisons corrected for multiple testing, examined cortisol and CRP across time points between groups.
Results
In both cognitively resilient and vulnerable individuals, cortisol increased with TSD compared to baseline in the morning and decreased with TSD + psychological stress in the afternoon compared to TSD alone. By contrast, there were no significant changes in CRP levels throughout the experiment. In addition, there were no significant time*group interactions in cortisol or CRP levels.
Conclusion
Salivary cortisol increased with TSD compared to baseline and showed a time-of-day effect with stress during TSD. Notably, cortisol and CRP did not differ between cognitively resilient and vulnerable individuals across TSD, psychological stress or recovery sleep and thus are not reliable biomarkers for predicting performance under these conditions.
Support
NASA NNX14AN49G.
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Affiliation(s)
- N Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - E M Yamazaki
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - L E MacMullen
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - A J Ecker
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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Malone SK, Peleckis AJ, Pack AI, Perez N, Yu G, Rickels MR, Goel N. 1020 Sleep and Glycemic Control in Adults With Long-Standing Type 1 Diabetes and Hypoglycemia Unawareness. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1016] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Nocturnal hypoglycemia is life threatening for individuals with type 1 diabetes (T1D) due to loss of hypoglycemia symptom recognition (hypoglycemia unawareness) and impaired glucose counterregulation. These individuals also show disturbed sleep, which may result from glycemic dysregulation. Whether use of a hybrid closed loop (HCL) insulin delivery system with integrated continuous glucose monitoring (CGM) designed for improving glycemic control, relates to better sleep across time in this population remains unknown.
Methods
Six adults (median age=58y,T1D duration=41y) participated in an 18-month ongoing clinical trial assessing the effectiveness of an HCL system. Sleep and glycemic control were measured concurrently using wrist actigraphs and CGM at baseline (1 week) and months 3 and 6 (3 weeks) following HCL initiation. BMI and hemoglobin A1c (HbA1c) were collected at all timepoints. Spearman’s correlations modeled associations between sleep, BMI, and glycemic control at each time point. Repeated ANOVAs modeled sleep and glycemic control changes from baseline to 3 months and to 6 months.
Results
Sleep and glycemic control indices showed significant associations at baseline and 3 months. More time-in-bed and later sleep offset related to higher HbA1c levels at baseline. Later sleep onset, midpoint and offset, and greater sleep efficiency associated with greater %time with hyperglycemia (glucose >180 mg/dL) or hypoglycemia (glucose <70 mg/dL) at baseline and 3 months. Longer sleep duration and greater sleep efficiency related to greater %time with hyperglycemia at 3 months. At 3 months, more wake after sleep onset associated with lower HbA1c levels and longer nocturnal awakenings and more sleep fragmentation associated with less glycemic variability. While both sleep and glycemic control improved from baseline to 3 and 6 months, these were not statistically significant.
Conclusion
Various dimensions of actigraphic sleep related to concurrently estimated glycemic indices indicative of poorer glycemic control and HbA1c across time in adults with long-standing T1D and hypoglycemia unawareness.
Support
This work was supported by NIH R01DK117488 (NG), R01DK091331 (MRR), and K99NR017416 (SKM).
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Affiliation(s)
- S K Malone
- Rory Meyers College of Nursing, New York University, New York, NY
| | - A J Peleckis
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - A I Pack
- Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - N Perez
- Rory Meyers College of Nursing, New York University, New York, NY
| | - G Yu
- Rory Meyers College of Nursing, New York University, New York, NY
| | - M R Rickels
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - N Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
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Abstract
Fibrosing mediastinitis (FM) is characterized by extensive and invasive fibro-inflammatory proliferation, triggered by a delayed hypersensitivity reaction to variety of infective or noninfective stimuli. The infective agents often have a geographic distribution such as Histoplasma capsulatum in North America and Mycobacterium tuberculosis in Asian regions. In few reports, the mediastinitis is caused by fungi, particularly Aspergillus species. We report the first case of possible aspergillous FM in a young pregnant woman.
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Affiliation(s)
- P Vaideeswar
- Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - J Chaudhari
- Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - N Goel
- Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Gupta H, Batta NS, Kataria H, Batra V, Upadhyay AD, Jain V, Mishra P, Goel N. A Comparison of the Reliability of the Patellar Tendon-Trochlear Groove (PTTG) Distance and the Tibial Tuberosity-Trochlear Groove (TTTG) Distance Measured on MRI. Malays Orthop J 2020; 14:34-41. [PMID: 32296480 PMCID: PMC7156171 DOI: 10.5704/moj.2003.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Introduction: An increased tibial tuberosity-trochlear groove (TTTG) distance is used for deciding a treatment plan in patello-femoral instability (PFI). The centre of the patellar tendon and the chondral trochlear groove can be directly visualised on MRI, and measured, giving the patellar tendon-trochlear groove (PTTG) distance. A study was designed to compare the inter-rater and the test-retest reliabilities of PTTG and TTTG measurements in MRI of patients without PFI and in a group with PFI. Materials and Methods: This cross-sectional reliability study was done on archival MRI films of 50 patients without patellar instability and 20 patients with patellar instability. TTTG and PTTG distances were independently measured by two orthopaedic surgeons and two radiologists. A hybrid PTTG measurement with bony landmarks on the femoral side and the patellar tendon landmark on the tibial side, was used to estimate the influence of the differences in the femoral and tibial landmarks on the difference in reliabilities. The intra-class correlation coefficient (ICC) was calculated for all four raters, as well as separately for each rater. Results: The PTTG distance had a higher inter-rater reliability (ICC=0.86, 95% CI=0.79-0.92) compared to the TTTG distance (ICC=0.70, 95% CI=0.59-0.80) in patients without PFI. Similar trends were seen in patients with PFI (0.83 vs 0.66). The inter-rater reliability for the hybrid PTTG distance was found to lie in between the TTTG and PTTG. Conclusions: The MRI-based PTTG distance had better inter-rater reliability compared with the MRI-based TTTG distance.
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Affiliation(s)
- H Gupta
- Department of Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - N S Batta
- Department of Radiodiagnosis, Mahajan Imaging, New Delhi, India
| | - H Kataria
- Department of Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - V Batra
- Department of Radiodiagnosis, Mahajan Imaging, New Delhi, India
| | - A D Upadhyay
- Department of Biostatistics, All India Institute Of Medical Sciences, New Delhi, India
| | - V Jain
- Department of Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - P Mishra
- Department of Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - N Goel
- Department of Sports Injury Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Affiliation(s)
- N. Goel
- Department of Chemistry and Centre for Advanced Studies in Chemistry, Panjab University, Chandigarh, India
| | - S. Gupta
- University Institute of Engineering & Technology, Panjab University, Chandigarh, India
| | - M. Sadhukhan
- Department of Chemistry, Indian Institute of Technology, Kanpur, India
| | - B. M. Deb
- Publishing Department, Visva-Bharati University, Kolkata, India
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Lubos D, Park J, Faestermann T, Gernhäuser R, Krücken R, Lewitowicz M, Nishimura S, Sakurai H, Ahn DS, Baba H, Blank B, Blazhev A, Boutachkov P, Browne F, Čeliković I, de France G, Doornenbal P, Fang Y, Fukuda N, Giovinazzo J, Goel N, Górska M, Ilieva S, Inabe N, Isobe T, Jungclaus A, Kameda D, Kim YK, Kojouharov I, Kubo T, Kurz N, Kwon YK, Lorusso G, Moschner K, Murai D, Nishizuka I, Patel Z, Rajabali MM, Rice S, Schaffner H, Shimizu Y, Sinclair L, Söderström PA, Steiger K, Sumikama T, Suzuki H, Takeda H, Wang Z, Warr N, Watanabe H, Wu J, Xu Z. Improved Value for the Gamow-Teller Strength of the ^{100}Sn Beta Decay. Phys Rev Lett 2019; 122:222502. [PMID: 31283269 DOI: 10.1103/physrevlett.122.222502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/11/2019] [Indexed: 06/09/2023]
Abstract
A record number of ^{100}Sn nuclei was detected and new isotopic species toward the proton dripline were discovered at the RIKEN Nishina Center. Decay spectroscopy was performed with the high-efficiency detector arrays WAS3ABi and EURICA. Both the half-life and the β-decay end point energy of ^{100}Sn were measured more precisely than the literature values. The value and the uncertainty of the resulting strength for the pure 0^{+}→1^{+} Gamow-Teller decay was improved to B_{GT}=4.4_{-0.7}^{+0.9}. A discrimination between different model calculations was possible for the first time, and the level scheme of ^{100}In is investigated further.
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Affiliation(s)
- D Lubos
- Physik Department E12, Technische Universität München, D-85748 Garching, Germany
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - J Park
- TRIUMF, Vancouver British Columbia, V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - T Faestermann
- Physik Department E12, Technische Universität München, D-85748 Garching, Germany
- Excellence Cluster "Origin and Structure of the Universe", D-85748, Garching, Germany
| | - R Gernhäuser
- Physik Department E12, Technische Universität München, D-85748 Garching, Germany
| | - R Krücken
- Physik Department E12, Technische Universität München, D-85748 Garching, Germany
- TRIUMF, Vancouver British Columbia, V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - M Lewitowicz
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Boulevard H. Becquerel, 14076 Caen, France
| | - S Nishimura
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Sakurai
- University of Tokyo, 7-3-1 Hongo Bunkyo, Tokyo 113-0033, Japan
| | - D S Ahn
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - B Blank
- CEN Bordeaux-Gradignan Le Haut-Vigneau, F-33175 Gradignan Cedex, France
| | - A Blazhev
- Institute of Nuclear Physics, University of Cologne, D-50937 Cologne, Germany
| | - P Boutachkov
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - F Browne
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- School of Computing, Engineering and Mathematics, University of Brighton, Brighton, BN2 4GJ, United Kingdom
| | - I Čeliković
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Boulevard H. Becquerel, 14076 Caen, France
- "Vinča" Institute of Nuclear Sciences, University of Belgrade, 11000 Belgrade, Serbia
| | - G de France
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Boulevard H. Becquerel, 14076 Caen, France
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Fang
- Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - N Fukuda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - J Giovinazzo
- CEN Bordeaux-Gradignan Le Haut-Vigneau, F-33175 Gradignan Cedex, France
| | - N Goel
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - M Górska
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - S Ilieva
- Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - N Inabe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Jungclaus
- Instituto de Estructura de la Materia, IEM-CSIC, E-28006 Madrid, Spain
| | - D Kameda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y K Kim
- Rare Isotope Science Project, Institute for Basic Science, Daejeon 305-811, Republic of Korea
- Department of Nuclear Engineering, Hanyang University, Seoul 133-791, Republic of Korea
| | - I Kojouharov
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - T Kubo
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Kurz
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - Y K Kwon
- Rare Isotope Science Project, Institute for Basic Science, Daejeon 305-811, Republic of Korea
| | - G Lorusso
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Moschner
- Institute of Nuclear Physics, University of Cologne, D-50937 Cologne, Germany
| | - D Murai
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - I Nishizuka
- Department of Physics, Faculty of Science, Tohoku University, Sendai 980-0845, Japan
| | - Z Patel
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - M M Rajabali
- TRIUMF, Vancouver British Columbia, V6T 2A3, Canada
- Physics Department, Tennessee Technological University, Cookeville, Tennessee 38505, USA
| | - S Rice
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - H Schaffner
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - Y Shimizu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - L Sinclair
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- University of York, York YO10 5DD, United Kingdom
| | - P-A Söderström
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Steiger
- Physik Department E12, Technische Universität München, D-85748 Garching, Germany
| | - T Sumikama
- Department of Physics, Faculty of Science, Tohoku University, Sendai 980-0845, Japan
| | - H Suzuki
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Takeda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Z Wang
- TRIUMF, Vancouver British Columbia, V6T 2A3, Canada
| | - N Warr
- Institute of Nuclear Physics, University of Cologne, D-50937 Cologne, Germany
| | - H Watanabe
- Beihang University, Beijing 100191, China
| | - J Wu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Peking University, Beijing 100871, China
| | - Z Xu
- University of Tokyo, 7-3-1 Hongo Bunkyo, Tokyo 113-0033, Japan
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Roane B, Goel N, Londono A, Toboni M, Arend R. Analysis of the utilization of next generation sequencing in gynecologic malignancies. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Iyengar A, Han J, Helmers M, Patrick W, Chung J, Goel N, Atluri P. Orthotopic Heart Transplant Volume Can Be Aggressively Increased While Maintaining Outcomes. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sandhu VK, Goel N, Duro T. Hydroxychloroquine: do we all see eye to eye? A single-site analysis of hydroxychloroquine dosing compared with the 2016 Revision of the American Academy of Ophthalmology guidelines. Lupus 2019; 28:438-439. [PMID: 30712492 DOI: 10.1177/0961203319826682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- V K Sandhu
- Loma Linda University Medical Center, Loma Linda, CA, USA
| | - N Goel
- Loma Linda University Medical Center, Loma Linda, CA, USA
| | - T Duro
- Loma Linda University Medical Center, Loma Linda, CA, USA
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Kaliki S, Pyda S, Goel N, Dave TV, Naik MN, Mishra DK. Malignant eyelid tumors: Are intra-operative rapid frozen section and permanent section diagnoses of surgical margins concordant? Int Ophthalmol 2018; 39:2205-2211. [PMID: 30535567 DOI: 10.1007/s10792-018-1058-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 12/03/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE To study the concordance between intra-operative rapid frozen section and permanent section diagnoses of surgical margins following wide surgical excisional biopsy of malignant eyelid tumors. METHODS This is a retrospective study of 120 cases and 429 frozen section slides. RESULTS Of 120 cases, 75 (63%) had sebaceous gland carcinoma, 34 (28%) had basal cell carcinoma, and 11 (9%) had squamous cell carcinoma. All cases with these malignant eyelid tumors underwent wide surgical excisional biopsy under frozen section control of surgical margins. A total of 429 frozen section slides were reviewed for rapid frozen section diagnosis. Eyelid reconstruction was performed in all cases after clearance was obtained by rapid frozen section diagnosis of surgical margins as negative for tumor infiltration. Permanent section diagnosis of surgical margins was positive for tumor infiltration in 5 (1%) slides, which were reported as negative on rapid frozen section diagnosis of surgical margins, and was negative for tumor infiltration in 3 (< 1%), which were reported as positive on initial rapid frozen section diagnosis of surgical margins. The sensitivity, specificity, and accuracy of intra-operative rapid frozen section diagnosis of surgical margins for malignant eyelid tumors were 89%, 99%, and 98%, respectively. CONCLUSION The concordance between the intra-operative rapid frozen section and permanent section diagnoses of surgical margins following wide surgical excisional biopsy of malignant eyelid tumors is excellent at 98%.
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Affiliation(s)
- Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, 500034, India.
| | - Sasi Pyda
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Nupur Goel
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Tarjani Vivek Dave
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Milind N Naik
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Dilip K Mishra
- Ophthalmic Pathology Laboratory (DKM), L V Prasad Eye Institute, Hyderabad, India
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Alloy LB, Ng TH, Titone MK, Dennis LE, Goel N. 0053 Circadian and Reward Measures Show Robust Bidirectional Relationships in Bipolar Spectrum Disorder in a 20-Day Naturalistic Ecological Momentary Assessment Study. Sleep 2018. [DOI: 10.1093/sleep/zsy061.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L B Alloy
- Department of Psychology, Temple University, Philadelphia, PA
| | - T H Ng
- Department of Psychology, Temple University, Philadelphia, PA
| | - M K Titone
- Department of Psychology, Temple University, Philadelphia, PA
| | - L E Dennis
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - N Goel
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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Zajko MJ, Taylor DM, Pearson-Leary J, Bhatnagar S, Goel N. 0012 Peripheral MicroRNAs Are Altered by Total Sleep Deprivation and Psychological Stress and Predict Cognitive Performance in Humans. Sleep 2018. [DOI: 10.1093/sleep/zsy061.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M J Zajko
- Department of Biomedical and Health Informatics, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - D M Taylor
- Department of Biomedical and Health Informatics, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - J Pearson-Leary
- Department of Anesthesiology, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - S Bhatnagar
- Department of Anesthesiology, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - N Goel
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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Goel N, Titone MK, Ng TH, Dennis LE, Alloy LB. 0054 Circadian Measures Are Not Phase Delayed in Bipolar Spectrum Disorder in a 20-Day Naturalistic Ecological Momentary Assessment Study. Sleep 2018. [DOI: 10.1093/sleep/zsy061.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Goel
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - M K Titone
- Department of Psychology, Temple University, Philadelphia, PA
| | - T H Ng
- Department of Psychology, Temple University, Philadelphia, PA
| | - L E Dennis
- Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - L B Alloy
- Department of Psychology, Temple University, Philadelphia, PA
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Miller G, Khariton K, Kardos S, Koh E, Goel N, Khariton A. Flow Interruption of the Distal Radial Artery: Treatment for Finger Ischemia in a Matured Radiocephalic AVF. J Vasc Access 2018. [DOI: 10.1177/112972980800900110] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose To establish an effective approach for diagnosis and treatment of hand ischemia in matured radiocephalic arteriovenous fistulae (AVF). Methods One hundred and fifty end-stage renal disease patients (4% of our practice) presented to our outpatient vascular access facility complaining of a range of symptoms including coldness, numbness and pain in the fingers indicative of ischemia due to steal syndrome. In 15 patients the symptoms of steal syndrome were limited to the fingers, sparing the hand. Physical examination was indicative of steal syndrome caused by shunting of blood from the ulnar artery via the palmar arch, away from the fingers and into the fistula. To confirm the diagnosis, angiography was performed which demonstrated retrograde flow in the distal radial artery (DRA), a hypertrophied palmar arch, and a patent hypertrophied ulnar artery. Ischemia was treated with DRA flow interruption. Transcatheter coil embolization of the DRA (10 patients) was preferred because it proved to be a quick, safe and effective technique. Whenever embolization was not possible ligation of the DRA was performed in accordance with accepted surgical literature (five patients). Results DRA flow interruption was effectively accomplished by either ligation or coil embolization in all cases. All patients had symptomatic improvement. Complete symptom resolution was experienced by 100% (10/10) of patients who received DRA embolization and by 3/5 patients who required ligation. The average follow-up period was 9 months. There were no complications during the procedure or during the follow-up period. Conclusion Diagnosis using physical examination, angiography and treatment with embolization or ligation of the DRA can be performed with great success in an outpatient setting.
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Affiliation(s)
- G.A. Miller
- American Access Care of Brooklyn, New York - USA
| | - K. Khariton
- American Access Care of Brooklyn, New York - USA
| | - S.V. Kardos
- American Access Care of Brooklyn, New York - USA
| | - E. Koh
- American Access Care of New Jersey, New York - USA
| | - N. Goel
- American Access Care of Florida, Plantation FL - USA
| | - A. Khariton
- American Access Care of Brooklyn, New York - USA
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Grover C, Goel N, Armour C, Van Asperen PP, Gaur SN, Moles RJ, Saini B. Medication education program for Indian children with asthma: A feasibility stud. Niger J Clin Pract 2017; 19:76-84. [PMID: 26755223 DOI: 10.4103/1119-3077.173716] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE It is postulated that children with asthma who receive an interactive, comprehensive, culturally relevant education program would improve their asthma knowledge (AK), asthma control, and adherence compared with children receiving usual care. The aim of this study was to develop, implement, and evaluate the efficacy of a culturally relevant asthma education intervention for children with asthma and their parents in India. METHODS Children with asthma (7-12 years) and their parents were recruited from an outpatient clinic in a Chest Diseases Hospital in New Delhi, and were randomly assigned to either an intervention or usual care group. At baseline, outcome data collected included pediatric asthma caregiver quality of life (PACQL, primary outcome), AK, asthma control, adherence, inhaler technique, action plan ownership, and goal achievement. These data were collected again at 1 and 6 months after baseline. Outcomes were compared within and between groups using ANOVA techniques. RESULTS Forty parent-child pairs were recruited. Of these, 24 pairs of children with asthma and their parents received the educational intervention. The PACQL significantly improved from baseline to 6 months in the intervention (5.87 ± 0.94-7.00 ± 0.03) versus the usual care group (5.90 ± 0.52-6.34 ± 0.56) (P < 0.001). Other outcomes such as the parents' and child's AK, child's asthma control and inhaler technique were significantly improved in the intervention group across the study. All the participants possessed a written asthma action plan at the end of the intervention. Eighty-five goals were set by children with asthma across all the visits and were achieved by completion. CONCLUSION An asthma educator delivered interactive program simultaneously involving children with asthma and their parents, improved quality of life, empowered and promoted better self-management skills.
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Affiliation(s)
- C Grover
- Faculty of Pharmacy, The University of Sydney, New South Wales, Australia
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Freeman E, Harper J, Goel N, Gilbert I, Unguris J, Schiff SJ, Tadigadapa S. Improving the magnetoelectric performance of Metglas/PZT laminates by annealing in a magnetic field. Smart Mater Struct 2017; 26:085038. [PMID: 28966478 PMCID: PMC5615411 DOI: 10.1088/1361-665x/aa770b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A comprehensive investigation of magnetostriction optimization in Metglas 2605SA1 ribbons is performed to enhance magnetoelectric performance. We explore a range of annealing conditions to relieve remnant stress and align the magnetic domains in the Metglas, while minimizing unwanted crystallization. The magnetostriction coefficient, magnetoelectric coefficient, and magnetic domain alignment are correlated to optimize magnetoelectric performance. We report on direct magnetostriction observed by in-plane Doppler vibrometer and domain imagining using scanning electron microscopy with polarization analysis for a range of annealing conditions. We find that annealing in an oxygen-free environment at 400 °C for 30 min yields an optimal magnetoelectric coefficient, magnetostriction and magnetostriction coefficient. The optimized ribbons had a magnetostriction of 50.6 ± 0.2 μm m-1 and magnetoelectric coefficient of 79.3 ± 1.5 μm m-1 mT-1. The optimized Metglas 2605SA1 ribbons and PZT-5A (d31 mode) sensor achieves a magnetic noise floor of approximately 600 pT Hz-1/2 at 100 Hz and a magnetoelectric coefficient of 6.1 ± 0.03 MV m-1 T-1.
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Affiliation(s)
- E Freeman
- Department of Electrical Engineering, The Pennsylvania State University, University Park, PA, United States of America
| | - J Harper
- Center for Neural Engineering, Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, United States of America
| | - N Goel
- Department of Electrical Engineering, The Pennsylvania State University, University Park, PA, United States of America
| | - I Gilbert
- Center for Nanoscale Science and Technology, National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - J Unguris
- Center for Nanoscale Science and Technology, National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - S J Schiff
- Center for Neural Engineering, Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, United States of America
- Departments of Neurosurgery and Physics, The Pennsylvania State University, University Park, PA, United States of America
| | - S Tadigadapa
- Department of Electrical Engineering, The Pennsylvania State University, University Park, PA, United States of America
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Boland E, Rao H, Dinges DF, Smith RV, Goel N, Detre J, Basner M, Sheline Y, Thase ME, Gehrman PR. 1094 META-ANALYSIS OF THE ANTIDEPRESSANT EFFECTS OF THERAPEUTIC SLEEP DEPRIVATION. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dennis LE, Ecker AJ, Goel N. 0178 INDIVIDUALS SHOW DIFFERENTIAL VULNERABILITY IN NEUROBEHAVIORAL AND AFFECTIVE RESPONSES TO STRESS AND SLEEP LOSS IN NON-LABORATORY CONDITIONS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dennis LE, Spaeth AM, Goel N. 0195 ENERGY BALANCE RESPONSES SHOW PHENOTYPIC STABILITY TO SLEEP RESTRICTION AND TOTAL SLEEP DEPRIVATION IN HEALTHY ADULTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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41
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Goel N, Hopkins C, Ruggieri M, Ahima RS, Allison KC. 0064 DELAYED EATING ADVERSELY IMPACTS WEIGHT AND METABOLISM COMPARED WITH DAYTIME EATING IN NORMAL WEIGHT ADULTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wattal C, Oberoi JK, Goel N, Raveendran R, Khanna S. Matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) for rapid identification of micro-organisms in the routine clinical microbiology laboratory. Eur J Clin Microbiol Infect Dis 2016; 36:807-812. [DOI: 10.1007/s10096-016-2864-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 12/01/2016] [Indexed: 11/24/2022]
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Kava S, Rajaram S, Arora VK, Goel N, Aggarwal S, Mehta S. Conventional cytology, visual tests and evaluation of P16(INK4A) as a biomarker in cervical intraepithelial neoplasia. Indian J Cancer 2016; 52:270-5. [PMID: 26905107 DOI: 10.4103/0019-509x.176729] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES (1) To detect cervical intraepithelial neoplasia (CIN) using Papanicolaou test (PAP test), visual tests (visual inspection after the application of acetic acid [VIA], visual inspection after the application of Lugol's iodine [VILI]), colposcopy, and biopsy. (2) To study the biomarker p16(INK4A) expression by immunostaining. MATERIALS AND METHODS Experimental study was conducted from November 2009 to April 2011. 1500 women were screened for cancer cervix using conventional PAP test, VIA, and VILI. Sensitivity, specificity, positive, and negative predictive values of these tests were calculated individually, sequentially, and in parallel. Women having positive results underwent colposcopy and biopsy if required. p16(INK4A) expression in biopsy samples was studied using immunohistochemistry. RESULTS All test positive cases (n = 235) underwent colposcopy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PAP with atypical squamous cells of undetermined significance (ASCUS) as cut-off was 40%, 99.25%, 35.25%, and 99.39%; VIA was 60%, 93.06%, 8.03%, and 99.56% and VILI was 80%, 86.06%, 5.4%, and 99.76%, respectively. When PAP, VIA, and VILI were used in parallel sensitivity, specificity, PPV, and NPV improved to 100%, 85.18%, 6.38%, and 100%, respectively. Colposcopic abnormalities were detected in 83 and biopsy proven CIN in 15. p(16INK4A) expression was seen in eight of 15 CIN cases. CONCLUSIONS (1) PAP test and visual techniques are complementary. (2) p(16INK4A) expression was seen in majority of CIN 2 lesions suggesting a higher grade lesion.
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Affiliation(s)
| | - S Rajaram
- Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Goel N, Barrett B, Duncan A, Gallagher MB, Mackey M. FRI0346 Evaluating Differences in The Enrolled Populations of Randomized Clinical Trials of Systemic Lupus Erythematosus. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4457] [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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Goel N, Eisenberg F, Barboza M, Campion D, Bibeau K. AB1035 Rheumatoid Arthritis and Juvenile Idiopathic Arthritis Registries: A Qualitative Analysis of Data in clinicaltrials.gov. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4398] [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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46
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Hillson J, Mant T, Ganguly T, Rosano M, Huntenburg C, Alai-Safar M, Darne S, Palmer D, Pavlova B, Doralt J, Reeve R, Goel N, Weilert D, Rhyne P, Caminis J, Roach J. FRI0182 A Single Dose Study Comparing Pharmacokinetics, Safety, and Immunogenicity of M923 (A Proposed Biosimilar To Adalimumab), US-Sourced Adalimumab, and EU-Sourced Adalimumab in Healthy Subjects. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3706] [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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Čeliković I, Lewitowicz M, Gernhäuser R, Krücken R, Nishimura S, Sakurai H, Ahn DS, Baba H, Blank B, Blazhev A, Boutachkov P, Browne F, de France G, Doornenbal P, Faestermann T, Fang Y, Fukuda N, Giovinazzo J, Goel N, Górska M, Ilieva S, Inabe N, Isobe T, Jungclaus A, Kameda D, Kim YK, Kwon YK, Kojouharov I, Kubo T, Kurz N, Lorusso G, Lubos D, Moschner K, Murai D, Nishizuka I, Park J, Patel Z, Rajabali M, Rice S, Schaffner H, Shimizu Y, Sinclair L, Söderström PA, Steiger K, Sumikama T, Suzuki H, Takeda H, Wang Z, Watanabe H, Wu J, Xu Z. New Isotopes and Proton Emitters-Crossing the Drip Line in the Vicinity of ^{100}Sn. Phys Rev Lett 2016; 116:162501. [PMID: 27152796 DOI: 10.1103/physrevlett.116.162501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Indexed: 06/05/2023]
Abstract
Several new isotopes, ^{96}In, ^{94}Cd, ^{92}Ag, and ^{90}Pd, have been identified at the RIKEN Nishina Center. The study of proton drip-line nuclei in the vicinity of ^{100}Sn led to the discovery of new proton emitters ^{93}Ag and ^{89}Rh with half-lives in the submicrosecond range. The systematics of the half-lives of odd-Z nuclei with T_{z}=-1/2 toward ^{99}Sn shows a stabilizing effect of the Z=50 shell closure. Production cross sections for nuclei in the vicinity of ^{100}Sn measured at different energies and target thicknesses were compared to the cross sections calculated by epax taking into account contributions of secondary reactions in the primary target.
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Affiliation(s)
- I Čeliković
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Boulevard H. Becquerel, 14076 Caen, France
- "Vinča" Institute of Nuclear Sciences, University of Belgrade, 11000 Belgrade, Serbia
| | - M Lewitowicz
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Boulevard H. Becquerel, 14076 Caen, France
| | - R Gernhäuser
- Physik Department E12, Technische Universität München, D-85748 Garching, Germany
| | - R Krücken
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - S Nishimura
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Sakurai
- University of Tokyo, 7-3-1 Hongo Bunkyo, Tokyo 113-0033, Japan
| | - D S Ahn
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Baba
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - B Blank
- CEN Bordeaux-Gradignan Le Haut-Vigneau, F-33175 Gradignan Cedex, France
| | - A Blazhev
- Institute of Nuclear Physics, University of Cologne, D-50937 Cologne, Germany
| | - P Boutachkov
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - F Browne
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- School of Computing, Engineering and Mathematics, University of Brighton, Brighton BN2 4GJ, United Kingdom
| | - G de France
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Boulevard H. Becquerel, 14076 Caen, France
| | - P Doornenbal
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Faestermann
- Physik Department E12, Technische Universität München, D-85748 Garching, Germany
- Excellence Cluster Universe, Technische Universität München, D-85748 Garching, Germany
| | - Y Fang
- Osaka University, Machikaneyama-machi 1-1, Osaka 560-0043 Toyonaka, Japan
| | - N Fukuda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - J Giovinazzo
- CEN Bordeaux-Gradignan Le Haut-Vigneau, F-33175 Gradignan Cedex, France
| | - N Goel
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - M Górska
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - S Ilieva
- Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - N Inabe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Isobe
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Jungclaus
- Instituto de Estructura de la Materia, IEM-CSIC, E-28006 Madrid, Spain
| | - D Kameda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y-K Kim
- Rare Isotope Science Project, Institute for Basic Science, Daejeon 305-811, Republic of Korea
- Department of Nuclear Engineering, Hanyang University, Seoul 133-791, Republic of Korea
| | - Y K Kwon
- Rare Isotope Science Project, Institute for Basic Science, Daejeon 305-811, Republic of Korea
| | - I Kojouharov
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - T Kubo
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Kurz
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - G Lorusso
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Lubos
- Physik Department E12, Technische Universität München, D-85748 Garching, Germany
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Excellence Cluster Universe, Technische Universität München, D-85748 Garching, Germany
| | - K Moschner
- Institute of Nuclear Physics, University of Cologne, D-50937 Cologne, Germany
| | - D Murai
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - I Nishizuka
- Department of Physics, Faculty of Science, Tohoku University, Sendai 980-0845, Japan
| | - J Park
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - Z Patel
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - M Rajabali
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S Rice
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - H Schaffner
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - Y Shimizu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - L Sinclair
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- University of York, York YO10 5DD, United Kingdom
| | - P-A Söderström
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Steiger
- Physik Department E12, Technische Universität München, D-85748 Garching, Germany
| | - T Sumikama
- Department of Physics, Faculty of Science, Tohoku University, Sendai 980-0845, Japan
| | - H Suzuki
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Takeda
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Z Wang
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - H Watanabe
- Beihang University, Beijing 100191, China
| | - J Wu
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Peking University, Beijing 100871, China
| | - Z Xu
- University of Tokyo, 7-3-1 Hongo Bunkyo, Tokyo 113-0033, Japan
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Wattal C, Goel N, Byotra S. Serotyping of invasive S. pneumoniae in adults, more than fifty years old, at a tertiary care center. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Dagar SS, Singh N, Goel N, Kumar S, Puniya AK. Role of anaerobic fungi in wheat straw degradation and effects of plant feed additives on rumen fermentation parameters in vitro. Benef Microbes 2016; 6:353-60. [PMID: 25391347 DOI: 10.3920/bm2014.0071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/19/2022]
Abstract
In the present study, rumen microbial groups, i.e. total rumen microbes (TRM), total anaerobic fungi (TAF), avicel enriched bacteria (AEB) and neutral detergent fibre enriched bacteria (NEB) were evaluated for wheat straw (WS) degradability and different fermentation parameters in vitro. Highest WS degradation was shown for TRM, followed by TAF, NEB and least by AEB. Similar patterns were observed with total gas production and short chain fatty acid profiles. Overall, TAF emerged as the most potent individual microbial group. In order to enhance the fibrolytic and rumen fermentation potential of TAF, we evaluated 18 plant feed additives in vitro. Among these, six plant additives namely Albizia lebbeck, Alstonia scholaris, Bacopa monnieri, Lawsonia inermis, Psidium guajava and Terminalia arjuna considerably improved WS degradation by TAF. Further evaluation showed A. lebbeck as best feed additive. The study revealed that TAF plays a significant role in WS degradation and their fibrolytic activities can be improved by inclusion of A. lebbeck in fermentation medium. Further studies are warranted to elucidate its active constituents, effect on fungal population and in vivo potential in animal system.
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Affiliation(s)
- S S Dagar
- Nutrition Biotechnology Laboratory, Dairy Cattle Nutrition Division, National Dairy Research Institute, Karnal 132001, Haryana, India Microbial Science Division, Agharkar Research Institute, Pune 411004, Maharashtra, India
| | - N Singh
- Nutrition Biotechnology Laboratory, Dairy Cattle Nutrition Division, National Dairy Research Institute, Karnal 132001, Haryana, India Department of Paramedical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India
| | - N Goel
- Nutrition Biotechnology Laboratory, Dairy Cattle Nutrition Division, National Dairy Research Institute, Karnal 132001, Haryana, India
| | - S Kumar
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348, USA Dairy Microbiology Division, National Dairy Research Institute, Karnal 132001, Haryana, India
| | - A K Puniya
- Dairy Microbiology Division, National Dairy Research Institute, Karnal 132001, Haryana, India
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Abstract
Group B Streptococcus (GBS) is an infrequent cause of meningitis in adults, usually affecting elderly patients and those with serious underlying disease. It is more commonly recognised as one of the leading aetiological agents of neonatal sepsis following maternally derived infection during pregnancy. We report a case of a previously healthy 26-year-old man who presented with fevers, confusion and headache. Lumbar puncture results were consistent with bacterial meningitis, and blood cultures grew GBS. To the best of our knowledge, our patient represents one of the few reported cases of GBS meningitis in a previously healthy young man. Interestingly, our patient had a significant family history of central nervous system infection including a son with herpes simplex virus encephalitis, a sister with meningococcal meningitis and a great-uncle with meningitis of unknown cause. We discuss genetic factors that may predispose certain people to develop meningitis with normally harmless microorganisms such as GBS.
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Affiliation(s)
| | | | - Nupur Goel
- West Middlesex University Hospital, London, UK
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