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Coleman JC, Tattersall L, Yianni V, Knight L, Yu H, Hallett SR, Johnson P, Caetano AJ, Cosstick C, Ridley AJ, Gartland A, Conte MR, Grigoriadis AE. The RNA binding proteins LARP4A and LARP4B promote sarcoma and carcinoma growth and metastasis. iScience 2024; 27:109288. [PMID: 38532886 PMCID: PMC10963253 DOI: 10.1016/j.isci.2024.109288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/01/2023] [Accepted: 02/16/2024] [Indexed: 03/28/2024] Open
Abstract
RNA-binding proteins (RBPs) are emerging as important regulators of cancer pathogenesis. We reveal that the RBPs LARP4A and LARP4B are differentially overexpressed in osteosarcoma and osteosarcoma lung metastases, as well as in prostate cancer. Depletion of LARP4A and LARP4B reduced tumor growth and metastatic spread in xenografts, as well as inhibiting cell proliferation, motility, and migration. Transcriptomic profiling and high-content multiparametric analyses unveiled a central role for LARP4B, but not LARP4A, in regulating cell cycle progression in osteosarcoma and prostate cancer cells, potentially through modulating key cell cycle proteins such as Cyclins B1 and E2, Aurora B, and E2F1. This first systematic comparison between LARP4A and LARP4B assigns new pro-tumorigenic functions to LARP4A and LARP4B in bone and prostate cancer, highlighting their similarities while also indicating distinct functional differences. Uncovering clear biological roles for these paralogous proteins provides new avenues for identifying tissue-specific targets and potential druggable intervention.
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Affiliation(s)
- Jennifer C. Coleman
- Centre for Craniofacial & Regenerative Biology, King’s College London, London, SE1 9RT UK
- Randall Centre for Cell and Molecular Biophysics, King’s College London, London, SE1 1UL UK
| | - Luke Tattersall
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Sheffield, S10 2RX UK
| | - Val Yianni
- Centre for Craniofacial & Regenerative Biology, King’s College London, London, SE1 9RT UK
| | - Laura Knight
- Centre for Craniofacial & Regenerative Biology, King’s College London, London, SE1 9RT UK
| | - Hongqiang Yu
- Centre for Craniofacial & Regenerative Biology, King’s College London, London, SE1 9RT UK
| | - Sadie R. Hallett
- Randall Centre for Cell and Molecular Biophysics, King’s College London, London, SE1 1UL UK
| | - Philip Johnson
- Centre for Craniofacial & Regenerative Biology, King’s College London, London, SE1 9RT UK
| | - Ana J. Caetano
- Centre for Craniofacial & Regenerative Biology, King’s College London, London, SE1 9RT UK
| | - Charlie Cosstick
- Centre for Craniofacial & Regenerative Biology, King’s College London, London, SE1 9RT UK
| | - Anne J. Ridley
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, BS8 1TD UK
| | - Alison Gartland
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, Sheffield, S10 2RX UK
| | - Maria R. Conte
- Randall Centre for Cell and Molecular Biophysics, King’s College London, London, SE1 1UL UK
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Armanini C, Junge K, Johnson P, Whitfield C, Renda F, Calisti M, Hughes J. Soft robotics for farm to fork: applications in agriculture & farming. Bioinspir Biomim 2024; 19:021002. [PMID: 38250751 DOI: 10.1088/1748-3190/ad2084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 01/19/2024] [Indexed: 01/23/2024]
Abstract
Agricultural tasks and environments range from harsh field conditions with semi-structured produce or animals, through to post-processing tasks in food-processing environments. From farm to fork, the development and application of soft robotics offers a plethora of potential uses. Robust yet compliant interactions between farm produce and machines will enable new capabilities and optimize existing processes. There is also an opportunity to explore how modeling tools used in soft robotics can be applied to improve our representation and understanding of the soft and compliant structures common in agriculture. In this review, we seek to highlight the potential for soft robotics technologies within the food system, and also the unique challenges that must be addressed when developing soft robotics systems for this problem domain. We conclude with an outlook on potential directions for meaningful and sustainable impact, and also how our outlook on both soft robotics and agriculture must evolve in order to achieve the required paradigm shift.
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Affiliation(s)
- Costanza Armanini
- Center for Artificial Intelligence and Robotics (CAIR), New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Kai Junge
- CREATE Lab, Institute of Mechanical Engineering, EPFL, Lausanne, Switzerland
| | - Philip Johnson
- Lincoln Institute for Agri-Food Tech, University of Lincoln, Lincoln, United Kingdom
| | | | - Federico Renda
- Department of Mechanical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Marcello Calisti
- Lincoln Institute for Agri-Food Tech, University of Lincoln, Lincoln, United Kingdom
| | - Josie Hughes
- CREATE Lab, Institute of Mechanical Engineering, EPFL, Lausanne, Switzerland
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Warner B, Pranzatelli T, Perez P, Ku A, Matuck BF, Huynh K, Sakai S, Abed M, Jang SI, Yamada E, Dominick K, Ahmed Z, Oliver A, Wasikowski R, Easter Q, Magone MT, Baer A, Pelayo E, Khavandgar Z, Gupta S, Kleiner D, Lessard C, Farris A, Martin D, Morell R, Zheng C, Rachmaninoff N, Maldonado-Ortiz J, Qu X, Aure M, Dezfulian M, Lake R, Teichmann S, Barber D, Tsoi L, Sowalsky A, Tyc K, Gudjonsson J, Byrd K, Johnson P, Liu J, Chiorini J. GZMK+CD8+ T cells Target a Specific Acinar Cell Type in Sjögren's Disease. Res Sq 2023:rs.3.rs-3601404. [PMID: 38196575 PMCID: PMC10775371 DOI: 10.21203/rs.3.rs-3601404/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Sjögren's Disease (SjD) is a systemic autoimmune disease without a clear etiology or effective therapy. Utilizing unbiased single-cell and spatial transcriptomics to analyze human minor salivary glands in health and disease we developed a comprehensive understanding of the cellular landscape of healthy salivary glands and how that landscape changes in SjD patients. We identified novel seromucous acinar cell types and identified a population of PRR4+CST3+WFDC2- seromucous acinar cells that are particularly targeted in SjD. Notably, GZMK+CD8 T cells, enriched in SjD, exhibited a cytotoxic phenotype and were physically associated with immune-engaged epithelial cells in disease. These findings shed light on the immune response's impact on transitioning acinar cells with high levels of secretion and explain the loss of this specific cell population in SjD. This study explores the complex interplay of varied cell types in the salivary glands and their role in the pathology of Sjögren's Disease.
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Affiliation(s)
- Blake Warner
- National Institute of Dental and Craniofacial Research
| | | | | | - Anson Ku
- Laboratory of Genitourinary Cancer Pathogenesis, Center for Cancer Research, National Cancer Institute
| | | | | | | | - Mehdi Abed
- Salivary Disorders Unit, National Institute of Dental and Craniofacial Research
| | | | - Eiko Yamada
- Salivary Disorders Unit, National Institute of Dental and Craniofacial Research
| | - Kalie Dominick
- Salivary Disorders Unit, National Institute of Dental and Craniofacial Research
| | - Zara Ahmed
- Salivary Disorders Unit, National Institute of Dental and Craniofacial Research
| | | | | | | | | | - Alan Baer
- Sjögren's Clinical Investigations Team, National Institute of Dental and Craniofacial Research
| | | | - Zohreh Khavandgar
- Sjögren's Clinical Investigations Team, National Institute of Dental and Craniofacial Research
| | - Sarthak Gupta
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
| | - David Kleiner
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute
| | - Christopher Lessard
- Genes & Human Disease Research Program, Oklahoma Medical Research Foundation
| | - A Farris
- Oklahoma Medical Research Fd. OMRF
| | | | - Robert Morell
- Genomics and Computational Biology Core, National Institutes on Deafness and Other Communication Disorders, NIH
| | - Changyu Zheng
- Genomics and Computational Biology Core, National Institute of Dental and Craniofacial Research
| | | | | | - Xufeng Qu
- Massey Cancer Center, Virginia Commonwealth University
| | - Marit Aure
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research
| | | | - Ross Lake
- Laboratory of Genitourinary Cancer Pathogenesis (LCGP) Microscopy Core Facility, Center for Cancer Research, National Cancer Institute
| | | | - Daniel Barber
- T-lymphocyte Biology Section, National Institute of Allergy and Infectious Diseases
| | - Lam Tsoi
- Medical University of South Carolina
| | | | - Katarzyna Tyc
- Department of Biostatistics, Virginia Commonwealth University
| | | | - Kevin Byrd
- Lab of Oral & Craniofacial Innovation (LOCI), Department of Innovation & Technology Research, ADA Science & Research Institute
| | - Philip Johnson
- Department of Biology, University of Maryland College Park
| | | | - John Chiorini
- National Institute of Dental and Craniofacial Research
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Cucchetti A, Johnson P, Capurso G, Crippa S, Pacilio CA, Fabbri C, Falconi M, Ercolani G. European' health care indicators and pancreatic cancer incidence and mortality: A mediation analysis of Eurostat data and Global Burden of Disease Study 2019. Pancreatology 2023; 23:829-835. [PMID: 37758550 DOI: 10.1016/j.pan.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/27/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
AIM To highlight correlations existing between incidence and mortality of pancreatic cancer, and health care indicators in 36 European countries. METHODS The Global Burden of Disease (GBD) and Eurostat databases were queried between 2004 and 2019. Incidence and mortality were age-standardized. From Eurostat, indicators regarding expenditure, hospital beds, medical technology, health personnel, physicians by medical specialty and unmet needs for medical examination were extracted. Correlations between GBD and Eurostat data were analysed through mediation analysis applying clustering for countries. RESULTS Incidence increased by +0.6% per year (p = 0.001) and mortality by +0.3% (p = 0.001), being increasing for most of the European countries considered. Incidence and mortality were strongly positively correlated (p = 0.001). Higher current health expenditure, expenditure in inpatient curative care, the number of available beds, the number of computed tomography scan, magnetic resonance units, practising medical doctors were all related to higher incidence (p < 0.05), whereas the unmet need for medical examinations was related to lower incidence. When the mediator' effect of incidence was handled, these indicators, together with expenditure on outpatient curative cares, the number of pet scanners and of radiation therapy equipment, were related to lower mortality (p < 0.05). CONCLUSIONS Health care environment correlates with reported incidence and mortality of pancreatic cancer. This highlights both that ameliorated socio-economic societies suffer from higher incidence but lower mortality, as well as the epidemiological bias originating from countries' diagnostic ability.
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Affiliation(s)
- Alessandro Cucchetti
- Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum - Univeristy of Bologna, Bologna, Italy; Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy.
| | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Gabriele Capurso
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Hospital, Milan, Italy
| | - Stefano Crippa
- Division of Pancreatic Surgery, Pancreas Translational & Clinical Research Center, Università Vita-Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Carlo Fabbri
- Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy; Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Ausl Romagna, Forlì-Cesena, Italy
| | - Massimo Falconi
- Division of Pancreatic Surgery, Pancreas Translational & Clinical Research Center, Università Vita-Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgio Ercolani
- Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum - Univeristy of Bologna, Bologna, Italy; Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy
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Vogel A, Kelley RK, Johnson P, Merle P, Yau T, Kudo M, Meyer T, Rimassa L. Predictive and Prognostic Potential of Liver Function Assessment in Patients with Advanced Hepatocellular Carcinoma: A Systematic Literature Review. Liver Cancer 2023; 12:372-391. [PMID: 37817754 PMCID: PMC10561324 DOI: 10.1159/000529173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/15/2022] [Indexed: 10/12/2023] Open
Abstract
Introduction We conducted a systematic literature review to assess the utility of liver function assessments for predicting disease prognosis and response to systemic anticancer therapy in patients with advanced hepatocellular carcinoma (aHCC). Methods This was a PRISMA-standard review and was registered with PROSPERO (CRD42021244588). MEDLINE and Embase were systematically searched (March 24, 2021) to identify publications reporting the efficacy and/or safety of systemic anticancer therapy (vs. any/no comparator) in liver-function-defined subgroups in phase 2 or 3 aHCC trials. Screening was completed by a single reviewer, with uncertainties resolved by a second reviewer and/or the authors. English-language full-text articles and congress abstracts were eligible for inclusion. Included publications were described and assessed for risk of bias using the GRADE methodology. Results Twenty (of 2,579) screened publications were eligible; seven categorized liver function using the albumin-bilirubin system, nine using the Child-Pugh system, four using both. GRADE assessment classified ten, nine, and one publication(s) as reporting moderate-quality, low-quality, and very-low-quality evidence, respectively. Analyses of cross-trial trends of within-exposure arm analyses (active and control) reported a positive relationship between baseline liver function and overall survival and progression-free survival, supporting liver function as a prognostic marker in aHCC. There were also signals for a modest relationship between more preserved baseline liver function and extent of systemic treatment benefit, and with more preserved liver function and lower incidence of safety events. Conclusion This review supports liver function as a prognostic variable in aHCC and highlights the value of a priori stratification of patients by baseline liver function in aHCC trials. The predictive value of liver function warrants further study. Findings were limited by the quality of available data.
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Affiliation(s)
- Arndt Vogel
- Department of Klinik für Gastroenterology, Hannover Medical School, Hannover, Germany
| | - Robin K. Kelley
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Philippe Merle
- Hepatology and Gastroenterology Unit, Hôpital de la Croix Rousse, Lyon, France
| | | | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University, Osaka-Sayama, Japan
| | - Tim Meyer
- Research Department of Oncology, UCL Cancer Institute, University College London, London, UK
- Royal Free Hospital, London, UK
| | - Lorenza Rimassa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
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Hamill V, Wong S, Benselin J, Krajden M, Hayes PC, Mutimer D, Yu A, Dillon JF, Gelson W, Velásquez García HA, Yeung A, Johnson P, Barclay ST, Alvarez M, Toyoda H, Agarwal K, Fraser A, Bartlett S, Aldersley M, Bathgate A, Binka M, Richardson P, Morling JR, Ryder SD, MacDonald D, Hutchinson S, Barnes E, Guha IN, Irving WL, Janjua NZ, Innes H. Mortality rates among patients successfully treated for hepatitis C in the era of interferon-free antivirals: population based cohort study. BMJ 2023; 382:e074001. [PMID: 37532284 PMCID: PMC10394680 DOI: 10.1136/bmj-2022-074001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES To quantify mortality rates for patients successfully treated for hepatitis C in the era of interferon-free, direct acting antivirals and compare these rates with those of the general population. DESIGN Population based cohort study. SETTING British Columbia, Scotland, and England (England cohort consists of patients with cirrhosis only). PARTICIPANTS 21 790 people who were successfully treated for hepatitis C in the era of interferon-free antivirals (2014-19). Participants were divided into three liver disease severity groups: people without cirrhosis (pre-cirrhosis), those with compensated cirrhosis, and those with end stage liver disease. Follow-up started 12 weeks after antiviral treatment completion and ended on date of death or 31 December 2019. MAIN OUTCOME MEASURES Crude and age-sex standardised mortality rates, and standardised mortality ratio comparing the number of deaths with that of the general population, adjusting for age, sex, and year. Poisson regression was used to identify factors associated with all cause mortality rates. RESULTS 1572 (7%) participants died during follow-up. The leading causes of death were drug related mortality (n=383, 24%), liver failure (n=286, 18%), and liver cancer (n=250, 16%). Crude all cause mortality rates (deaths per 1000 person years) were 31.4 (95% confidence interval 29.3 to 33.7), 22.7 (20.7 to 25.0), and 39.6 (35.4 to 44.3) for cohorts from British Columbia, Scotland, and England, respectively. All cause mortality was considerably higher than the rate for the general population across all disease severity groups and settings; for example, all cause mortality was three times higher among people without cirrhosis in British Columbia (standardised mortality ratio 2.96, 95% confidence interval 2.71 to 3.23; P<0.001) and more than 10 times higher for patients with end stage liver disease in British Columbia (13.61, 11.94 to 15.49; P<0.001). In regression analyses, older age, recent substance misuse, alcohol misuse, and comorbidities were associated with higher mortality rates. CONCLUSION Mortality rates among people successfully treated for hepatitis C in the era of interferon-free, direct acting antivirals are high compared with the general population. Drug and liver related causes of death were the main drivers of excess mortality. These findings highlight the need for continued support and follow-up after successful treatment for hepatitis C to maximise the impact of direct acting antivirals.
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Affiliation(s)
- Victoria Hamill
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
- Joint first authors
| | - Stanley Wong
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Joint first authors
| | - Jennifer Benselin
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, UK
| | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - David Mutimer
- Liver and Hepatology Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Amanda Yu
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - John F Dillon
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, UK
| | - William Gelson
- Cambridge Liver Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Hector A Velásquez García
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alan Yeung
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
| | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | | | - Maria Alvarez
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Hidenori Toyoda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Kosh Agarwal
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - Andrew Fraser
- Aberdeen Royal Infirmary, Aberdeen, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Sofia Bartlett
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark Aldersley
- Leeds Liver Unit, St James's University Hospital, Leeds, UK
| | | | - Mawuena Binka
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Paul Richardson
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Joanne R Morling
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, UK
- Lifespan and Population Health, University of Nottingham, Nottingham, UK
| | - Stephen D Ryder
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Douglas MacDonald
- Gastroenterology and Hepatology, Royal Free London NHS Foundation Trust, London, UK
| | - Sharon Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
| | - Eleanor Barnes
- Nuffield Department of Medicine and the Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Indra Neil Guha
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, UK
| | - William L Irving
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, UK
| | - Naveed Z Janjua
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital Vancouver, British Columbia, Canada
| | - Hamish Innes
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
- Lifespan and Population Health, University of Nottingham, Nottingham, UK
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Kaushik K, Krishna K, Johnson P, Gupta PSP, Nandi S, Mondal SS, Suganthi RU, Nikhil Kumar Tej J. Effect of α-Tocopherol in the vitrification medium on the viability, lipid peroxidation, expression of key developmental, apoptotic and stress-related genes in ovine secondary follicles. Reprod Domest Anim 2023. [PMID: 37086264 DOI: 10.1111/rda.14364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/24/2023] [Accepted: 04/19/2023] [Indexed: 04/23/2023]
Abstract
The present study aimed to evaluate the effect of α-tocopherol on viability, lipid peroxidation, and the expression of apoptosis, stress, and development related genes in the vitrified sheep secondary follicles. Ovarian secondary follicles (200-300 μm) were isolated and distributed separately to the vitrification treatment and supplemented with 5 mM, 10 mM, 20 mM and 30 mM of α-tocopherol (while the control fresh group was without vitrification and supplementation of α-tocopherol). After a week, the follicles were thawed and evaluated for follicular viability by trypan blue dye exclusion method, lipid peroxidation and gene expression studies. The results showed that the vitrification with 10 and 20 mM of α-tocopherol positively affected (P<0.05) the viability of vitrified follicles in comparison with vitrified ones without α-tocopherol but the higher concentration of α-tocopherol, i.e., 30 mM negatively affected the viability (P<0.05) in comparison with the 10 and 20 mM of α-tocopherol groups. The malondialdehyde (MDA) levels were significantly (P<0.05) higher in the vitrified without α-tocopherol group in comparison to the vitrified with 20 mM of α-tocopherol group. The expression of apoptotic-related gene, BCL2L1 was significantly higher in 10 mM α-tocopherol group compared to the control fresh and CASPASE 3, 9 expressions were significantly higher in the vitrified group when compared to the vitrified with 10 mM α-tocopherol group. Expressions of BAX, BAD, BAK, BMP-15 and GDF-9 showed no significant difference among the groups. The mRNA expression of SOD1 was significantly higher in the vitrified without α-tocopherol group when compared to other groups. We conclude that the supplementation of 10 and 20 mM α-tocopherol in vitrification solution was the efficient vitrification procedure for the vitrification of ovine secondary follicles.
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Affiliation(s)
- Kalpana Kaushik
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, Karnataka, India
- Department of Biotechnology, Jain University, Bengaluru, Karnataka, India
| | - Kavya Krishna
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, Karnataka, India
| | - P Johnson
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, Karnataka, India
| | - P S P Gupta
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, Karnataka, India
| | - S Nandi
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, Karnataka, India
| | - S S Mondal
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, Karnataka, India
| | - R U Suganthi
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, Karnataka, India
| | - J Nikhil Kumar Tej
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, Karnataka, India
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Mosconi C, O'Rourke J, Kloeckner R, Sturm L, Golfieri R, Celsa C, Fateen W, Odisio BC, Garanzini EM, Peck-Radosavljevic M, Borghi A, Ma YT, Stoehr F, Bettinger D, Giuffrida P, Aithal GP, Lin YM, Spreafico C, Giampalma E, Johnson P, Cucchetti A. Textbook Outcome After Trans-arterial Chemoembolization for Hepatocellular Carcinoma. Cardiovasc Intervent Radiol 2023; 46:449-459. [PMID: 36849836 DOI: 10.1007/s00270-023-03375-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/27/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Textbook Outcome (TO) is inclusive of quality indicators and it not been provided for trans-arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS Data on treatment-naïve HCC patients receiving TACE from 10 centers were reviewed. TO was defined as "no post-TACE grade 3-4 complications, no prolonged hospital stay (defined as a post-procedure stay ≤ 75th percentile of the median values from the total cohort), no 30-day mortality/readmission and the achievement of an objective response (OR) at post-TACE imaging." Grade of adverse event was classified according to the Common Terminology Criteria for Adverse Events and short-term efficacy was assessed by response. Pooled estimates were calculated to account for hospital's effect and risk-adjustment was applied to allow for diversity of patients in each center. RESULTS A total of 1124 patients (2014-2018) fulfilling specific inclusion criteria were included. Baseline clinical features showed considerable heterogeneity (I2 > 0.75) across centers. TACE-related mortality was absent in 97.6%, readmission was not required after 94.9% of procedures, 91.5% of patients had no complication graded 3-4, 71.8% of patients did not require prolonged hospitalization, OR of the target lesion was achieved in 68.5%. Risk-adjustment showed that all indicators were achieved in 43.1% of patients, and this figure was similar across centers. The median overall survival for patients who achieved all indicators was 33.1 months, 11.9 months longer than for patients who did not. CONCLUSIONS A useful benchmark for TACE in HCC patients has been developed, which provides an indication of survival and allows for a comparison of treatment quality across different hospitals.
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Affiliation(s)
- Cristina Mosconi
- Department of Diagnostic Medicine and Prevention, Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Via Albertoni 15, 40138, Bologna, Italy.
| | - Joanne O'Rourke
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, Medical School, University of Birmingham, Birmingham, UK
| | - Roman Kloeckner
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lukas Sturm
- Department of Medicine II, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Hugstetter Street 55, 79106, Freiburg, Germany.,Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Rita Golfieri
- Department of Diagnostic Medicine and Prevention, Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Via Albertoni 15, 40138, Bologna, Italy
| | - Ciro Celsa
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Marina, Italy
| | - Waleed Fateen
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK
| | - Bruno C Odisio
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Markus Peck-Radosavljevic
- Department of Internal Medicine and Gastroenterology, Klinikum Klagenfurt Am Wörthersee, Klagenfurt, Austria
| | - Alberto Borghi
- Department of Internal Medicine, Infermi Hospital, Area Vasta Romagna, Faenza, Italy
| | - Yuk Ting Ma
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, Medical School, University of Birmingham, Birmingham, UK
| | - Fabian Stoehr
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Dominik Bettinger
- Department of Medicine II, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Hugstetter Street 55, 79106, Freiburg, Germany.,Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Paolo Giuffrida
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Marina, Italy
| | - Guruprasad P Aithal
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK
| | - Yuan-Mao Lin
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlo Spreafico
- Department of Radiology, Fondazione IRCCS Istituto Nazionale Tumori di Milano, Milan, Italy
| | | | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Alessandro Cucchetti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Morgagni-Pierantoni Hospital, Area Vasta Romagna, Forlì, Italy
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9
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Marsh J, Sell E, Greenhawt M, Johnson P. Variability of allergen quantity in commercially available peanut-containing foods. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.384] [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: 02/05/2023]
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10
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Sztuk TKS, Rigby NM, Nørskov-Nielsen L, Koppelman SJ, Sancho AI, Knudsen NPH, Marsh J, Johnson P, Gupta S, Mackie AR, Larsen JM, Bøgh KL. Dose and route of administration determine the efficacy of prophylactic immunotherapy for peanut allergy in a Brown Norway rat model. Front Immunol 2023; 14:1121497. [PMID: 36911669 PMCID: PMC9996042 DOI: 10.3389/fimmu.2023.1121497] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction Allergen-specific immunotherapy (IT) is emerging as a viable option for treatment of peanut allergy. Yet, prophylactic IT remains unexplored despite early introduction of peanut in infancy was shown to prevent allergy. There is a need to understand how allergens interact with the immune system depending on the route of administration, and how different dosages of allergen may protect from sensitisation and a clinical active allergy. Here we compared peanut allergen delivery via the oral, sublingual (SL), intragastric (IG) and subcutaneous (SC) routes for the prevention of peanut allergy in Brown Norway (BN) rats. Methods BN rats were administered PBS or three different doses of peanut protein extract (PPE) via either oral IT (OIT), SLIT, IGIT or SCIT followed by intraperitoneal (IP) injections of PPE to assess the protection from peanut sensitisation. The development of IgE and IgG1 responses to PPE and the major peanut allergens were evaluated by ELISAs. The clinical response to PPE was assessed by an ear swelling test (EST) and proliferation was assessed by stimulating splenocytes with PPE. Results Low and medium dose OIT (1 and 10 mg) and all doses of SCIT (1, 10, 100 µg) induced sensitisation to PPE, whereas high dose OIT (100 mg), SLIT (10, 100 or 1000 µg) or IGIT (1, 10 and 100 mg) did not. High dose OIT and SLIT as well as high and medium dose IGIT prevented sensitisation from the following IP injections of PPE and suppressed PPE-specific IgE levels in a dose-dependent manner. Hence, administration of peanut protein via different routes confers different risks for sensitisation and protection from peanut allergy development. Overall, the IgE levels toward the individual major peanut allergens followed the PPE-specific IgE levels. Discussion Collectively, this study showed that the preventive effect of allergen-specific IT is determined by the interplay between the specific site of PPE delivery for presentation to the immune system, and the allergen quantity, and that targeting and modulating tolerance mechanisms at specific mucosal sites may be a prophylactic strategy for prevention of peanut allergy.
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Affiliation(s)
| | - Neil Marcus Rigby
- School of Food Science & Nutrition, University of Leeds, Leeds, United Kingdom
| | | | - Stef J Koppelman
- Institute of Agriculture and Natural Resources, Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Ana Isabel Sancho
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | | | - Justin Marsh
- Institute of Agriculture and Natural Resources, Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Philip Johnson
- Institute of Agriculture and Natural Resources, Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | | | - Alan Robert Mackie
- School of Food Science & Nutrition, University of Leeds, Leeds, United Kingdom
| | - Jeppe Madura Larsen
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
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11
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Robertson A, Makris A, Johnson P, Middleton S, Norman M, Sullivan C, Hennessy A. Delivery outcomes as a result of snoring as determined by standard sleep surveys. Obstet Med 2022; 15:253-259. [PMID: 36523878 PMCID: PMC9745590 DOI: 10.1177/1753495x211064107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 11/15/2021] [Indexed: 11/15/2023] Open
Abstract
Background Sleep-disordered breathing (SDB), is an umbrella term that encompasses obstructive sleep apnea (OSA), central sleep apnea (CSA) and hypoventilation. is common but studies in the pregnant population are limited. Data suggests relationships between OSA and preeclampsia, but the relationship between snoring and pregnancy outcomes is unknown. Methods A prospective study of 2224 singleton pregnancies was undertaken. Women were questioned using the Berlin Questionnaire (BQ- 2 or more categories where the score is positive.) and the Epworth Sleepiness Scale (ESS >10/24), the results compared with pregnancy outcomes with regard to hypertension in pregnancy. Results Women having symptoms raising the possibility of OSA defined by the BQ with a score >7 was 45.5%, and using ESS with a score >10, was 36%. The birth and neonatal outcomes for self-reported snoring and increased daytime sleepiness showed increased adverse outcomes notably increased caesarean section rates and low APGAR scores but not birth before 37 weeks of gestation. Conclusion Using questionnaires designed for the general population, the prevalence of possible undiagnosed OSA is high in the pregnant population. The increased adverse delivery and neonatal outcomes for self-reported snoring and increased daytime sleepiness with these tools indicated the need for further investigation of the links between snoring SDB and pregnancy outcomes.
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Affiliation(s)
- A Robertson
- Western Sydney University
NSW, Australia
- Campbelltown Hospital, South Western Sydney Local Health District, Campbelltown, NSW,
Australia
| | - A Makris
- Liverpool Hospital, Liverpool, NSW, Australia
| | - P Johnson
- David Reid Laboratory, University of Sydney, NSW, Australia
| | - S Middleton
- Liverpool Hospital, Liverpool, NSW, Australia
| | - M Norman
- David Reid Laboratory, University of Sydney, NSW, Australia
| | - C Sullivan
- David Reid Laboratory, University of Sydney, NSW, Australia
| | - A Hennessy
- Western Sydney University
NSW, Australia
- Campbelltown Hospital, South Western Sydney Local Health District, Campbelltown, NSW,
Australia
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12
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Kananen L, Eriksdotter M, Boström A, Kivipelto M, Annetorp M, Metzner C, Bäck Jerlardtz V, Engström M, Johnson P, Lundberg L, Åkesson E, Sühl Öberg C, Hägg S, Religa D, Jylhävä J, Cederholm T. Body mass index and Mini Nutritional Assessment-Short Form as predictors of in-geriatric hospital mortality in older adults with COVID-19. Clin Nutr 2022; 41:2973-2979. [PMID: 34389208 PMCID: PMC8318666 DOI: 10.1016/j.clnu.2021.07.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/06/2021] [Accepted: 07/20/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Overweight and obesity have been consistently reported to carry an increased risk for poorer outcomes in coronavirus disease 2019 (COVID-19) in adults. Existing reports mainly focus on in-hospital and intensive care unit mortality in patient cohorts usually not representative of the population with the highest mortality, i.e. the very old and frail patients. Accordingly, little is known about the risk patterns related to body mass and nutrition in very old patients. Our aim was to assess the relationship between body mass index (BMI), nutritional status and in-geriatric hospital mortality among geriatric patients treated for COVID-19. As a reference, the analyses were performed also in patients treated for other diagnoses than COVID-19. METHODS We analyzed up to 10,031 geriatric patients with a median age of 83 years of which 1409 (14%) were hospitalized for COVID-19 and 8622 (86%) for other diagnoses in seven geriatric hospitals in the Stockholm region, Sweden during March 2020-January 2021. Data were available in electronic hospital records. The associations between 1) BMI and 2) nutritional status, assessed using the Mini-Nutritional Assessment - Short Form (MNA-SF) scale, and short-term in-geriatric hospital mortality were analyzed using logistic regression. RESULTS After adjusting for age, sex, comorbidity, polypharmacy, frailty and the wave of the pandemic (first vs. second), underweight defined as BMI<18.5 increased the risk of in-hospital mortality in COVID-19 patients (odds ratio [OR] = 2.30; confidence interval [CI] = 1.17-4.31). Overweight and obesity were not associated with in-hospital mortality. Malnutrition; i.e. MNA-SF 0-7 points, increased the risk of in-hospital mortality in patients treated for COVID-19 (OR = 2.03; CI = 1.16-3.68) and other causes (OR = 6.01; CI = 2.73-15.91). CONCLUSIONS Our results indicate that obesity is not a risk factor for very old patients with COVID-19, but emphasize the role of underweight and malnutrition for in-hospital mortality in geriatric patients with COVID-19.
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Affiliation(s)
- L. Kananen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Faculty of Social Sciences (Health Sciences), Gerontology Research Center, Tampere University, Tampere, Finland,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland,Corresponding author. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - M. Eriksdotter
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - A.M. Boström
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden,Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - M. Kivipelto
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden,Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - M. Annetorp
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - C. Metzner
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - V. Bäck Jerlardtz
- Department of Geriatric Medicine, Jakobsbergsgeriatriken, Stockholm, Sweden
| | - M. Engström
- Department of Geriatric Medicine, Sabbatsbergsgeriatriken, Stockholm, Sweden
| | - P. Johnson
- Department of Geriatric Medicine, Capio Geriatrik Nacka AB, Nacka, Sweden
| | - L.G. Lundberg
- Department of Geriatric Medicine, Dalengeriatriken Aleris Närsjukvård AB, Stockholm, Sweden
| | - E. Åkesson
- Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - C. Sühl Öberg
- Department of Geriatric Medicine, Handengeriatriken, Aleris Närsjukvård AB, Stockholm, Sweden
| | - S. Hägg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - D. Religa
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - J. Jylhävä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Faculty of Social Sciences (Health Sciences), Gerontology Research Center, Tampere University, Tampere, Finland
| | - T. Cederholm
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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13
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Carter R, Hardway H, Johnson P, Douglass E, Adedinsewo D. Multi-category classification of left ventricle ejection fraction using a convolutional neural network. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Screening for left ventricular (LV) systolic dysfunction (defined as ejection fraction ≤35%) based on data from a standard 12-lead electrocardiogram (ECG) has become well established when standard digital ECGs are available–8 independent leads sampled at least 250 hertz for 10 seconds. As the algorithm has been incorporated into various clinical scenarios and ancillary research projects, a limitation of the binary classification at 35% has become apparent.
Purpose
The objective of this study was to develop and validate a deep learning-based algorithm that would classify LVEF into three categories based on only the digital ECG input.
Methods
After IRB approval, native digital resting ECGs acquired between 1/1/2010 and 12/31/2021 on patients seen in Mayo Clinic in Jacksonville were extracted from the institutional electronic ECG database management system (MUSE, GE Healthcare). These ECGs were matched with transthoracic echocardiograms obtained up to four days prior or 30 days after the ECGs acquisition. A convolutional neural network consisting of 8 layers of convolutions, batch normalization and pooling was trained using Keras and Tensorflow with hyper-parameter optimization for L1 and L2 regularization, learning rate adjustments, and class weights to predict three classes of LVEF: ≤35%, 36–51%, and ≥52% based on clinical relevance. The primary measure of overall performance was the detection of LVEF ≤35%; however, the triad of model predictions was also considered in translating the model output to human interpretable findings.
Results
A total of 30,153 patients (60,169 ECG pairings; mean age 63 years; 48% male) were randomly split at the patient level into training (24,172 patients), validation (2,973 patients) and testing (3,008 patients). The trained model provided robust discrimination in the withheld testing data – AUROC of 0.941 (95% CI: 0.931 to 0.950). Using the optimal model threshold based on Youden's index from the validation data (0.186), sensitivity and specificity were estimated to be 87.9% (95% CI: 83.8% to 91.2%) and 86.3% (95% CI: 85.4% to 87.2%) in the testing data. In instances where discordant predictions were observed, the posterior distribution of model probabilities provide additional insights into the possible underlying value of LVEF (Figure 1).
Conclusions
The utilization of a multi-category deep learning classification model for the detection of reduced ejection fraction adds new dimensions to the use of AI technologies on digital ECGs. This work shows high discrimination can still be obtained when using three classes of LVEF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Carter
- Mayo Clinic , Jacksonville , United States of America
| | - H Hardway
- Mayo Clinic , Jacksonville , United States of America
| | - P Johnson
- Mayo Clinic , Jacksonville , United States of America
| | - E Douglass
- Mayo Clinic , Jacksonville , United States of America
| | - D Adedinsewo
- Mayo Clinic , Jacksonville , United States of America
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14
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Adedinsewo D, Hardway H, Morales-Lara CA, Johnson P, Douglass E, Dangott B, Nakhleh R, Narula T, Patel P, Goswami R, Heckman A, Lopez-Jimenez F, Noseworthy P, Yamani M, Carter R. Screening for cardiac allograft rejection among heart transplant recipients using an electrocardiogram-based deep learning model. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Current approaches utilizing non-invasive methods to screen for cardiac allograft rejection (gene expression profiling and cell free DNA) have yet to be broadly integrated into heart transplant management and have shown limited discrimination (AUCs of 0.68 and 0.77, respectively). Changes in the electrocardiogram (ECG) have been reported at the time of severe cardiac rejection, including low voltages and conduction abnormalities. It remains unknown if subtle ECG changes correlating with cardiac allograft rejection can be detected earlier using machine learning methods.
Purpose
We sought to develop an artificial intelligence (AI) model to detect cardiac allograft rejection based on the 12 lead ECG.
Methods
We identified all patients who underwent a heart transplant at 3 hospital sites within a single health system from Jan 1998 through Apr 2021 and extracted digital 12-lead ECG data as well as endomyocardial biopsy pathology results from the electronic medical record. We partitioned our data into a training (80%), validation (10%), and test set (10%) based on a group stratification sampling. Each patient was present in only one set and each set had a positivity rate of 2.6% with 6,074/758/758 ECGs belonging to 1,146/140/141 unique patients in each set respectively. Cardiac allograft rejection was defined as moderate or severe acute cellular rejection based on International Society for Heart and Lung Transplantation (ISHLT) guidelines. A convolutional neural network, using the 12-lead ECG data as input, was trained with hyperparameter optimization for regularization, learning rate adjustments, and class weights. Model performance metrics were based on the test data and estimated using the final model architecture.
Results
1,587 heart transplant recipients who had at least one endomyocardial biopsy were evaluated for inclusion. We limited our sample to ECGs performed within 30 days of the biopsy date (7,590 ECGs, representing 1,425 unique patients). Our study population had a median age of 55.8 years and 28.7% were female. The median number of ECG-biopsy pairs per patient was 5. The majority of endomyocardial biopsy results were classified as none or mild rejection (97.1%), and 2.9% had moderate/severe rejection. The ECG-based AI model detected cardiac allograft rejection with an area under the receiver operative curve (AUC) of 0.84 in the test set. The sensitivity, specificity, positive and negative predictive values were 95%, 52.6%. 5.2% and 99.7% respectively.
Conclusions
An AI-ECG model appears to outperform novel non-invasive laboratory tests (gene expression profiling and cell free DNA) for detecting cardiac allograft rejection and does not require a blood draw or the additional complexities surrounding sample processing. This model relies on a readily available and relatively inexpensive test, the ECG. In addition, AI predictions can be made available within a few minutes following ECG acquisition.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): Mayo Clinic
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Affiliation(s)
- D Adedinsewo
- Mayo Clinic, Cardiovascular Medicine , Jacksonville , United States of America
| | - H Hardway
- Mayo Clinic, Quantitative Health Sciences , Jacksonville , United States of America
| | - C A Morales-Lara
- Mayo Clinic, Cardiovascular Medicine , Jacksonville , United States of America
| | - P Johnson
- Mayo Clinic, Quantitative Health Sciences , Jacksonville , United States of America
| | - E Douglass
- Mayo Clinic, Cardiovascular Medicine , Jacksonville , United States of America
| | - B Dangott
- Mayo Clinic, Laboratory Medicine and Pathology , Jacksonville , United States of America
| | - R Nakhleh
- Mayo Clinic, Laboratory Medicine and Pathology , Jacksonville , United States of America
| | - T Narula
- Mayo Clinic, Transplant Medicine , Jacksonville , United States of America
| | - P Patel
- Mayo Clinic, Transplant Medicine , Jacksonville , United States of America
| | - R Goswami
- Mayo Clinic, Transplant Medicine , Jacksonville , United States of America
| | - A Heckman
- Mayo Clinic, Cardiovascular Medicine , Jacksonville , United States of America
| | - F Lopez-Jimenez
- Mayo Clinic, Cardiovascular Medicine , Rochester , United States of America
| | - P Noseworthy
- Mayo Clinic, Cardiovascular Medicine , Rochester , United States of America
| | - M Yamani
- Mayo Clinic, Cardiovascular Medicine , Jacksonville , United States of America
| | - R Carter
- Mayo Clinic, Quantitative Health Sciences , Jacksonville , United States of America
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15
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Townsend P, Abicht T, Alli A, Johnson P, Rohr A. Successful Outflow Graft Stent Placement for a Malfunctioning Left Ventricular Assist Device. J Vasc Interv Radiol 2022; 33:1270-1271. [PMID: 36182257 DOI: 10.1016/j.jvir.2022.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/20/2022] [Accepted: 06/25/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Patricia Townsend
- Department of Radiology, The University of Kansas Medical Center, Kansas City, Kansas.
| | - Travis Abicht
- Department of Cardiothoracic Surgery, The University of Kansas Medical Center, Kansas City, Kansas
| | - Adam Alli
- Department of Radiology, The University of Kansas Medical Center, Kansas City, Kansas
| | - Philip Johnson
- Department of Radiology, The University of Kansas Medical Center, Kansas City, Kansas
| | - Aaron Rohr
- Department of Radiology, The University of Kansas Medical Center, Kansas City, Kansas
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16
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Johnson P, Pedersen J, Peskir G, Zucca C. Detecting the presence of a random drift in Brownian motion. Stoch Process Their Appl 2022. [DOI: 10.1016/j.spa.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Counter C, Owen R, Sinha S, Muthusamy A, Drage M, Callaghan C, Elker D, Harper S, Sutherland A, Van Dellen D, Johnson P, Manas D, Shaw J, Forsythe J, Wilson C, Hughes S, Casey J, White S. O007 Pancreas and islet transplantation in the United Kingdom during the COVID-19 era. Br J Surg 2022; 109:znac242.007. [PMCID: PMC9384530 DOI: 10.1093/bjs/znac242.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction Methods Results Conclusion Take-home message
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Affiliation(s)
| | - R Owen
- NHSBT Pancreas Advisory Group
| | - S Sinha
- NHSBT Pancreas Advisory Group
| | | | - M Drage
- NHSBT Pancreas Advisory Group
| | | | - D Elker
- NHSBT Pancreas Advisory Group
| | | | | | | | | | - D Manas
- NHSBT Pancreas Advisory Group
| | - J Shaw
- NHSBT Pancreas Advisory Group
| | | | | | | | - J Casey
- NHSBT Pancreas Advisory Group
| | - S White
- NHSBT Pancreas Advisory Group
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18
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Johnson P, Chan JK, Vavasour IM, Abel S, Lee LE, Yong H, Laule C, Li DKB, Tam R, Traboulsee A, Carruthers RL, Kolind SH. Quantitative MRI findings indicate diffuse white matter damage in Susac Syndrome. Mult Scler J Exp Transl Clin 2022; 8:20552173221078834. [PMID: 35186315 PMCID: PMC8851927 DOI: 10.1177/20552173221078834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 01/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background Susac Syndrome (SuS) is an autoimmune endotheliopathy impacting the brain, retina and cochlea that can clinically mimic multiple sclerosis (MS). Objective To evaluate non-lesional white matter demyelination changes in SuS compared to MS and healthy controls (HC) using quantitative MRI. Methods 3T MRI including myelin water imaging and diffusion basis spectrum imaging were acquired for 7 SuS, 10 MS and 10 HC participants. Non-lesional white matter was analyzed in the corpus callosum (CC) and normal appearing white matter (NAWM). Groups were compared using ANCOVA with Tukey correction. Results SuS CC myelin water fraction (mean 0.092) was lower than MS(0.11, p = 0.01) and HC(0.11, p = 0.04). Another myelin marker, radial diffusivity, was increased in SuS CC(0.27μm2/ms) compared to HC(0.21μm2/ms, p = 0.008) and MS(0.23μm2/ms, p = 0.05). Fractional anisotropy was lower in SuS CC(0.82) than HC(0.86, p = 0.04). Fiber fraction (reflecting axons) did not differ from HC or MS. In NAWM, radial diffusivity and apparent diffusion coefficient were significantly increased in SuS compared to HC(p < 0.001 for both measures) and MS(p = 0.003, p < 0.001 respectively). Conclusions Our results provided evidence of myelin damage in SuS, particularly in the CC, and more extensive microstructural injury in NAWM, supporting the hypothesis that there are widespread microstructural changes in SuS syndrome including diffuse demyelination.
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Affiliation(s)
| | - JK Chan
- Department of Medicine (Neurology), University of British Columbia, Canada
| | - IM Vavasour
- Department of Radiology, University of British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD)
| | | | | | - H Yong
- Department of Medicine (Neurology), University of British Columbia, Canada
| | - C Laule
- Department of Radiology, University of British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD)
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
- Department of Physics and Astronomy, University of British Columbia, Canada
| | - DKB Li
- Department of Medicine (Neurology), University of British Columbia, Canada
- Department of Radiology, University of British Columbia, Canada
| | - R Tam
- Department of Radiology, University of British Columbia, Canada
- School of Biomedical Engineering, University of British Columbia, Canada
| | | | - RL Carruthers
- Department of Medicine (Neurology), University of British Columbia, Canada
| | - SH Kolind
- Department of Medicine (Neurology), University of British Columbia, Canada
- Department of Radiology, University of British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD)
- Department of Physics and Astronomy, University of British Columbia, Canada
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Burnett A, Johnson P, Locke I, Illidge T. The Radiotherapy Learning Healthcare System - Working Together to Improve the Quality of Radiotherapy Nationally. Clin Oncol (R Coll Radiol) 2022; 34:411-414. [PMID: 35120791 DOI: 10.1016/j.clon.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/23/2021] [Accepted: 12/13/2021] [Indexed: 11/19/2022]
Affiliation(s)
- A Burnett
- NHS England and NHS Improvement, London, UK.
| | - P Johnson
- NHS England and NHS Improvement, London, UK
| | - I Locke
- NHS England and NHS Improvement, London, UK
| | - T Illidge
- The University of Manchester, Manchester, UK
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20
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Gupta PSP, Kaushik K, Johnson P, Krishna K, Nandi S, Mondal S, Nikhil Kumar Tej J, Somoskoi B, Cseh S. Effect of different vitrification protocols on post thaw viability and gene expression of ovine preantral follicles. Theriogenology 2022; 178:1-7. [PMID: 34735977 DOI: 10.1016/j.theriogenology.2021.10.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022]
Abstract
The aim of the present study was to establish a vitrification protocol for ovine preantral follicles, which can retain viability after thawing and to evaluate the impact of different vitrification treatments on apoptosis and development-related gene expression. Preantral follicles were isolated from cortical slices of ovaries by the mechanical method of isolation. The isolated preantral follicles (200-300 μm) were randomly assigned into four groups. Group1 - Control Fresh preantral follicles (256 follicles); Group 2- Vitrification treatment A (259 follicles) (Vitrification solution 1 (VS1) - Fetal bovine serum (FBS)10%, Ethylene glycol (EG):1.8 M, Dimethyl sulfoxide (DMSO): 1.4 M, Sucrose-0.3 M for 4 min; VS2- FBS10%, EG:4.5 M, DMSO: 3.5 M, Sucrose:0.3 M for 45 s), Group 3 - Vitr. treatment B (235 follicles) (VS1-FBS 20%, EG:1.3 M, DMSO1.05 M for 15 min, VS2- FBS 20%, EG:2.7 M, DMSO:2.1 M for 5 min) and Group 4-Vitrification treatment C (248 follicles) (VS1-Glycerol(Gly):1.2 M for 3 min, VS2- Gly:1.2 M, EG:3.6 M for 3 min, VS3- Gly3M, EG: 4.5 M for 1 min). Preantral follicles were placed in corresponding vitrification treatments and later plunged immediately into liquid nitrogen (-196 °C). After a week, the follicles were thawed and analyzed for follicular viability by trypan blue dye exclusion method as well as for gene expression. The results showed that the low concentration of cryoprotectants (vitrification treatment B) negatively affected the viability of preantral follicles in comparison with control follicles. There was no significant difference in the viability rates among the Control (87%), Treatment A (79%) and Treatment C (75%). The percentage of viable preantral follicles (73%) derived from Treatment B was significantly decreased (P<0.05%) in comparison to that of control. The expression of apoptotic gene BAK was higher in the vitrification treatment B group. Expressions of the other apoptosis-related genes i.e. Bcl2L1, BAD, BAX, Caspase 3, and Annexin showed no significant difference among the groups. The expression pattern of development competence genes GDF-9 and BMP-15 were higher (P < 0.05) in vitrification treatment A and C, respectively. Expression of NOBOX gene was significantly increased in preantral follicles with Vitrification treatment B compared to the control group. We conclude that both the Vitrification treatment A and Treatment C were the efficient vitrification treatment methods for the vitrification of ovine preantral follicles.
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Affiliation(s)
- P S P Gupta
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India.
| | - Kalpana Kaushik
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - P Johnson
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - Kavya Krishna
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - S Nandi
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - S Mondal
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - J Nikhil Kumar Tej
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - B Somoskoi
- Dept. and Clinic of Obstetrics & Reproduction, University of Veterinary Science, Budapest, Hungary
| | - S Cseh
- Dept. and Clinic of Obstetrics & Reproduction, University of Veterinary Science, Budapest, Hungary
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21
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Means K, Townsend K, Johnson P. Multicavitary septic effusions associated with actinobacillosis in an adult Tennessee Walking Horse with weight loss. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13549] [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: 11/28/2022]
Affiliation(s)
- K. Means
- Department of Veterinary Medicine and Surgery College of Veterinary Medicine University of Missouri Columbia Missouri USA
| | - K. Townsend
- Department of Veterinary Medicine and Surgery College of Veterinary Medicine University of Missouri Columbia Missouri USA
| | - P. Johnson
- Department of Veterinary Medicine and Surgery College of Veterinary Medicine University of Missouri Columbia Missouri USA
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22
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Rea B, Johnson P, Clayton J, Shetty P, Worthman S, Alexander M, Trilk J. Lifestyle Medicine Education: Essential Component of Family Medicine. J Fam Pract 2022; 71:S66-S70. [PMID: 35389848 DOI: 10.12788/jfp.0273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | | | | | - Paulina Shetty
- American College of Lifestyle Medicine, Chesterfield, MO
| | | | | | - Jennifer Trilk
- University of South Carolina School of Medicine Greenville, Greenville, SC
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Karlsen TH, Sheron N, Zelber-Sagi S, Carrieri P, Dusheiko G, Bugianesi E, Pryke R, Hutchinson SJ, Sangro B, Martin NK, Cecchini M, Dirac MA, Belloni A, Serra-Burriel M, Ponsioen CY, Sheena B, Lerouge A, Devaux M, Scott N, Hellard M, Verkade HJ, Sturm E, Marchesini G, Yki-Järvinen H, Byrne CD, Targher G, Tur-Sinai A, Barrett D, Ninburg M, Reic T, Taylor A, Rhodes T, Treloar C, Petersen C, Schramm C, Flisiak R, Simonova MY, Pares A, Johnson P, Cucchetti A, Graupera I, Lionis C, Pose E, Fabrellas N, Ma AT, Mendive JM, Mazzaferro V, Rutter H, Cortez-Pinto H, Kelly D, Burton R, Lazarus JV, Ginès P, Buti M, Newsome PN, Burra P, Manns MP. The EASL-Lancet Liver Commission: protecting the next generation of Europeans against liver disease complications and premature mortality. Lancet 2022; 399:61-116. [PMID: 34863359 DOI: 10.1016/s0140-6736(21)01701-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/10/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Tom H Karlsen
- Department of Transplantation Medicine and Research Institute for Internal Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway.
| | - Nick Sheron
- Institute of Hepatology, Foundation for Liver Research, Kings College London, London, UK
| | - Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel; Department of Gastroenterology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Patrizia Carrieri
- Aix-Marseille University, Inserm, Institut de recherche pour le développement, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), ISSPAM, Marseille, France
| | - Geoffrey Dusheiko
- School of Medicine, University College London, London, UK; Kings College Hospital, London, UK
| | - Elisabetta Bugianesi
- Department of Medical Sciences, Division of Gastroenterology, University of Torino, Torino, Italy
| | | | - Sharon J Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, UK
| | - Bruno Sangro
- Liver Unit, Clinica Universidad de Navarra-IDISNA and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Pamplona, Spain
| | - Natasha K Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Population Health Sciences, University of Bristol, Bristol, UK
| | - Michele Cecchini
- Health Division, Organisation for Economic Co-operation and Development, Paris, France
| | - Mae Ashworth Dirac
- Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Department of Family Medicine, University of Washington, Seattle, WA, USA; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Annalisa Belloni
- Health Economics and Modelling Division, Public Health England, London, UK
| | - Miquel Serra-Burriel
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Cyriel Y Ponsioen
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Brittney Sheena
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Alienor Lerouge
- Health Division, Organisation for Economic Co-operation and Development, Paris, France
| | - Marion Devaux
- Health Division, Organisation for Economic Co-operation and Development, Paris, France
| | - Nick Scott
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
| | - Margaret Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia; Department of Infectious Diseases, Alfred Hospital, Melbourne, VIC, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Henkjan J Verkade
- Paediatric Gastroenterology and Hepatology, Department of Paediatrics, University Medical Centre Groningen, University of Groningen, Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany
| | - Ekkehard Sturm
- Division of Paediatric Gastroenterology and Hepatology, University Children's Hospital Tübingen, Tübingen, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany
| | | | | | - Chris D Byrne
- Department of Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK; Southampton National Institute for Health Research, Biomedical Research Centre, University Hospital Southampton and Southampton General Hospital, Southampton, UK
| | - Giovanni Targher
- Department of Medicine, Section of Endocrinology, Diabetes, and Metabolism, University of Verona, Verona, Italy
| | - Aviad Tur-Sinai
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Damon Barrett
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Tatjana Reic
- European Liver Patients Organization, Brussels, Belgium; Croatian Society for Liver Diseases-Hepatos, Split, Croatia
| | | | - Tim Rhodes
- London School of Hygiene & Tropical Medicine, London, UK
| | - Carla Treloar
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Claus Petersen
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
| | - Christoph Schramm
- Martin Zeitz Center for Rare Diseases, Hamburg Center for Translational Immunology (HCTI), and First Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Poland
| | - Marieta Y Simonova
- Department of Gastroenterology, HPB Surgery and Transplantation, Clinic of Gastroentrology, Military Medical Academy, Sofia, Bulgaria
| | - Albert Pares
- Liver Unit, Hospital Clinic of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBEREHD, Madrid, Spain
| | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Alessandro Cucchetti
- Department of Medical and Surgical Sciences-DIMEC, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Isabel Graupera
- Liver Unit, Hospital Clinic of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBEREHD, Madrid, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, Spain
| | - Christos Lionis
- Clinic of Social and Family Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Elisa Pose
- Liver Unit, Hospital Clinic of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, Spain
| | - Núria Fabrellas
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBEREHD, Madrid, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, Spain
| | - Ann T Ma
- Liver Unit, Hospital Clinic of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan M Mendive
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III, Madrid, Spain; La Mina Health Centre, Catalan Institute of Health (ICS), Barcelona, Spain
| | - Vincenzo Mazzaferro
- HPB Surgery and Liver Transplantation, Istituto Nazionale Tumori IRCCS Foundation (INT), Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Helena Cortez-Pinto
- Clínica Universitária de Gastrenterologia and Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Deirdre Kelly
- Liver Unit, Birmingham Women's and Children's Hospital and University of Birmingham, UK
| | - Robyn Burton
- Alcohol, Drugs, Tobacco and Justice Division, Public Health England, London, UK
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, Barcelona, Spain
| | - Pere Ginès
- Liver Unit, Hospital Clinic of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBEREHD, Madrid, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, Spain
| | - Maria Buti
- CIBEREHD del Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario Valle Hebron, Barcelona, Spain
| | - Philip N Newsome
- National Institute for Health Research Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, University of Birmingham, Birmingham, UK
| | - Patrizia Burra
- Multivisceral Transplant Unit, Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
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Kaushik K, Gupta P, Johnson P, Krishna K, Nandi S, Mondal S, Kumar Tej JN, Bence S, Cseh S. Effect of retinol in the vitrification medium on viability of vitrified ovine preantral follicles and expression of key developmental and apoptosis related genes. Cryo Letters 2022; 43:10-17. [PMID: 35315865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Vitrification increases the production of reactive oxygen species (ROS) and the antioxidants in the vitrification solution may be beneficial by reducing excessive ROS production. OBJECTIVE To evaluate the effect of retinol supplementation in vitrification solution on viability, apoptosis and development-related gene expression in vitrified sheep preantral follicles. MATERIALS AND METHODS Preantral follicles were isolated and randomly assigned into one of five groups: Group1, control fresh preantral follicles; Group 2, vitrification treatment; Group 3, vitrification + 2 μM retinol; Group 4, vitrification + 5 μM retinol; Group 5, vitrification + 10 μM retinol. Preantral follicles were placed in vitrification solutions and then plunged into liquid nitrogen (-196°C). After a week, the follicles were thawed and analyzed for follicular viability by trypan blue exclusion method and for gene expression. RESULTS Vitrification with 5 μM retinol positively affected viability in comparison with vitrification without retinol (P < 0.05). There was no significant difference in viability among the Group 1, Group 2, Group 3 and Group 5. Expression of apoptotic genes BAX and Casp 3 were higher in the vitrified group, and vitrification with 5 μM retinol (Group 4) is comparable to the control fresh. Expressions of other apoptosis-related genes (i.e., BCL2L1, BAD and BAK) showed significant difference between the control fresh group and the vitrification group with 5 μM retinol. Expression of Annexin5 was also significantly different among various groups. The expression of development competence genes GDF-9 and BMP-15 were higher (P < 0.05) in the Group vitrified with 5 μM retinol. CONCLUSION The supplementation of 5 μM retinol in vitrification solution was beneficial for the vitrification of ovine preantral follicles.
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Affiliation(s)
- K Kaushik
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - Psp Gupta
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India.
| | - P Johnson
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - K Krishna
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - S Nandi
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - S Mondal
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - J N Kumar Tej
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - S Bence
- Department and Clinic of Obstetrics and Reproduction, University of Veterinary Science, Budapest, Hungary
| | - S Cseh
- Department and Clinic of Obstetrics and Reproduction, University of Veterinary Science, Budapest, Hungary
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25
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Gupta PSP, Kaushik K, Krishna K, Nikhil Kumar Tej J, Nandi S, Mondal S, Johnson P. Regulatory role of Wnt signal in the estradiol synthesis of different size categories of ovarian follicles in buffalo (Bubalus bubalis). Reprod Domest Anim 2021; 57:368-380. [PMID: 34967467 DOI: 10.1111/rda.14075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 11/27/2022]
Abstract
The aim of the present study was to understand the role of Wnt signal in ovarian estradiol synthesis in various size categories of ovarian follicles. A six- day cell culture system was adopted to test the effect of a Wnt inhibitor i.e. Inhibitor of Wnt response (IWR) on the ovarian granulosa cell estradiol synthesis and associated genes related to estradiol synthesis and Wnt signaling (CYP19A1, CCND2, WNT2, FZD6, DVL1, APC, AXIN2, CTNNB1) in buffalo. It was conducted with four groups: Group 1:control, Group 2: control + FSH, Group 3: IWR, Group 4:IWR + FSH. No significant effect of IWR was observed on the ovarian granulosa cell proliferation. No significant difference in the estradiol levels was found in the spent media harvested after six days of in vitro culture among different groups in small and large-sized ovarian follicles. However, the estradiol level varied significantly (P < 0.05) among different treatment groups in medium-sized follicles. The estradiol level was significantly lower (P < 0.05) in IWR group compared to the control group and was also significantly lower in IWR+FSH group compared to the FSH group. The Wnt inhibitor had significantly (P< 0.05) reduced the gene expression of CYP19A1 in large ovarian follicles. Varied effects of IWR-1 and FSH on the expression of other genes were observed. The results indicated that there is a positive role of Wnt signal in estradiol synthesis in buffalo but the positive role was more discernable in medium and large-sized follicles.
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Affiliation(s)
- P S P Gupta
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - Kalpana Kaushik
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - Kavya Krishna
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - J Nikhil Kumar Tej
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - S Nandi
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - S Mondal
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - P Johnson
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
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26
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Innes H, Jepsen P, McDonald S, Dillon J, Hamill V, Yeung A, Benselin J, Went A, Fraser A, Bathgate A, Ansari MA, Barclay ST, Goldberg D, Hayes PC, Johnson P, Barnes E, Irving W, Hutchinson S, Guha IN. Performance of models to predict hepatocellular carcinoma risk among UK patients with cirrhosis and cured HCV infection. JHEP Rep 2021; 3:100384. [PMID: 34805817 PMCID: PMC8585647 DOI: 10.1016/j.jhepr.2021.100384] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND & AIMS Hepatocellular carcinoma (HCC) prediction models can inform clinical decisions about HCC screening provided their predictions are robust. We conducted an external validation of 6 HCC prediction models for UK patients with cirrhosis and a HCV virological cure. METHODS Patients with cirrhosis and cured HCV were identified from the Scotland HCV clinical database (N = 2,139) and the STratified medicine to Optimise Treatment of Hepatitis C Virus (STOP-HCV) study (N = 606). We calculated patient values for 4 competing non-genetic HCC prediction models, plus 2 genetic models (for the STOP-HCV cohort only). Follow-up began at the date of sustained virological response (SVR) achievement. HCC diagnoses were identified through linkage to nation-wide cancer, hospitalisation, and mortality registries. We compared discrimination and calibration measures between prediction models. RESULTS Mean follow-up was 3.4-3.9 years, with 118 (Scotland) and 40 (STOP-HCV) incident HCCs observed. The age-male sex-ALBI-platelet count score (aMAP) model showed the best discrimination; for example, the Concordance index (C-index) in the Scottish cohort was 0.77 (95% CI 0.73-0.81). However, for all models, discrimination varied by cohort (being better for the Scottish cohort) and by age (being better for younger patients). In addition, genetic models performed better in patients with HCV genotype 3. The observed 3-year HCC risk was 3.3% (95% CI 2.6-4.2) and 5.1% (3.5-7.0%) in the Scottish and STOP-HCV cohorts, respectively. These were most closely matched by aMAP, in which the mean predicted 3-year risk was 3.6% and 5.0% in the Scottish and STOP-HCV cohorts, respectively. CONCLUSIONS aMAP was the best-performing model in terms of both discrimination and calibration and, therefore, should be used as a benchmark for rival models to surpass. This study underlines the opportunity for 'real-world' risk stratification in patients with cirrhosis and cured HCV. However, auxiliary research is needed to help translate an HCC risk prediction into an HCC-screening decision. LAY SUMMARY Patients with cirrhosis and cured HCV are at high risk of developing liver cancer, although the risk varies substantially from one patient to the next. Risk calculator tools can alert clinicians to patients at high risk and thereby influence decision-making. In this study, we tested the performance of 6 risk calculators in more than 2,500 patients with cirrhosis and cured HCV. We show that some risk calculators are considerably better than others. Overall, we found that the 'aMAP' calculator worked the best, but more work is needed to convert predictions into clinical decisions.
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Key Words
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- C-index, Concordance index
- External validation
- GGT, gamma glutamyl transferase
- GRS, genetic risk score
- Genetic risk scores
- HCC, hepatocellular carcinoma
- ICD, International Classification of Diseases
- IDU, injecting-drug user
- IF, interferon
- PNPLA3, patatin-like phospholipase domain-containing protein 3
- Primary liver cancer
- Prognosis
- Risk prediction
- SMR01, Scottish Inpatient Hospital Admission Database
- SMR06, Scottish Cancer Register
- STOP-HCV, STratified medicine to Optimise Treatment of Hepatitis C Virus
- SVR, sustained virological response
- THRI, Toronto HCC Risk Index
- VHA, Veteran Health Affairs
- aMAP, age-male sex-ALBI-platelet count score
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Affiliation(s)
- Hamish Innes
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Peter Jepsen
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Scott McDonald
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
| | - John Dillon
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - Victoria Hamill
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
| | - Alan Yeung
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
| | - Jennifer Benselin
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | | | - Andrew Fraser
- Aberdeen Royal Infirmary, Aberdeen, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | | | - M. Azim Ansari
- Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine and the Oxford NIHR Biomedical Research Centre, Oxford University, Oxford, UK
| | | | - David Goldberg
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
| | | | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine and the Oxford NIHR Biomedical Research Centre, Oxford University, Oxford, UK
| | - William Irving
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Sharon Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Public Health Scotland, Glasgow, UK
| | - Indra Neil Guha
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
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Cucchetti A, Gramenzi A, Johnson P, Giannini EG, Tovoli F, Rapaccini GL, Marra F, Cabibbo G, Caturelli E, Gasbarrini A, Svegliati-Baroni G, Sacco R, Zoli M, Morisco F, Di Marco M, Mega A, Foschi FG, Biasini E, Masotto A, Nardone G, Raimondo G, Azzaroli F, Vidili G, Brunetto MR, Farinati F, Trevisani F. Material deprivation affects the management and clinical outcome of hepatocellular carcinoma in a high-resource environment. Eur J Cancer 2021; 158:133-143. [PMID: 34666215 DOI: 10.1016/j.ejca.2021.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/31/2021] [Accepted: 09/14/2021] [Indexed: 02/07/2023]
Abstract
AIM This study investigated how material deprivation in Italy influences the stage of hepatocellular carcinoma (HCC) at diagnosis and the chance of cure. METHODS 4114 patients from the Italian Liver Cancer database consecutively diagnosed with HCC between January 2008 and December 2018 were analysed about severe material deprivation (SMD) rate tertiles of the region of birth and region of managing hospitals, according to the European Statistics on Income and Living Conditions. The main outcomes were HCC diagnosis modalities (during or outside surveillance), treatment adoption and overall survival. RESULTS In more deprived regions, HCC was more frequently diagnosed during surveillance, while the incidental diagnosis was prevalent in the least deprived. Tumour characteristics did not differ among regions. The proportion of patients undergoing potentially curative treatments progressively decreased as the SMD worsened. Consequently, overall survival was better in less deprived regions. Patients who moved from most deprived to less deprived regions increased their probability of receiving potentially curative treatments by 1.11 times (95% CI 1.03 to 1.19), decreasing their mortality likelihood (hazard ratio 0.78 95% CI 0.67 to 0.90). CONCLUSIONS Socioeconomic status measured through SMD does not seem to influence HCC features at diagnosis but brings a negative effect on the chance of receiving potentially curative treatments. Patient mobility from the most deprived to the less deprived regions increased the access to curative therapies, with the ultimate result of improving survival.
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Affiliation(s)
- Alessandro Cucchetti
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Morgagni-Pierantoni Hospital, Forlì, Italy.
| | - Annagiulia Gramenzi
- Department of Medical and Surgical Sciences, Semeiotica Medica Unit, University of Bologna, Italy.
| | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, UK.
| | - Edoardo G Giannini
- Department of Internal Medicine, Gastroenterology Unit, IRCCS Policlinico San Martino, University of Genova, Italy.
| | - Francesco Tovoli
- Internal Medicine Unit, S. Orsola-Malpighi Hospital, Bologna, Italy.
| | - Gian Ludovico Rapaccini
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Roma, Italy.
| | - Fabio Marra
- Department of Experimental and Clinical Medicine, University of Firenze, Italy.
| | - Giuseppe Cabibbo
- Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties (PROMISE), Section of Gastroenterology and Hepatology, University of Palermo, Italy.
| | | | - Antonio Gasbarrini
- Internal Medicine and Gastroenterology Unit, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Roma, Italy.
| | | | - Rodolfo Sacco
- Gastroenterology and Digestive Endoscopy, Foggia University Hospital, Foggia, Italy.
| | - Marco Zoli
- Department of Medical and Surgical Sciences, Internal Medicine Unit, University of Bologna, Italy.
| | - Filomena Morisco
- Department of Medicine and Surgery, Gastroenterology Unit, University of Napoli "Federico II", Italy.
| | | | - Andrea Mega
- Gastroenterology Unit, Bolzano Regional Hospital, Bolzano, Italy.
| | - Francesco G Foschi
- Department of Internal Medicine, Ospedale per gli Infermi di Faenza, Italy.
| | - Elisabetta Biasini
- Infectious Diseases and Hepatology Unit, Azienda Ospedaliero-Universitaria di Parma, Italy.
| | - Alberto Masotto
- Gastroenterology Unit, Ospedale Sacro Cuore Don Calabria, Negrar, Italy.
| | - Gerardo Nardone
- Department of Clinical Medicine and Surgery, Hepato-Gastroenterology Unit, University of Napoli "Federico II", Italy.
| | - Giovanni Raimondo
- Department of Clinical and Experimental Medicine, Clinical and Molecular Hepatology Unit, University of Messina, Italy.
| | - Francesco Azzaroli
- Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Bologna, Italy.
| | - Gianpaolo Vidili
- Department of Medical, Surgical and Experimental Sciences, Clinica Medica Unit, University of Sassari, Italy.
| | - Maurizia R Brunetto
- Department of Clinical and Experimental Medicine, Hepatology and Liver Physiopathology Laboratory and Internal Medicine, University of Pisa, Italy.
| | - Fabio Farinati
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy.
| | - Franco Trevisani
- Department of Medical and Surgical Sciences, Semeiotica Medica Unit, University of Bologna, Italy.
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Tsou B, Fliotsos M, Zafar S, Smith K, Johnson P, Schein O, Woreta F. 380 Evaluating the Use of Advanced Neuroimaging in the Emergency Department for Ocular Complaints. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kolamunnage-Dona R, Berhane S, Potts H, Williams EH, Tanner J, Janowitz T, Hoare M, Johnson P. Sorafenib is associated with a reduced rate of tumour growth and liver function deterioration in HCV-induced hepatocellular carcinoma. J Hepatol 2021; 75:879-887. [PMID: 34052255 PMCID: PMC9158473 DOI: 10.1016/j.jhep.2021.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Sorafenib has been the standard of care for patients with advanced hepatocellular carcinoma and although immunotherapeutic approaches are now challenging this position, it retains an advantage in HCV-seropositive patients. We aimed to quantify the rate of tumour progression in patients receiving sorafenib and relate this figure to survival, both overall, and according to viral status. METHODS Using serial data from an international clinical trial we applied a joint model to combine survival and progression over time in order to estimate the rate of tumour growth as assessed by tumour burden and serum alpha-fetoprotein, and the impact of treatment on liver function. RESULTS High tumour burden at baseline was associated with an increased risk of death. In patients still alive at the end of the study, the progression in relation to tumour burden was very low compared to those who died within the study. Overall, the change in mean tumour burden was 0.12 mm per day or an absolute growth rate of 3.6 mm/month. Median doubling time was 665 days. For those who progressed above 0.12 mm per day or the 12% rate, median survival was 234 days compared to 384 days if the rate was below 12%. Tumour growth rate and serum alpha-fetoprotein rise were significantly lower in those who were HCV seropositive as was the rate of decline in liver function. These results were replicated in 2 independent patient groups. CONCLUSION Our analysis suggests that sorafenib treatment is associated with improved survival in patients with advanced hepatocellular carcinoma mainly by decreasing the rate of tumour growth and liver function deterioration among patients with HCV infection. LAY SUMMARY Among patients receiving sorafenib for advanced hepatocellular carcinoma the rate of tumour growth (as assessed by changes in tumour size and the biomarker alpha-fetoprotein) and the deterioration of liver function is less in those who have the hepatitis C virus, than in those who do not.
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Affiliation(s)
| | - Sarah Berhane
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, UK; Institute of Applied Health Research, University of Birmingham, UK
| | - Harry Potts
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - James Tanner
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Tobias Janowitz
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK; Cold Spring Harbor Laboratory, NY, USA; Northwell Health Cancer Institute, NY, USA
| | - Matthew Hoare
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK; Department of Medicine, University of Cambridge, Cambridge, UK
| | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, UK.
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Edeline J, Lamarca A, McNamara MG, Jacobs T, Hubner RA, Palmer D, Groot Koerkamp B, Johnson P, Guiu B, Valle JW. Locoregional therapies in patients with intrahepatic cholangiocarcinoma: A systematic review and pooled analysis. Cancer Treat Rev 2021; 99:102258. [PMID: 34252720 DOI: 10.1016/j.ctrv.2021.102258] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/02/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Locoregional treatments (LRT) including radioembolisation (SIRT), transarterial chemo-embolisation (TACE), hepatic arterial infusion (HAI) of chemotherapy, external beam radiotherapy (EBRT) and ablation have been studied for the management of intrahepatic cholangiocarcinoma (iCC). The aim of this systematic review was to provide outcome benchmarks for clinical trial design. METHODS Identification of studies reporting outcomes of patients treated with LRT for iCC was performed using PubMed and Embase. Pooled weighted means were calculated for progression-free survival (PFS) and overall survival (OS); meta-analysis of proportions was used for estimation of pooled response rate. RESULTS 6325 entries were reviewed; 93 studies were eligible, representing 101 cohorts and 3990 patients: 15 cohorts (645 patients) for ablation, 18 cohorts (541 patients) for EBRT, 27 cohorts (1232 patients) for SIRT, 22 cohorts (1145 patients) for TACE, 16 cohorts (331 patients) for HAI and 3 cohorts (96 patients) not pooled. 74% of the studies were retrospective, 99% non-randomised. The pooled mean weighted OS was 30.2 months (95% confidence interval (CI): 21.8-38.6) for ablation, 18.9 (14.2-23.5) for EBRT, 14.1 (12.1-16.0) for SIRT, 15.9 (12.9-19.0) for TACE and 21.3 (15.4-27.1) for HAI. The pooled complete response rate was 93.9% for ablation. When analysed together, SIRT, TACE and HAI had a pooled mean weighted OS of 15.7 months, and 25.2 months for patients treated in first-line with concomitant systemic chemotherapy. CONCLUSIONS Available literature on LRT for iCC was heterogeneous and of insufficient quality to make strong recommendations. Ablation achieved satisfactory outcomes, and may be recommended when surgery is not feasible.
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Affiliation(s)
- Julien Edeline
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France.
| | - Angela Lamarca
- Department of Medical Oncology, The Christie NHS Foundation, Manchester/Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Mairéad G McNamara
- Division of Cancer Sciences, University of Manchester/Department of Medical Oncology, Manchester, United Kingdom
| | - Timothy Jacobs
- The Library, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Richard A Hubner
- Department of Medical Oncology, The Christie NHS Foundation, Manchester/Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Dan Palmer
- University of Liverpool, Liverpool, United Kingdom
| | - Bas Groot Koerkamp
- Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | | | - Boris Guiu
- Departement of Radiology, St-Eloi University Hospital, Montpellier, France
| | - Juan W Valle
- Division of Cancer Sciences, University of Manchester/Department of Medical Oncology, Manchester, United Kingdom
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Gupta P, Johnson P, Kaushik K, Krishna K, Nandi S, Mondal S, Nikhil Kumar Tej J, Somoskoi B, Cseh S. Effect of retinol as antioxidant on the post-thaw viability and the expression of apoptosis and developmental competence-related genes of vitrified preantral follicles in buffalo (Bubalus bubalis). Reprod Domest Anim 2021; 56:1446-1455. [PMID: 34449946 DOI: 10.1111/rda.14009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022]
Abstract
The present study evaluated the effect of supplementation of retinol in the vitrification solution on the viability, apoptosis and development-related gene expression in vitrified buffalo preantral follicles. Preantral follicles isolated from cortical slices of ovaries were randomly assigned into three groups: Group1-Control fresh preantral follicles; Group 2-Vitrification treatment (Vitrification solution 1 (VS1) -TCM-199 + 25 mM HEPES + Foetal bovine serum (FBS) 10%, Ethylene glycol (EG): 10%, Dimethyl sulphoxide (DMSO): 10%, Sucrose-0.3 M for 4 min; VS2- TCM-199 + 25 mM HEPES + FBS10%, EG:25%, DMSO: 25%, Sucrose:0.3 M for 45 s); Group3-vitrification treatment +5 μM of Retinol. Preantral follicles were placed in corresponding vitrification medium and plunged into liquid nitrogen (-196°C). After a week, the follicles were thawed and analysed for follicular viability and gene expression. There was no significant difference in the viability rates among the Group 1(Fresh preantral follicles) (91.46 ± 2.39%), Group 2 (89.59 ± 2.46%) and Group 3 (87.19 ± 4.05%). There was a significantly (p < .05) higher mRNA expression of BCL2L1, GDF-9 and BMP-15 in the vitrification + retinol group compared with the control group. There was a significantly (p < .05) higher expression of Caspase-3 and Annexin-5 in the vitrification group and Vitrification + retinol group compared with control group of follicles. It is concluded that the supplementation of 5 μM of Retinol in Vitrification solution was an efficient vitrification procedure for the vitrification of buffalo preantral follicles.
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Affiliation(s)
- Psp Gupta
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - P Johnson
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - K Kaushik
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - K Krishna
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - S Nandi
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - S Mondal
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - J Nikhil Kumar Tej
- ICAR-National Institute of Animal Nutrition and Physiology, Bengaluru, India
| | - B Somoskoi
- Department and Clinic of Obstetrics & Reproduction, University of Veterinary Medicine, Budapest, Hungary
| | - S Cseh
- Department and Clinic of Obstetrics & Reproduction, University of Veterinary Medicine, Budapest, Hungary
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Edeline J, Lamarca A, McNamara M, Jacobs T, Hubner R, Palmer D, Johnson P, Guiu B, Valle J. P-229 Systematic review and pooled analysis of locoregional therapies in patients with intrahepatic cholangiocarcinoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.283] [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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Abstract
The validation of diagnostic methods (and the subsequent results generated by a laboratory) are improved through participation in inter-laboratory comparisons (IC), such as proficiency-testing (PT) programmes and other exercises referred to as 'ring tests' or 'ring trials' (RTs). This is a requirement to comply with international quality standards. Validating a method is a continuous process and taking part in ongoing PT programmes supports the management of a method's life cycle, providing continuing assessment of fitness (sometimes referred to as the 'validation retention status'). Proficiency-testing panel designs ensure that the methods used, particularly diagnostic specificity and sensitivity, are suitably challenged. Appraising PT results over time can illustrate whether the laboratory's performance is stable, improving or worsening, and proficiency tests can also highlight variations in the performance of assays. The development of new proficiency tests can support the implementation of novel diagnostics technologies, such as whole genome sequencing and point-of-care testing, and assist in cross-sectoral partnerships focusing on One Health approaches, which are high on the agenda for infectious disease control. For example, the rapid design and distribution of emergency exempted assays for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) means that these assays were not as rigorously evaluated as assays for established infectious diseases. Therefore, participation in PT programmes for SARS-CoV-2 is essential to understand the performance of these assays. While other mechanisms help to underpin laboratory activities, PT has been, and should remain, an integral part of laboratory quality assurance. Resources must be directed towards increasing and improving the quality of PT (for example, availability and accessibility of suitable biological and reference materials are essential for a PT provider to execute its duties), to support established and novel methods such as genomic and point-of-care tests.
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Hutchings M, Mous R, Clausen MR, Johnson P, Linton K, Lewis DJ, Chamuleau ME, Balari AS, Cunningham D, DeMarco D, Chen K, Elliott B, Lugtenburg P. SUBCUTANEOUS EPCORITAMAB IN PATIENTS WITH RELAPSED/REFRACTORY B‐CELL NON‐HODGKIN LYMPHOMA: SAFETY PROFILE AND ANTI‐TUMOR ACTIVITY. Hematol Oncol 2021. [DOI: 10.1002/hon.16_2879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M Hutchings
- Rigshospitalet, Copenhagen University Hospital Department of Hematology Copenhagen Denmark
| | - R Mous
- On behalf of the Lunenburg Lymphoma Phase I/II Consortium‐HOVON/LLPC Universitair Medisch Centrum Utrecht Department of Hematology Utrecht Netherlands
| | - M. R Clausen
- Vejle Hospital Department of Hematology Veile Denmark
| | - P Johnson
- Cancer Research UK, Cancer Services University of Southampton Department of Hematology Southampton UK
| | - K Linton
- Christie Hospital NHS Foundation Trust Division of Cancer Services Manchester UK
| | - D. J Lewis
- Plymouth University Medical School Department of Hematology Plymouth UK
| | - M. E.D Chamuleau
- On behalf of the Lunenburg Lymphoma Phase I/II Consortium‐HOVON/LLPC VU University Medical Center Department of Hematology Amsterdam Netherlands
| | - A. S Balari
- Institut Català d'Oncologia‐Hospital Duran i Reynals, Hospitalet del Llobregat Department of Hematology Barcelona Spain
| | - D Cunningham
- The Royal Marsden NHS Foundation Trust Department of Hematology Sutton UK
| | - D DeMarco
- Genmab Clinical Research and Development Princeton, New Jersey USA
| | - K.‐M Chen
- Genmab Clinical Research and Development Princeton, New Jersey USA
| | - B Elliott
- Genmab Clinical Research and Development Princeton, New Jersey USA
| | - P Lugtenburg
- On behalf of the Lunenburg Lymphoma Phase I/II Consortium‐HOVON/LLPC Erasmus MC Cancer Institute Department of Hematology Rotterdam Netherlands
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Booth S, Kirkwood A, Johnson P, Barrington S, Gallop‐Evans E, Peggs K, Warbey V, Burton C, Ardavan A, Phillips B, Lawrie E, Pike L, Northend M, Clifton‐Hadley L, Jenner R, Collins GP. ANIMATE: A PHASE II STUDY OF NIVOLUMAB IN TRANSPLANT ELIGIBLE PATIENTS WITH RELAPSED/REFRACTORY CLASSIC HODGKIN LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.159_2880] [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: 11/07/2022]
Affiliation(s)
- S. Booth
- Oxford University Hospitals Department of Haematology Oxford UK
| | - A. Kirkwood
- UCL Cancer Institute CR UK and UCL Cancer Trials Centre London UK
| | - P. Johnson
- University of Southampton Department of Medicine London UK
| | - S. Barrington
- King’s College London King’s College London and Guys’ & St Thomas PET Imaging Centre London UK
| | - E. Gallop‐Evans
- Velindre University NHS Trust Department of Oncology Cardiff UK
| | - K. Peggs
- University College London Hospitals Haematology London UK
| | - V. Warbey
- King’s College London King’s College London and Guys’ & St Thomas PET Imaging Centre London UK
| | - C. Burton
- Leeds Cancer Centre Haematology Leeds UK
| | - A. Ardavan
- University of Oxford Department of Physics Oxford UK
| | - B. Phillips
- University of Manchester and Manchester Academic Health Science Centre Division of Cancer Science Manchester UK
| | - E. Lawrie
- UCL Cancer Institute CR UK and UCL Cancer Trials Centre London UK
| | - L. Pike
- King’s College London King’s College London and Guys’ & St Thomas PET Imaging Centre London UK
| | - M. Northend
- UCL Cancer Institute CR UK and UCL Cancer Trials Centre London UK
| | | | - R. Jenner
- UCL Cancer Institute CR UK and UCL Cancer Trials Centre London UK
| | - G. P. Collins
- Oxford University Hospitals Department of Haematology Oxford UK
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Barrans SL, Cucco F, Davies J, van Hoppe M, Mell T, Mercer K, Stanton L, Caddy J, Tooze R, Burton C, Westhead D, Du M, Davies A, Johnson P. MOLECULAR HIGH GRADE (MHG) GENE EXPRESSION PROFILE IN DLBCL IS ENRICHED AMONG PATIENTS WITH EARLY TREATMENT FAILURE. Hematol Oncol 2021. [DOI: 10.1002/hon.12_2880] [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: 11/08/2022]
Affiliation(s)
- S. L Barrans
- Leeds Teaching Hospitals HMDS Institute of Oncology Leeds UK
| | - F Cucco
- University of Cambridge Department of Pathology Cambridge UK
| | - J Davies
- University of Leeds Bioinformatics Group Faculty of Biological sciences Leeds UK
| | - M van Hoppe
- Leeds Teaching Hospitals HMDS Institute of Oncology Leeds UK
| | - T Mell
- Leeds Teaching Hospitals HMDS Institute of Oncology Leeds UK
| | - K Mercer
- University of Southampton SCTU Southampton UK
| | - l Stanton
- University of Southampton SCTU Southampton UK
| | - J Caddy
- University of Southampton SCTU Southampton UK
| | - R Tooze
- University or Leeds School of medicine Leeds UK
| | - C Burton
- Leeds Teaching Hospitals HMDS Institute of Oncology Leeds UK
| | - D Westhead
- University of Leeds Bioinformatics Group Faculty of Biological sciences Leeds UK
| | - M Du
- University of Cambridge Department of Pathology Cambridge UK
| | - A Davies
- University of Southampton SCTU Southampton UK
| | - P Johnson
- University of Southampton Medicine Southampton UK
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Davies A, McKay P, Osborne W, Stanton L, Tansley‐Hancock O, Lawrence M, Mercer K, Allen A, Pottinger B, Zhelyazkova A, Miall F, Rafferty J, Sale B, Cucco F, Nunn L, Coleman A, Griffiths G, Du MQ, Burton C, Barrons S, Johnson P. 9P GAIN PREDICTS OUTCOMES IN PATIENTS WITH RELAPSED/REFRACTORY (R/R) DIFFUSE LARGE B‐CELL LYMPHOMA (DLBCL) TREATED WITH R‐GEMOX +/‐ ATEZOLIZUMAB. ARGO: A RANDOMISED PHASE II STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.11_2880] [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: 11/09/2022]
Affiliation(s)
- A Davies
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - P McKay
- Beatson West of Scotland Cancer Centre Department of Haematology Glasgow UK
| | - W Osborne
- Freeman Hospital The Newcastle upon Tyne Hospitals NHS Foundation Trust Department of Haematology Newcastle UK
| | - L Stanton
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - O Tansley‐Hancock
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - M Lawrence
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - K Mercer
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - A Allen
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - B Pottinger
- Royal Cornwall Hospitals NHS Trust Department of Haematology Truro UK
| | - A Zhelyazkova
- The Pennine Acute Hospitals NHS Trust Department of Haematology Manchester UK
| | - F Miall
- University Hospitals of Leicester NHS Trust Department of Haematology Leicester UK
| | - J Rafferty
- Patient Representative, c/o CRUK Southampton Clinical Trials Unit Southampton UK
| | - B Sale
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - F Cucco
- University of Cambridge Department of Pathology Cambridge UK
| | - L Nunn
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - A Coleman
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - G Griffiths
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
| | - M. Q Du
- University of Cambridge Department of Pathology Cambridge UK
| | - C Burton
- Leeds Cancer Centre Haematological Malignancies Diagnostic Service Leeds UK
| | - S Barrons
- Leeds Cancer Centre Haematological Malignancies Diagnostic Service Leeds UK
| | - P Johnson
- University of Southampton Southampton Cancer Research UK (CRUK) Centre CRUK/NIHR Experimental Cancer Medicines Centre CRUK Southampton Clinical Trials Unit Southampton UK
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Martelli M, Zucca E, Botto B, Kryachok I, Ceriani L, Balzarotti M, Tucci A, Cabras MG, Zilioli VR, Rusconi C, Angrilli F, Arcaini L, Iwanicka AD, Ferreri A, Merli F, Zhao W, Hodgson D, Ionescu C, Fosså A, Cwynarski K, Mikhaeel G, Jerkeman M, Janikova A, Hüttmann A, Ciccone G, Metser U, Barrington S, Malkowski B, Versari A, Esposito F, Cozens K, Ielmini N, Ricardi R, Cavalli F, Johnson P, Davies A. IMPACT OF DIFFERENT INDUCTION REGIMENS ON THE OUTCOME OF PRIMARY MEDIASTINAL B CELL LYMPHOMA IN THE PROSPECTIVE IELSG 37 TRIAL. Hematol Oncol 2021. [DOI: 10.1002/hon.49_2879] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Johnson P, Thompson S, Adamo D, Fleming C, Bancos I, McKenzie T, Cheville J, Young W, Andrews J. Abstract No. 191 Adrenal venous sampling for lateralization of cortisol hypersecretion in patients with adrenocorticotropic hormone–independent Cushing syndrome and bilateral adrenal masses. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Nikhil Kumar Tej J, Johnson P, Krishna K, Kaushik K, Gupta PSP, Nandi S, Mondal S. Copper and Selenium stimulates CYP19A1 expression in caprine ovarian granulosa cells: possible involvement of AKT and WNT signalling pathways. Mol Biol Rep 2021; 48:3515-3527. [PMID: 33881728 DOI: 10.1007/s11033-021-06346-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
The role of copper and selenium on activation of estradiol synthesis pathways viz. PKA/AKT/WNT is not clearly elucidated. On this background we attempt to elcuiated the role of copper and selenium on mRNA expression of genes associated with estradiol synthesis in caprine ovarian granulose cell models. Ovarian granulosa cells from medium (3-5 mm) sized follicles were aspirated and distributed separately to different groups. Group I: control, Group II: cupric chloride (Cu: 0.5 mM), Group III: sodium selenite (Se: 100 ng/ml), Group IV: Cu + Se. The cells (105/well) were cultured in 96 well plate in the base culture medium of MEMα comprising of nonessential amino acids (1.1 mM), FSH (10 ng/mL), transferrin (5 µg/mL), IGF-I (2 ng/mL), androstenedione (10-6 M), penicillin (100 IU/mL), streptomycin (0.1 mg/mL) and fungizone (0.625 µl/mL) and insulin (1 ng/mL). The cells were incubated in a carbondioxide incubator (38 °C, 5% CO2, 95% RH). The medium was changed on alternate days and cells were harvested on day 6. Day 6 media was used for estimation of estradiol. The RNA isolated form harvested cells was used for qPCR assay. There was no significant (p > 0.05) difference in estradiol concentration between groups. The mRNA expression of AKT1, CYP19A1, WNT2 & 4, FZD6 and APC2 were significantly (p < 0.05) higher in Cu and Cu + Se groups compared to control. Whereas, the mRNA transcript of DVL1 and CSNK1 was significantly (p < 0.05) higher in Cu + Se group compared to control. Incontrast, no significant difference in mRNA expression of PRKAR1A and CTNNB1 was noticed. Our study support a key role of copper and selenium in activation of AKT and WNT signalling pathway that further lead to increase in the mRNA expression of CYP19A1.
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Affiliation(s)
- J Nikhil Kumar Tej
- ICAR-National Dairy Research Institute (NDRI), Karnal, Haryana, 132001, India.
| | - P Johnson
- Animal Biotechnology Lab, ICAR-National Institute of Animal Nutrition and Physiology (NIANP), Bengaluru, Karnataka, India
| | - Kavya Krishna
- Animal Biotechnology Lab, ICAR-National Institute of Animal Nutrition and Physiology (NIANP), Bengaluru, Karnataka, India
| | - Kalpana Kaushik
- Animal Biotechnology Lab, ICAR-National Institute of Animal Nutrition and Physiology (NIANP), Bengaluru, Karnataka, India
| | - P S P Gupta
- Animal Biotechnology Lab, ICAR-National Institute of Animal Nutrition and Physiology (NIANP), Bengaluru, Karnataka, India
| | - S Nandi
- Animal Biotechnology Lab, ICAR-National Institute of Animal Nutrition and Physiology (NIANP), Bengaluru, Karnataka, India
| | - S Mondal
- Animal Biotechnology Lab, ICAR-National Institute of Animal Nutrition and Physiology (NIANP), Bengaluru, Karnataka, India
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Gabay M, Johnson P, Fanikos J, Amerine L, Kienle P, Olsen M, Roussel C, Moody ML. Report on 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination. Am J Health Syst Pharm 2021; 78:1568-1575. [PMID: 33773495 DOI: 10.1093/ajhp/zxab134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE The 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination was convened in order to gather subject matter experts in the field of hazardous drug (HD) handling to develop consensus statements regarding surface contamination monitoring for adoption by stakeholders in the drug supply chain, policy, and healthcare arenas. SUMMARY The Safe to Touch conference convened virtually on September 22, 24, and 26, 2020. An expert panel of healthcare providers with experience in HD handling, monitoring, and research; pharmacy and nursing operations; and medication safety led the conference. An experienced audience of approximately 25 reaction panel members provided feedback to the panel via a preconference survey, during the conference, and at a postconference virtual town hall. Additionally, expert speakers presented on a range of issues, including the impact of HD surface contamination on health, current regulations and standards, surface contamination monitoring technologies, and variables impacting surface contamination testing. CONCLUSION At the end of the conference, the expert panel developed 11 consensus statements and corresponding recommendations that should be widely disseminated in order to educate individuals regarding the impact of HD surface contamination and increase the scope of HD surface contamination monitoring. Institutions involved in the handling of HDs should set short- and long-term goals for implementation of applicable consensus statements.
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Affiliation(s)
- Michael Gabay
- Drug Information Group, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | | | | | - Lindsey Amerine
- University of North Carolina Health System, Chapel Hill, NC, and UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | | | - MiKaela Olsen
- John Hopkins Hospital and Greenspring Oncology, Baltimore, MD, USA
| | - Christine Roussel
- Laboratory and Pharmacy Services, Doylestown Hospital, Doylestown, PA, USA
| | - Mary Lynn Moody
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
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Hughes DM, Berhane S, Emily de Groot CA, Toyoda H, Tada T, Kumada T, Satomura S, Nishida N, Kudo M, Kimura T, Osaki Y, Kolamunage-Dona R, Amoros R, Bird T, Garcίa-Fiñana M, Johnson P. Serum Levels of α-Fetoprotein Increased More Than 10 Years Before Detection of Hepatocellular Carcinoma. Clin Gastroenterol Hepatol 2021; 19:162-170.e4. [PMID: 32389887 PMCID: PMC7611145 DOI: 10.1016/j.cgh.2020.04.084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/09/2020] [Accepted: 04/30/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Ultrasound (US)-based screening has been recommended for patients with an increased risk of hepatocellular carcinoma (HCC). US analysis, however, is limited in patients who are obese or have small tumors. The addition of serum level of α-fetoprotein (AFP) measurements to US analysis can increase detection of HCC. We analyzed data from patients with chronic liver disease, collected over 15 years in an HCC surveillance program, to develop a model to assess risk of HCC. METHODS We collected data from 3450 patients with chronic liver disease undergoing US surveillance in Japan from March 1998 through April 2014, and followed them up for a median of 8.83 years. We performed longitudinal discriminant analysis of serial AFP measurements (median number of observations/patient, 56; approximately every 3 months) to develop a model to determine the risk of HCC. We validated the model using data from 2 cohorts of patients with chronic liver disease in Japan (404 and 2754 patients) and 1 cohort in Scotland (1596 patients). RESULTS HCC was detected in 413 patients (median tumor diameter, 1.8 cm), during a median follow-up time of 6.60 years. In the development data set, the model identified patients who developed HCC with an area under the curve of 0.78; it correctly identified 74.3% of patients who did develop HCC, and 72.9% of patients who did not. Overall, 73.1% of patients were classified correctly. The model could be used to assign patients to a high-risk group (27.5 HCCs/1000 patient-years) vs a low-risk group (4.9 HCCs/1000 patient-years). A similar performance was observed when the model was used to assess patients with cirrhosis. Analysis of the validation cohorts produced similar results. CONCLUSIONS We developed and validated a model to identify patients with chronic liver disease who are at risk for HCC based on change in serum AFP level over time. The model could be used to assign patients to high-risk vs low-risk groups, and might be used to select patients for surveillance.
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Affiliation(s)
| | | | - C A Emily de Groot
- Department of Economics, University of St Andrews, St Andrews, United Kingdom
| | - Hidenori Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Toshifumi Tada
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Takashi Kumada
- Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan
| | - Shinji Satomura
- Department of Molecular Biochemistry and Clinical Investigation, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoshi Nishida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Toru Kimura
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Yukio Osaki
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan; Department of Internal Medicine, Meiwa Hospital, Nishinomiya, Japan
| | | | | | - Tom Bird
- Medical Research Council Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom.
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Ramadan S, Marsh J, El-Sherbeny GA, El-Halawany ESF, Luan F, Baumert JL, Johnson P, Osman Y, Goodman RE. Purification of soybean cupins and comparison of IgE binding with peanut allergens in a population of allergic subjects. Food Chem Toxicol 2021; 147:111866. [PMID: 33217527 DOI: 10.1016/j.fct.2020.111866] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 10/23/2022]
Abstract
Identification, purification and characterization of allergens is crucial to the understanding of IgE-mediated disease. Immunologic and structural studies with purified allergens is essential for understanding relative immunogenicity and cross-reactivity. In this work, the complex soybean 7S vicilins (Gly m 5) with three subunits and 11S legumins (Gly m 6) with five subunits were purified and characterized along with purified peanut allergens (Ara h 1, 2, 3, and 6) by label-free liquid chromatography-tandem mass spectrometry (LC-MS/MS). Individual subjects plasma IgE binding was tested from subjects allergic to soybeans and or peanuts by immunoblotting, ImmunoCAP™ and ISAC™ ImmunoCAP chip, comparing these soybean proteins with those of purified peanut allergens; vicilin (Ara h 1), 2S albumin (Ara h 2 and Ara h 6) and 11S globulin (Ara h 3). Results show differences between methods and subjects demonstrating the complexity of finding answers to questions of cross-reactivity.
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Affiliation(s)
- Samah Ramadan
- Department of Botany, Faculty of Science, Mansoura University, 35516, Egypt
| | - Justin Marsh
- Food Allergy Research and Resource Program, Food Science & Technology, University of Nebraska, Lincoln, 68588-6207, USA
| | | | | | - Fulei Luan
- Hisense Home Appliances Group Co. Ltd., Qingdao, Shandong, 266104, China
| | - Joseph L Baumert
- Food Allergy Research and Resource Program, Food Science & Technology, University of Nebraska, Lincoln, 68588-6207, USA
| | - Philip Johnson
- Food Allergy Research and Resource Program, Food Science & Technology, University of Nebraska, Lincoln, 68588-6207, USA
| | - Yehia Osman
- Department of Botany, Faculty of Science, Mansoura University, 35516, Egypt
| | - Richard E Goodman
- Food Allergy Research and Resource Program, Food Science & Technology, University of Nebraska, Lincoln, 68588-6207, USA.
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Bowe CM, Gurney B, Sloane J, Johnson P, Newlands C. Operative time, length of stay and reoperation rates for orthognathic surgery. Br J Oral Maxillofac Surg 2020; 59:163-167. [PMID: 33441281 DOI: 10.1016/j.bjoms.2020.08.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/05/2020] [Indexed: 11/18/2022]
Abstract
Orthognathic surgery improves quality of life in terms of oral function and facial aesthetics. Our aim was to establish and compare operative time and length of inpatient stay for orthognathic procedures, and to assess the reoperation rate. Departmental electronic data base was used to identify all patients undergoing orthognathic surgery in a single unit between the 01/01/2016 and the 01/08/2018. 251 patients were identified who underwent 409 orthognathic surgery procedures. The mean operating time for a bimaxillary osteotomy (n=107) was 139.3 min. For single jaw procedures, the mean operating time for a Le Fort I osteotomy (n= 42) was 82.2 min and for a bilateral sagittal split osteotomy (BSSO) (n= 102) was 80.3min. Bimaxillary osteotomy combined with genioplasty (n=17) this increased the operating time on average by 31 min. and of a BSSO combined with a genioplasty (n=14) by 27 mins. The mean postoperative hospital stay was 1.2 ± 0.2 days. 96.4% patients spent only one postoperative night in hospital. 6/251 (2.4%) patients required re-operation. In regression analysis, age was the only significant factor in increasing length of stay (p<0.008), 95% CI 0.03-0.2). Our review shows short operating times and postoperative inpatient stays in a large cohort of patients undergoing orthognathic surgery. This is combined with a low reoperation rate. This may point to a patient benefit from high volume orthognathic centres.
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Affiliation(s)
- C M Bowe
- Department of Oral and Maxillofacial Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, UK.
| | - B Gurney
- Department of Oral and Maxillofacial Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, UK
| | - J Sloane
- Department of Oral and Maxillofacial Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, UK
| | - P Johnson
- Department of Oral and Maxillofacial Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, UK
| | - C Newlands
- Department of Oral and Maxillofacial Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, UK
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Cawich SO, Johnson P, Gardner MT, Pearce NW, Sinanan A, Gosein M, Shah S. Venous drainage of the left liver: an evaluation of anatomical variants and their clinical relevance. Clin Radiol 2020; 75:964.e1-964.e6. [PMID: 32958222 DOI: 10.1016/j.crad.2020.07.039] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 07/02/2020] [Indexed: 11/17/2022]
Abstract
AIM To evaluate the variations in venous drainage from the left liver. MATERIALS AND METHODS A retrospective evaluation was performed of all consecutive abdominal computed tomography (CT) examinations at a tertiary referral facility between 1 January and 30 June 2018. Osirix (Pixmeo SARL, Bernex, Switzerland) was used to examine the major hepatic veins and their tributaries in each scan. The classification of variants as proposed by Nakamura and Tsuzuki was used to describe the findings. The following information was collected: ramification pattern, number, length and diameter of middle (MHV) and left (LHV) hepatic vein tributaries. Two researchers collected data independently, and the average measurements were used as the final dimensions. RESULTS Of 102 examinations evaluated, only 27 demonstrated the conventional venous drainage patterns. The LHV and MHV combined to form a common trunk that emptied into the inferior vena cava (IVC) in 75 (73.5%) cases. The common trunk had a mean length of 8.89 mm and mean diameter of 20.18 mm. Other patterns included Nakamura and Tsuzuki type I (27.5%), type II (29.4%) and type III variants (16.7%). In addition, 4.9% of patients had absent superior middle veins and 80% had supernumerary short hepatic veins (4%). CONCLUSION Only 26.5% of patients in this population had conventional venous drainage from the left liver. Surgeons and radiologists in hepatobiliary practice should be aware of these variants in order to minimise morbidity when performing invasive procedures.
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Affiliation(s)
- S O Cawich
- Department of Surgery, General Hospital, Port of Spain, Trinidad and Tobago.
| | - P Johnson
- Department of Surgery, Radiology, Anaesthetics and Intensive Care, Faculty of Medical Sciences, University of the West Indies, Mona Campus, Kingston 7, Jamaica
| | - M T Gardner
- Department of Basic Medical Sciences, University of the West Indies, Mona Campus, Kingston 7, Jamaica
| | - N W Pearce
- University Surgical Unit, Southampton General Hospital, Southampton, UK
| | | | - M Gosein
- Department of Surgery, General Hospital, Port of Spain, Trinidad and Tobago
| | - S Shah
- Department of Surgery, Radiology, Anaesthetics and Intensive Care, Faculty of Medical Sciences, University of the West Indies, Mona Campus, Kingston 7, Jamaica
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Holzhauser T, Johnson P, Hindley JP, O'Connor G, Chan CH, Costa J, Fæste CK, Hirst BJ, Lambertini F, Miani M, Robert MC, Röder M, Ronsmans S, Bugyi Z, Tömösközi S, Flanagan SD. Are current analytical methods suitable to verify VITAL® 2.0/3.0 allergen reference doses for EU allergens in foods? Food Chem Toxicol 2020; 145:111709. [PMID: 32866515 DOI: 10.1016/j.fct.2020.111709] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 01/25/2023]
Abstract
Food allergy affects up to 6% of Europeans. Allergen identification is important for the risk assessment and management of the inadvertent presence of allergens in foods. The VITAL® initiative for voluntary incidental trace allergen labeling suggests protein reference doses, based on clinical reactivity in food challenge studies, at or below which voluntary labelling is unnecessary. Here, we investigated if current analytical methodology could verify the published VITAL® 2.0 doses, that were available during this analysis, in serving sizes between 5 and 500 g. Available data on published and commercial ELISA, PCR and mass spectrometry methods, especially for the detection of peanuts, soy, hazelnut, wheat, cow's milk and hen's egg were reviewed in detail. Limit of detection, quantitative capability, matrix compatibility, and specificity were assessed. Implications by the recently published VITAL® 3.0 doses were also considered. We conclude that available analytical methods are capable of reasonably robust detection of peanut, soy, hazelnut and wheat allergens for levels at or below the VITAL® 2.0 and also 3.0 doses, with some methods even capable of achieving this in a large 500 g serving size. Cow's milk and hen's egg are more problematic, largely due to matrix/processing incompatibility. An unmet need remains for harmonized reporting units, available reference materials, and method ring-trials to enable validation and the provision of comparable measurement results.
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Affiliation(s)
- Thomas Holzhauser
- Paul-Ehrlich-Institut, Division of Allergology, D-63225, Langen, Germany.
| | - Philip Johnson
- University of Nebraska-Lincoln, Department of Food Science and Technology, FARRP, Rm 266 Food Innovation Center, 1901 N 21 Street, PO Box 886207, Lincoln, NE, 68588-6207, USA.
| | | | - Gavin O'Connor
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116, Braunschweig, Germany.
| | | | - Joana Costa
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.
| | - Christiane K Fæste
- Norwegian Veterinary Institute, Toxicology Research Group, P.O. Box 750 Sentrum, 0106, Oslo, Norway.
| | | | | | - Michela Miani
- International Life Sciences Institute, European Branch, ILSI Europe a.i.s.b.l., Brussels, Belgium.
| | - Marie-Claude Robert
- Nestlé Research, Institute of Food Safety and Analytical Sciences, Lausanne, Switzerland.
| | - Martin Röder
- Ifp Institut für Produktqualität GmbH, Wagner-Régeny-Str. 8, 12489, Berlin, Germany.
| | | | - Zsuzsanna Bugyi
- Budapest University of Technology and Economics, Department of Applied Biotechnology and Food Science, Research Group of Cereal Science and Food Quality, Budapest, Hungary.
| | - Sándor Tömösközi
- Budapest University of Technology and Economics, Department of Applied Biotechnology and Food Science, Research Group of Cereal Science and Food Quality, Budapest, Hungary.
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González LA, Pantoja-Marquez AE, Johnson P. Diffuse Cystic Lung Disease: Consider Sjögren Syndrome in the Differential Diagnosis. Am J Med 2020; 133:e438-e439. [PMID: 32087099 DOI: 10.1016/j.amjmed.2020.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 01/14/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Luis Alonso González
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Universidad de Antioquia, Medellín, Colombia; Medicarte IPS, Rheumatology Unit, Medellín, Colombia.
| | | | - Philip Johnson
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Universidad de Antioquia, Medellín, Colombia
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Stubberfield E, Pringle M, Landén A, Veldman KT, Geurts Y, Jouy E, Le Devendec L, Rubin JE, Kulathunga DGRS, Kristensen KA, Chanter J, Bollard A, Johnson P, Maycock J, Habighorst-Blome K, Rohde J, Card RM. Validation of an antimicrobial susceptibility testing protocol for Brachyspira hyodysenteriae and Brachyspira pilosicoli in an international ring trial. Vet Microbiol 2020; 244:108645. [PMID: 32402332 DOI: 10.1016/j.vetmic.2020.108645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/27/2020] [Accepted: 03/17/2020] [Indexed: 10/24/2022]
Abstract
Brachyspira hyodysenteriae and Brachyspira pilosicoli cause economically important enteric disease in pigs. Treatment of these infections often includes antimicrobial administration, which can be most effective when therapeutic options are informed by antimicrobial susceptibility testing data. Here we describe a method for broth dilution antimicrobial susceptibility testing of these bacteria, both of which are difficult to culture in vitro. The protocol was evaluated for its fitness for use in an inter-laboratory ring trial involving eight laboratories from seven countries, and employing eleven test strains (5 Brachyspira hyodysenteriae including the type strain B78T and 6 Brachyspira pilosicoli) and six antibiotics. Overall intra- and inter-laboratory reproducibility of this method was very good (>90 % MICs at mode +/- 1 log2). Whole genome sequencing revealed good correspondence between reduced susceptibility and the presence of previously defined antimicrobial resistance determinants. Interestingly, lnu(C) was identified in B. pilosicoli isolates with elevated MICs of lincomycin, whilst tva(B) was associated with elevated MICs of pleuromutilins in this species. We designated two new control strains with MICs lying within currently tested ranges, including for the pleuromutilins, in contrast to the control strain B. hyodysenteriae B78T. These were deposited at the DSMZ-German Collection of Microorganisms and Cell Cultures GmbH. The validation of a standard protocol and identification of new control strains facilitates comparisons between studies, establishment of robust interpretative criteria, and ultimately contributes to rational antimicrobial use when treating infected livestock.
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Affiliation(s)
- E Stubberfield
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, Surrey, KT15 3NB, United Kingdom
| | - M Pringle
- Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute, SVA, SE-751 89, Uppsala, Sweden
| | - A Landén
- Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute, SVA, SE-751 89, Uppsala, Sweden
| | - K T Veldman
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Lelystad, Netherlands
| | - Y Geurts
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Lelystad, Netherlands
| | - E Jouy
- Mycoplasmology-Bacteriology-Antimicrobial Resistance Unit, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Ploufragan, France
| | - L Le Devendec
- Mycoplasmology-Bacteriology-Antimicrobial Resistance Unit, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Ploufragan, France
| | - J E Rubin
- Department of Veterinary Microbiology, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan, S7N 5B4, Canada
| | - D G R S Kulathunga
- Department of Veterinary Microbiology, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan, S7N 5B4, Canada
| | - K A Kristensen
- National Food Institute, Technical University of Denmark, 2800, Kgs. Lyngby, Denmark
| | - J Chanter
- Animal and Plant Health Agency, Starcross VIC, Devon, United Kingdom
| | - A Bollard
- VETQAS Quality Assurance Unit, Animal and Plant Health Agency, Sutton Bonington, Leicestershire, United Kingdom
| | - P Johnson
- VETQAS Quality Assurance Unit, Animal and Plant Health Agency, Sutton Bonington, Leicestershire, United Kingdom
| | - J Maycock
- VETQAS Quality Assurance Unit, Animal and Plant Health Agency, Sutton Bonington, Leicestershire, United Kingdom
| | - K Habighorst-Blome
- Institute for Microbiology, University of Veterinary Medicine, Foundation, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - J Rohde
- Institute for Microbiology, University of Veterinary Medicine, Foundation, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - R M Card
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, Surrey, KT15 3NB, United Kingdom.
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Best J, Bechmann LP, Sowa JP, Sydor S, Dechêne A, Pflanz K, Bedreli S, Schotten C, Geier A, Berg T, Fischer J, Vogel A, Bantel H, Weinmann A, Schattenberg JM, Huber Y, Wege H, von Felden J, Schulze K, Bettinger D, Thimme R, Sinner F, Schütte K, Weiss KH, Toyoda H, Yasuda S, Kumada T, Berhane S, Wichert M, Heider D, Gerken G, Johnson P, Canbay A. GALAD Score Detects Early Hepatocellular Carcinoma in an International Cohort of Patients With Nonalcoholic Steatohepatitis. Clin Gastroenterol Hepatol 2020; 18:728-735.e4. [PMID: 31712073 DOI: 10.1016/j.cgh.2019.11.012] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/23/2019] [Accepted: 11/03/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The prevalence of nonalcoholic steatohepatitis (NASH) associated hepatocellular carcinoma (HCC) is increasing. However, strategies for detection of early-stage HCC in patients with NASH have limitations. We assessed the ability of the GALAD score, which determines risk of HCC based on patient sex; age; and serum levels of α-fetoprotein (AFP), AFP isoform L3 (AFP-L3), and des-gamma-carboxy prothrombin (DCP), to detect HCC in patients with NASH. METHODS We performed a case-control study of 125 patients with HCC (20% within Milan Criteria) and 231 patients without HCC (NASH controls) from 8 centers in Germany. We compared the performance of serum AFP, AFP-L3, or DCP vs GALAD score to identify patients with HCC using receiver operating characteristic curves and corresponding area under the curve (AUC) analyses. We also analyzed data from 389 patients with NASH under surveillance for HCC in Japan, followed for a median of 167 months. During the 5-year screening period, 26 patients developed HCC. To compensate for irregular intervals of data points, we performed locally weighted scatterplot smoothing, linear regression, and a non-linear curve fit to assess development of GALAD before HCC development. RESULTS The GALAD score identified patients with any stage HCC with an AUC of 0.96 - significantly greater than values for serum levels of AFP (AUC, 0.88), AFP-L3 (AUC, 0.86) or DCP (AUC, 0.87). AUC values for the GALAD score were consistent in patients with cirrhosis (AUC, 0.93) and without cirrhosis (AUC, 0.98). For detection of HCC within Milan Criteria, the GALAD score achieved an AUC of 0.91, with a sensitivity of 68% and specificity of 95% at a cutoff of -0.63. In a pilot Japanese cohort study, the mean GALAD score was higher in patients with NASH who developed HCC than in those who did not develop HCC as early as 1.5 years before HCC diagnosis. GALAD scores were above -0.63 approximately 200 days before the diagnosis of HCC. CONCLUSIONS In a case-control study performed in Germany and a pilot cohort study in Japan, we found the GALAD score may detect HCC with high levels of accuracy in patients with NASH, with and without cirrhosis. The GALAD score can detect patients with early-stage HCC, and might facilitate surveillance of patients with NASH, who are often obese, which limits the sensitivity of detection of liver cancer by ultrasound.
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Affiliation(s)
- Jan Best
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany
| | - Lars P Bechmann
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany
| | - Jan-Peter Sowa
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany
| | - Svenja Sydor
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany
| | - Alexander Dechêne
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Department of Gastroenterology, Hepatology and Endocrinology, Paracelsus Medical University, Klinikum Nürnberg, Nürnberg, Germany
| | - Kristina Pflanz
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Sotiria Bedreli
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Clemens Schotten
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Andreas Geier
- Division of Hepatology, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Berg
- Section of Hepatology, Division of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Janett Fischer
- Section of Hepatology, Division of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Arndt Vogel
- Clinic of Gastroenterology, Hepatology and Endocrinology, Hannover Medical High School, Hannover, Germany
| | - Heike Bantel
- Clinic of Gastroenterology, Hepatology and Endocrinology, Hannover Medical High School, Hannover, Germany
| | - Arndt Weinmann
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - Jörn M Schattenberg
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - Yvonne Huber
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - Henning Wege
- Department of Medicine I, University Medical Center, Hamburg-Eppendorf, Germany
| | - Johann von Felden
- Department of Medicine I, University Medical Center, Hamburg-Eppendorf, Germany
| | - Kornelius Schulze
- Department of Medicine I, University Medical Center, Hamburg-Eppendorf, Germany
| | - Dominik Bettinger
- Department of Medicine II, Medical Center University of Freiburg, Freiburg, Germany; Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Robert Thimme
- Department of Medicine II, Medical Center University of Freiburg, Freiburg, Germany
| | - Friedrich Sinner
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany
| | - Kerstin Schütte
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany
| | - Karl Heinz Weiss
- Department of Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany
| | - Hidenori Toyoda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Satoshi Yasuda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Takashi Kumada
- Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan
| | - Sarah Berhane
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Marc Wichert
- Central Laboratory, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Dominik Heider
- Department of Mathematics and Computer Science, Philipps-University Marburg, Marburg, Germany
| | - Guido Gerken
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Ali Canbay
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany.
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Rohr A, Maxwell K, Best S, Lemons S, Johnson P. Rare presentation and endovascular treatment of multifocal iliac venous stenoses due to right sided May-Thurner Syndrome. Radiol Case Rep 2020; 15:201-203. [PMID: 31890068 PMCID: PMC6928296 DOI: 10.1016/j.radcr.2019.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022] Open
Abstract
May-Thurner Syndrome (MTS) is a well-recognized anatomical variant describing compression of the left common iliac vein and may manifest as lower extremity swelling, pain, ulceration, discoloration, and paresthesia. Right-sided MTS is documented in the literature, though exceedingly rare. Specifically, no current reports describe a multifocal stenoses of the right iliac vein due to anatomical variants associated with left sided IVC. We present a case involving a patient with this pathophysiology, radiographic/sonographic correlate imaging, and subsequent endovascular treatment.
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Affiliation(s)
- Aaron Rohr
- University of Kansas Medical Center, Department of Radiology, 3901 Rainbow Boulevard, Mail Stop 4032, Kansas City 66160, Kansas
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