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Fattahi N, Reed J, Heronemus E, Fernando P, Hansen R, Parameswaran P. Polyethylene glycol hydrogel coatings for protection of electroactive bacteria against chemical shocks. Bioelectrochemistry 2024; 156:108595. [PMID: 37976771 DOI: 10.1016/j.bioelechem.2023.108595] [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] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
Loss of bioelectrochemical activity in low resource environments or from chemical toxin exposure is a significant limitation in microbial electrochemical cells (MxCs), necessitating the development of materials that can stabilize and protect electroactive biofilms. Here, polyethylene glycol (PEG) hydrogels were designed as protective coatings over anodic biofilms, and the effect of the hydrogel coatings on biofilm viability under oligotrophic conditions and ammonia-N (NH4+-N) shocks was investigated. Hydrogel deposition occurred through polymerization of PEG divinyl sulfone and PEG tetrathiol precursor molecules, generating crosslinked PEG coatings with long-term hydrolytic stability between pH values of 3 and 10. Simultaneous monitoring of coated and uncoated electrodes co-located within the same MxC anode chamber confirmed that the hydrogel did not compromise biofilm viability, while the coated anode sustained nearly a 4 × higher current density (0.44 A/m2) compared to the uncoated anode (0.12 A/m2) under oligotrophic conditions. Chemical interactions between NH4+-N and PEG hydrogels revealed that the hydrogels provided a diffusive barrier to NH4+-N transport. This enabled PEG-coated biofilms to generate higher current densities during NH4+-N shocks and faster recovery afterwards. These results indicate that PEG-based coatings can expand the non-ideal chemical environments that electroactive biofilms can reliably operate in.
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Affiliation(s)
- Niloufar Fattahi
- Tim Taylor Department of Chemical Engineering, Kansas State University, Manhattan, KS 66506, USA
| | - Jeffrey Reed
- Tim Taylor Department of Chemical Engineering, Kansas State University, Manhattan, KS 66506, USA
| | - Evan Heronemus
- Department of Civil Engineering, Kansas State University, Manhattan, KS 66506, USA
| | - Priyasha Fernando
- Department of Civil Engineering, Kansas State University, Manhattan, KS 66506, USA
| | - Ryan Hansen
- Tim Taylor Department of Chemical Engineering, Kansas State University, Manhattan, KS 66506, USA.
| | - Prathap Parameswaran
- Department of Civil Engineering, Kansas State University, Manhattan, KS 66506, USA.
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Hoffmann L, Ehmsen ML, Hansen J, Hansen R, Knap MM, Mortensen HR, Poulsen PR, Ravkilde T, Rose HK, Schmidt HH, Worm ES, Møller DS. Repeated deep-inspiration breath-hold CT scans at planning underestimate the actual motion between breath-holds at treatment for lung cancer and lymphoma patients. Radiother Oncol 2023; 188:109887. [PMID: 37659663 DOI: 10.1016/j.radonc.2023.109887] [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: 06/25/2023] [Revised: 08/04/2023] [Accepted: 08/23/2023] [Indexed: 09/04/2023]
Abstract
PURPOSE/OBJECTIVE Deep-inspiration breath-hold (DIBH) during radiotherapy may reduce dose to the lungs and heart compared to treatment in free breathing. However, intra-fractional target shifts between several breath-holds may decrease target coverage. We compared target shifts between four DIBHs at the planning-CT session with those measured on CBCT-scans obtained pre- and post-DIBH treatments. MATERIAL/METHODS Twenty-nine lung cancer and nine lymphoma patients were treated in DIBH. An external gating block was used as surrogate for the DIBH-level with a window of 2 mm. Four DIBH CT-scans were acquired: one for planning (CTDIBH3) and three additional (CTDIBH1,2,4) to assess the intra-DIBH target shifts at scanning by registration to CTDIBH3. During treatment, pre-treatment (CBCTpre) and post-treatment (CBCTpost) scans were acquired. For each pair of CBCTpre/post, the target intra-DIBH shift was determined. For lung cancer, tumour (GTV-Tlung) and lymph nodes (GTV-Nlung) were analysed separately. Group mean (GM), systematic and random errors, and GM for the absolute maximum shifts (GMmax) were calculated for the shifts between CTDIBH1,2,3,4 and between CBCTpre/post. RESULTS For GTV-Tlung, GMmax was larger at CBCT than CT in all directions. GMmax in cranio-caudal direction was 3.3 mm (CT)and 6.1 mm (CBCT). The standard deviations of the shifts in the left-right and cranio-caudal directions were larger at CBCT than CT. For GTV-Nlung and CTVlymphoma, no difference was found in GMmax or SD. CONCLUSION Intra-DIBH shifts at planning-CT session are generally smaller than intra-DIBH shifts observed at CBCTpre/post and therefore underestimate the intra-fractional DIBH uncertainty during treatment. Lung tumours show larger intra-fractional variations than lymph nodes and lymphoma targets.
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Affiliation(s)
- Lone Hoffmann
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - M L Ehmsen
- Danish Center for Proton Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - J Hansen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - R Hansen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - M M Knap
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - H R Mortensen
- Danish Center for Proton Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - P R Poulsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Danish Center for Proton Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - T Ravkilde
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - H K Rose
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - H H Schmidt
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - E S Worm
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - D S Møller
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Johnson BN, Cooper L, Beck JJ, Finnicum CT, Davis CM, Van Asselt AJ, Kallsen N, Silvernail C, Viet S, Long K, Huizenga P, Vaselaar E, Pfeifle M, Nelson L, Streier Z, Katz C, Leonard KB, Matthiesen N, Buschette N, Weisser L, Jahnke M, Bohlen K, Young SL, Sulaiman RA, Prouse BR, Basel DA, Black M, Hansen R, Petersen JL, Willemsen G, Boomsma DI, Bleile MJ, Ehli EA. More Than Results: The Clinical and Research Relationship in the Evolving Detection and Surveillance of SARS-CoV-2. S D Med 2023; 76:248-256. [PMID: 37732913] [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: 09/22/2023]
Abstract
INTRODUCTION During the coronavirus disease 2019 (COVID-19) pandemic, real-time reverse transcription polymerase chain reaction (RT-PCR) became an essential tool for laboratories to provide high-sensitivity qualitative diagnostic testing for patients and real-time data to public health officials. Here we explore the predictive value of quantitative data from RT-PCR cycle threshold (Ct) values in epidemiological measures, symptom presentation, and variant transition. METHODS To examine the association with hospitalizations and deaths, data from 74,479 patients referred to the Avera Institute for Human Genetics (AIHG) for COVID-19 testing in 2020 were matched by calendar week to epidemiological data reported by the South Dakota Department of Health. We explored the association between symptom data, patient age, and Ct values for 101 patients. We also explored changes in Ct values during variant transition detected by genomic surveillance sequencing of the AIHG testing population during 2021. RESULTS Measures from AIHG diagnostic testing strongly explain variance in the South Dakota state positivity percentage (R2 = 0.758), a two-week delay in hospitalizations (R2 = 0.856), and a four-week delay in deaths (R2 = 0.854). Based on factor analysis of patient symptoms, three groups could be distinguished which had different presentations of age, Ct value, and time from collection. Additionally, conflicting Ct value results among SARSCoV- 2 variants during variant transition may reflect the community transmission dynamics. CONCLUSIONS Measures of Ct value in RT-PCR diagnostic assays combined with routine screening have valuable applications in monitoring the dynamics of SARS-CoV-2 within communities.
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Affiliation(s)
- Brandon N Johnson
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Leslie Cooper
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Jeffrey J Beck
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Casey T Finnicum
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Christel M Davis
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Austin J Van Asselt
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Noah Kallsen
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Cody Silvernail
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Sarah Viet
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Kayla Long
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Patricia Huizenga
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Ethan Vaselaar
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Mackenzie Pfeifle
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Laiken Nelson
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Zachary Streier
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Cory Katz
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Kayli B Leonard
- Avera Health Clinical Intelligence, Sioux Falls, South Dakota
| | - Neil Matthiesen
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Nicholas Buschette
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Lisa Weisser
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Mike Jahnke
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Krista Bohlen
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Samuel L Young
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Raed A Sulaiman
- Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
- Physicians Laboratory, Sioux Falls, South Dakota
| | - Bruce R Prouse
- Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
- Physicians Laboratory, Sioux Falls, South Dakota
| | - David A Basel
- Avera Health
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota
| | - Mike Black
- Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Ryan Hansen
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Jason L Petersen
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Gonneke Willemsen
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Development and Reproduction Research Institute
| | - Michelle J Bleile
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
- Physicians Laboratory, Sioux Falls, South Dakota
| | - Erik A Ehli
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
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Jiao B, Fredricks DN, Srinivasan S, Hansen R. Economic Evaluation of a Point-of-Care Test for Bacterial Vaginosis Among Women With Vaginal Symptoms. Sex Transm Dis 2023; 50:310-316. [PMID: 36728351 DOI: 10.1097/olq.0000000000001766] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND There is an unmet need for a clinical diagnostic technology to detect bacterial vaginosis (BV) rapidly and accurately. Novel point-of-care (POC) tests have the potential to fulfill this gap. Our objective was to determine the cost-effectiveness of a hypothetical clinician-administered POC test for diagnosing BV in the United States. METHODS We developed a state-transition microsimulation model to evaluate the cost-effectiveness of using the POC test versus usual care among women of reproductive age with vaginal symptoms. We adopted a healthcare sector perspective that included relevant healthcare costs and a societal perspective that further incorporated productivity costs. Model parameters were empirically estimated based on commercial insurance claims data or derived from published literature. The primary model outcome was incremental cost-effectiveness ratio. We started with analyzing a hypothetical POC test with a sensitivity and specificity of 0.9 and a cost of $40, followed by extensive sensitivity analyses. RESULTS Using the hypothetical POC test to diagnose BV increased costs by $16 and quality-adjusted life-years by 0.0005 per person compared with the usual care, leading to an incremental cost-effectiveness ratio of $31,108 per quality-adjusted life-year gained. When also capturing the productivity costs, the POC test resulted in an average cost savings of $57. The sensitivity analyses showed that the POC test's sensitivity was more influential on its cost-effectiveness than specificity. CONCLUSIONS Using the POC test to diagnose BV is likely to be cost-effective relative to usual care, especially with a high sensitivity or a substantial positive effect on productivity.
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Affiliation(s)
| | - David N Fredricks
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA
| | - Sujatha Srinivasan
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA
| | - Ryan Hansen
- From the The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, WA
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Chowdhry S, Milutinovic S, Tse E, Garcia S, Perusse D, Ritland M, Ko J, Wilkinson D, Turner K, Steffy A, Plum J, Norman B, Pferdekamper A, Meyer T, Liao D, Elsdon R, Lange J, Pinkerton A, Hansen R, Hassig C, Kasibhatla S. Abstract 1626: Tumors driven by oncogene amplified extrachromosomal DNA (ecDNA) demonstrate enhanced sensitivity to cell cycle checkpoint kinase 1 (CHK1) inhibition. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-1626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Patients whose tumors harbor oncogene amplification on extrachromosomal DNA (ecDNA) fail to respond to targeted or immune therapy and have poor prognosis. ecDNA are cancer-specific circular fragments of genomic DNA engendered with unique properties, including open chromatin architecture associated with hyper transcription and a predilection for structural variation. In addition, ecDNA+ tumors have tremendous copy number heterogeneity mediated through acentric, non-Mendelian segregation. These properties afford ecDNA+ tumors with unparalleled genomic plasticity permitting circumvention of therapeutic pressure. However, these features also confer heightened levels of DNA replication stress (RS), and we have found that ecDNA amplified tumor cells are hyper-reliant on CHK1, a master regulator of the cellular RS response. We identified CHK1 as an ecDNA essential target in a CRISPR genetic screen using a methotrexate-induced ecDNA amplification model in HeLa cancer cells. ecDNA-dependent cell fitness assessment of CHK1 was confirmed using a flow cytometry-based CRISPR competition assay. The target was further validated using a CHK1 inhibitor (CHK1i) tool compound in MYC-amplified COLO320 isogenic cell lines that demonstrated a 10-fold enhanced cytotoxicity in the ecDNA amplified setting.Based on these results, we developed a highly potent, selective, and orally bioavailable CHK1i optimized as an ecDNA-directed therapeutic (ecDTx). An advanced lead, BBI-cmpd1, robustly induced RS biomarkers (e.g., pRPA) in ecDNA+ COLO320 tumor cells as compared to matched chromosomally-amplified (ecDNA-) COLO320 cells, consistent with the increased reliance on CHK1 to manage elevated RS in the ecDNA amplified setting. BBI-cmpd1 demonstrated potent anti-proliferative activity against a panel of ecDNA+ oncogene amplified tumor lines as compared to non-amplified lines demonstrating oncogene and indication agnostic efficacy in ecDNA-based tumors. Oral administration of BBI-cmpd1 resulted in on-target activity against CHK1 and anti-tumor activity in an ecDNA oncogene amplified tumor model in vivo. These findings support the clinical utility of potent, selective, and oral CHK1i to address the significant unmet need driven by ecDNA oncogene amplified cancers.
Citation Format: Sudhir Chowdhry, Snezana Milutinovic, Edison Tse, Salvador Garcia, Dean Perusse, Melissa Ritland, Juyeon Ko, Deepti Wilkinson, Kristen Turner, Auzon Steffy, Joshua Plum, Ben Norman, AnnMarie Pferdekamper, Todd Meyer, Debbie Liao, Rachelle Elsdon, Joshua Lange, Anthony Pinkerton, Ryan Hansen, Christian Hassig, Shailaja Kasibhatla. Tumors driven by oncogene amplified extrachromosomal DNA (ecDNA) demonstrate enhanced sensitivity to cell cycle checkpoint kinase 1 (CHK1) inhibition [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1626.
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Park TJ, Hansen R, Gillard P, Shah D, Ferguson WG, Piccini J, Romano MA, Devine B. Healthcare resource utilization and costs for patients with postoperative atrial fibrillation in the United States. J Med Econ 2023; 26:1417-1423. [PMID: 37801391 DOI: 10.1080/13696998.2023.2267390] [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: 07/20/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Postoperative atrial fibrillation (POAF) is one of the most common complications following cardiac surgery. POAF is associated with increased hospitalization costs, but its long-term economic burden is not well defined. OBJECTIVE To assess 30-day and 1-year incremental healthcare resource utilization (HRU) and costs associated with POAF in the United States (US). METHODS This retrospective cohort study used claims data from the IBM Watson MarketScan database. A cohort of US adults aged 55--90 years who underwent open-heart surgery between 1 January 2017 and 31 December 2018 was used to compare patients who experienced POAF versus patients who did not (controls). The outcomes of interest were incremental HRU and costs, which were assessed during the index hospitalization and 30-day and 1-year postdischarge time periods. Inverse probability weighting was used to adjust for differences in baseline characteristics. RESULTS A total of 8,020 patients met the study inclusion criteria with 5,765 patients in the control cohort (mean age, 63.4 years) and 2,255 patients in the POAF cohort (mean age, 65.8 years). After adjustment, patients with POAF had an index hospitalization that was 1.9 days longer (99% CI, 1.3-2.4 days; p < 0.001) and cost $13,919 more (99% CI, $2,828-$25,011; p < 0.001) than for patients without POAF. POAF patients also had significantly higher HRU at 30 days and 1-year postdischarge with incremental costs of $4,649 (99% CI, $1,479-$7,819; p < 0.001) and $10,671 (99% CI, $2,407-$18,935; p < 0.001), respectively. CONCLUSION POAF following open-heart surgery poses a significant economic burden up to 1 year postdischarge.
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Affiliation(s)
- Tae Jin Park
- Allergan, an AbbVie Company, Irvine, CA, USA
- University of Washington, Seattle, WA, USA
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Irwin AN, Bratberg JP, Al-Jammali Z, Arnold J, Gray M, Floyd AS, Bolivar D, Hansen R, Hartung DM, Green TC. Implementation of an academic detailing intervention to increase naloxone distribution and foster engagement in harm reduction from the community clinician. J Am Pharm Assoc (2003) 2023; 63:284-294.e1. [PMID: 36567216 PMCID: PMC9933140 DOI: 10.1016/j.japh.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/10/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Respond to Prevent (R2P) is a randomized clinical trial which sought to accelerate distribution of naloxone and other harm reduction materials from community pharmacies. R2P combined an online continuing education course with in-store materials, specifically designed for use in community pharmacies, and then supported implementation through the one-on-one educational technique of academic detailing. OBJECTIVE The objective of this paper is to describe and synthesize our experiences providing academic detailing as part of the R2P randomized trial. METHODS Closed-ended items from standardized post detailing questionnaires were analyzed with descriptive statistics. Open-ended items were content analyzed for key themes using immersion-crystallization qualitative methods. RESULTS A total of 176 pharmacies participated in R2P with 175 receiving their initial academic detailing visit between August 2019 and May 2021. Initial visits were in-person and lasted a median of 35 minutes (interquartile range, 20-45 minutes). The R2P naloxone guide was the most common topic covered (n = 162, 92.6%). Following a fidelity check to assess adequacy of the R2P program implementation, 80 pharmacies (45.7%) required secondary academic detailing. Secondary detailing was more targeted and most frequently focused on the sale of nonprescription syringes (n = 28; 35.2%) or disposal container distribution (n = 30; 37.5%). Analysis of the open-ended items identified factors that the detailers perceived to affect the quality of academic detailing sessions, including the pharmacy environment, participant knowledge of and attitudes toward the subject matter, and ability of the detailer to remain flexible yet consistent. CONCLUSION R2P provided a standardized process to foster naloxone distribution and engagement in harm reduction with demonstrated implementation in 175 community pharmacies across 4 states. Academic detailing was perceived to be well-received and effective at providing education and promoting distribution of naloxone and nonprescription syringes in community pharmacies. Additional research is needed to confirm these perceptions through evaluation post-intervention behavioral and attitude changes.
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Patel RS, Walker T, Weber ZT, Kelley SD, Hansen R. A pilot study using geospatial analysis to identify hot-spot of populations utilizing services at university based counseling centers. J Am Coll Health 2022; 70:1280-1285. [PMID: 32721188 DOI: 10.1080/07448481.2020.1798970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
Objective: Our pilot study tests whether university counseling centers (UCC) can apply the concept of cluster analysis, and geospatial analysis to identify clusters of "hot spots". Participants: Study participants were university students who received services from a large mid-western UCC between August 2015 and July 2016. The study was approved by the University's Institutional Review Board (IRB). Data collected include demographics, address, educational level and declared major. Methods: Data analysis, conducted using SYSTAT 13.1, IBM SPSS Statistics, ArcGIS Desktop and 10.2, ArcOnline, Microsoft excel to clean and analyze demographic data. Analysis included optimized cluster analysis with a p-value < 0.05 as statistically significant. Results: 927 participants, average age was 21.6. We identified "hotspots" using cluster analysis based on age, address, and country of origin. Conclusions: Our study shows that UCCs can apply cluster analysis, and geospatial analysis to identify clusters of "hot spots" to target risk populations.
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Affiliation(s)
- Rahul S Patel
- Counseling and Consultation Service, Office of Student Life, The Ohio State University, Columbus, Ohio, USA
| | - Tanesha Walker
- Department of Counselor Education, University of Toledo, Toledo, Ohio, USA
| | - Zachary T Weber
- College of Medicine, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Sarah D Kelley
- School of Rehabilitation and Communication Sciences, Ohio University, Dublin, Ohio, USA
| | - Ryan Hansen
- Counseling and Consultation Service, Office of Student Life, The Ohio State University, Columbus, Ohio, USA
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Ko GC, Hansen R, Carlson J. Comparing costs and health care resource utilization between nmHSPC and mHSPC patients: a retrospective claims analysis. J Manag Care Spec Pharm 2022; 28:287-295. [PMID: 35199577 PMCID: PMC10372963 DOI: 10.18553/jmcp.2022.28.3.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND: Prostate cancer is common among men in the United States, and hormone sensitive-prostate cancer (HSPC) is the predominant etiology. However, there is a paucity of evidence documenting the financial impact of metastatic disease within this etiology. OBJECTIVE: To estimate the differences in health care resource utilization (HCRU) and costs for patients with nonmetastatic HSPC (nmHSPC) and metastatic HSPC (mHSPC) and their payers. METHODS: We conducted a retrospective cohort analysis using claims data from the IBM MarketScan databases from January 2016 to December 2019. HSPC was defined as having at least 1 inpatient services or 2 outpatient services claims with a prostate cancer diagnosis and a claim for androgen deprivation therapy use within 6 months of the initial diagnostic claim. Metastatic patients had a secondary diagnosis code of metastasis with their initial diagnostic claim. We compared mean 12-month HCRU, patient out-of-pocket (OOP), and payer costs between patients with nmHSPC and mHSPC using multivariable linear regression. RESULTS: 4,329 patients met the study inclusion criteria, 600 of which had mHSPC. Patients with mHSPC had more outpatient prescription fills (10.91 additional fills; 95% CI = 8.09-13.99) and outpatient services visits (10.61 additional visits; 95% CI = 8.38-13.04) but similar other HCRU. The overall 12-month costs of patients with mHSPC were significantly greater than patients with nmHSPC for patient OOP ($1,244; 95% CI = $1,004-$1,513) and payers ($113,725; 95% CI = $91,494-$141,127). CONCLUSIONS: Compared with patients with nmHSPC, individuals with mHSPC incur greater HCRU and significant personal and overall financial burden. DISCLOSURES: This study had no outside funding support. The authors have nothing to disclose.
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Affiliation(s)
| | - Ryan Hansen
- Department of Pharmacy, University of Washington, Seattle
| | - Josh Carlson
- Department of Pharmacy, University of Washington, Seattle
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Green TC, Bratberga J, Irwin AN, Boggisb J, Gray M, Leichtling G, Bolivar D, Floyd A, Al-Jammali Z, Arnold J, Hansen R, Hartung D. Study protocol for the Respond to Prevent Study: a multi-state randomized controlled trial to improve provision of naloxone, buprenorphine and nonprescription syringes in community pharmacies. Subst Abus 2022; 43:901-905. [PMID: 35213293 PMCID: PMC9720900 DOI: 10.1080/08897077.2021.2010162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Access to the opioid antidote naloxone is a critical component of addressing the opioid crisis. Naloxone is a population-level prevention intervention associated with substantial reductions in overdose mortality and reduction of nonfatal overdose. Pharmacies' pivotal role in dispensing medications like buprenorphine for the treatment of opioid use disorder and selling nonprescription syringes places them at the crossroads of opioid access and risk mitigation methods like naloxone provision. Testing ways to optimize pharmacy-based naloxone provision will be key as the country expands the implementation of naloxone through the medical system. In the Respond to Prevent Study, we conducted a large, practical study of a pharmacy-focused intervention in a sample of Washington, Oregon, Massachusetts and New Hampshire community chain pharmacies to increase naloxone dispensing and improve opioid safety. The intervention integrated two evidence-based educational toolkits and streamlined materials to enhance the focus on naloxone policy, stigma reduction, and patient communications around naloxone, nonprescription syringes and buprenorphine access. The real-world study implemented a stepped wedge, clustered randomized trial design across 175 community chain pharmacies to evaluate the effectiveness of the Respond to Prevent intervention in increasing: (a) pharmacy based naloxone distribution rates, naloxone-related patient engagement, and pharmacist and technicians' attitudes, knowledge, perceived behavioral control and self-efficacy toward naloxone; and (b) pharmacy nonprescription syringe sales, and pharmacist and technicians' attitudes, knowledge, perceived behavioral control and self-efficacy toward dispensing buprenorphine for opioid use disorder (secondary outcomes). This commentary provides a brief narrative about the study and presents insights on the design and adaptations to our study protocol, including those adopted during the unprecedented COVID-19 pandemic further compounded by Western wildfires in 2020.
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Affiliation(s)
- Traci C Green
- Brandeis University, Opioid Policy Research Collaborative, The Heller School for Social Policy and Management, 415 South Street, Heller-Brown Building, Waltham, MA 02453 USA
| | - Jeffrey Bratberga
- University of Rhode Island College of Pharmacy, 7 Greenhouse Road, Kingston, RI 02881 USA
| | - Adriane N Irwin
- Oregon State University College of Pharmacy, 1601 SW Jefferson Way, Corvallis, OR 97331 USA
| | - Jesse Boggisb
- Brandeis University, Opioid Policy Research Collaborative, The Heller School for Social Policy and Management, 415 South Street, Heller-Brown Building, Waltham, MA 02453 USA
| | - Mary Gray
- Comagine Health, 650 NE Holladay St # 1700, Portland, OR 97232 USA
| | | | - Derek Bolivar
- Brandeis University, Opioid Policy Research Collaborative, The Heller School for Social Policy and Management, 415 South Street, Heller-Brown Building, Waltham, MA 02453 USA
| | - Anthony Floyd
- University of Washington, University of Washington, Box 357631, H364 Health Sciences Building, Seattle WA 98195-7631 USA
| | - Zain Al-Jammali
- Oregon State University College of Pharmacy, 1601 SW Jefferson Way, Corvallis, OR 97331 USA
| | - Jenny Arnold
- Washington State Pharmacy Association, 411 Williams Ave S, Renton, WA 98057 USA
| | - Ryan Hansen
- University of Washington, University of Washington, Box 357631, H364 Health Sciences Building, Seattle WA 98195-7631 USA
| | - Daniel Hartung
- Oregon State University College of Pharmacy, 1601 SW Jefferson Way, Corvallis, OR 97331 USA
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Hansen MB, Stangerup M, Hansen R, Sode LP, Hesselbo B, Kostadinov K, Calum H, Olesen BS. Changing hand hygiene behaviour might not be that easy. J Hosp Infect 2021; 123:137-138. [PMID: 34774973 DOI: 10.1016/j.jhin.2021.11.001] [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: 11/02/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Affiliation(s)
| | - M Stangerup
- Infection Control Unit, Bispebjerg and Frederiksberg Hospitals, Denmark
| | - R Hansen
- Department of Orthopedic, Bispebjerg University Hospital, Denmark
| | - L P Sode
- Department of Orthopedic, Bispebjerg University Hospital, Denmark
| | - B Hesselbo
- Infection Control Unit, Bispebjerg and Frederiksberg Hospitals, Denmark
| | - K Kostadinov
- Department of Orthopedic, Bispebjerg University Hospital, Denmark
| | - H Calum
- Infection Control Unit, Bispebjerg and Frederiksberg Hospitals, Denmark; Department of Clinical Microbiology, Amager and Hvidovre Hospitals, Denmark
| | - B S Olesen
- Department of Clinical Microbiology, Copenhagen University Hospital Herlev and Gentofte, Denmark
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Brouwer E, Yeung K, Barthold D, Hansen R. Characterizing patient assistance program use and patient responsiveness to specialty drug price for multiple sclerosis in a mid-size integrated health system. J Manag Care Spec Pharm 2021; 27:732-742. [PMID: 34057391 PMCID: PMC10391270 DOI: 10.18553/jmcp.2021.27.6.732] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND: There is concern that increasingly common use of patient assistance programs (PAPs), out-of-pocket assistance provided by manufacturers or foundations, distorts our understanding of patient behavior and insurance design incentives. Yet the current literature on prescription drug cost sharing largely overlooks their use. PAPs prevalence and impact on drug demand and price elasticity is a major knowledge gap. OBJECTIVE: To examine the use of PAPs among patients with multiple sclerosis (MS) and the association with drug demand in a specialty pharmacy program within a regional integrated health system that facilitates their use. METHODS: We used pharmaceutical claims data from December 2017 to December 2018 linked to detailed payer information from Kaiser Permanente Washington to characterize the prevalence of PAPs for users of 7 MS specialty drug molecules. We estimated price elasticity of demand (PED) in a two-part model by using the presence of copayment assistance as a source of cost variation. The first part estimated marginal probability of a claim in a given month with a probit model, comparing PAP users and nonusers, whereas the second part estimated days supplied of a medication, given a claim was made as a measure for demand. RESULTS: Of 789 unique patients, 480 (60.7%) used PAPs in at least 1 drug claim during the 13-month time frame, and 248 patients (31.4%) used PAPs for all of their MS drug claims. When used, copay assistance covered 100% of out-of-pocket (OOP) charges for 98% of claims and reduced patient annual OOP cost by $3,493 on average. People who used PAPs had much higher OOP charges, a lower Charlson comorbidity score, and were more likely to have insurance through an exchange. The OOP costs charged to patients was higher for claims where patient assistance was used than claims where assistance was not used ($294 vs $42, P < 0.001). Total claim amount was higher for claims that used assistance ($6,169) than claims that did not ($5,503, P < 0.001). The probability of a patient having a drug claim in a given month was 1.9% higher among those using patient assistance, although this finding was not significant (P = 0.258). An average change in price of -$168.21 with PAP use led to an average change in demand of -0.05 days, for an overall price elasticity of demand (SD = 0.028, P = 0.852) given PAP use of 0.005, indicating that the presence of PAPs did not significantly affect demand. PED estimates were not statistically significant by drug, and the exclusion of Medicare patients did not change this interpretation. CONCLUSIONS: In a mid-size integrated health system in the state of Washington, a program that promotes adherence to specialty drugs via facilitated PAP use was found to reduce patient OOP costs but had no effect on prescription drug utilization. Payers may consider embracing PAPs to remove patient financial barriers to necessary medications and use tools other than cost sharing to influence patient consumption of specialty drugs. DISCLOSURES: This manuscript was funded in part through a Pre-Doctoral Fellowship in Health Outcomes from the PhRMA Foundation awarded to Brouwer for the completion of her dissertation work. Yeung receives some salary support from Kaiser Permanente. The other authors have nothing to disclose.
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Affiliation(s)
| | - Kai Yeung
- Kaiser Permanente Washington Research Institute, Seattle
| | | | - Ryan Hansen
- Department of Pharmacy, University of Washington, Seattle
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Singer D, Hansen R. Designing robust contamination control in manufacturing - do we select isolators or biosafety cabinets? Cytotherapy 2021. [DOI: 10.1016/s1465324921005983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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De Roover R, Hansen R, Crijns W, Muurholm C, Poels K, Skouboe S, Haustermans K, Poulsen P, Depuydt T. PO-1591: Dosimetric accuracy of beam gating, MLC tracking and couch tracking to manage prostate rotation. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01609-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Skouboe S, De Roover R, Muurholm C, Crijns W, Ravkilde T, Hansen R, Depuydt T, Poulsen P. OC-0704: Six degrees of freedom dynamic motion-including dose reconstruction in a treatment planning system. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00726-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Muurholm C, Ravkilde T, De Roover R, Skouboe S, Hansen R, Crijns W, Keall P, Depuydt T, Poulsen P. OC-0342: Experimental validation of real-time rotation-including dose reconstruction during tumor tracking. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Wolf J, Hansen R, Hassis K, Lapps W, Warmuth E. The impact of export regulations on recombinant viral vaccine development for emerging infectious diseases. Vaccine 2020; 38:7198-7200. [PMID: 33032845 PMCID: PMC7535798 DOI: 10.1016/j.vaccine.2020.09.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 11/29/2022]
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Tymoszuk P, Petzer V, Asshoff M, Schroll A, Seifert M, Hansen R, Milutinovic S, Strouse B, Hassig C, Weiss G, Theurl I. SAT0020 MOMELOTINIB, A JANUS KINASE 1/2 AND ACTIVIN RECEPTOR 1 INHIBITOR, AMELIORATES JOINT INFLAMMATION, SYSTEMIC TH17 DIFFERENTIATION AND ARTHRITIS-LINKED ANEMIA IN PRE-CLINICAL AUTOIMMUNE RA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Janus kinases (JAKs) serve as signaling hubs orchestrating inflammation, innate and adaptive immunity and erythropoiesis. Unfortunately, some of these agents cause suppression of JAK-dependent erythropoiesis, thereby exacerbating inflammation-associated anemia, leading to potential under-dosing and reduced therapeutic benefit. We previously showed that the JAKi momelotinib (MMB) can correct anemia in a rat model of RA, an effect that has been clinically reproduced in myelofibrosis patients treated with MMB. Subsequently, the molecular basis for MMB’s anemia benefit was determined to be a consequence of its potent inhibition of Activin Receptor Type 1 (ACVR1), resulting in decreased hepcidin and, as a consequence, increased systemic iron availability and improved erythropoiesis.Objectives:The goal of the current study was to investigate the effects of MMB on arthritis in pre-clinical RA models.Methods:The anti-arthritic activity of daily administration of MMB was assessed in Streptococcus cell wall-induced arthritis in Lewis rats (PG-PS model) and in collagen antibody-induced arthritis (CAIA) in DBA/1 mice. Consecutive assessment of arthritis was performed by joint thickness measurements and paw scoring. Following 3 weeks of treatment, synovial immune cell infiltration and T cell subset differentiation was quantified. Cytokine gene expression was profiled by quantitative rt-PCR. Anemia was assessed by determination of blood hemoglobin and serum, spleen and liver iron levels.Results:MMB reduced inflammatory granulocyte and macrophage infiltration in synovial tissue by more than 60% at all tested doses as compared to vehicle treatment in PG-PS animals. Importantly, MMB treatment effectively decreased arthritogenic Th17 cell differentiation and overall CD4+ T cells in the synovia beginning at the lowest tested dose and coincided with complete remission of joint swelling at 25 mg/kg. Anti-arthritic activity of MMB was confirmed with significant reductions in arthritis scoring, which demonstrated non-inferiority versus the TNF-α inhibitor, etanercept, in the CAIA model. Consistent with its inhibitory activity on the ACVR1-hepcidin axis, MMB reduced circulating hepcidin levels and mobilized systemic iron, resulting in substantial improvement of the RA-associated anemia in rats.Conclusion:MMB is a highly efficacious anti-arthritic agent that ameliorates local joint inflammation and reduces the systemic differentiation of major arthritogenic effector cell population, Th17 lymphocytes. In accord with our previous report, MMB is distinct from other JAKi due to its ability to inhibit ACVR1 signaling leading to decreased plasma hepcidin, improved iron homeostasis and increased erythropoiesis. The dual anti-inflammatory and anemia-improving pharmacologic activities of MMB position it as a promising and differentiated therapeutic agent for the treatment of RA and other inflammatory diseases with an anemia component.Disclosure of Interests:Piotr Tymoszuk: None declared, Verena Petzer: None declared, Malte Asshoff: None declared, Andrea Schroll: None declared, Markus Seifert: None declared, Ryan Hansen Employee of: I’m a former employee of Sierra Oncology, Snezana Milutinovic Employee of: I’m a former employee of Sierra Oncology, Bryan Strouse Employee of: I’m an employee of Sierra Oncology, Christian Hassig Employee of: I am a former employee of Sierra Oncology, Guenter Weiss: None declared, Igor Theurl Grant/research support from: I have received research support from Sierra Oncology, Consultant of: I have consulted for Kymba Ltd.
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Johnston K, Danchenko N, Hansen R, Dinet J, Liovas A, Armstrong A, Bains S, Sullivan SD. Cost effectiveness and impact on quality of life of abobotulinumtoxinA and onabotulinumtoxinA in the treatment of children with lower limb spasticity in Canada. J Med Econ 2020; 23:631-640. [PMID: 31985313 DOI: 10.1080/13696998.2020.1722138] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Injectable botulinum neurotoxins are a mainstay of treatment for pediatric spasticity. AbobotulinumtoxinA and onabotulinumtoxinA are both injectable toxin therapies used to treat pediatric lower limb (PLL) spasticity in Canada. The objective of this study was to assess the cost-effectiveness of abobotulinumtoxinA vs. onabotulinumtoxinA in the treatment of PLL spasticity in Canada.Methods: A probabilistic Markov cohort model with a 2-year time horizon was developed, with health states defined by response to therapy, as characterized by the goal attainment scale (GAS). Based on randomized controlled trial evidence, response to therapy was similar or higher for abobotulinumtoxinA relative to onabotulinumtoxinA; uncertainty was incorporated into model parameters, however, as the two therapies have not been compared head-to-head. Canadian resource use and cost data were incorporated.Results: In the base case, abobotulinumtoxinA generated 1.48 quality-adjusted life years over the model time horizon, compared to 1.47 for onabotulinumtoxinA. AbobotulinumtoxinA was associated with cost savings of $123 CAD, reflecting lower costs in both medication acquisition and health services. The estimated improvement to quality of life and reduced costs result in an estimate of economic dominance for abobotulinumtoxinA over onabotulinumtoxinA. This dominant result persisted across probabilistic and scenario analyses.Key points for decision makersBased on a review of available clinical evidence, abobotulinumtoxinA was found to have significant and/or numerical efficacy benefits to onabotulinumtoxinA on functional outcomes (Goal Attainment Scale) and tone (Modified Ashworth Scale) and in the treatment of pediatric lower limb spasticityIn this cost-effectiveness analysis, abobotulinumtoxinA was found to be associated with greater quality-adjusted life years and lower costs than onabotulinumtoxinA (economically dominant)A limitation of this analysis was the uncertainty around key parameters. Specifically, the lack of head-to-head comparison data for the two therapies, and variable data regarding likely onabotulinumtoxinA dosing in PLL in clinical practice. However, across a range of plausible scenarios, the economic dominant result remained.
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Affiliation(s)
- Karissa Johnston
- Broadstreet Health Economics and Outcomes Research, Vancouver, Canada
| | | | - Ryan Hansen
- Choice Institute, University of Washington, Seattle, WA, USA
| | - Jerome Dinet
- Ipsen Biopharmaceuticals Canada, Mississauga, Canada
| | - Anna Liovas
- Ipsen Biopharmaceuticals Canada, Mississauga, Canada
| | - Ava Armstrong
- Ipsen Biopharmaceuticals Canada, Mississauga, Canada
| | | | - Sean D Sullivan
- Choice Institute, University of Washington, Seattle, WA, USA
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Knight MT, Newman MC, Benzinger MJ, Neufang KL, Agin JR, McAllister JS, Ramos M, Carter M, Duran B, Hagan K, Hansen R, Rudolph C, Quinley S, Updaw A, Neufang K, Brook L, Lucia L, Koeritzer B, Tomer J, Smith T, Brown D, Lobo C, Tobin P, O’Brien-Gammon L, Boleszcczuk P. Comparison of the Petrifilm Dry Rehydratable Film and Conventional Culture Methods for Enumeration of Yeasts and Molds in Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.806] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A collaborative study was performed involving 18 laboratories and 6 food types to compare 3M Petrifilm yeast and mold count plates with the method described in the U.S. Food and Drug Administration’s Bacteriological Analytical Manual. Four species of mold and 2 species of yeast were used to inoculate the following foods: hot dogs, corn meal, ketchup, orange juice, yogurt, and cake mix. Each collaborator received 15 samples of each food type: 5 low-level inoculations, 5 high- level inoculations, and 5 uninoculated samples. There was no significant difference between the means of the 2 methods for any product or inoculation level. The Petrifilm yeast and mold count plate method for enumeration of yeasts and molds in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | | | | | - Karen L Neufang
- Q Laboratories, Inc., 2014 Harrison Ave, Cincinnati, OH 45214
| | - James R Agin
- Q Laboratories, Inc., 2014 Harrison Ave, Cincinnati, OH 45214
| | - J Sue McAllister
- 3M Microbiology Products, 3M Center Bldg. 270-3N-04, St. Paul, MN 55144
| | - Mary Ramos
- 3M Microbiology Products, 3M Center Bldg. 270-3N-04, St. Paul, MN 55144
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21
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Bianco C, Nunez A, Sanchez-Cordon P, Hansen R, Reid S, Jeckel S, Brown I, Thomas S, Poulos C, Brooks S. Pathology of Natural Highly Pathogenic Avian Influenza Viruses (HPAIV) H5N8 (2017) and HPAIV H5N6 (2018) Infection in Wild Birds in the UK. J Comp Pathol 2020. [DOI: 10.1016/j.jcpa.2019.10.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Cornhill A, Dykstra S, Mikami Y, Flewitt J, Seib M, Yee K, Faris P, Hansen R, Lydell C, Howarth A, Heydari B, White J. 4179Feasibility and validation of routine CMR-based phenotyping for the prediction of heart failure admission or death in patients with systolic dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0125] [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: 11/15/2022] Open
Abstract
Abstract
Background
Standardized patient phenotyping using cardiovascular magnetic resonance (CMR) imaging has been shown to be of clinical value for prediction of adverse events in patients with heart failure and reduced ejection fraction (HFrEF). Studies have validated the prognostic capacity of function (LV, RV and LA) and replacement fibrosis burden in patients with ischemic and non-ischemic cardiomyopathy. The translation and validation of routine CMR-based phenotyping into clinical practice has yet to be demonstrated in prospective studies.
Purpose
This study was designed to explore feasibility and prognostic value of routine CMR-based patient phenotyping in a high-volume clinical referral center for patients with HFrEF.
Methods
One thousand three hundred and ninety-three consecutive patients with chronic HFrEF were prospectively recruited between January 2015 and June 2018. Chronic HFrEF was defined by LVEF≤50% by CMR, with no recent (within 90 days) acute myocardial infarction or myocarditis diagnosis. Patients with congenital heart disease and those without LGE CMR protocol were excluded. All patients underwent standardized CMR protocols with multi-chamber volumetric analysis and regional myocardial fibrosis coding. Pharmacy, ECG, laboratory and patient reported data was used for statistical modelling. A minimum three-month follow-up was mandated to identify the composite clinical outcome of heart failure hospitalization or death.
Results
The cohort had a median age of 61 years with 23% being female. The median follow-up was 737 days with 146 patients (10.5%) experiencing the composite outcome. Numerous imaging and non-imaging variables were significantly different between patients with and without the composite outcome, including: median LVEF (32% vs 39%, p<0.0001), RVEF (46% vs 51% p<0.0001), LV mass (77g/m2 vs. 65g/m2, p<0.0001), digoxin (19% vs. 9%, p<0.0001) and diuretic (63% vs 41%, p<0.0001) use. Presence of replacement fibrosis (HR=2.09, p=0.001), particularly midwall striae (HR=2.01, p<0.0001), diffuse (HR=3.88, p<0.0001) and RV insertion site fibrosis (HR=1.54, p=0.022) patterns, were significantly associated with the combined endpoint. A stepwise multivariable model was applied using all eligible variables and resulted in robust accuracy for prediction of the combined outcome with a concordance index of 0.751 (Figure 1).
Conclusions
This study demonstrates the feasibility and prognostic value of automated patient phenotyping that captures patient reported data, imaging, and administrative data for risk prediction modelling in HFrEF. The incremental application of machine learning is being explored.
Acknowledgement/Funding
J White: Early Investigator Award (Heart and Stroke Foundation of Alberta), Calgary Health Trust
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Affiliation(s)
- A Cornhill
- University of Calgary Foothills Hospital, Calgary, Canada
| | - S Dykstra
- University of Calgary Foothills Hospital, Calgary, Canada
| | - Y Mikami
- University of Calgary Foothills Hospital, Calgary, Canada
| | - J Flewitt
- University of Calgary Foothills Hospital, Calgary, Canada
| | - M Seib
- University of Calgary Foothills Hospital, Calgary, Canada
| | - K Yee
- University of Calgary Foothills Hospital, Calgary, Canada
| | - P Faris
- University of Calgary Foothills Hospital, Calgary, Canada
| | - R Hansen
- University of Calgary Foothills Hospital, Calgary, Canada
| | - C Lydell
- University of Calgary Foothills Hospital, Calgary, Canada
| | - A Howarth
- University of Calgary Foothills Hospital, Calgary, Canada
| | - B Heydari
- University of Calgary Foothills Hospital, Calgary, Canada
| | - J White
- University of Calgary Foothills Hospital, Calgary, Canada
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Muurholm C, Ravkilde T, Skouboe S, Worm E, Hansen R, Høyer M, Keall P, Poulsen P. OC-0302 Dose-guided motion management during liver SBRT delivery using real-time reconstructed tumor DVHs. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30722-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Worm E, Hansen R, Høyer M, Bertholet J, Weber B, Dolcet A, Poulsen P. OC-0297 Detailed PTV margin assessment for liver SBRT with CBCT-guidance or realtime monitoring and gating. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30717-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Skouboe S, Ravkilde T, Bertholet J, Hansen R, Worm E, Muurholm C, Weber B, Høyer M, Poulsen P. OC-0543 First clinical real-time motion-including tumor dose reconstruction during radiotherapy delivery. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30963-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hansen R, Shirtcliff RM, Ludwig S, Dysert J, Allen G, Milgrom P. Changes in Silver Diamine Fluoride Use and Dental Care Costs: A Longitudinal Study. Pediatr Dent 2019; 41:35-44. [PMID: 30803475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose: This study evaluated the impact of silver diamine fluoride (SDF) by investigating coverage and reimbursement policies. Methods: We performed a population-level retrospective cohort analysis (N equals 117,599) using claims. We evaluated two policy events: (1) dental board approval permitting SDF use by expanded practice dental hygienists (EPDHs); (2) approval of SDF by Medicaid. Coincident with coverage, Advantage Dental Services instituted EPDH practice algorithms. To evaluate changes, we: estimated CDT code 1354 utilization and average quarterly costs; stratified the population into patients who initiated preventive care from an EPHD or dentist; estimated outcome differences with either policy in quarterly trends; and counted SDF use with claims by quarter and calculated utilization per 1,000 patients. Results: Average per-patient quarterly dental costs (June 2017) ranged from $384 to $423. SDF use grew associated with Medicaid policy: rates increased from $0.32 per 1,000 to $156 per 1,000 in six quarters. Care initiated by EPDHs had lower costs, with quarterly savings of $201 (P=0.011) per patient, without differences in SDF utilization. Conclusions: Policy makers can use our results to improve access and reduce costs. Clinical experts should address more clearly when SDF substitutes for or is used in conjunction with restorative treatment.
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Affiliation(s)
- Ryan Hansen
- Dr. Hansen is an assistant professor, Comparative Health Outcomes Policy and Economics Institute, School of Pharmacy
| | - R Mike Shirtcliff
- Dr. Shirtcliff is president of RMS Dental Director, Inc., Redmond, Ore., USA
| | - Sharity Ludwig
- Ms. Ludwig is director of Community Programs, Advantage Dental Services, LLC, Redmond, Ore., USA
| | - Jeanne Dysert
- Ms. Dysert is retired, a former vice president for operations advantage Dental Services, LLC, Redmond, Ore., USA
| | - Gary Allen
- Dr. Allen is vice president and dental director, all at Advantage Dental Services, LLC, Redmond, Ore., USA
| | - Peter Milgrom
- Dr. Milgrom is Emeritus professor, Department of Oral Health Sciences, School of Dentistry, both at the University of Washington, Seattle, Wash., USA;,
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Bacci JL, Hansen R, Ree C, Reynolds MJ, Stergachis A, Odegard PS. The effects of vaccination forecasts and value-based payment on adult immunizations by community pharmacists. Vaccine 2018; 37:152-159. [PMID: 30446177 DOI: 10.1016/j.vaccine.2018.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 07/16/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND The prevalence of vaccine-preventable diseases in adults remains a significant public health issue in the United States. The objectives of this demonstration project were to increase the number of influenza, pneumococcal, pertussis, and herpes zoster immunizations administered to adults by community pharmacists, evaluate the percentage of immunizations documented in the state immunization information system (IIS), and design and pilot a value-based payment model. METHODS A one-year prospective, observational demonstration project was conducted in 70 community pharmacies in western Washington State from September 1, 2016 to August 31, 2017. An immunization interface was integrated into workflow at each pharmacy to enable "forecasting" of and proactive recommendation to patients about their vaccine needs and documentation of vaccines administered in the state IIS. Categorical value-based payment models were developed and implemented in a subgroup of 12 community pharmacies from March 1 to November 30, 2017. The change in the number of immunizations administered in comparison to the baseline period and the percentage of immunizations documented in the state IIS during the demonstration period were analyzed using descriptive statistics. RESULTS There was a 15% total increase in the collective number of influenza, pneumococcal, pertussis, and herpes zoster vaccines administered in the demonstration year in the 70 pharmacies, due to increases in influenza and pertussis vaccinations. Eighty-three percent of the vaccines administered were documented in the state IIS. Pneumococcal, pertussis, and herpes zoster performance appeared to be unaffected by the value-based payment models while influenza performance improved across the 12 pilot pharmacies. CONCLUSIONS This work demonstrated that community pharmacists contribute to improving adult immunizations through vaccine "forecasting" and proactive recommendation. Meaningful quality measures with both positive and negative incentives could further drive adoption of best immunization practices. Further implementation and outcomes research is needed to fully examine the impact and scalability of these strategies.
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Affiliation(s)
- Jennifer L Bacci
- University of Washington School of Pharmacy, 1959 NE Pacific Street Box 357630, Seattle, WA 98195-7630, United States.
| | - Ryan Hansen
- University of Washington School of Pharmacy, 1959 NE Pacific Street Box 357630, Seattle, WA 98195-7630, United States
| | - Christina Ree
- Bartell Drugs, 4025 Delridge Way SW Suite 400, Seattle, WA 98106, United States
| | - Marci J Reynolds
- Quality Food Centers, 10116 NE 8th St, Bellevue, WA 98004, United States
| | - Andy Stergachis
- University of Washington School of Pharmacy, 1959 NE Pacific Street Box 357630, Seattle, WA 98195-7630, United States
| | - Peggy S Odegard
- University of Washington School of Pharmacy, 1959 NE Pacific Street Box 357630, Seattle, WA 98195-7630, United States
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Maraldo M, Lundgaard A, Josipovic M, Bidstrup P, Rechner L, Hansen R, Damkjær S, Jørgensen M, Safwat A, Specht L, Hjalgrim L. The Feasibility of Deep Inspiration Breath-Hold in Children: Results of the TEDDI Pilot Study. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.893] [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: 10/28/2022]
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Skouboe S, Ravkilde T, Muurholm C, Worm E, Hansen R, Weber B, Høyer M, Poulsen P. OC-0415: Real-time dose reconstruction for moving tumours in stereotactic liver radiotherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30725-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Marciano S, Haddad L, Borzi S, D’Amico C, Gaite L, Aubone M, Sirotinsky M, Ratusnu N, Frola M, Aparicio M, Ríos B, Anselmo M, Hansen R, De Filippi S, García Dans C, de Labra L, Peche M, Strella T, Ibáñez Duran M, García Rosales M, Dirchwolf M, Galdame O, Gadano A. Access to direct-acting antivirals for the treatment of hepatitis C in a country with limited resources. Revista de Gastroenterología de México (English Edition) 2018. [DOI: 10.1016/j.rgmxen.2018.05.013] [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: 11/29/2022] Open
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McIlroy J, Ianiro G, Mukhopadhya I, Hansen R, Hold GL. Review article: the gut microbiome in inflammatory bowel disease-avenues for microbial management. Aliment Pharmacol Ther 2018; 47:26-42. [PMID: 29034981 DOI: 10.1111/apt.14384] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [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] [Received: 05/05/2017] [Revised: 05/29/2017] [Accepted: 09/25/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND The concept of an altered collective gut microbiota rather than identification of a single culprit is possibly the most significant development in inflammatory bowel disease research. We have entered the "omics" era, which now allows us to undertake large-scale/high-throughput microbiota analysis which may well define how we approach diagnosis and treatment of inflammatory bowel disease (IBD) in the future, with a strong steer towards personalised therapeutics. AIM To assess current epidemiological, experimental and clinical evidence of the current status of knowledge relating to the gut microbiome, and its role in IBD, with emphasis on reviewing the evidence relating to microbial therapeutics and future microbiome modulating therapeutics. METHODS A Medline search including items 'intestinal microbiota/microbiome', 'inflammatory bowel disease', 'ulcerative colitis', 'Crohn's disease', 'faecal microbial transplantation', 'dietary manipulation' was performed. RESULTS Disease remission and relapse are associated with microbial changes in both mucosal and luminal samples. In particular, a loss of species richness in Crohn's disease has been widely observed. Existing therapeutic approaches broadly fall into 3 categories, namely: accession, reduction or indirect modulation of the microbiome. In terms of microbial therapeutics, faecal microbial transplantation appears to hold the most promise; however, differences in study design/methodology mean it is currently challenging to elegantly translate results into clinical practice. CONCLUSIONS Existing approaches to modulate the gut microbiome are relatively unrefined. Looking forward, the future of microbiome-modulating therapeutics looks bright with several novel strategies/technologies on the horizon. Taken collectively, it is clear that ignoring the microbiome in IBD is not an option.
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Affiliation(s)
- J McIlroy
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - G Ianiro
- Internal Medicine, Gastroenterology and Liver Unit, Gastroenterology Area, Fondazione Policlinico Universitario Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - I Mukhopadhya
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - R Hansen
- Royal Hospital for Children, Glasgow, UK
| | - G L Hold
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Abstract
SummaryWe have recently shown that intravenous immunoglobulin (IVIG) therapy leads to an increased rate of anti-platelet antibody clearance in an animal model of immune thrombocytopenia. The present study was performed to confirm the importance of the FcRn receptor in mediating this effect of IVIG. The pharmacokinetics of an anti-platelet antibody, 7E3, were studied in mice lacking expression of FcRn and in control mice, both in the presence and absence of IVIG. IVIG increased the clearance of 7E3 in mice with functioning FcRn receptors, with an average clearance value of 14.4 ± 1.4 ml/d/kg in IVIG treated mice vs. 5.2 ± 0.3 ml/d/kg in controls (P <0.001). In mice lacking expression of FcRn, IVIG treatment did not increase 7E3 clearance (61.0 ± 3.6 ml/d/kg vs. 71.5 ± 4.0 ml/d/kg in controls). Thus, these data support the hypothesis that IVIG increases antibody elimination via saturation of FcRn.
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Logan M, Ijaz UZ, Hansen R, Gerasimidis K, Russell RK. Letter: reproducible evidence shows that exclusive enteral nutrition significantly reduces faecal calprotectin concentrations in children with active Crohn's disease. Aliment Pharmacol Ther 2017; 46:1119-1120. [PMID: 29105140 DOI: 10.1111/apt.14351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- M Logan
- School of Engineering, University of Glasgow, Glasgow, UK
| | - U Z Ijaz
- School of Engineering, University of Glasgow, Glasgow, UK
| | - R Hansen
- Department of Paediatric Gastroenterology, The Royal Hospital for Children Glasgow, Glasgow, UK
| | - K Gerasimidis
- School of Medicine, University of Glasgow, Glasgow, UK
| | - R K Russell
- Department of Paediatric Gastroenterology, The Royal Hospital for Children Glasgow, Glasgow, UK
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Potthoff K, Nusch A, Söling U, Hansen R, Salat C, Grebhardt S, Harde J, Marschner N. Overall survival and quality of life in patients with metastatic breast cancer treated with nab-paclitaxel: Final results of the non-interventional study NABUCCO. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Howard J, Harris I, Frank G, Kiptanui Z, Qian J, Hansen R. UNDERSTANDING GLOBAL INFLUENCERS OF GENERIC DRUG USE AMONG OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J. Howard
- IMPAQ International, Columbia, Maryland,
| | - I. Harris
- IMPAQ International, Columbia, Maryland,
| | - G. Frank
- IMPAQ International, Columbia, Maryland,
| | | | - J. Qian
- Auburn University, Auburn, Alabama
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Colvill E, Petersen J, Høyer M, Worm E, Hansen R, Poulsen P. PV-0137: Validation of fast motion-including dose reconstruction for proton scanning therapy in the liver. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30580-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Bertholet J, Hansen R, Worm E, Toftegaard J, Wan H, Parikh P, Høyer M, Poulsen P. OC-0464: Validation of a fully automatic real-time liver motion monitoring method on a conventional linac. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30905-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gomes N, Frederick B, Hansen R, Zhang G, Gustafson D, Pronk G, Su TT. Abstract B24: Development of a radiation modulator that functions via translation inhibition. Cancer Res 2017. [DOI: 10.1158/1538-7445.transcontrol16-b24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Translation is essential for cellular maintenance and growth, as well as survival in response to a variety of stresses. Translation factors are often overexpressed in cancers, and their experimental inhibition has been shown to retard cancer cell growth in a variety of pre-clinical models. Further, clinically relevant forms of cellular stress (e.g. ionizing radiation, hypoxia) result in altered translational programs. Inhibition of translation following such stress results in impaired cellular recovery. Taken together these observations suggest that modulation of translation, alone or in combination with genotoxic stress, is of potential therapeutic relevance in oncology.
Bouvardin (BVD) is a plant-derived protein synthesis inhibitor that we identified in a screen for enhancers of ionizing radiation (IR) in D. melanogaster. We previously demonstrated that BVD functions as a translation elongation inhibitor by blocking dissociation of elongation factor 2 (eEF2) from the ribosome. In preclinical models of head and neck cancer (HNC) and glioma, two cancer indications for which IR is a standard of care, we demonstrated that BVD enhanced clonogenic death induced by IR. Further, BVD enhanced the growth inhibitory effects of IR in HNC tumor xenografts in mice.
We show here that a fully synthetic derivative of BVD, SVC112, exhibits promising therapeutic properties in tissue culture and xenograft models of HNC. Like BVD, SVC112 inhibits general de novo protein synthesis in cell culture. In a panel of 19 HNC cell lines SVC112 exhibits antiproliferative activity with an average IC50 of ~160 nM, with no IC50 exceeding 500 nM. Combinations of SVC112 and IR dose-response curves in HNC cells yield average combination-index (CI) values generally lower than 1, especially in maximally tolerated dose ranges. CI values of 1 are indicative of additive interactions, while CI values <1 are indicative of synergy between two agents. Further, in clonogenic assays physiologically achievable levels of SVC112 consistently exhibit dose modifying factors (DMF) of >1 in HNC cells, when combined with a range of clinically relevant IR doses. DMF values of 1 are indicative of additive interactions, while DMF values >1 indicate synergistic enhancement of IR mediated clonogenic death. Additionally in clonogenic assays, SVC112 enhances cisplatin-IR mediated clonogenic death. Finally, SVC112 enhances the growth inhibitory effects of IR-cisplatin treatment (alone and in combination) in HNC tumor xenografts in mice. Taken together these data demonstrate that inhibition of translation elongation in combination with existing standards of care is a potentially promising treatment option for cancers of the head and neck.
*This project has been funded in whole or in part with Federal funds from the NCI/NIH, Department of Health and Human Services, under Contract No. HHSN261201300021C
Citation Format: Nathan Gomes, Barb Frederick, Ryan Hansen, Gan Zhang, Daniel Gustafson, Gijsbertus Pronk, Tin Tin Su. Development of a radiation modulator that functions via translation inhibition. [abstract]. In: Proceedings of the AACR Special Conference on Translational Control of Cancer: A New Frontier in Cancer Biology and Therapy; 2016 Oct 27-30; San Francisco, CA. Philadelphia (PA): AACR; Cancer Res 2017;77(6 Suppl):Abstract nr B24.
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Affiliation(s)
- Nathan Gomes
- 1University of Colorado/SuviCa Inc., Boulder, CO,
| | | | - Ryan Hansen
- 3Colorado State University, Fort Collins, CO,
| | | | | | | | - Tin Tin Su
- 1University of Colorado/SuviCa Inc., Boulder, CO,
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Plaschke C, Gehl J, Johannesen H, Hendel H, Kiss K, Hansen R, Wessel I. PO-095: Electrochemotherapy for mucosal head and neck tumours: results from a phase II clinical trial. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30229-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mazor Y, Hansen R, Prott G, Kellow J, Malcolm A. The importance of a high rectal pressure on strain in constipated patients: implications for biofeedback therapy. Neurogastroenterol Motil 2017; 29. [PMID: 27647462 DOI: 10.1111/nmo.12940] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 04/13/2016] [Accepted: 08/09/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND A subset of patients with chronic constipation display a relatively high manometric rectal pressure on strain. We hypothesized that these patients represent a unique phenotype of functional defecatory disorder (FDD) and would benefit from undergoing anorectal biofeedback (BF). METHODS Of 138 consecutive patients with chronic constipation and symptoms of FDD, 19 were defined as having a high rectal pressure on strain, using a statistically derived cut-off of 78 mm Hg. This subset was compared with remaining patients in regard to baseline clinical profile and physiology, and outcome of BF. KEY RESULTS There was a greater representation of males in the high rectal pressure group. Their constipation score, impact of bowel dysfunction on quality of life and satisfaction with bowel habits did not differ from the remaining patients. Eighty-four percent of patients in the high group successfully expelled the rectal balloon and 95% displayed paradoxical anal contraction on strain (P<.05 compared with the remaining patients). Following BF, 89% of patients in the high group reduced their rectal pressure to normal. End of BF treatment outcomes improved significantly, and to a similar degree, in both groups. CONCLUSIONS & INFERENCES We have identified a subgroup of patients with dyssynergic symptoms but without a formal Rome III diagnosis of FDD, who were characterized by a high straining rectal pressure. Although these patients displayed some physiological differences to the patients with lower straining rectal pressure, they suffer similarly. Importantly, we have shown that these patients can respond favorably to anorectal BF.
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Affiliation(s)
- Y Mazor
- Neurogastroenterology Unit, Royal North Shore Hospital, University of Sydney, St Leonards, NSW, Australia
| | - R Hansen
- Neurogastroenterology Unit, Royal North Shore Hospital, University of Sydney, St Leonards, NSW, Australia
| | - G Prott
- Neurogastroenterology Unit, Royal North Shore Hospital, University of Sydney, St Leonards, NSW, Australia
| | - J Kellow
- Neurogastroenterology Unit, Royal North Shore Hospital, University of Sydney, St Leonards, NSW, Australia
| | - A Malcolm
- Neurogastroenterology Unit, Royal North Shore Hospital, University of Sydney, St Leonards, NSW, Australia
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Hansen R, Andersen J, Vinther A, Pielmeier U, Larsen R. Breaking up Prolonged Sitting does not Alter Postprandial Glycemia in Young, Normal-Weight Men and Women. Int J Sports Med 2016; 37:e1. [DOI: 10.1055/s-0036-1597544] [Citation(s) in RCA: 2] [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: 10/20/2022]
Affiliation(s)
- R. Hansen
- Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - J. Andersen
- Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - A. Vinther
- Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - U. Pielmeier
- Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - R. Larsen
- Health Science and Technology, Aalborg University, Aalborg, Denmark
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Ferraro FR, Hansen R, Deling L. Executive Function Index (EFI) performance in nonclinical individuals with high levels of autistic traits. Appl Neuropsychol Adult 2016; 25:149-154. [PMID: 27929658 DOI: 10.1080/23279095.2016.1263199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study examined the ability of the Executive Function Index (EFI) to detect differences in executive functioning amongst participants with varying levels of subclinical autistic symptoms as quantified by the Autism Spectrum Quotient (ASQ). Participants were a nonclinical college subject sample classified as displaying either Low (0-15 ASQ score, n = 182) ASQ traits or High (16 or higher ASQ score, n = 91) ASQ traits. Participants were given the ASQ (Baron-Cohen et al., 2001) and the EFI (Spinella, 2005 ). High ASQ subjects were significantly impaired (p's < .04) on the Motivation/Drive (EFI-1) and Organization (EFI-4) subscales of the EFI, as compared to the Low ASQ subjects. However, no High/Low ASQ group differences were observed for EFI-2 (Impulse Control), EFI-3 (Empathy), EFI-5 (Planning) subscales or the EFI-Total Score (p's > .12), although these differences were in the predicted direction (High ASQ < Low ASQ). Use of the EFI as a measure of executive function performance in nonclinical ASQ trait individuals requires further study and may not be sensitive enough of an instrument to assess EF in nonclinical populations with autistic traits.
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Affiliation(s)
- F R Ferraro
- a Department of Psychology , University of North Dakota , Grand Forks , ND , USA
| | - R Hansen
- a Department of Psychology , University of North Dakota , Grand Forks , ND , USA
| | - L Deling
- a Department of Psychology , University of North Dakota , Grand Forks , ND , USA
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Knadler MP, Nguyen TH, Campanale K, De Veer MJ, Beals JM, Li S, Hansen R, Siesky A, Michael MD, Porter CJH. Addition of 20-kDa PEG to Insulin Lispro Alters Absorption and Decreases Clearance in Animals. Pharm Res 2016; 33:2920-2929. [PMID: 27528391 PMCID: PMC5093203 DOI: 10.1007/s11095-016-2014-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/08/2016] [Indexed: 01/21/2023]
Abstract
PURPOSE Determine the pharmacokinetics of insulin peglispro (BIL) in 5/6-nephrectomized rats and study the absorption in lymph duct cannulated (LDC) sheep. METHODS BIL is insulin lispro modified with 20-kDa linear PEG at lysine B28 increasing the hydrodynamic size to 4-fold larger than insulin lispro. Pharmacokinetics of BIL and insulin lispro after IV administration were compared in 5/6-nephrectomized and sham rats. BIL was administered IV or SC into the interdigital space of the hind leg, and peripheral lymph and/or serum samples were collected from both LDC and non-LDC sheep to determine pharmacokinetics and absorption route of BIL. RESULTS The clearance of BIL was similar in 5/6-nephrectomized and sham rats, while the clearance of insulin lispro was 3.3-fold slower in 5/6-nephrectomized rats than in the sham rats. In non-LDC sheep, the terminal half-life after SC was about twice as long vs IV suggesting flip-flop pharmacokinetics. In LDC sheep, bioavailability decreased to <2%; most of the dose was absorbed via the lymphatic system, with 88% ± 19% of the dose collected in the lymph after SC administration. CONCLUSION This work demonstrates that increasing the hydrodynamic size of insulin lispro through PEGylation can impact both absorption and clearance to prolong drug action.
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Affiliation(s)
- Mary Pat Knadler
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, 46285, USA.
| | - Tri-Hung Nguyen
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria, 3052, Australia
| | - Kristina Campanale
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, 46285, USA
| | - Michael J De Veer
- Department of Physiology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, 3800, Australia
| | - John M Beals
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, 46285, USA
| | - Shun Li
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, 46285, USA
| | - Ryan Hansen
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, 46285, USA
| | - Angela Siesky
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, 46285, USA
| | - M Dodson Michael
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, 46285, USA
| | - Christopher J H Porter
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria, 3052, Australia
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
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Colvill E, Booth J, Nill S, Fast M, Bedford J, Oelfke U, Nakamura M, Poulsen P, Hansen R, Worm E, Ravkilde T, Rydhoeg JS, Pommer T, Munck Af Rosenschoeld P, Lang S, Guckenberger M, Groh C, Herrmann C, Verellen D, Poels K, Wang L, Hadsell M, Blanck O, Sothmann T, Keall P. TH-AB-303-01: Benchmarking Real-Time Adaptive Radiotherapy Systems: A Multi- Platform Multi-Institutional Study. Med Phys 2016. [DOI: 10.1118/1.4926156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Potthoff K, Nusch A, Söling U, Hansen R, Salat C, Grebhardt S, Marschner N. Efficacy and safety of nab-paclitaxel in patients with metastatic breast cancer: final results of the non-interventional study NABUCCO. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Montenovo MI, Jalikis FG, Li M, Yeh M, Dick A, Hansen R, Reyes JD. Superior Patient and Graft Survival in Adult Liver Transplant with Rabbit Antithymocyte Globulin Induction: Experience with 595 Patients. EXP CLIN TRANSPLANT 2016; 15:425-431. [PMID: 27309029 DOI: 10.6002/ect.2015.0350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The use of induction therapy in liver transplant is debatable. We aimed to compare clinical outcomes of different induction protocols in liver transplant recipients. MATERIALS AND METHODS This was a retrospective cohort analyses using the University of Washington Transplant Database from January 2005 to May 2012 for adult (≥ 18 y old) primary liver transplant patients. All patients received induction therapy. Maintenance immunosuppressive agents were tacrolimus or tacrolimus-mycophenolate mofetil. Primary endpoints were acute cellular rejection, patient survival, and graft survival. In patients with chronic hepatitis C, the degree of histologic inflammation or fibrosis at 1 year was assessed. Cox proportional hazards models were constructed to evaluate variables associated with both patient and graft survival. RESULTS We identified 595 patients: 322 patients received rabbit antithymocyte globulin and 273 received interleukin 2 receptor blocker. Acute cellular rejection was higher in patients who received interleukin 2 receptor blocker than in patients who received rabbit antithymocyte globulin (27% vs 18%; P < .03). Both patient survival at 1 year (95% vs 90%), 3 years (92% vs 87%), and 5 years (86% vs 80%) and graft survival at 1 year (93% vs 88%), 3 years (90% vs 86%), and 5 years (83% vs 78%) were superior with rabbit antithymocyte globulin than with the interleukin 2 receptor blocker (P < .002). In patients with hepatitis C virus, type of induction therapy did not have any effect on the timing of hepatitis C virus recurrence. At 1 year after transplant, 33.3% in the rabbit antithymocyte globulin group had grade 3/4 inflammation and 10.2% had stage 3/4 fibrosis, compared with 16.8% and 4.8% in the interleukin 2 receptor blocker group (P ≤ .002 and not significant). Female recipient, Model for End-Stage Liver Disease score, hepatocellular carcinoma, and high preoperative serum creatinine levels were associated with less favorable patient and graft survival. CONCLUSIONS Rabbit antithymocyte globulin is associated with lower rejection rate and improved patient and graft survival in liver transplant. Type of therapy affects the degree of histologic hepatitis C virus recurrence.
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Affiliation(s)
- Martin I Montenovo
- From the Division of Transplantation, Department of Surgery, School of Pharmacy, University of Washington, Seattle, Washington, USA
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Poulsen P, Worm E, Hansen R, Larsen L, Grau C, Høyer M. PV-0326: Respiratory gating guided by internal electromagnetic motion monitoring during liver SBRT. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31575-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Assenholt M, Hansen R, Hansen J. EP-1605: Dose from kV cone beam CT to lens, breast and gonads for children using different standard protocols. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32856-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kaifie A, Kirschner M, Wolf D, Maintz C, Hänel M, Gattermann N, Gökkurt E, Platzbecker U, Hollburg W, Göthert JR, Parmentier S, Lang F, Hansen R, Isfort S, Schmitt K, Jost E, Serve H, Ehninger G, Berdel WE, Brümmendorf TH, Koschmieder S. Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry. J Hematol Oncol 2016; 9:18. [PMID: 26944254 PMCID: PMC4779229 DOI: 10.1186/s13045-016-0242-9] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [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: 11/01/2015] [Accepted: 02/10/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Patients with Ph-negative myeloproliferative neoplasms (MPN), such as polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are at increased risk for thrombosis/thromboembolism and major bleeding. Due to the morbidity and mortality of these events, antiplatelet and/or anticoagulant agents are commonly employed as primary and/or secondary prophylaxis. On the other hand, disease-related bleeding complications (i.e., from esophageal varices) are common in patients with MPN. This analysis was performed to define the frequency of such events, identify risk factors, and assess antiplatelet/anticoagulant therapy in a cohort of patients with MPN. METHODS The MPN registry of the Study Alliance Leukemia is a non-interventional prospective study including adult patients with an MPN according to WHO criteria (2008). For statistical analysis, descriptive methods and tests for significant differences as well as contingency tables were used to identify the odds of potential risk factors for vascular events. RESULTS MPN subgroups significantly differed in sex distribution, age at diagnosis, blood counts, LDH levels, JAK2V617F positivity, and spleen size (length). While most thromboembolic events occurred around the time of MPN diagnosis, one third of these events occurred after that date. Splanchnic vein thrombosis was most frequent in post-PV-MF and MPN-U patients. The chance of developing a thromboembolic event was significantly elevated if patients suffered from post-PV-MF (OR 3.43; 95% CI = 1.39-8.48) and splenomegaly (OR 1.76; 95% CI = 1.15-2.71). Significant odds for major bleeding were previous thromboembolic events (OR = 2.71; 95% CI = 1.36-5.40), splenomegaly (OR = 2.22; 95% CI 1.01-4.89), and the administration of heparin (OR = 5.64; 95% CI = 1.84-17.34). Major bleeding episodes were significantly less frequent in ET patients compared to other MPN subgroups. CONCLUSIONS Together, this report on an unselected "real-world" cohort of German MPN patients reveals important data on the prevalence, diagnosis, and treatment of thromboembolic and major bleeding complications of MPN.
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Affiliation(s)
- A. Kaifie
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - M. Kirschner
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - D. Wolf
- Internal Medicine 3, Oncology, Hematology and Rheumatology, University Clinic Bonn (UKB), Bonn, Germany
| | - C. Maintz
- Practice for Hematology and Oncology, Wuerselen, Germany
| | - M. Hänel
- Department for Hematology, Oncology, Stem Cell Transplantation, Hospital Chemnitz, Chemnitz, Germany
| | - N. Gattermann
- Department for Hematology, Oncology and Clinical Immunology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - E. Gökkurt
- Practice for Hematology-Oncology Eppendorf, Hamburg, Germany
| | - U. Platzbecker
- Department for Hematology, University Hospital Dresden, Dresden, Germany
| | - W. Hollburg
- Practice for Hematology and Oncology Altona, Hamburg, Germany
| | - J. R. Göthert
- Department for Hematology, University Hospital Essen, Essen, Germany
| | - S. Parmentier
- Department for Hematology, Oncology and Palliative Care, Rems-Murr-Hospitals, Winnenden, Germany
| | - F. Lang
- Department for Hematology and Oncology, University Hospital Frankfurt/Main, Frankfurt/Main, Germany
| | - R. Hansen
- Practice for Hematology and Oncology, Kaiserslautern, Germany
| | - S. Isfort
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - K. Schmitt
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - E. Jost
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - H. Serve
- Department for Hematology and Oncology, University Hospital Frankfurt/Main, Frankfurt/Main, Germany
| | - G. Ehninger
- Department for Hematology, University Hospital Dresden, Dresden, Germany
| | - W. E. Berdel
- Department of Medicine A, University Hospital Münster, Münster, Germany
| | - T. H. Brümmendorf
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - S. Koschmieder
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
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Cheavens JS, Cukrowicz KC, Hansen R, Mitchell SM. Incorporating Resilience Factors Into the Interpersonal Theory of Suicide: The Role of Hope and Self-Forgiveness in an Older Adult Sample. J Clin Psychol 2015; 72:58-69. [PMID: 26448342 DOI: 10.1002/jclp.22230] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The interpersonal theory of suicide posits that perceived burdensomeness and thwarted belongingness are risk factors for suicide ideation. To more comprehensively characterize this model, it is important to identify resilience factors. Forgiveness of oneself may attenuate the relation between perceived burdensomeness and suicide ideation. Similarly, hope might weaken the association between thwarted belongingness and suicide ideation. METHOD We examined these relations cross-sectionally in a sample (N = 91) of older adults after including symptoms of depression and demographic variables in the models. RESULTS Self-forgiveness moderated the relation between perceived burdensomeness and suicide ideation. Hope did not moderate the relation between thwarted belongingness and suicide ideation. CONCLUSIONS These findings suggest that including resilience factors (i.e., self-forgiveness) in models of suicide ideation may result in better identification of those most at risk for suicide and may allow for more precise intervention targets.
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