1
|
Mattke S, Jun H, Hanson M, Chu S, Kordower JH, Reiman EM. Health Economic Considerations in the Deployment of an Alzheimer's Prevention Therapy. J Prev Alzheimers Dis 2024; 11:303-309. [PMID: 38374736 DOI: 10.14283/jpad.2024.23] [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] [Indexed: 02/21/2024]
Abstract
INTRODUCTION As treatments for secondary prevention of Alzheimer's disease (AD) are being studied, concerns about their value for money have appeared. We estimate cost-effectiveness of a hypothetical screening and prevention program. METHODS We use a Markov model to project cost-effectiveness of a treatment that reduces progression to symptomatic AD by 50% with either chronic treatment until progression to mild cognitive impairment or treatment for one year followed by monitoring with AD blood tests and retreatment with one dose in case of amyloid re-accumulation. Diagnoses would be made with an AD blood test with sensitivity and specificity of 80%, and inconclusive results in 20%. Individuals testing negative would be re-tested in five years and those with inconclusive results in one. RESULTS The program would generate per-person value of $53,721 from a payer (reduction of direct cost and patient QALY gains) and $69,861 from a societal perspective (adding valuation of reduced caregiver burden). With chronic treatment, it would be cost-effective up to annual drug prices of $7,000 and $10,300, respectively. Time-limited treatment would be cost-effective at annual drug prices of $54,257 and $78,458 from a payer and societal perspective, respectively. Higher specificity of the blood test would decrease cost per person with similar value generation DISCUSSION: A hypothetical prevention treatment for AD could be economically viable from a payer and societal perspective.
Collapse
Affiliation(s)
- S Mattke
- Soeren Mattke, M.D., D.Sc., Director, Center for Improving Chronic Illness Care, Research Professor of Economics, USC Dornsife, 635 Downey Way, #505N, Los Angeles, CA 90089, Mobile: +1 202 468 5797,
| | | | | | | | | | | |
Collapse
|
2
|
Hu G, Lin J, Feng H, Horswell R, Chu S, Shen Y. Trends of hypertensive disorders of pregnancy among the Medicaid population before and during COVID-19. Res Sq 2023:rs.3.rs-3616259. [PMID: 38077001 PMCID: PMC10705593 DOI: 10.21203/rs.3.rs-3616259/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Hypertensive disorders of pregnancy (HDP) are a group of high blood pressure disorders during pregnancy that are a leading cause of maternal and infant morbidity and mortality. The trend of HDP among the Medicaid population during the coronavirus disease of 2019 (COVID-19) is severely lacking. To determine the trends in the annual prevalence of HDP among Louisiana Medicaid pregnant women before and during the COVID-19 pandemic (2016-2021), a total of 113,776 pregnant women aged 15-50 years was included in this study. For multiparous individuals, only the first pregnancy was used in the analyses. Women with a diagnosis of each type-specific HDP were identified by using the ICD-10 codes. The prevalence of HDP increased from 10.5% in 2016 to 17.7% in 2021. The highest race/ethnicity-specific incidence of HDP was seen in African American women (13.1%), then white women (9.4%), followed by other women (7.9%). HDP remains as a very prevalent and significant global health issue, especially in African American women. Obesity and physical inactivity are major risk factors of HDP, which became amplified during the COVID-19 pandemic and led to a higher prevalence of HDP. Severe HDP substantially increases the risk of mortality in offspring and long-term issues in both the mother and infant. This is very pertinent to the Medicaid population due to the disparities and barriers that diminish the quality of healthcare they receive.
Collapse
Affiliation(s)
- Gang Hu
- Pennington Biomedical Research Center
| | | | | | | | - San Chu
- Pennington Biomedical Research Center
| | - Yun Shen
- Pennington Biomedical Research Center
| |
Collapse
|
3
|
Yoshida Y, Chu S, Zu Y, Fox S, Mauvais-Jarvis F. Effect of menopausal hormone therapy on COVID-19 severe outcomes in women - A population-based study of the US National COVID Cohort Collaborative (N3C) data. Maturitas 2023; 170:39-41. [PMID: 36773498 PMCID: PMC9633103 DOI: 10.1016/j.maturitas.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
Whether menopausal hormone therapy (MHT) lessens the severity of COVID-19 among women is unclear. Leveraging a U.S. national COVID-19 cohort and a cross-sectional analysis, we found MHT use was marginally associated with a lower risk of mortality (odds ratio [OR] 0.73, 95 % CI 0.53-1.01) and significantly associated with a lower risk of prolonged hospital stay (0.7, 0.49-0.99) among inpatient women. When stratifying by MHT type, estrogen-only and estrogen-plus-progestin therapies had a more prominent protective effect than progestin-only therapy, although this difference did not achieve statistical significance. Women with COVID-19 can continue to use MHT. Clinical trials are needed to evaluate MHT's therapeutic effect on COVID-19, especially in terms of severity.
Collapse
Affiliation(s)
- Yilin Yoshida
- Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA; Tulane Center of Excellence in Sex-Based Biology & Medicine.
| | - San Chu
- Pennington Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Yuanhao Zu
- Department of Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Sarah Fox
- School of Science and Engineering, Tulane University, New Orleans, LA, USA
| | - Franck Mauvais-Jarvis
- Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA; Tulane Center of Excellence in Sex-Based Biology & Medicine; Southeast Louisiana Veterans Health Care System, New Orleans, LA 70119, USA
| |
Collapse
|
4
|
Anzalone AJ, Horswell R, Hendricks BM, Chu S, Hillegass WB, Beasley WH, Harper JR, Kimble W, Rosen CJ, Miele L, McClay JC, Santangelo SL, Hodder SL. Higher hospitalization and mortality rates among SARS-CoV-2-infected persons in rural America. J Rural Health 2023; 39:39-54. [PMID: 35758856 PMCID: PMC9349606 DOI: 10.1111/jrh.12689] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE Rural communities are among the most underserved and resource-scarce populations in the United States. However, there are limited data on COVID-19 outcomes in rural America. This study aims to compare hospitalization rates and inpatient mortality among SARS-CoV-2-infected persons stratified by residential rurality. METHODS This retrospective cohort study from the National COVID Cohort Collaborative (N3C) assesses 1,033,229 patients from 44 US hospital systems diagnosed with SARS-CoV-2 infection between January 2020 and June 2021. Primary outcomes were hospitalization and all-cause inpatient mortality. Secondary outcomes were utilization of supplemental oxygen, invasive mechanical ventilation, vasopressor support, extracorporeal membrane oxygenation, and incidence of major adverse cardiovascular events or hospital readmission. The analytic approach estimates 90-day survival in hospitalized patients and associations between rurality, hospitalization, and inpatient adverse events while controlling for major risk factors using Kaplan-Meier survival estimates and mixed-effects logistic regression. FINDINGS Of 1,033,229 diagnosed COVID-19 patients included, 186,882 required hospitalization. After adjusting for demographic differences and comorbidities, urban-adjacent and nonurban-adjacent rural dwellers with COVID-19 were more likely to be hospitalized (adjusted odds ratio [aOR] 1.18, 95% confidence interval [CI], 1.16-1.21 and aOR 1.29, CI 1.24-1.1.34) and to die or be transferred to hospice (aOR 1.36, CI 1.29-1.43 and 1.37, CI 1.26-1.50), respectively. All secondary outcomes were more likely among rural patients. CONCLUSIONS Hospitalization, inpatient mortality, and other adverse outcomes are higher among rural persons with COVID-19, even after adjusting for demographic differences and comorbidities. Further research is needed to understand the factors that drive health disparities in rural populations.
Collapse
Affiliation(s)
- Alfred Jerrod Anzalone
- University of Nebraska Medical Center, Omaha, Nebraska, USA
- Great Plains IDeA-CTR, Omaha, Nebraska, USA
| | - Ronald Horswell
- Pennington Biomedical Research Centre, Baton Rouge, Louisiana, USA
- LA CaTS Center, Baton Rouge, Louisiana, USA
| | - Brian M. Hendricks
- West Virginia University, Morgantown, West Virginia, USA
- West Virginia Clinical and Translational Sciences Institute, Morgantown, West Virginia, USA
| | - San Chu
- Pennington Biomedical Research Centre, Baton Rouge, Louisiana, USA
- LA CaTS Center, Baton Rouge, Louisiana, USA
| | - William B. Hillegass
- University of Mississippi Medical Center, Jackson, Mississippi, USA
- Mississippi Center for Clinical and Translational Research, Jackson, Mississippi, USA
| | - William H. Beasley
- University of Oklahoma, Norman, Oklahoma, USA
- Oklahoma Clinical and Translational Science Institute, Oklahoma City, Oklahoma, USA
| | | | - Wesley Kimble
- West Virginia University, Morgantown, West Virginia, USA
- West Virginia Clinical and Translational Sciences Institute, Morgantown, West Virginia, USA
| | - Clifford J. Rosen
- Maine Medical Center Research Institute, Scarborough, Maine, USA
- Northern New England Clinical & Translational Research Network, Burlington, Vermont, USA
| | - Lucio Miele
- LA CaTS Center, Baton Rouge, Louisiana, USA
- Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - James C. McClay
- University of Nebraska Medical Center, Omaha, Nebraska, USA
- Great Plains IDeA-CTR, Omaha, Nebraska, USA
| | - Susan L. Santangelo
- Maine Medical Center Research Institute, Scarborough, Maine, USA
- Northern New England Clinical & Translational Research Network, Burlington, Vermont, USA
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Sally L. Hodder
- West Virginia University, Morgantown, West Virginia, USA
- West Virginia Clinical and Translational Sciences Institute, Morgantown, West Virginia, USA
| | | |
Collapse
|
5
|
Yoshida Y, Chu S, Fox S, Zu Y, Lovre D, Denson JL, Miele L, Mauvais-Jarvis F. Sex differences in determinants of COVID-19 severe outcomes - findings from the National COVID Cohort Collaborative (N3C). BMC Infect Dis 2022; 22:784. [PMID: 36224551 PMCID: PMC9555705 DOI: 10.1186/s12879-022-07776-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The impact of comorbidities and biomarkers on COVID-19 severity vary by sex but have not yet been verified in population-based studies. We examined the association of comorbidities, inflammatory biomarkers, and severe outcomes in men and women hospitalized for COVID-19. DESIGN This is a retrospective cohort analysis based on the National COVID Cohort Collaborative (N3C). We included 574,391 adult patients admitted for COVID-19 at hospitals or emergency rooms between 01/01/2020 and 12/31/2021. METHODS We defined comorbidities at or before the first admission for COVID-19 by Charlson Comorbidity Index (CCI) and CCI components. We used the averaged lab values taken within 15 days before or after the admission date to measure biomarkers including c-reactive protein (CRP), ferritin, procalcitonin, N-terminal pro b-type natriuretic peptide (NT proBNP), d-dimer, absolute lymphocyte counts, absolute neutrophil counts, and platelets. Our primary outcome was all-cause mortality; secondary outcomes were invasive mechanical ventilation (IMV) and hospital length of stay (LOS). We used logistic regression adjusted for age, race, ethnicity, visit type, and medications to assess the association of comorbidities, biomarkers, and mortality disaggregating by sex. RESULTS Moderate to severe liver disease, renal disease, metastatic solid tumor, and myocardial infarction were the top four fatal comorbidities among patients who were hospitalized for COVID-19 (adjusted odds ratio [aOR] > 2). These four comorbid conditions remained the most lethal in both sexes, with a higher magnitude of risk in women than in men (p-interaction < 0.05). Abnormal elevations of CRP, ferritin, procalcitonin, NT proBNP, neutrophil, and platelet counts, and lymphocytopenia were significantly associated with the risk of death, with procalcitonin and NT proBNP as the strongest predictors (aOR > 2). The association between the abnormal biomarkers and death was stronger in women than in men (p-interaction < 0.05). CONCLUSION There are sex differences in inpatient mortality associated with comorbidities and biomarkers. The significant impact of these clinical determinants in women with COVID-19 may be underappreciated as previous studies stressed the increased death rate in male patients that is related to comorbidities or inflammation. Our study highlights the importance and the need for sex-disaggregated research to understand the risk factors of poor outcomes and health disparities in COVID-19.
Collapse
Affiliation(s)
- Yilin Yoshida
- Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave. New Orleans, 70112, New Orleans, LA, USA.
| | - San Chu
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Sarah Fox
- School of Science and Engineering, Tulane University, New Orleans, LA, USA
| | - Yuanhao Zu
- Department of Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Dragana Lovre
- Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave. New Orleans, 70112, New Orleans, LA, USA
| | - Joshua L Denson
- Pulmonary and Critical Care, Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Lucio Miele
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Franck Mauvais-Jarvis
- Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave. New Orleans, 70112, New Orleans, LA, USA
| |
Collapse
|
6
|
Ho SSK, Hon SSF, Hung E, Lee JFY, Mo F, Tong M, So C, Chu S, Ng DCK, Lam D, Cho C, Mak TWC, Ng SSM, Futaba K, Suen J, To KF, Chan AWH, Yeung WWK, Ma BBY. Prognostic implication of the neoadjuvant rectal score and other biomarkers of clinical outcome in Hong Kong Chinese patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy. Hong Kong Med J 2022; 28:230-238. [PMID: 35667869 DOI: 10.12809/hkmj208969] [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] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Neoadjuvant chemoradiotherapy is a standard treatment for locally advanced rectal cancer, for which pathological complete response is typically used as a surrogate survival endpoint. Neoadjuvant rectal score is a new biomarker that has been shown to correlate with survival. The main objectives of this study were to investigate factors contributing to pathological complete response, to validate the prognostic significance of neoadjuvant rectal score, and to investigate factors associated with a lower neoadjuvant rectal score in a cohort of Hong Kong Chinese. METHODS Data of patients with locally advanced rectal cancer who received neoadjuvant chemoradiotherapy from August 2006 to October 2018 were retrieved from hospital records and retrospectively analysed. RESULTS Of 193 patients who had optimal response to neoadjuvant chemoradiotherapy and surgery, tumour down-staging was the only independent prognostic factor that predicted pathological complete response (P<0.0001). Neoadjuvant rectal score was associated with overall survival (hazard ratio [HR]=1.042, 95% confidence interval [CI]=1.021-1.064; P<0.0001), disease-free survival (HR=1.042, 95% CI=1.022-1.062; P<0.0001), locoregional recurrence-free survival (HR=1.070, 95% CI=1.039-1.102; P<0.0001) and distant recurrence-free survival (HR=1.034, 95% CI=1.012-1.056; P=0.002). Patients who had pathological complete response were associated with a lower neoadjuvant rectal score (P<0.0001), but pathological complete response was not associated with survival. For patients with intermediate neoadjuvant rectal scores, late recurrences beyond 72 months from diagnosis were observed. CONCLUSION Neoadjuvant rectal score is an independent prognostic marker of survival and disease recurrence in a cohort of Hong Kong Chinese patients who received neoadjuvant chemoradiotherapy for locally advanced rectal cancer.
Collapse
Affiliation(s)
- S S K Ho
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | - S S F Hon
- Department of Surgery, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
| | - E Hung
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong
| | - J F Y Lee
- Department of Surgery, Prince of Wales Hospital, Hong Kong
| | - F Mo
- State Key Laboratory in Translational Oncology in South China, Sir YK Pao Centre for Cancer, Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - M Tong
- State Key Laboratory in Translational Oncology in South China, Sir YK Pao Centre for Cancer, Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - C So
- State Key Laboratory in Translational Oncology in South China, Sir YK Pao Centre for Cancer, Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - S Chu
- Department of Surgery, Prince of Wales Hospital, Hong Kong
| | - D C K Ng
- Department of Surgery, North District Hospital, Hong Kong
| | - D Lam
- Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong
| | - C Cho
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong
| | - T W C Mak
- Department of Surgery, Prince of Wales Hospital, Hong Kong
| | - S S M Ng
- Department of Surgery, Prince of Wales Hospital, Hong Kong
| | - K Futaba
- Department of Surgery, Prince of Wales Hospital, Hong Kong
| | - J Suen
- Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong
| | - K F To
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong
| | - A W H Chan
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong
| | | | - B B Y Ma
- State Key Laboratory in Translational Oncology in South China, Sir YK Pao Centre for Cancer, Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
7
|
Thirumal R, Vanchiere C, Bhandari R, Jiwani S, Horswell R, Chu S, Chamaria S, Katikaneni P, Boerma M, Gopinathannair R, Olshansky B, Bailey S, Dominic P. The Inverse Correlation Between the Duration of Lifetime Occupational Radiation Exposure and the Prevalence of Atrial Arrhythmia. Front Cardiovasc Med 2022; 9:863939. [PMID: 35711353 PMCID: PMC9196104 DOI: 10.3389/fcvm.2022.863939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Advancements in fluoroscopy-assisted procedures have increased radiation exposure among cardiologists. Radiation has been linked to cardiovascular complications but its effect on cardiac rhythm, specifically, is underexplored. Methods Demographic, social, occupational, and medical history information was collected from board-certified cardiologists via an electronic survey. Bivariate and multivariable logistic regression analyses were performed to assess the risk of atrial arrhythmias (AA). Results We received 1,478 responses (8.8% response rate) from cardiologists, of whom 85.4% were male, and 66.1% were ≤65 years of age. Approximately 36% were interventional cardiologists and 16% were electrophysiologists. Cardiologists > 50 years of age, with > 10,000 hours (h) of radiation exposure, had a significantly lower prevalence of AA vs. those with ≤10,000 h (11.1% vs. 16.7%, p = 0.019). A multivariable logistic regression was performed and among cardiologists > 50 years of age, exposure to > 10,000 radiation hours was significantly associated with a lower likelihood of AA, after adjusting for age, sex, diabetes mellitus, hypertension, and obstructive sleep apnea (adjusted OR 0.57; 95% CI 0.38-0.85, p = 0.007). The traditional risk factors for AA (age, sex, hypertension, diabetes mellitus, and obstructive sleep apnea) correlated positively with AA in our data set. Cataracts, a well-established complication of radiation exposure, were more prevalent in those exposed to > 10,000 h of radiation vs. those exposed to ≤10,000 h of radiation, validating the dependent (AA) and independent variables (radiation exposure), respectively. Conclusion AA prevalence may be inversely associated with radiation exposure in Cardiologists based on self-reported data on diagnosis and radiation hours. Large-scale prospective studies are needed to validate these findings.
Collapse
Affiliation(s)
- Rithika Thirumal
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, United States
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Catherine Vanchiere
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States
- Department of Internal Medicine, Temple University, Philadelphia, PA, United States
| | - Ruchi Bhandari
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV, United States
| | - Sania Jiwani
- Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Ronald Horswell
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - San Chu
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | | | - Pavan Katikaneni
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States
- Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Marjan Boerma
- Department of Pharmaceutical Sciences, University of Arkansas Medical Center, Little Rock, AK, United States
| | - Rakesh Gopinathannair
- Department of Cardiology, Kansas City Heart Rhythm Institute, Overland Park, KS, United States
| | - Brian Olshansky
- Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Steven Bailey
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States
- Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States
- Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Paari Dominic
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States
- Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| |
Collapse
|
8
|
Pfaff ER, Girvin AT, Gabriel DL, Kostka K, Morris M, Palchuk MB, Lehmann HP, Amor B, Bissell M, Bradwell KR, Gold S, Hong SS, Loomba J, Manna A, McMurry JA, Niehaus E, Qureshi N, Walden A, Zhang XT, Zhu RL, Moffitt RA, Haendel MA, Chute CG, Adams WG, Al-Shukri S, Anzalone A, Baghal A, Bennett TD, Bernstam EV, Bernstam EV, Bissell MM, Bush B, Campion TR, Castro V, Chang J, Chaudhari DD, Chen W, Chu S, Cimino JJ, Crandall KA, Crooks M, Davies SJD, DiPalazzo J, Dorr D, Eckrich D, Eltinge SE, Fort DG, Golovko G, Gupta S, Haendel MA, Hajagos JG, Hanauer DA, Harnett BM, Horswell R, Huang N, Johnson SG, Kahn M, Khanipov K, Kieler C, Luzuriaga KRD, Maidlow S, Martinez A, Mathew J, McClay JC, McMahan G, Melancon B, Meystre S, Miele L, Morizono H, Pablo R, Patel L, Phuong J, Popham DJ, Pulgarin C, Santos C, Sarkar IN, Sazo N, Setoguchi S, Soby S, Surampalli S, Suver C, Vangala UMR, Visweswaran S, von Oehsen J, Walters KM, Wiley L, Williams DA, Zai A. Synergies between centralized and federated approaches to data quality: a report from the national COVID cohort collaborative. J Am Med Inform Assoc 2022; 29:609-618. [PMID: 34590684 PMCID: PMC8500110 DOI: 10.1093/jamia/ocab217] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/19/2021] [Accepted: 09/23/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE In response to COVID-19, the informatics community united to aggregate as much clinical data as possible to characterize this new disease and reduce its impact through collaborative analytics. The National COVID Cohort Collaborative (N3C) is now the largest publicly available HIPAA limited dataset in US history with over 6.4 million patients and is a testament to a partnership of over 100 organizations. MATERIALS AND METHODS We developed a pipeline for ingesting, harmonizing, and centralizing data from 56 contributing data partners using 4 federated Common Data Models. N3C data quality (DQ) review involves both automated and manual procedures. In the process, several DQ heuristics were discovered in our centralized context, both within the pipeline and during downstream project-based analysis. Feedback to the sites led to many local and centralized DQ improvements. RESULTS Beyond well-recognized DQ findings, we discovered 15 heuristics relating to source Common Data Model conformance, demographics, COVID tests, conditions, encounters, measurements, observations, coding completeness, and fitness for use. Of 56 sites, 37 sites (66%) demonstrated issues through these heuristics. These 37 sites demonstrated improvement after receiving feedback. DISCUSSION We encountered site-to-site differences in DQ which would have been challenging to discover using federated checks alone. We have demonstrated that centralized DQ benchmarking reveals unique opportunities for DQ improvement that will support improved research analytics locally and in aggregate. CONCLUSION By combining rapid, continual assessment of DQ with a large volume of multisite data, it is possible to support more nuanced scientific questions with the scale and rigor that they require.
Collapse
Affiliation(s)
- Emily R Pfaff
- Department of Medicine, UNC Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | | | - Davera L Gabriel
- Section of Biomedical Informatics and Data Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kristin Kostka
- The OHDSI Center at the Roux Institute, Northeastern University, Portland, Maine, USA
| | - Michele Morris
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Harold P Lehmann
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | | | | | - Sigfried Gold
- Section of Biomedical Informatics and Data Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Stephanie S Hong
- Section of Biomedical Informatics and Data Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Amin Manna
- Palantir Technologies, Denver, Colorado, USA
| | - Julie A McMurry
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | | | - Anita Walden
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Richard L Zhu
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Richard A Moffitt
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Melissa A Haendel
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Christopher G Chute
- Schools of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Sciarratta C, Sserunga MN, Sekiziyivu A, Lubega I, Nakato WN, Twinomuhwezi E, Tumwine C, Wasswa CK, Doshi R, Chu S, Gidudu J. Using an AEFI Parent Diary Card Following Fractional-Dose Yellow Fever (fYF) Vaccination in Uganda; a Tool for Consideration for Future Clinical Trials in Low- and Middle-Income Countries. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.275] [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: 11/24/2022] Open
|
10
|
Anzalone A(J, Horswell R, Chu S, Hendricks B, Harper J, Beasley W, Miele L, Rosen CJ, McClay J, Hodder SL. 33. Evaluation of Rural-Urban Differences in Hospitalization and Mortality Rates for US COVID-19 Patients in the United States. Open Forum Infect Dis 2021. [PMCID: PMC8644257 DOI: 10.1093/ofid/ofab466.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Rural communities are among the most vulnerable and resource-scarce populations in the United States. Rural data is rarely centralized, precluding comparability across regions, and no significant studies have studied this population at scale. The purpose of this study is to present findings from the National COVID Cohort Collaborative (N3C) to provide insight into future research and highlight the urgent need to address health disparities in rural populations.
N3C Patient Distribution
This figure shows the geospatial distribution of the N3C COVID-19 positive population. N3C contains data from 55 data contributors from across the United States, 40 of whom include sufficient location information to map by ZIP Code centroid spatially. Of those sites, we selected 27 whose data met our minimum robustness qualifications for inclusion in our study. This bubble map is to scale with larger bubbles representing more patients. A. shows all N3C patients. B. shows only urban N3C distribution. C. shows the urban-adjacent rural patient distribution. D. shows the nonurban-adjacent rural patient distribution, representing the most isolated patients in N3C.
Methods
This retrospective cohort of 573,018 patients from 27 hospital systems presenting with COVID-19 between January 2020 and March 2021, of whom 117,897 were admitted (see Data Analysis Plan diagram for inclusion/exclusion criteria), analyzes outcomes and 30-day survival for the hospitalized population by the degree of rurality.
Multivariate Cox regression analysis and mixed-effects models were used to estimate the association between rurality, hospitalization, and all-cause mortality, controlling for major risk factors associated with rural-urban health discrepancies and differences in health system outcomes. The difference in distribution by rurality is described as well as supplemented by population-level statistics to confirm representativeness.
Data Analysis Plan
This data analysis plan includes an overview of study inclusion and exclusion criteria, the matrix for data robustness to determine potential sites to include, and our covariate selection, model building, and residual testing strategy.
Results
This study demonstrates a significant difference between hospital admissions and outcomes in urban versus urban-adjacent rural (UAR) and nonurban-adjacent rural (NAR) lines. Hospital admissions for UAR (OR 1.41, p< 0.001, 95% CI: 1.37 – 1.45) and NAR (OR 1.42, p< 0.001, 95% CI: 1.35 – 1.50) were significantly higher than their urban counterparts. Similar distributions were present for all-cause mortality for UAR (OR 1.39, p< 0.001, 95% CI: 1.30 – 1.49) and NAR (OR 1.38, p< 0.001, 95% CI: 1.22 – 1.55) compared to urban populations. These associations persisted despite adjustments for significant differences in BMI, Charlson Comorbidity index Score, gender, age, and the quarter of diagnosis for COVID-19.
Baseline Characteristics Hospitalized COVID-19 Positive Population by Rurality Category, January 2020 – March 2021
Survival Curves in Hospitalized Patients Over 30 Days from Day of Admission
This figure shows a survival plot of COVID-19 positive hospitalized patients in N3C by rural category (A), Charlson Comorbidity Index (B), Quarter of Diagnosis (C), and Age Group (D) from hospital admission through day 30. Events were censored at day 30 based on the incidence of death or transfer to hospice care. These four factors had the highest predictive power of the covariates evaluated in this study.
Unadjusted and Adjusted Odds Ratios for Hospitalization and All-Cause Mortality by Rural Category, January 2020 – March 2021
This figure shows the adjusted and unadjusted odds ratios for being hospitalized or dying after hospitalization for the COVID-19 positive population in N3C. Risk is similar between adjusted and unadjusted models, suggesting a real impact of rurality on all-cause mortality. A shows the unadjusted odds ratios for admission to the hospital after a positive COVID-19 diagnosis for all N3C patients. B shows the unadjusted odds ratios for all-cause mortality at any point after hospitalization for COVID-19 positive patients. C shows the adjusted odds ratios for being admitted to the hospital after a positive COVID-19 diagnosis for all N3C patients. D shows the adjusted odds ratios for all-cause mortality for all-cause mortality at any point after hospitalization for COVID-19 positive patients. Adjusted models include adjustments for gender, race, ethnicity, BMI, age, Charlson Comorbidity Index (CCI) composite score, rurality, and quarter of diagnosis. The data provider is included as a random effect in all models.
Conclusion
In N3C, we found that hospitalizations and all-cause mortality were greater among rural populations when compared to urban populations after adjustment for several factors, including age and co-morbidities. This study also identified key demographic and clinical disparities among rural patients that require further investigation.
Disclosures
Sally L. Hodder, M.D., Gilead (Advisor or Review Panel member)Merck (Grant/Research Support, Advisor or Review Panel member)Viiv Healthcare (Grant/Research Support, Advisor or Review Panel member)
Collapse
Affiliation(s)
| | - Ronald Horswell
- Pennington Biomedical Research Centre, Baton Rouge, Louisiana
| | - San Chu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | | | | | | | - Lucio Miele
- LSUHSC School of Medicine, New Orleans, New Orleans, Louisiana
| | | | - James McClay
- University of Nebraska Medical Center, Omaha, NE
| | - Sally L Hodder
- West Virginia University School of Medicine, Morgantown, West Virginia
| |
Collapse
|
11
|
Oates GR, Juarez LD, Horswell R, Chu S, Miele L, Fouad MN, Curry WA, Fort D, Hillegass WB, Danos DM. The Association Between Neighborhood Social Vulnerability and COVID-19 Testing, Positivity, and Incidence in Alabama and Louisiana. J Community Health 2021; 46:1115-1123. [PMID: 33966116 PMCID: PMC8106900 DOI: 10.1007/s10900-021-00998-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Accepted: 04/29/2021] [Indexed: 11/28/2022]
Abstract
Racial/ethnic and socioeconomic disparities in COVID-19 burden have been widely reported. Using data from the state health departments of Alabama and Louisiana aggregated to residential Census tracts, we assessed the relationship between social vulnerability and COVID-19 testing rates, test positivity, and incidence. Data were cumulative for the period of February 27, 2020 to October 7, 2020. We estimated the association of the 2018 Social Vulnerability Index (SVI) overall score and theme scores with COVID-19 tests, test positivity, and cases using multivariable negative binomial regressions. We adjusted for rurality with 2010 Rural-Urban Commuting Area codes. Regional effects were modeled as fixed effects of counties/parishes and state health department regions. The analytical sample included 1160 Alabama and 1105 Louisiana Census tracts. In both states, overall social vulnerability and vulnerability themes were significantly associated with increased COVID-19 case rates (RR 1.57, 95% CI 1.45-1.70 for Alabama; RR 1.36, 95% CI 1.26-1.46 for Louisiana). There was increased COVID-19 testing with higher overall vulnerability in Louisiana (RR 1.26, 95% CI 1.14-1.38), but not in Alabama (RR 0.95, 95% CI 0.89-1.02). Consequently, test positivity in Alabama was significantly associated with social vulnerability (RR 1.66, 95% CI 1.57-1.75), whereas no such relationship was observed in Louisiana (RR 1.05, 95% CI 0.98-1.12). Social vulnerability is a risk factor for COVID-19 infection, particularly among racial/ethnic minorities and those in disadvantaged housing conditions without transportation. Increased testing targeted to vulnerable communities may contribute to reduction in test positivity and overall COVID-19 disparities.
Collapse
Affiliation(s)
- Gabriela R Oates
- School of Medicine, University of Alabama At Birmingham, Birmingham, AL, USA.
| | - Lucia D Juarez
- School of Medicine, University of Alabama At Birmingham, Birmingham, AL, USA
| | | | - San Chu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Lucio Miele
- Health Sciences Center, Louisiana State University, New Orleans, LA, USA
| | - Mona N Fouad
- School of Medicine, University of Alabama At Birmingham, Birmingham, AL, USA
| | - William A Curry
- School of Medicine, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Daniel Fort
- Ochsner Center for Outcomes Research, Ochsner Health, New Orleans, LA, USA
| | | | - Denise M Danos
- Health Sciences Center, Louisiana State University, New Orleans, LA, USA
| |
Collapse
|
12
|
Mossman B, Perry LM, Walsh LE, Gerhart J, Malhotra S, Horswell R, Chu S, Raines AM, Lefante J, Blais CM, Miele L, Melancon B, Alonzi S, Voss H, Freestone L, Dunn A, Hoerger M. Anxiety, depression, and end-of-life care utilization in adults with metastatic cancer. Psychooncology 2021; 30:1876-1883. [PMID: 34157174 DOI: 10.1002/pon.5754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/15/2021] [Accepted: 06/07/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE End-of-life care for patients with cancer is often overly burdensome, and palliative and hospice care are underutilized. The objective of this study was to evaluate whether the mental health diagnoses of anxiety and depression were associated with variation in end-of-life care in metastatic cancer. METHODS This study used electronic health data from 1,333 adults with metastatic cancer who received care at two academic health centers in Louisiana, USA, and died between 1/1/2011-12/31/2017. The study used descriptive statistics to characterize the sample and logistic regression to examine whether anxiety and depression diagnoses in the six months before death were associated with utilization outcomes (chemotherapy, intensive care unit [ICU] visits, emergency department visits, mechanical ventilation, inpatient hospitalization, palliative care encounters, and hospice utilization), while controlling for key demographic and health covariates. RESULTS Patients (56.1% male; 65.6% White, 31.1% Black) commonly experienced depression (23.9%) and anxiety (27.2%) disorders within six months of death. Anxiety was associated with an increased likelihood of chemotherapy (odds ratio [OR] = 1.42, p = 0.016), ICU visits (OR = 1.40, p = 0.013), and inpatient hospitalizations (OR = 1.85, p < 0.001) in the 30 days before death. Anxiety (OR = 1.95, p < 0.001) and depression (OR = 1.34, p = 0.038) were associated with a greater likelihood of a palliative encounter. CONCLUSIONS Patients with metastatic cancer who had an anxiety disorder were more likely to have burdensome end-of-life care, including chemotherapy, ICU visits, and inpatient hospitalizations in the 30 days before death. Depression and anxiety both increased the odds of palliative encounters. These results emphasize the importance of mental health considerations in end-of-life care.
Collapse
Affiliation(s)
- Brenna Mossman
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA
| | - Laura M Perry
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA
| | - Leah E Walsh
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - James Gerhart
- Department of Psychology, Central Michigan University, Mount Pleasant, Michigan, USA.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Sonia Malhotra
- Department of Palliative Medicine & Supportive Care, University Medical Center, New Orleans, Louisiana, USA.,Section of General Internal Medicine & Geriatrics, Deming Department of Medicine, Tulane School of Medicine, New Orleans, Louisiana, USA
| | - Ronald Horswell
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - San Chu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Amanda M Raines
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana, USA.,South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA.,Department of Psychiatry, School of Medicine, Louisiana State University, New Orleans, Louisiana, USA
| | - John Lefante
- Department of Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Christopher M Blais
- Department of Infectious Disease, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
| | - Lucio Miele
- Department of Genetics and Louisiana Cancer Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Brian Melancon
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Sarah Alonzi
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA
| | - Hallie Voss
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA
| | - Lily Freestone
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA
| | - Addison Dunn
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA
| | - Michael Hoerger
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA.,Department of Palliative Medicine & Supportive Care, University Medical Center, New Orleans, Louisiana, USA.,Departments of Psychiatry and Medicine, Tulane Cancer Center, and Freeman School of Business, Tulane University, New Orleans, Louisiana, USA
| |
Collapse
|
13
|
Rolnik DL, Matheson A, Liu Y, Chu S, Mcgannon C, Mulcahy B, Malhotra A, Palmer KR, Hodges RJ, Mol BW. Impact of COVID-19 pandemic restrictions on pregnancy duration and outcome in Melbourne, Australia. Ultrasound Obstet Gynecol 2021; 58:677-687. [PMID: 34309931 DOI: 10.1002/uog.23743] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 05/03/2021] [Revised: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To investigate the effect of restriction measures implemented to mitigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during the coronavirus disease 2019 (COVID-19) pandemic on pregnancy duration and outcome. METHODS A before-and-after study was conducted with cohort sampling in three maternity hospitals in Melbourne, Australia, including women who were pregnant when restriction measures were in place during the COVID-19 pandemic (estimated conception date between 1 November 2019 and 29 February 2020) and women who were pregnant before the restrictions (estimated conception date between 1 November 2018 and 28 February 2019). The primary outcome was delivery before 34 weeks' gestation or stillbirth. The main secondary outcome was a composite of adverse perinatal outcomes. Pregnancy outcomes were compared between women exposed to restriction measures and unexposed controls using the χ-square test and modified Poisson regression models, and duration of pregnancy was compared between the groups using survival analysis. RESULTS In total, 3150 women who were exposed to restriction measures during pregnancy and 3175 unexposed controls were included. Preterm birth before 34 weeks or stillbirth occurred in 95 (3.0%) exposed pregnancies and in 130 (4.1%) controls (risk ratio (RR), 0.74 (95% CI, 0.57-0.96); P = 0.021). Preterm birth before 34 weeks occurred in 2.4% of women in the exposed group and in 3.4% of women in the control group (RR, 0.71 (95% CI, 0.53-0.95); P = 0.022), without evidence of an increase in the rate of stillbirth in the exposed group (0.7% vs 0.9%; RR, 0.83 (95% CI, 0.48-1.44); P = 0.515). Competing-risks regression analysis showed that the effect of the restriction measures on spontaneous preterm birth was stronger and started earlier (subdistribution hazard ratio (HR), 0.81 (95% CI, 0.64-1.03); P = 0.087) than the effect on medically indicated preterm birth (subdistribution HR, 0.89 (95% CI, 0.70-1.12); P = 0.305). The effect was stronger in women with a previous preterm birth (RR, 0.42 (95% CI, 0.21-0.82); P = 0.008) than in parous women without a previous preterm birth (RR, 0.93 (95% CI, 0.63-1.38); P = 0.714) (P for interaction = 0.044). Composite adverse perinatal outcome was less frequent in the exposed group than in controls (all women: 2.1% vs 2.9%; RR, 0.73 (95% CI, 0.54-0.99); P = 0.042); women with a previous preterm birth: 4.5% vs 8.4%; RR, 0.54 (95% CI, 0.25-1.18); P = 0.116). CONCLUSIONS Restriction measures implemented to mitigate SARS-CoV-2 transmission during the COVID-19 pandemic were associated with a reduced rate of preterm birth before 34 weeks. This reduction was mainly due to a lower rate of spontaneous prematurity. The effect was more substantial in women with a previous preterm birth and was not associated with an increased stillbirth rate. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- D L Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Department of Obstetrics and Gynaecology, Women's and Newborn Program, Monash Health, Melbourne, Australia
| | - A Matheson
- Department of Obstetrics and Gynaecology, Women's and Newborn Program, Monash Health, Melbourne, Australia
| | - Y Liu
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Department of Obstetrics and Gynaecology, Women's and Newborn Program, Monash Health, Melbourne, Australia
| | - S Chu
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Department of Obstetrics and Gynaecology, Women's and Newborn Program, Monash Health, Melbourne, Australia
| | - C Mcgannon
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Department of Obstetrics and Gynaecology, Women's and Newborn Program, Monash Health, Melbourne, Australia
| | - B Mulcahy
- Monash Newborn, Monash Children's Hospital, Melbourne, Australia
| | - A Malhotra
- Monash Newborn, Monash Children's Hospital, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
| | - K R Palmer
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Department of Obstetrics and Gynaecology, Women's and Newborn Program, Monash Health, Melbourne, Australia
| | - R J Hodges
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Department of Obstetrics and Gynaecology, Women's and Newborn Program, Monash Health, Melbourne, Australia
| | - B W Mol
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Department of Obstetrics and Gynaecology, Women's and Newborn Program, Monash Health, Melbourne, Australia
- Aberdeen Centre for Women's Health Research, School of Medicine, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
14
|
Chu S, Aamar A, Hale S, Roxas A, Redfearn D. Letter in response to "Polypharmacy is a determinant of hospitalization in Parkinson's disease". Eur Rev Med Pharmacol Sci 2021; 25:5887-5888. [PMID: 34661246 DOI: 10.26355/eurrev_202110_26864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S Chu
- Guy's, King's, and St. Thomas' School of Medical Education, King's College London, UK.
| | | | | | | | | |
Collapse
|
15
|
Ramanathan D, Chu S, Prendes M, Carroll B. 654 Validated outcome measures and post-surgical scar assessment instruments in eyelid surgery: A systematic review. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.684] [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]
|
16
|
Perry LM, Walsh LE, Horswell R, Miele L, Chu S, Melancon B, Lefante J, Blais CM, Rogers JL, Hoerger M. Racial Disparities in End-of-Life Care Between Black and White Adults With Metastatic Cancer. J Pain Symptom Manage 2021; 61:342-349.e1. [PMID: 32947018 PMCID: PMC8100959 DOI: 10.1016/j.jpainsymman.2020.09.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/27/2020] [Accepted: 09/09/2020] [Indexed: 12/29/2022]
Abstract
CONTEXT The comfort of patients with cancer near the end of life (EOL) is often undermined by unnecessary and burdensome treatments. There is a need for more research examining racial disparities in EOL care, especially in regions with a history of racial discrimination. OBJECTIVES To examine whether black adults received more burdensome EOL care than white adults in a population-based data set of cancer decedents in Louisiana, a state with a history of slavery and long-standing racial disparities. METHODS This was a retrospective analysis of EOL care from the Research Action for Health Network (REACHnet), a regional Patient-Centered Outcomes Research Institute-funded database. The sample consisted of 875 white and 415 black patients with metastatic cancer who died in Louisiana from 2011 to 2017. We used logistic regression to examine whether race was associated with five indicators of burdensome care in the last 30 days of life: chemotherapy use, inpatient hospitalization, intensive care unit admission, emergency department (ED) admission, and mechanical ventilation. RESULTS Most patients (85.0%) received at least one indicator of burdensome care: hospitalization (76.5%), intensive care unit admission (44.1%), chemotherapy (29.1%), mechanical ventilation (23.0%), and ED admission (18.3%). Odds ratios (ORs) indicated that black individuals were more likely than white individuals to be hospitalized (OR = 1.66; 95% CI = 1.21-2.28; P = 0.002) or admitted to the ED (OR = 1.57; 95% CI = 1.16-2.13; P = 0.004) during their last month of life. CONCLUSION Findings have implications for informing health care decision making near the EOL for patients, families, and clinicians, especially in regions with a history of racial discrimination and disparities.
Collapse
Affiliation(s)
| | | | - Ronald Horswell
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Lucio Miele
- LSU Health Sciences Center, New Orleans, Louisiana, USA
| | - San Chu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Brian Melancon
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | | | | | | |
Collapse
|
17
|
Fan Y, Shen Y, Zhou J, Shi L, Nauman E, Katzmarzyk PT, Price-Haywood EG, Horswell R, Chu S, Bazzano AN, Hu G. Visit-to-Visit Hemoglobin A 1c Variability Is Associated With the Risk of Lower-Extremity Amputation in Patients With Type 2 Diabetes. Diabetes Care 2020; 43:e178-e180. [PMID: 32887709 PMCID: PMC7576434 DOI: 10.2337/dc20-1615] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/29/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Yuxin Fan
- Pennington Biomedical Research Center, Baton Rouge, LA.,Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Yun Shen
- Pennington Biomedical Research Center, Baton Rouge, LA.,Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jian Zhou
- Pennington Biomedical Research Center, Baton Rouge, LA.,Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lizheng Shi
- Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | | | | | - Eboni G Price-Haywood
- Ochsner Health System Center for Outcomes and Health Services Research, New Orleans, LA.,Ochsner Clinical School, University of Queensland, New Orleans, LA
| | | | - San Chu
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Alessandra N Bazzano
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA
| |
Collapse
|
18
|
Ho S, Hon S, Hung E, Mo F, So C, Tong M, Lee J, Chu S, Ng D, Lam D, Cho C, Mak T, Ng S, Suen J, Chan A, Yeung W, Ma B. 91P Prognostic biomarker of clinical outcome in locally advanced rectal cancer in Chinese patients. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
19
|
Dumas SA, Chu S, Horswell R. Analysis of Pregnancy and Birth Rates Among Black and White Medicaid-Enrolled Teens. J Adolesc Health 2020; 67:409-415. [PMID: 32576486 PMCID: PMC7483952 DOI: 10.1016/j.jadohealth.2020.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/03/2020] [Accepted: 04/22/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE In the United States, black teens overall have higher pregnancy and birth rates than whites, and it is commonly believed that minority race and low income account for this disparity. We examined racial differences in pregnancy and birth rates among teens from low-income households using Medicaid-enrollment as a proxy for low income. METHODS This was a retrospective study of Louisiana Medicaid claims data for female teens aged 15-17 years in 2014 (n = 66,069). Pregnancy and pregnancy outcome codes were identified (n = 2,276) and analyzed for differences by black and white race. We conducted validity analyses with different rate definitions and teens' claims status. RESULTS The cohort was 36% white and 54% black. More black teens than whites lacked any claims data (15.6% vs. 12.6%; p < .001). Rates calculated as events per 1,000 person-years of Medicaid coverage showed no difference in live birth rates between white and black teens (24.6 vs. 25.8; relative incidence ratio, 1.05; 95% confidence interval, .93-1.18; p = .43); however, pregnancy rates for whites were higher than those for blacks (42.7 vs. 36.1; relative incidence ratio, .85; 95% confidence interval, .77-.93; p < .001). CONCLUSION In contrast to national trends, which include teens from diverse racial and socioeconomic backgrounds, Louisiana Medicaid-enrolled teens aged 15-17 years had equal birth rates regardless of black or white race, and whites had higher pregnancy rates. Decreased racial disparities in pregnancy and birth rates among these adolescents highlights socioeconomic influences in sexual health behavior and a need to examine the interplay of risk factors contributing to racial disparities seen among adolescents nationally.
Collapse
Affiliation(s)
- S. Amanda Dumas
- Louisiana State University Health Sciences Center, Department of Pediatrics, 200 Henry Clay Avenue, State Street Campus, New Orleans, Louisiana 70118 USA
| | - San Chu
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808 USA
| | - Ronald Horswell
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808 USA
| |
Collapse
|
20
|
Conic RRZ, Chu S, Tamashunas NL, Damiani G, Bergfeld W. Prevalence of cardiac and metabolic diseases among patients with alopecia areata. J Eur Acad Dermatol Venereol 2020; 35:e128-e129. [PMID: 32780884 DOI: 10.1111/jdv.16864] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/24/2020] [Accepted: 08/05/2020] [Indexed: 12/15/2022]
Affiliation(s)
- R R Z Conic
- Department of Surgery, University of Maryland, Baltimore, MD, USA.,Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - S Chu
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA.,Department of Dermatology, Cleveland Clinic, Cleveland, OH, USA
| | - N L Tamashunas
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - G Damiani
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA.,Centro Studi GISED, Young Dermatologists Italian Network, Bergamo, Italy.,Clinical Dermatology, IRCCS Instituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - W Bergfeld
- Department of Dermatology, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
21
|
Salem I, Schrom K, Chu S, Retuerto M, Richardson B, Margvicius S, Cameron M, Ghannoum M, McCormick T, Cooper K. 362 Psoriatic fungal and bacterial microbiomes identify patient endotypes. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.369] [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: 11/30/2022]
|
22
|
Shen Y, Zhou J, Shi L, Nauman E, Katzmarzyk PT, Price-Haywood EG, Horswell R, Chu S, Yang S, Bazzano AN, Nigam S, Hu G. Effectiveness of sodium-glucose co-transporter-2 inhibitors on ischaemic heart disease. Diabetes Obes Metab 2020; 22:1197-1206. [PMID: 32166884 PMCID: PMC7547648 DOI: 10.1111/dom.14025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 12/15/2022]
Abstract
AIM To compare the cardiovascular risks between users and non-users of sodium-glucose co-transporter-2 (SGLT2) inhibitors based on electronic medical record data from a large integrated healthcare system in South Louisiana. MATERIALS AND METHODS Demographic, anthropometric, laboratory and medication prescription information for patients with type 2 diabetes who were new users of SGLT2 inhibitors, either as initial treatments or as add-on treatments, were obtained from electronic health records. Mediation analysis was performed to evaluate the association of use of SGLT2 inhibitors and changes of metabolic risk factors with the risk of incident ischaemic heart disease. RESULTS A total of 5338 new users of SGLT2 inhibitors were matched with 13 821 non-users. During a mean follow-up of 3.26 years, 2302 incident cases of ischaemic heart disease were defined. After adjusting for multiple confounding factors, patients using SGLT2 inhibitors had a lower risk of incident ischaemic heart disease compared to patients not using SGLT2 inhibitors (hazard ratio [HR] 0.63, 95% confidence interval [CI] 0.54-0.73). Patients using SGLT2 inhibitors also had a lower risk of incident ischaemic heart disease within 6 months (HR 0.36, 95% CI 0.25-0.44), 12 months (HR 0.40, 95% CI 0.32-0.49), 24 months (HR 0.53, 95% CI 0.43-0.60) and 36 months (HR 0.65, 95% CI 0.54-0.73), respectively. Reductions in systolic blood pressure partly mediated lowering risk of ischaemic heart disease among patients using SGLT2 inhibitors. CONCLUSIONS The real-world data in the present study show the contribution of SGLT2 inhibitors to reducing risk of ischaemic heart disease, and their benefits beyond glucose-lowering.
Collapse
Affiliation(s)
- Yun Shen
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Jian Zhou
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Lizheng Shi
- Department of Global Health Management and Policy, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | | | - Eboni G. Price-Haywood
- Ochsner Health System Center for Outcomes and Health Services Research, New Orleans, LA, USA
| | | | - San Chu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Shengping Yang
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Alessandra N. Bazzano
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Somesh Nigam
- Blue Cross and Blue Shield of Louisiana, Baton Rouge, LA, USA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| |
Collapse
|
23
|
Chu S, Damiani G, Richardson B, Gao X, Cameron M, McCormick T, Cooper K. 010 Correlation of psoriasis severity with burden of disease cost in psoriatic patients. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
24
|
Perry LM, Walsh LE, Horswell R, Miele L, Chu S, Melancon B, Lefante J, Blais CM, Hoerger M. Racial disparities in end-of-life care among Louisiana cancer decedents in a population-based study from 2011-2017. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.31_suppl.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
46 Background: Cancer patients’ comfort near the end of life is often undermined by unnecessary aggressive treatments. Furthermore, Black adults receive more aggressive end of life care compared to White adults. We hypothesized that these inequalities would be especially pronounced in Louisiana given regional trends of high cancer mortality coupled with inaccessibility to high quality cancer care. Methods: This was a retrospective analysis of end-of-life care using a Patient-Centered Outcomes Research Institute (PCORI)-funded PCORnet database in the Deep South, called Research Action for Health Network (REACHnet). Of 3,089,092 individuals included, 1,290 met eligibility criteria for the present study: 1) died in Louisiana with a metastatic cancer diagnosis between January 1, 2011 and December 31, 2017, 2) had at least one outpatient clinic visit within six months of death, and 3) self-identified as White or Black. In collaboration with the Louisiana Clinical and Translational Science (LA CaTS) Center, we extracted data on five validated indicators of aggressive care in the final 30 days of life: chemotherapy use, inpatient hospitalizations, ED admissions, ICU admissions, and mechanical ventilation. Hypotheses were analyzed using binary logistic regression to examine whether patient race (White vs. Black) was associated with receipt of each indicator of aggressive end-of-life care, while controlling for sex, age, number of comorbidities, and cancer type. Results: Patients were either White ( n = 875, 67.8%) or Black ( n = 415, 32.2%) adults, and the majority were ≥60 years old (72.4%). Most patients (85.0%) received at least one indicator of aggressive care in the last 30 days of life ( M = 1.91, SD = 1.23), most commonly inpatient hospitalizations (77.0%). Black individuals were more likely than White individuals to be hospitalized ( OR = 1.66, 95% CI: 1.21 to 2.27, p= .002) or admitted to the ED ( OR= 1.57, 95% CI: 1.16 to 2.13, p= .004) during their last month of life, but race was not associated with other indicators. Conclusions: Findings have implications for informing healthcare decision making near the end of life for patients, families, and clinicians in the Deep South.
Collapse
Affiliation(s)
| | | | | | | | - San Chu
- Pennington Biomedical Research Center, Baton Rouge, LA
| | | | | | | | | |
Collapse
|
25
|
Lam G, Tong M, Lee J, Chu S, Ng D, Lam D, Cho C, Hung E, Li L, Ho W, Hui E, Chan A, Hon S, Mak T, Ng S, Suen J, Mo F, Ma B. A multicenter phase II study of neoadjuvant FOLFOXIRI followed by concurrent capecitabine and radiotherapy for high risk rectal cancer: A final report. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz421.001] [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
|
26
|
Simon JN, Vrellaku B, Monterisi S, Chu S, Rawlings N, Lomas O, Marchal GA, Waithe D, Gajendragadkar P, Jayaram R, Channon K, Swietach P, Zaccolo M, Eaton P, Casadei B. 2161Redox-mediated PKA-RIalpha localisation to the lysosome inhibits myocardial calcium release and robustly reduces myocardial injury. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Kinase oxidation is a critical signalling mechanism through which changes in the intracellular redox state alter cardiac function. In the myocardium, type-1 protein kinase A (PKARIα) can be reversibly oxidised, forming interprotein disulphide bonds within the holoenzyme complex. However, the effect of PKARIα oxidation on downstream signalling in the heart, particularly under states of oxidative stress, remains unexplored.
Purpose
To determine the direct functional consequences of PKARIα oxidation in the heart and investigate their impact on ischaemia/reperfusion (I/R) injury.
Methods and results
Experiments using the AKAR3ev FRET biosensor in murine left ventricular (LV) myocytes and Fluorescence Recovery After Photobleaching (FRAP) of GFP-tagged wild-type (WT) and mutant RIα proteins expressed in RIα-null fibroblasts showed that PKARIα oxidation does not increase the kinases' catalytic activity, but enhances its binding to A-kinase anchoring proteins (AKAP; n=30–39/N=3, p<0.01). Super-resolution microscopy revealed localisation of oxidised PKARIα to lysosomes in WT myocytes, which was completely absent in “redox dead” Cys17Ser PKARIα knock-in mice (KI; panel A; n=38–41/N=3, p<0.01) and reduced when AKAP binding was prevented using the RIAD disruptor peptide (30.6±5.1% reduction; n=35–37/N=3, p<0.01).
Displacement of PKARIα from lysosomes resulted in spontaneous sarcoplasmic reticulum calcium release and dramatic calcium oscillations in KI LV myocytes (panel B), which were preventable by ryanodine receptor blockade (1 mM tetracaine; n=14, p<0.01), acute depletion of endolysosomal calcium stores (100 nM bafilomycin; n=7; p<0.01), or lysosomal two-pore channel inhibition (5 μM Ned-19; n=9; p<0.05).
I/R (secondary to cardiopulmonary bypass) was found to induce PKARIα oxidation in the myocardium of patients undergoing cardiac surgery (panel C; n=18, p<0.05). Absence of this response in KI mouse hearts resulted in 2-fold larger infarcts (p<0.01) and a concomitant reduction in LV contractile recovery (final LVDP of 55.9±8.6 vs 82.5±7.1 mmHg in WT; n=7–8, p<0.05), both which were prevented by addition of Ned-19 at the time of reperfusion (panel D; n=4, p<0.01).
Conclusions
Oxidised PKARIα acts as a potent inhibitor of intracellular calcium release in the heart through its redox-dependent interaction with the lysosome. In the setting of I/R, where PKARIα oxidation is induced, this regulatory mechanism is critical for protecting the heart from injury and offers a novel target for the design of cardioprotective therapeutics.
Acknowledgement/Funding
British Heart Foundation CH/12/3/29609, RG/16/12/32451; Garfield-Weston Foundation MPS/IVIMS-11/12-4032; Wellcome Trust Fellowship 0998981Z/12/Z
Collapse
Affiliation(s)
- J N Simon
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| | - B Vrellaku
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| | - S Monterisi
- University of Oxford, Department of Physiology, Anatomy and Genetics, Oxford, United Kingdom
| | - S Chu
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| | - N Rawlings
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| | - O Lomas
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| | - G A Marchal
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| | - D Waithe
- University of Oxford, Wolfson Imaging Centre, Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - P Gajendragadkar
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| | - R Jayaram
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| | - K Channon
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| | - P Swietach
- University of Oxford, Department of Physiology, Anatomy and Genetics, Oxford, United Kingdom
| | - M Zaccolo
- University of Oxford, Department of Physiology, Anatomy and Genetics, Oxford, United Kingdom
| | - P Eaton
- King's College London, Cardiovascular Division, The Rayne Institute, London, United Kingdom
| | - B Casadei
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Oxford, United Kingdom
| |
Collapse
|
27
|
Pathmarajah T, Chu S, Sieunarine K. A rare case of Listeria monocytogenes causing mycotic aneurysm of the common femoral artery: A case report. Int J Surg Case Rep 2019; 61:238-241. [PMID: 31382235 PMCID: PMC6698314 DOI: 10.1016/j.ijscr.2019.07.063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 03/05/2019] [Revised: 06/30/2019] [Accepted: 07/22/2019] [Indexed: 11/19/2022] Open
Abstract
Immunosuppressed patients may not display typical clinical or biochemical features associated with mycotic aneurysms. Clinicians should have a high index of suspicion for infective aetiology when treating aneurysmal disease in immunocompromised patients. It is important to obtain intraoperative tissue samples for histopathology and microbiological assessment in immunocompromised patients for detection of rare pathogens. Autogenous vein should be used in infected surgical fields to avoid the risk of prosthetic graft infection.
Introduction Mycotic aneurysms are an uncommon occurrence, withStaphylococcus and Salmonella species found to be the causative pathogen in up to 95% of cases. We believe this is the first described case of a common femoral artery mycotic aneurysm due to Listeria monocytogenes. Presentation of case A 66-year-old male presented with a two-month history of an increasing painful mass in his left groin, on the background of immunosuppression treatment for ankylosing spondylitis. He was afebrile on assessment, with a normal white cell count. Contrast enhanced CT scan showed a common femoral artery aneurysm, with no infective features. His aneurysm was excised and repaired with a Dacron tube graft. L. monocytogenes was cultured from the aneurysm tissue, and he was commenced on appropriate antibiotic treatment. The prosthetic graft was also replaced with a venous bypass of the aneurysm. Discussion L. monocytogenes is a rare cause of mycotic aneurysm with less than 40 cases reported in the literature. Immunosuppression is a recognised risk factor for Listerial infections. Immunocompromised patients may not display typical clinical or biochemical features associated with a mycotic aneurysm. Prosthetic graft infections are associated with significant mortality, with excision of the prosthetic material and venous reconstruction associated with good outcomes for eradicating infection. Conclusion This report highlights the importance of obtaining intraoperative tissue samples for microbiological and histopathological assessment in immunocompromised patients. This is important for the detection of rare organisms such as L.monocytogenes, requiring targeted antibiotic therapy. Inappropriate treatment of Listerial infections can result in serious invasive illness.
Collapse
Affiliation(s)
- T Pathmarajah
- Department of Vascular and Endovascular Surgery, Royal Perth Hospital, Perth, Australia.
| | - S Chu
- Department of Plastic and Reconstructive Surgery, Fiona Stanley Hospital, Perth, Australia
| | - K Sieunarine
- Department of Vascular and Endovascular Surgery, Royal Perth Hospital, Perth, Australia
| |
Collapse
|
28
|
Khandelwal AR, Poorman K, Moore-Medlin T, Ma X, Gundale A, Horswell R, Chu S, Winerip M, Nathan CAO. Abstract 4023: Co-occurring mutations in recurrent/persistent head and neck squamous cell carcinoma (HNSCC) patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-4023] [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
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer and lacks effective targeted therapies. HPV(-) patients have a 50-60% recurrence rate and could benefit from adjuvant therapy. Although HPV(+) patients have a significantly better survival, 20% have persistent/recurrent disease. Therefore, biomarkers could potentially help identify patients that would benefit from adjuvant targeted agents. Our objective was to evaluate if the mutational and biomarker analysis of tumor samples from OPSCC patients predict recurrence and/ or persistence in patients undergoing definitive therapy with curative intent. 44 advanced stage OPSCC patients that underwent comprehensive genomic profiling by Caris Life Sciences were included in this retrospective study. Next Generation Sequencing (NGS) on genomic DNA from FFPE tumors was performed using the Illumina Nextseq (592-gene, n=17)/MiSeq (44-gene, n=23) platform. Tumors were analyzed for total mutational load (TML), CNV’s and microsatellite instability status. IHC for tumor protein expression of ERCC1, PD-L1, RRM1, TrkA/B/C, TS and TUBB3 was performed using automated platforms. The ASCO/CAP scoring criteria and the cutoff points from published evidence was used in IHC evaluation. Of the 44 patients, 27 were HPV(+) tumors and 11 had HPV(-) disease. Patients with lack of progression free survival data were excluded. Only 4 patients in the entire cohort harbored a pathogenic PIK3CA mutation. Among HPV(+) patients, 22 patients were TP53 WT and 2 patients were found to be TP53 mutant. Although there was no significant change in the TML in smokers compared to nonsmokers (mean 8.77 vs 6.5, respectively; p=0.253), TML was higher in HPV(-) smokers compared to HPV(+) nonsmokers (mean 10.33 vs 6.5, p=0.0661). Our study presented a higher incidence of recurrent/persistent disease in the Caucasians (60%) in comparison to African-Americans (21%). Considering the sample size in the current study, the racial difference in outcomes appears likely to be present regardless of HPV status or disease state. The co-occurrence of multiple deleterious mutations was observed in 70% of the non-responders. Particularly, mutations in CHEK2, PTCH, MUTYH were noted in 50% of the recurrent/persistent patients. CNV mutations in SMAD2, MALT1, NFKBIA in 50% of the recurrent/persistent patients were found. The co-occurrence of multiple mutations were absent in responders in spite of an appreciable sample size in the responder group (n=12). This study also affirmed an improved prognosis in patients with HPV(+), with higher expression of TUBB3, and with positive expression of PD-1 in the tumors. Co-occurrence of multiple deleterious mutations were associated with patients who did not respond to therapy. Therefore, combination rescue therapies that can target multiple pathways to abrogate the mutational effects can aid/enhance therapeutic benefits in HNSCC patients.
Citation Format: Alok R. Khandelwal, Kelsey Poorman, Tara Moore-Medlin, Xiaohui Ma, Abhijit Gundale, Ronald Horswell, San Chu, Michelle Winerip, Cherie-Ann O. Nathan. Co-occurring mutations in recurrent/persistent head and neck squamous cell carcinoma (HNSCC) patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4023.
Collapse
Affiliation(s)
| | | | | | | | | | | | - San Chu
- 3Pennington Biomedical Research Center, Baton Rogue, LA
| | | | | |
Collapse
|
29
|
Ireland JL, Sebalo I, McNeill K, Murphy K, Brewer G, Ireland CA, Chu S, Lewis M, Greenwood L, Nally T. Impacting on factors promoting intra-group aggression in secure psychiatric settings. Heliyon 2019; 5:e01400. [PMID: 30976684 PMCID: PMC6439227 DOI: 10.1016/j.heliyon.2019.e01400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/07/2019] [Accepted: 03/18/2019] [Indexed: 11/26/2022] Open
Abstract
Three preliminary and linked studies investigate the impact of making alterations to factors considered relevant to engaging in and experiencing intra-group aggression (bullying) among adult male patients detained in a single secure forensic hospital. Study one (n = 44) outlines the institutional factors, attitudes towards bullying and environmental factors that increase the likelihood of engaging in bullying and/or being victimised. Study two (n = 53 patients and 167 staff) assesses the effect of three variations of intervention that aimed to reduce intra-group aggression through direct alteration of the physical and psychosocial environment, using data from both patients and staff. Study three (n = 414) looks at the effects of two variations of the intervention used in study two, which offered patients’ participation in individual and communal activities. It was predicted that changes to the physical and social environment would produce a reduction in the factors shown to predict intra-group aggression. Attitudes supportive of bullying and the presence of social hierarchies each increased the likelihood of engaging in bullying. Indirect changes to the social environment on the wards had more positive effects than those incorporating direct alterations to the physical and social environment. The differences in effectiveness of the two approaches are discussed in relation to the established predictors of intra-group aggression. The research concludes by noting the preliminary nature of the research and outlining potential directions for future research and intervention.
Collapse
Affiliation(s)
- J L Ireland
- University of Central Lancashire, Preston, UK.,Ashworth Research Centre, Mersey Care NHS Trust, UK
| | - I Sebalo
- University of Central Lancashire, Preston, UK.,Ashworth Research Centre, Mersey Care NHS Trust, UK
| | - K McNeill
- University of Central Lancashire, Preston, UK.,Ashworth Research Centre, Mersey Care NHS Trust, UK
| | - K Murphy
- Ashworth Research Centre, Mersey Care NHS Trust, UK
| | - G Brewer
- University of Central Lancashire, Preston, UK.,University of Liverpool, UK
| | - C A Ireland
- University of Central Lancashire, Preston, UK.,Ashworth Research Centre, Mersey Care NHS Trust, UK
| | - S Chu
- University of Central Lancashire, Preston, UK.,Ashworth Research Centre, Mersey Care NHS Trust, UK
| | - M Lewis
- University of Central Lancashire, Preston, UK.,Ashworth Research Centre, Mersey Care NHS Trust, UK
| | - L Greenwood
- University of Central Lancashire, Preston, UK.,Ashworth Research Centre, Mersey Care NHS Trust, UK
| | - T Nally
- University of Central Lancashire, Preston, UK.,Ashworth Research Centre, Mersey Care NHS Trust, UK
| |
Collapse
|
30
|
Yang Y, Chu S, Shang S, Yang Z, Wang C. Short communication: Genotyping and single nucleotide polymorphism analysis of bovine leukemia virus in Chinese dairy cattle. J Dairy Sci 2019; 102:3469-3473. [PMID: 30712932 DOI: 10.3168/jds.2018-15481] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/05/2018] [Indexed: 11/19/2022]
Abstract
Bovine leukemia virus (BLV) causes enzootic leucosis in cattle and is classified into 10 genotypes with a worldwide distribution, except for several European countries, Australia, and New Zealand. Although BLV is widespread in Chinese cows with the positive rate of 49.1% at the individual level, very little is known about the BLV genotype in dairy cattle in China. To determine BLV genetic variability in cows in China, 112 BLV-positive samples from 5 cities in China were used for BLV molecular characterization in this study. Phylogenetic analysis using the neighbor-joining method on partial env sequence encoding gp51 obtained from 5 Chinese cities and those available in GenBank (n = 53, representing BLV genotype 1-10) revealed the Chinese strains belonged to genotype 6. Seven unique SNP were identified among Yancheng, Shanghai, and Bengbu strains out of the total 12 SNP identified in Chinese strains. The genotyping coupled with SNP analysis of BLV can serve as a useful molecular epidemiological tool for tracing the source of pathogens. This study highlights the importance of genetic analysis of geographically diverse BLV strains to understand BLV global genetic diversity.
Collapse
Affiliation(s)
- Y Yang
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, Jiangsu, China; International Corporation Laboratory of Agriculture and Agricultural Products Safety, Yangzhou University, Yangzhou 225009, Jiangsu, China.
| | - S Chu
- College of Animal Science and Technology, Yangzhou University, Yangzhou 225009, Jiangsu, China
| | - S Shang
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, Jiangsu, China; International Corporation Laboratory of Agriculture and Agricultural Products Safety, Yangzhou University, Yangzhou 225009, Jiangsu, China
| | - Z Yang
- International Corporation Laboratory of Agriculture and Agricultural Products Safety, Yangzhou University, Yangzhou 225009, Jiangsu, China; College of Animal Science and Technology, Yangzhou University, Yangzhou 225009, Jiangsu, China
| | - C Wang
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849
| |
Collapse
|
31
|
Chu S, Zhang Y, Jiang Y, Sun W, Zhu Q, Liu S, Chen C, Zhang Z, Huang B, Jiang F, Zhang J. Cesarean section and risks of overweight and obesity in school-aged children: a population-based study. QJM 2018; 111:859-865. [PMID: 30184122 DOI: 10.1093/qjmed/hcy195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Obesity puts a great health burden in the world. Previous studies suggest that caesarean section (CS) may increase the risk of obesity in children, but it is still uncertain whether this association is causal or due to residual confounding by medical indication. AIM To assess the association between CS, CS without medical indications in particular and the risk of overweight and obesity in school-aged children. DESIGN Cross-sectional survey. METHODS The 2014 Shanghai Child Health, Education and Lifestyle Evaluation was a large population-based survey with cluster random probability sampling in 26 primary schools in Shanghai, China, in 2014. The mode of delivery was reported by parents. The height, weight and waist circumference of the children were measured. Logistic regression models with SURVEYLOGISTIC procedure were used to estimate the risk of childhood obesity. Pupils delivered vaginally were served as the reference group. RESULTS A total of 17 571 pupils completed this survey, and 13 724 of them who were singleton, born term and between 5 and 13 years old were included in our analysis. CS was associated with increased risks of overweight and obesity (BMI: adjusted OR = 1.28 [95%CI 1.13-1.45] and 1.44 [1.26-1.66], respectively; weight for height ratio [WHtR] >0.46: 1.33 [1.20-1.48]). Similar results were found in CS without medical indication (BMI: overweight = 1.24 [1.05-1.47], obesity = 1.43 [1.19-1.72]; WHtR > 0.46: 1.30 [1.13-1.50]). CONCLUSIONS CS overall and CS without medical indications were associated with increased risks of overweight and obesity in primary school children.
Collapse
Affiliation(s)
- S Chu
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Laboratory of Respiratory Disease, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Y Zhang
- Child Health Advocacy Institute, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Y Jiang
- Department of Developmental and Behavioral Pediatrics, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - W Sun
- Department of Developmental and Behavioral Pediatrics, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Q Zhu
- Department of Developmental and Behavioral Pediatrics, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - S Liu
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - C Chen
- Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Z Zhang
- School of Public Health, Guilin Medical University, Guilin, China
| | - B Huang
- School of Public Health, Guilin Medical University, Guilin, China
| | - F Jiang
- Department of Developmental and Behavioral Pediatrics, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - J Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- School of Public Health, Guilin Medical University, Guilin, China
| |
Collapse
|
32
|
Chu S, Li C. 145 Utilizing qSOFA Score as a Prognosis Predictor of Patients With Influenza Infection in the Emergency Department. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.150] [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]
|
33
|
Valand HA, Chu S, Bhala R, Foley R, Hirsch JA, Tu RK. Comparison of Advanced Imaging Resources, Radiology Workforce, and Payment Methodologies between the United States and Canada. AJNR Am J Neuroradiol 2018; 39:1785-1790. [PMID: 30166430 DOI: 10.3174/ajnr.a5755] [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] [Received: 05/16/2018] [Accepted: 06/14/2018] [Indexed: 11/07/2022]
Abstract
The purpose of this Practice Perspectives was to review the United States and Canadian approaches to health care access and payment for advanced imaging. The historical background, governmental role, workforce, coding, payment, radiologic challenges, cost, resource intensity, and overall outcomes in longevity are reviewed.
Collapse
Affiliation(s)
- H A Valand
- From the American University of Integrative Sciences (H.A.V.), Brampton, Ontario, Canada
| | - S Chu
- Vancouver Coastal Health Authority (S.C.), Washington State Radiological Society, Vancouver, British Columbia, Canada
| | - R Bhala
- American Society of Neuroradiology (R.B.), Oak Brook, Illinois
| | - R Foley
- Ontario Association of Radiologists (R.F.), Oakville, Ontario, Canada
| | - J A Hirsch
- Massachusetts General Hospital (J.A.H.), Harvard Medical School, Boston, Massachusetts
| | - R K Tu
- Progressive Radiology (R.K.T.), George Washington University, United Medical Center, Falls Church, Virginia.
| |
Collapse
|
34
|
Chu S, Xia YL, Zhou J, Jiang J, Sheng QH, Ding YS. 194Baseline echocardiography-indicated impaired atrial function predicts reoccurrence and thromboembolic risks after catheter ablation of atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Chu
- Peking University First Hospital, Department of Cardiology, Beijing, China People's Republic of
| | - Y L Xia
- Peking University First Hospital, Department of Cardiology, Beijing, China People's Republic of
| | - J Zhou
- Peking University First Hospital, Department of Cardiology, Beijing, China People's Republic of
| | - J Jiang
- Peking University First Hospital, Department of Cardiology, Beijing, China People's Republic of
| | - Q H Sheng
- Peking University First Hospital, Department of Cardiology, Beijing, China People's Republic of
| | - Y S Ding
- Peking University First Hospital, Department of Cardiology, Beijing, China People's Republic of
| |
Collapse
|
35
|
Solon AP, Bunin G, Chu S, Kardar M. Optimal paths on the road network as directed polymers. Phys Rev E 2018; 96:050301. [PMID: 29347789 DOI: 10.1103/physreve.96.050301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Indexed: 11/07/2022]
Abstract
We analyze the statistics of the shortest and fastest paths on the road network between randomly sampled end points. We find that, to a good approximation, the optimal paths can be described as directed polymers in a disordered medium, which belong to the Kardar-Parisi-Zhang universality class of interface roughening. Comparing the scaling behavior of our data with simulations of directed polymers and previous theoretical results, we are able to point out the few characteristics of the road network that are relevant to the large-scale statistics of optimal paths. Indeed, we show that the local structure is akin to a disordered environment with a power-law distribution which become less important at large scales where long-ranged correlations in the network control the scaling behavior of the optimal paths.
Collapse
Affiliation(s)
- A P Solon
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - G Bunin
- Department of Physics, Technion, Haifa 32000, Israel
| | - S Chu
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - M Kardar
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| |
Collapse
|
36
|
Koh Y, Chu S, Shaw J, Walker R. Close Versus Distant Administration of Erythropoietin and Acute Coronary Syndrome Outcomes in Chronic Kidney Patients on Dialysis. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.592] [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]
|
37
|
Geller M, Bendzick L, Ryan C, Chu S, Lenvik A, Skubitz A, Boylan K, Isaksson Vogel R, Miller J, Felices M. Combination therapy with IL-15 superagonist (ALT-803) and PD-1 blockade enhances human NK cell immunotherapy against ovarian cancer. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.060] [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: 11/25/2022]
|
38
|
Lee S, Lee J, Lee J, Chu S, Cha S, Park H. Cell protectant of clinical grade for cell delivery without cryopreservation. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.202] [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]
|
39
|
Hemida MG, Chu DKW, Perera RAPM, Ko RLW, So RTY, Ng BCY, Chan SMS, Chu S, Alnaeem AA, Alhammadi MA, Webby RJ, Poon LLM, Balasuriya UBR, Peiris M. Coronavirus infections in horses in Saudi Arabia and Oman. Transbound Emerg Dis 2017; 64:2093-2103. [PMID: 28296228 PMCID: PMC7169745 DOI: 10.1111/tbed.12630] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Indexed: 12/01/2022]
Abstract
Equine coronaviruses (ECoV) are the only coronavirus known to infect horses. So far, data on ECoV infection in horses remain limited to the USA, France and Japan and its geographic distribution is not well understood. We carried out RT‐PCR on 306 nasal and 315 rectal swabs and tested 243 sera for antibodies to detect coronavirus infections in apparently healthy horses in Saudi Arabia and Oman. We document evidence of infection with ECoV and HKU23 coronavirus by RT‐PCR. There was no conclusive evidence of Middle East respiratory syndrome coronavirus infection in horses. Serological data suggest that lineage A betacoronavirus infections are commonly infecting horses in Saudi Arabia and Oman but antibody cross‐reactivities between these viruses do not permit us to use serological data alone to identify which coronaviruses are causing these infections.
Collapse
Affiliation(s)
- M G Hemida
- Department of Microbiology and Parasitology, College of Veterinary Medicine, King Faisal University, Al-Hasa, Saudi Arabia.,Department of Virology Faculty of Veterinary Medicine, Kaferelsheik University, Kaferelsheik, Egypt
| | - D K W Chu
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - R A P M Perera
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - R L W Ko
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - R T Y So
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - B C Y Ng
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - S M S Chan
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - S Chu
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - A A Alnaeem
- Department of Clinical Studies, College of Veterinary Medicine, King Faisal University, Al-Hasa, Saudi Arabia
| | - M A Alhammadi
- Department of Microbiology and Parasitology, College of Veterinary Medicine, King Faisal University, Al-Hasa, Saudi Arabia
| | - R J Webby
- Division of Virology, Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - L L M Poon
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - U B R Balasuriya
- Maxwell H. Gluck Equine Research Center, Department of Veterinary Science, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA.,Department of Microbiology, Immunology and Molecular Genetics, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - M Peiris
- School of Public Health, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
40
|
Chen E, Chu S, Gov L, Kim Y, Lodoen M, Tenner A, Liu W. CD200 modulates macrophage cytokine secretion and phagocytosis in response to poly(lactic co-glycolic acid) microparticles and films. J Mater Chem B 2017; 5:1574-1584. [PMID: 28736613 PMCID: PMC5515357 DOI: 10.1039/c6tb02269c] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Biocompatibility is a major concern for developing biomaterials used in medical devices, tissue engineering and drug delivery. Poly(lactic-co-glycolic acid) (PLGA) is one of the most widely used biodegradable materials, yet still triggers a significant foreign body response that impairs healing. Immune cells including macrophages respond to the implanted biomaterial and mediate the host response, which can eventually lead to device failure. Previously in our laboratory, we found that CD200, an immunomodulatory protein, suppressed macrophage inflammatory activation in vitro and reduced local immune cell infiltration around a biomaterial implant. While in our initial study we used polystyrene as a model material, here we investigate the effect of CD200 on PLGA, a commonly used biomaterial with many potential clinical applications. We fabricated PLGA with varied geometries, modified their surfaces with CD200, and examined macrophage cytokine secretion and phagocytosis. We found that CD200 suppressed secretion of the pro-inflammatory cytokine TNF-α and enhanced secretion of the anti-inflammatory cytokine IL-10, suggesting a role for CD200 in promoting wound healing and tissue remodeling. In addition, we found that CD200 increased phagocytosis in both murine macrophages and human monocytes. Together, these data suggest that modification with CD200 leads to a response that simultaneously prevents inflammation and enhances phagocytosis. This immunomodulatory feature may be used as a strategy to mitigate inflammation or deliver drugs or anti-inflammatory agents targeting macrophages.
Collapse
Affiliation(s)
- E.Y. Chen
- Department of Chemical Engineering and Materials Science, University of California, Irvine
- The Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine
| | - S. Chu
- Department of Molecular Biology and Biochemistry, University of California, Irvine
| | - L. Gov
- Department of Molecular Biology and Biochemistry, University of California, Irvine
| | - Y.K. Kim
- Department of Chemical Engineering and Materials Science, University of California, Irvine
- The Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine
- Department of Biomedical Engineering, University of California, Irvine
| | - M.B. Lodoen
- Department of Molecular Biology and Biochemistry, University of California, Irvine
| | - A.J. Tenner
- Department of Molecular Biology and Biochemistry, University of California, Irvine
| | - W.F. Liu
- Department of Chemical Engineering and Materials Science, University of California, Irvine
- The Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine
- Department of Biomedical Engineering, University of California, Irvine
| |
Collapse
|
41
|
Felices M, Chu S, Kodal B, Bendzick L, Ryan C, Lenvik AJ, Boylan KLM, Wong HC, Skubitz APN, Miller JS, Geller MA. IL-15 super-agonist (ALT-803) enhances natural killer (NK) cell function against ovarian cancer. Gynecol Oncol 2017; 145:453-461. [PMID: 28236454 DOI: 10.1016/j.ygyno.2017.02.028] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/06/2017] [Accepted: 02/15/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Natural killer (NK) cells represent a powerful immunotherapeutic target as they lyse tumors directly, do not require differentiation, and can elicit potent inflammatory responses. The objective of these studies was to use an IL-15 super-agonist complex, ALT-803 (Altor BioScience Corporation), to enhance the function of both normal and ovarian cancer patient derived NK cells by increasing cytotoxicity and cytokine production. METHODS NK cell function from normal donor peripheral blood mononuclear cells (PBMCs) and ovarian cancer patient ascites was assessed using flow cytometry and chromium release assays ±ALT-803 stimulation. To evaluate the ability of ALT-803 to enhance NK cell function in vivo against ovarian cancer, we used a MA148-luc ovarian cancer NOD scid gamma (NSG) xenogeneic mouse model with transferred human NK cells. RESULTS ALT-803 potently enhanced functionality of NK cells against all ovarian cancer cell lines with significant increases seen in CD107a, IFNγ and TNFα expression depending on target cell line. Function was also rescued in NK cells derived from ovarian cancer patient ascites. Finally, only animals treated with intraperitoneal ALT-803 displayed an NK dependent significant decrease in tumor. CONCLUSIONS ALT-803 enhances NK cell cytotoxicity against ovarian cancer in vitro and in vivo and is able to rescue functionality of NK cells derived from ovarian cancer patient ascites. These findings suggest that ALT-803 has the potential to enhance NK cell-based immunotherapeutic approaches for the treatment of ovarian cancer.
Collapse
Affiliation(s)
- M Felices
- Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, United States.
| | - S Chu
- Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, United States
| | - B Kodal
- Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, United States
| | - L Bendzick
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States
| | - C Ryan
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States
| | - A J Lenvik
- Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, United States
| | - K L M Boylan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - H C Wong
- Altor BioScience Corporation, Miramar, FL, United States
| | - A P N Skubitz
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States; Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - J S Miller
- Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, United States
| | - M A Geller
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, United States
| |
Collapse
|
42
|
Fuller P, Leung D, Chu S. Genetics and genomics of ovarian sex cord-stromal tumors. Clin Genet 2017; 91:285-291. [DOI: 10.1111/cge.12917] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/22/2016] [Accepted: 10/24/2016] [Indexed: 12/20/2022]
Affiliation(s)
- P.J. Fuller
- Centre for Endocrinology and Metabolism; Hudson Institute of Medical Research; Clayton Australia
- Department of Molecular and Translational Science; Monash University; Clayton Australia
| | - D. Leung
- Centre for Endocrinology and Metabolism; Hudson Institute of Medical Research; Clayton Australia
- Department of Molecular and Translational Science; Monash University; Clayton Australia
| | - S. Chu
- Centre for Endocrinology and Metabolism; Hudson Institute of Medical Research; Clayton Australia
- Department of Molecular and Translational Science; Monash University; Clayton Australia
| |
Collapse
|
43
|
Yeung WW, Ma BB, Lee JF, Ng SS, Cheung MH, Ho WM, Tsang MW, Chu S, Lam DC, Mo FK. Clinical outcome of neoadjuvant chemoradiation in locally advanced rectal cancer at a tertiary hospital. Hong Kong Med J 2016; 22:546-55. [PMID: 27795447 DOI: 10.12809/hkmj154788] [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] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To review the clinical outcome of locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by definitive surgery with or without adjuvant chemotherapy and to elucidate the prognostic factors for treatment outcome. METHODS This historical cohort study was conducted at a tertiary public hospital in Hong Kong. All patients who had undergone neoadjuvant chemoradiation for locally advanced rectal cancer in our department from November 2005 to October 2014 were recruited. Local recurrence-free survival, distant metastasis-free survival, disease-free survival, and overall survival of patients were documented. RESULTS A total of 135 patients who had received neoadjuvant chemoradiation during the study period were reviewed. There were 130 patients who had completed neoadjuvant chemoradiation and surgery. The median follow-up time was 35.1 months. The 3- and 5-year local recurrence-free survival, distant metastasis-free survival, disease-free survival, as well as overall survival rates were 91.8% and 86.7%, 73.9% and 72.1%, 70.1% and 64.6%, as well as 86.5% and 68.4%, respectively. The rate of pathological complete response was 13.8%. The T and N downstaging rate was 49.2% and 63.1%, respectively. The rate of conversion from threatened circumferential resection margin to clearance of margin was 90.6%. Of the 42 cases that were initially deemed to require abdominal perineal resection, 15 (35.7%) were converted to sphincter-sparing surgery. CONCLUSIONS The treatment outcome of neoadjuvant chemoradiation for locally advanced rectal cancer was comparable with overseas data in terms of local control rate and overall survival. This strategy may increase the chance of achieving a clear surgical margin by downstaging the tumour, especially in patients who presented with threatened circumferential margin.
Collapse
Affiliation(s)
- W Wk Yeung
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - B By Ma
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J Fy Lee
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S Sm Ng
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M Hy Cheung
- Department of Surgery, North District Hospital, Sheung Shui, Hong Kong
| | - W M Ho
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M Wk Tsang
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S Chu
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - D Cm Lam
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - F Kf Mo
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| |
Collapse
|
44
|
Zang F, Chu S, Gerasopoulos K, Culver JN, Ghodssi R. Rapid fabrication of supercapacitor electrodes using bionanoscaffolds in capillary microfluidics. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/1742-6596/660/1/012010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
45
|
Alogna VK, Attaya MK, Aucoin P, Bahník Š, Birch S, Birt AR, Bornstein BH, Bouwmeester S, Brandimonte MA, Brown C, Buswell K, Carlson C, Carlson M, Chu S, Cislak A, Colarusso M, Colloff MF, Dellapaolera KS, Delvenne JF, Di Domenico A, Drummond A, Echterhoff G, Edlund JE, Eggleston CM, Fairfield B, Franco G, Gabbert F, Gamblin BW, Garry M, Gentry R, Gilbert EA, Greenberg DL, Halberstadt J, Hall L, Hancock PJB, Hirsch D, Holt G, Jackson JC, Jong J, Kehn A, Koch C, Kopietz R, Körner U, Kunar MA, Lai CK, Langton SRH, Leite FP, Mammarella N, Marsh JE, McConnaughy KA, McCoy S, McIntyre AH, Meissner CA, Michael RB, Mitchell AA, Mugayar-Baldocchi M, Musselman R, Ng C, Nichols AL, Nunez NL, Palmer MA, Pappagianopoulos JE, Petro MS, Poirier CR, Portch E, Rainsford M, Rancourt A, Romig C, Rubínová E, Sanson M, Satchell L, Sauer JD, Schweitzer K, Shaheed J, Skelton F, Sullivan GA, Susa KJ, Swanner JK, Thompson WB, Todaro R, Ulatowska J, Valentine T, Verkoeijen PPJL, Vranka M, Wade KA, Was CA, Weatherford D, Wiseman K, Zaksaite T, Zuj DV, Zwaan RA. Registered Replication Report: Schooler and Engstler-Schooler (1990). Perspect Psychol Sci 2014; 9:556-78. [PMID: 26186758 DOI: 10.1177/1745691614545653] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Trying to remember something now typically improves your ability to remember it later. However, after watching a video of a simulated bank robbery, participants who verbally described the robber were 25% worse at identifying the robber in a lineup than were participants who instead listed U.S. states and capitals-this has been termed the "verbal overshadowing" effect (Schooler & Engstler-Schooler, 1990). More recent studies suggested that this effect might be substantially smaller than first reported. Given uncertainty about the effect size, the influence of this finding in the memory literature, and its practical importance for police procedures, we conducted two collections of preregistered direct replications (RRR1 and RRR2) that differed only in the order of the description task and a filler task. In RRR1, when the description task immediately followed the robbery, participants who provided a description were 4% less likely to select the robber than were those in the control condition. In RRR2, when the description was delayed by 20 min, they were 16% less likely to select the robber. These findings reveal a robust verbal overshadowing effect that is strongly influenced by the relative timing of the tasks. The discussion considers further implications of these replications for our understanding of verbal overshadowing.
Collapse
|
46
|
Sahebally SM, Burke JP, Chu S, Mabadeje O, Geoghegan J. A randomized controlled trial comparing polyethylene glycol + ascorbic acid with sodium picosulphate + magnesium citrate solution for bowel cleansing prior to colonoscopy. Ir J Med Sci 2014; 184:819-23. [PMID: 25156179 DOI: 10.1007/s11845-014-1182-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 08/09/2014] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Adequate bowel cleansing which is acceptable to the patient is a prerequisite for safe and effective colonoscopy. A 2-L polyethylene glycol solution containing ascorbic acid and electrolytes (PEG-Asc) is an alternative to sodium picosulphate + magnesium citrate (SPS-Mg) for bowel preparation. The aim of the current study is to compare PEG-Asc to SPS-Mg in terms of tolerability and efficacy. METHODS This was a single blind, randomized controlled trial. A blinded assessment of bowel cleansing was made by the attending endoscopist. Patients completed a questionnaire on the acceptability of the preparation. RESULTS One hundred and thirty (130) consecutive patients attending for day case colonoscopy were randomly allocated to bowel preparation with PEG-Asc (n = 66) or SPS-Mg (n = 64). More patients found PEG-Asc to taste unpleasant (37.9 vs. 10.9%, P < 0.001) and more patients found PEG-Asc to be a more distressing preparation than SPS-Mg (15.1 vs. 4.7%, P = 0.043). However, there was no difference in the proportion of patients being able to complete bowel preparation (PEG-Asc vs. SPS-Mg, 92.4 vs. 93.8%, P = 0.520). There was no detectable difference between PEG-Asc and SPS-Mg in the quality of cleansing with a good or very good preparation being reported by the endoscopist in 46.9 and 54.5% of cases, respectively (P = 0.242). CONCLUSIONS More patients find PEG-Asc to taste unpleasant and to be a more distressing preparation than SPS-Mg. However, there was no detectable difference between PEG-Asc and SPS-Mg in bowel cleansing prior to colonoscopy.
Collapse
Affiliation(s)
- S M Sahebally
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland.
| | - J P Burke
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland.
| | - S Chu
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland
| | - O Mabadeje
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland
| | - J Geoghegan
- Department of Surgery, St Columcille's Hospital, Loughlinstown, Dublin, Ireland
| |
Collapse
|
47
|
Lee K, Patel S, Hayashibara K, Chu S, Gillis A, Rijlaarsdam M, Dorssers L, Looijenga L. 699: MicroRNA profiling in serum samples from donors with germ cell cancer. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50617-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: 11/26/2022]
|
48
|
Degoricija L, Lee K, Patel S, Chu S, Gillis A, Rijlaarsdam M, Dorssers L, Looijenga L. 703: Whole transcriptome analysis of testicular germ cell tumors. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50621-1] [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: 11/16/2022]
|
49
|
Wang HX, Chu S, Li J, Lai WN, Wang HX, Wu XJ, Kang X, Qiu YR. Increased IL-17 and IL-21 producing TCRαβ+CD4−CD8− T cells in Chinese systemic lupus erythematosus patients. Lupus 2014; 23:643-54. [PMID: 24554709 DOI: 10.1177/0961203314524467] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 01/23/2014] [Indexed: 01/06/2023]
Abstract
Background: Increased numbers of TCRαβ+CD4−CD8− T cells in the peripheral blood of systemic lupus erythematosus (SLE) patients in the United States and United Kingdom have been reported. However, the proportions of TCRαβ+CD4−CD8− T cells and their involvement in the pathogenesis of SLE in Chinese populations are yet to be determined. Methods: A total of 120 SLE patients, 38 rheumatoid arthritis (RA) patients and 43 normal control subjects were examined. The proportion of TCRαβ+CD4−CD8− T cells in the peripheral blood, Fas expression on these cells, and intracellular cytokine levels in these cells were assessed using flow cytometry. Plasma cytokine concentrations were measured using enzyme-linked immunosorbent assay. Results: The percentages of TCRαβ+CD4−CD8− T cells were increased in Chinese SLE patients, particularly in active SLE patients, correlated with decreased Fas expression on these cells. IL-17 and IL-21 levels in the blood and in TCRαβ+CD4−CD8− T cells from SLE patients were increased. Moreover, a positive correlation was evident between IL-17- and IL-21-producing TCRαβ+CD4−CD8− T cells. Conclusions: Increased TCRαβ+CD4−CD8− T cells expressing inflammatory cytokines, such as IL-17 and IL-21, may be implicated in the pathogenesis of SLE in patients. Appropriate IL-17- and/or IL-21 blockage may be utilized as a novel immunotherapeutic strategy for SLE patients.
Collapse
Affiliation(s)
- H-X Wang
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - S Chu
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - J Li
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - W-N Lai
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - H-X Wang
- Department of Laboratory Medicine, Nanyang Center Hospital, Henan, China
| | - X-J Wu
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - X Kang
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Y-R Qiu
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangdong, China
| |
Collapse
|
50
|
Chung S, Chu S, Huang Y. The association between sleep and body weight changes from birth to 3 years. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.211] [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: 11/26/2022]
|