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Dalla Costa G, Nos C, Zabalza A, Buron M, Magyari M, Sellebjerg F, Guerrero AI, Roselli L, La Porta ML, Martinis M, Bailon R, Kontaxis S, Laporta E, Garcia E, Pokorny FB, Schuller BW, Folarin A, Stewart C, Leocani L, Vairavan S, Cummins N, Dobson R, Hotopf M, Narayan V, Montalban X, Sorensen PS, Comi G. A wearable device perspective on the standard definitions of disability progression in multiple sclerosis. Mult Scler 2024; 30:103-112. [PMID: 38084497 DOI: 10.1177/13524585231214362] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Multiple sclerosis (MS) is a leading cause of disability among young adults, but standard clinical scales may not accurately detect subtle changes in disability occurring between visits. This study aims to explore whether wearable device data provides more granular and objective measures of disability progression in MS. METHODS Remote Assessment of Disease and Relapse in Central Nervous System Disorders (RADAR-CNS) is a longitudinal multicenter observational study in which 400 MS patients have been recruited since June 2018 and prospectively followed up for 24 months. Monitoring of patients included standard clinical visits with assessment of disability through use of the Expanded Disability Status Scale (EDSS), 6-minute walking test (6MWT) and timed 25-foot walk (T25FW), as well as remote monitoring through the use of a Fitbit. RESULTS Among the 306 patients who completed the study (mean age, 45.6 years; females 67%), confirmed disability progression defined by the EDSS was observed in 74 patients, who had approximately 1392 fewer daily steps than patients without disability progression. However, the decrease in the number of steps experienced over time by patients with EDSS progression and stable patients was not significantly different. Similar results were obtained with disability progression defined by the 6MWT and the T25FW. CONCLUSION The use of continuous activity monitoring holds great promise as a sensitive and ecologically valid measure of disability progression in MS.
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Affiliation(s)
| | - Carlos Nos
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Zabalza
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mathias Buron
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Melinda Magyari
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Finn Sellebjerg
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ana Isabel Guerrero
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | - Raquel Bailon
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragon Institute of Engineering Research (I3A), IIS Aragon, University of Zaragoza, Zaragoza, Spain
- Centro de Investigacion Biomedica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Spyridon Kontaxis
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragon Institute of Engineering Research (I3A), IIS Aragon, University of Zaragoza, Zaragoza, Spain
- Centro de Investigacion Biomedica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Estela Laporta
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragon Institute of Engineering Research (I3A), IIS Aragon, University of Zaragoza, Zaragoza, Spain
- Centro de Investigacion Biomedica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Esther Garcia
- Centro de Investigacion Biomedica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
- Department of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Barcelona, Spain
| | - Florian B Pokorny
- Chair of Embedded Intelligence for Healthcare and Wellbeing, University of Augsburg, Augsburg, Germany
- Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Björn W Schuller
- Chair of Embedded Intelligence for Healthcare and Wellbeing, University of Augsburg, Augsburg, Germany
- Group on Language, Audio & Music, Imperial College London, London, UK
| | - Amos Folarin
- Department of Biostatistics & Health informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Institute of Health Informatics, University College London, London, UK
| | - Callum Stewart
- Department of Biostatistics & Health informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Institute of Health Informatics, University College London, London, UK
| | | | - Srinivasan Vairavan
- Janssen Research and Development LLC, Janssen Global Services, LLC, Titusville, NJ, USA
| | - Nicholas Cummins
- Department of Biostatistics & Health informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Richard Dobson
- Department of Biostatistics & Health informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Vaibhav Narayan
- Janssen Research and Development LLC, Janssen Global Services, LLC, Titusville, NJ, USA
| | - Xavier Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Per Soelberg Sorensen
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Giancarlo Comi
- Vita-Salute San Raffaele University, Milan, Italy/Multiple Sclerosis Center, Casa di Cura Igea, Milan, Italy
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Lavalle R, Condominas E, Haro JM, Giné-Vázquez I, Bailon R, Laporta E, Garcia E, Kontaxis S, Alacid GR, Lombardini F, Preti A, Peñarrubia-Maria MT, Coromina M, Arranz B, Vilella E, Rubio-Alacid E, Matcham F, Lamers F, Hotopf M, Penninx BWJH, Annas P, Narayan V, Simblett SK, Siddi S. The Impact of COVID-19 Lockdown on Adults with Major Depressive Disorder from Catalonia: A Decentralized Longitudinal Study. Int J Environ Res Public Health 2023; 20:5161. [PMID: 36982069 PMCID: PMC10048808 DOI: 10.3390/ijerph20065161] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
The present study analyzes the effects of each containment phase of the first COVID-19 wave on depression levels in a cohort of 121 adults with a history of major depressive disorder (MDD) from Catalonia recruited from 1 November 2019, to 16 October 2020. This analysis is part of the Remote Assessment of Disease and Relapse-MDD (RADAR-MDD) study. Depression was evaluated with the Patient Health Questionnaire-8 (PHQ-8), and anxiety was evaluated with the Generalized Anxiety Disorder-7 (GAD-7). Depression's levels were explored across the phases (pre-lockdown, lockdown, and four post-lockdown phases) according to the restrictions of Spanish/Catalan governments. Then, a mixed model was fitted to estimate how depression varied over the phases. A significant rise in depression severity was found during the lockdown and phase 0 (early post-lockdown), compared with the pre-lockdown. Those with low pre-lockdown depression experienced an increase in depression severity during the "new normality", while those with high pre-lockdown depression decreased compared with the pre-lockdown. These findings suggest that COVID-19 restrictions affected the depression level depending on their pre-lockdown depression severity. Individuals with low levels of depression are more reactive to external stimuli than those with more severe depression, so the lockdown may have worse detrimental effects on them.
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Affiliation(s)
- Raffaele Lavalle
- Dipartimento di Neuroscienze, Università degli Studi di Torino, 10124 Turin, Italy
| | - Elena Condominas
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Departament de Medicina, Universitat de Barcelona, 08830 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM-Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Departament de Medicina, Universitat de Barcelona, 08830 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM-Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Iago Giné-Vázquez
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Departament de Medicina, Universitat de Barcelona, 08830 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM-Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Raquel Bailon
- Aragón Institute of Engineering Research (I3A), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, 50018 Zaragoza, Spain
- Centros de Investigación Biomédica en Red en el área de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Estela Laporta
- Centros de Investigación Biomédica en Red en el área de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Ester Garcia
- Centros de Investigación Biomédica en Red en el área de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
- Microelectrónica y Sistemas Electrónicos, Universidad Autónoma de Barcelona, 08193 Bellaterra, Spain
| | - Spyridon Kontaxis
- Aragón Institute of Engineering Research (I3A), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, 50018 Zaragoza, Spain
- Centros de Investigación Biomédica en Red en el área de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Gemma Riquelme Alacid
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Departament de Medicina, Universitat de Barcelona, 08830 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM-Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Federica Lombardini
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Departament de Medicina, Universitat de Barcelona, 08830 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM-Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonio Preti
- Dipartimento di Neuroscienze, Università degli Studi di Torino, 10124 Turin, Italy
| | - Maria Teresa Peñarrubia-Maria
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Parc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu, 08830 St Boi de Llobregat, Spain
- Unitat de Suport a la Recerca Regió Metropolitana Sud, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Marta Coromina
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Departament de Medicina, Universitat de Barcelona, 08830 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM-Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Belén Arranz
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Departament de Medicina, Universitat de Barcelona, 08830 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM-Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, 43206 Reus, Spain
- Neuriociències i Salut Mental, Institut d’Investigació Sanitària Pere Virgili-CERCA, 43204 Reus, Spain
- Universitat Rovira i Virgili, 43003 Reus, Spain
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Elena Rubio-Alacid
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Departament de Medicina, Universitat de Barcelona, 08830 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM-Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Faith Matcham
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
- School of Psychology, University of Sussex, East Sussex BN1 9QH, UK
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, 1081 BT Amsterdam, The Netherlands
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, 1081 BT Amsterdam, The Netherlands
| | | | - Vaibhav Narayan
- Research and Development Information Technology, Janssen Research & Development, LLC, Titusville, NJ 08560, USA
| | - Sara K. Simblett
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Sara Siddi
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Departament de Medicina, Universitat de Barcelona, 08830 Barcelona, Spain
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Siddi S, Giné-Vázquez I, Bailon R, Matcham F, Lamers F, Kontaxis S, Laporta E, Garcia E, Arranz B, Dalla Costa G, Guerrero AI, Zabalza A, Buron MD, Comi G, Leocani L, Annas P, Hotopf M, Penninx BWJH, Magyari M, Sørensen PS, Montalban X, Lavelle G, Ivan A, Oetzmann C, White KM, Difrancesco S, Locatelli P, Mohr DC, Aguiló J, Narayan V, Folarin A, Dobson RJB, Dineley J, Leightley D, Cummins N, Vairavan S, Ranjan Y, Rashid Z, Rintala A, Girolamo GD, Preti A, Simblett S, Wykes T, Myin-Germeys I, Haro JM. Biopsychosocial Response to the COVID-19 Lockdown in People with Major Depressive Disorder and Multiple Sclerosis. J Clin Med 2022; 11:7163. [PMID: 36498739 PMCID: PMC9738639 DOI: 10.3390/jcm11237163] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/22/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Changes in lifestyle, finances and work status during COVID-19 lockdowns may have led to biopsychosocial changes in people with pre-existing vulnerabilities such as Major Depressive Disorders (MDDs) and Multiple Sclerosis (MS). METHODS Data were collected as a part of the RADAR-CNS (Remote Assessment of Disease and Relapse-Central Nervous System) program. We analyzed the following data from long-term participants in a decentralized multinational study: symptoms of depression, heart rate (HR) during the day and night; social activity; sedentary state, steps and physical activity of varying intensity. Linear mixed-effects regression analyses with repeated measures were fitted to assess the changes among three time periods (pre, during and post-lockdown) across the groups, adjusting for depression severity before the pandemic and gender. RESULTS Participants with MDDs (N = 255) and MS (N = 214) were included in the analyses. Overall, depressive symptoms remained stable across the three periods in both groups. A lower mean HR and HR variation were observed between pre and during lockdown during the day for MDDs and during the night for MS. HR variation during rest periods also decreased between pre- and post-lockdown in both clinical conditions. We observed a reduction in physical activity for MDDs and MS upon the introduction of lockdowns. The group with MDDs exhibited a net increase in social interaction via social network apps over the three periods. CONCLUSIONS Behavioral responses to the lockdown measured by social activity, physical activity and HR may reflect changes in stress in people with MDDs and MS. Remote technology monitoring might promptly activate an early warning of physical and social alterations in these stressful situations. Future studies must explore how stress does or does not impact depression severity.
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Affiliation(s)
- Sara Siddi
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM (Madrid 28029), Universitat de Barcelona, 08007 Barcelona, Spain
| | - Iago Giné-Vázquez
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM (Madrid 28029), Universitat de Barcelona, 08007 Barcelona, Spain
| | - Raquel Bailon
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50001 Zaragoza, Spain
- Centros de Investigación Biomédica en Red en el Área de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Faith Matcham
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
- School of Psychology, University of Sussex, Falmer BN1 9QH, UK
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
- Mental Health Program, Amsterdam Public Health Research Institute, 1081 BT Amsterdam, The Netherlands
| | - Spyridon Kontaxis
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50001 Zaragoza, Spain
- Centros de Investigación Biomédica en Red en el Área de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Estela Laporta
- Centros de Investigación Biomédica en Red en el Área de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | - Esther Garcia
- Centros de Investigación Biomédica en Red en el Área de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
- Microelectrónica y Sistemas Electrónicos, Universidad Autónoma de Barcelona, 08193 Bellaterra, Spain
| | - Belen Arranz
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM (Madrid 28029), Universitat de Barcelona, 08007 Barcelona, Spain
| | - Gloria Dalla Costa
- Faculty of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Ana Isabel Guerrero
- Multiple Sclerosis Centre of Catalonia (Cemcat), Department of Neurology/Neuroimmunology, Vall d’Hebron Institut de Recerca, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - Ana Zabalza
- Multiple Sclerosis Centre of Catalonia (Cemcat), Department of Neurology/Neuroimmunology, Vall d’Hebron Institut de Recerca, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - Mathias Due Buron
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Giancarlo Comi
- Faculty of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Casa Cura Policlinico, 20144 Milan, Italy
| | - Letizia Leocani
- Faculty of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, Scientific Institute San Raffaele, 20132 Milan, Italy
| | | | - Matthew Hotopf
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
- Mental Health Program, Amsterdam Public Health Research Institute, 1081 BT Amsterdam, The Netherlands
| | - Melinda Magyari
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Per S. Sørensen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Xavier Montalban
- Multiple Sclerosis Centre of Catalonia (Cemcat), Department of Neurology/Neuroimmunology, Vall d’Hebron Institut de Recerca, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - Grace Lavelle
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Alina Ivan
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Carolin Oetzmann
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Katie M. White
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Sonia Difrancesco
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Patrick Locatelli
- Department of Engineering and Applied Science, University of Bergamo, 24129 Bergamo, Italy
| | - David C. Mohr
- Center for Behavioral Intervention Technologies, Department of Preventative Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Jordi Aguiló
- Centros de Investigación Biomédica en Red en el Área de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
- Microelectrónica y Sistemas Electrónicos, Universidad Autónoma de Barcelona, 08193 Bellaterra, Spain
| | - Vaibhav Narayan
- Research and Development Information Technology, Janssen Research & Development, LLC, Titusville, NJ 08560, USA
| | - Amos Folarin
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Richard J. B. Dobson
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Judith Dineley
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Daniel Leightley
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Nicholas Cummins
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Srinivasan Vairavan
- Research and Development Information Technology, Janssen Research & Development, LLC, Titusville, NJ 08560, USA
| | - Yathart Ranjan
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Zulqarnain Rashid
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Aki Rintala
- Department for Neurosciences, Center for Contextual Psychiatry, Katholieke Universiteit Leuven, 7001 Leuven, Belgium
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, 15210 Lahti, Finland
| | - Giovanni De Girolamo
- IRCCS Instituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Antonio Preti
- Dipartimento di Neuroscienze, Università degli Studi di Torino, 10126 Torino, Italy
| | - Sara Simblett
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | - Til Wykes
- Institute of Psychiatry, King’s College London, Psychology and Neuroscience, London SE5 8AF, UK
| | | | - Inez Myin-Germeys
- Department for Neurosciences, Center for Contextual Psychiatry, Katholieke Universiteit Leuven, 7001 Leuven, Belgium
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM (Madrid 28029), Universitat de Barcelona, 08007 Barcelona, Spain
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Srinivasan R, Iliopoulos O, Rathmell W, Narayan V, Maughan B, Oudard S, Else T, Maranchie J, Welsh S, Iversen AB, Chen K, Perini R, Liu Y, Linehan W, Jonasch E. LBA69 Belzutifan, a HIF-2α Inhibitor, for von Hippel-Lindau (VHL) disease-associated neoplasms: 36 months of follow-up of the phase II LITESPARK-004 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Raz E, Cavalcanti DD, Sen C, Nossek E, Potts M, Peschillo S, Lotan E, Narayan V, Ali A, Sharashidze V, Nelson PK, Shapiro M. Tumor Embolization through Meningohypophyseal and Inferolateral Trunks is Safe and Effective. AJNR Am J Neuroradiol 2022; 43:1142-1147. [PMID: 35902121 PMCID: PMC9575419 DOI: 10.3174/ajnr.a7579] [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: 01/18/2022] [Accepted: 06/02/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Skull base tumors are commonly supplied by dural branches of the meningohypophyseal and inferolateral trunks. Embolization through these arteries is often avoided due to technical challenges and inherent risks; however, successful embolization can be a valuable surgical adjunct. We aimed to review the success and complications in our series of tumor embolizations through the meningohypophyseal and inferolateral trunks. MATERIALS AND METHODS We performed a retrospective review of patients with tumor treated with preoperative embolization at our institution between 2010 and 2020. We reviewed the following data: patients' demographics, tumor characteristics, endovascular embolization variables, and surgical results including estimated blood loss, the need for transfusion, and operative time. RESULTS Among 155 tumor embolization cases, we identified 14 patients in whom tumor embolization was performed using the meningohypophyseal (n = 13) or inferolateral (n = 4) trunk. In this group of patients, on average, 79% of tumors were embolized. No mortality or morbidity from the embolization procedure was observed in this subgroup of patients. The average estimated blood loss in the operation was 395 mL (range, 200-750 mL). None of the patients required a transfusion, and the average operative time was 7.3 hours. CONCLUSIONS Some skull base tumors necessitate embolization through ICA branches such as the meningohypophyseal and inferolateral trunks. Our series demonstrates that an effective and safe embolization may be performed through these routes.
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Affiliation(s)
- E Raz
- From the Departments of Radiology (E.R., D.D.C., E.L., V.N., A.A., V.S., P.K.N., M.S.)
| | - D D Cavalcanti
- From the Departments of Radiology (E.R., D.D.C., E.L., V.N., A.A., V.S., P.K.N., M.S.)
| | - C Sen
- Neurointerventional Section, and Neurosurgery (C.S., E.N. P.K.N.), NYU Langone Health, New York, New York
| | - E Nossek
- Neurointerventional Section, and Neurosurgery (C.S., E.N. P.K.N.), NYU Langone Health, New York, New York
| | - M Potts
- Department of Neurological Surgery (M.P.), Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - S Peschillo
- Department of Neurosurgery (S.P.), University of Catania, Catania, Italy
| | - E Lotan
- From the Departments of Radiology (E.R., D.D.C., E.L., V.N., A.A., V.S., P.K.N., M.S.)
| | - V Narayan
- From the Departments of Radiology (E.R., D.D.C., E.L., V.N., A.A., V.S., P.K.N., M.S.)
| | - A Ali
- From the Departments of Radiology (E.R., D.D.C., E.L., V.N., A.A., V.S., P.K.N., M.S.)
| | - V Sharashidze
- From the Departments of Radiology (E.R., D.D.C., E.L., V.N., A.A., V.S., P.K.N., M.S.)
| | - P K Nelson
- From the Departments of Radiology (E.R., D.D.C., E.L., V.N., A.A., V.S., P.K.N., M.S.).,Neurointerventional Section, and Neurosurgery (C.S., E.N. P.K.N.), NYU Langone Health, New York, New York
| | - M Shapiro
- From the Departments of Radiology (E.R., D.D.C., E.L., V.N., A.A., V.S., P.K.N., M.S.)
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Matcham F, Leightley D, Siddi S, Lamers F, White K, Annas P, De Girolamo G, Difrancesco S, Haro J, Horsfall M, Ivan A, Lavelle G, Li Q, Lombardini F, Mohr D, Narayan V, Oetzmann C, Penninx B, Simblett S, Bruce S, Nica R, Wykes T, Brasen J, Myin-Germeys I, Rintala A, Conde P, Dobson R, Folarin A, Stewart C, Ranjan Y, Rashid Z, Cummins N, Manyakov N, Vairavan S, Hotopf M. Remote Assessment of Disease and Relapse in Major Depressive Disorder (RADAR-MDD): Recruitment, retention, and data availability in a longitudinal remote measurement study. Eur Psychiatry 2022. [PMCID: PMC9564033 DOI: 10.1192/j.eurpsy.2022.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Major Depressive Disorder (MDD) is prevalent, often chronic, and requires ongoing monitoring of symptoms to track response to treatment and identify early indicators of relapse. Remote Measurement Technologies (RMT) provide an exciting opportunity to transform the measurement and management of MDD, via data collected from inbuilt smartphone sensors and wearable devices alongside app-based questionnaires and tasks.
Objectives
To describe the amount of data collected during a multimodal longitudinal RMT study, in an MDD population.
Methods
RADAR-MDD is a multi-centre, prospective observational cohort study. People with a history of MDD were provided with a wrist-worn wearable, and several apps designed to: a) collect data from smartphone sensors; and b) deliver questionnaires, speech tasks and cognitive assessments and followed-up for a maximum of 2 years.
Results
A total of 623 individuals with a history of MDD were enrolled in the study with 80% completion rates for primary outcome assessments across all timepoints. 79.8% of people participated for the maximum amount of time available and 20.2% withdrew prematurely. Data availability across all RMT data types varied depending on the source of data and the participant-burden for each data type. We found no evidence of an association between the severity of depression symptoms at baseline and the availability of data. 110 participants had > 50% data available across all data types, and thus able to contribute to multiparametric analyses.
Conclusions
RADAR-MDD is the largest multimodal RMT study in the field of mental health. Here, we have shown that collecting RMT data from a clinical population is feasible.
Disclosure
No significant relationships.
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Narayan V, Boorjian S, Alemozaffer M, Konety B, Gomella L, Kamat A, Lerner S, Svatek R, Karsh L, Canter D, Lotan Y, Inman B, Yang M, Garcia-Horton V, Sawutz D, Parker N, Dinney C. Subgroup analyses of the phase 3 study of intravesical nadofaragene firadenovec in patients with high-grade, BCG-unresponsive Non-Muscle Invasive Bladder Cancer (NMIBC). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01121-0] [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: 10/20/2022]
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8
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Narayan V, Boorjian S, Alemozaffer M, Konety B, Gomella L, Kamat A, Lerner S, Svatek R, Karsh L, Canter D, Lotan Y, Inman B, Yang M, Garcia-Horton V, Sawutz D, Parker N, Dinney C. Significant anti-adenovirus antibody response positively correlates with efficacy in patients treated with nadofaragene firadenovec for high-grade BCG-unresponsive Non-Muscle Invasive Bladder Cancer (NMIBC). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01122-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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McLaughlin V, Highland K, Hemnes A, Kim N, Chin K, Farber H, Zhao C, Narayan V, Chakinala M. Characteristics and clinical course of the first 500 patients (pts) from SPHERE (SelexiPag: tHe usErs dRug rEgistry) receiving selexipag in real-world clinical practice. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2298] [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: 11/14/2022] Open
Abstract
Abstract
Background
SPHERE is a US, multicentre, prospective registry collecting real-world data from pts with pulmonary arterial hypertension (PAH) treated with selexipag, a selective oral IP prostacyclin receptor agonist.
Methods
SPHERE (planned N=800) included newly initiated (NI, receiving selexipag ≤60 days) and previously initiated (PI) pts. We describe disease characteristics, selexipag dose and clinical course of the first 500 pts and risk assessment based on REVEAL 2.0 risk calculator and COMPERA risk assessment strategy.
Results
Disease characteristics at initiation were: 75.0% female, median age 61.0 years, idiopathic etiology (49.2%) or associated with connective tissue disease (26.4%). Pts were mostly WHO functional class (FC) II (31.0%) or III (49.6%) (unknown for 9.2%). Median time from PAH diagnosis to selexipag initiation was 3.4 years. Of the first 500 pts enrolled, 138 (28%) were NI and 362 (72%) were PI; characteristics were consistent between NI and PI.
Risk classification at initiation differed depending on method used: with REVEAL 2.0, low/intermediate/high risk were 41.8%/29.6%/28.6% (38.4%/26.1%/35.5% for NI and 43.1%/30.9%/26.0% for PI, respectively) and with COMPERA were 22.0%/67.2%/9.6% (13.8%/73.2%/10.9% for NI and 25.1%/64.9%/9.1% for PI), respectively. Note, missing variables in real-world registry data may affect risk assessment.
In both cohorts, median individualised maintenance dose was 1200 μg twice daily (NI 1000 μg, PI 1200 μg); median time to individualised maintenance dose was 8.1 weeks. Median treatment duration was 21.7 months (17.7 months NI, 25.8 months PI). Overall, 32.4% of pts discontinued selexipag (46.4% NI, 27.1% PI), most commonly (22.8%) for adverse events (AEs) (34.8% NI, 18.2% PI). Of note, disease progression is classified as an AE. No selexipag-related deaths were reported.
At 18 months, WHO FC improved/remained stable in the majority of pts (205/235, 87%; improved, 24%; stable, 63%), but worsened in 12.8% of pts. At 18 months, the majority of pts had improved/stable risk by REVEAL 2.0 (265/334, 79% [improved, 22%; stable, 57%]) and by COMPERA (255/316, 81% [improved, 23%; stable, 58%]). This was consistent for NI and PI.
For both risk assessment tools higher risk was associated with increased risk of death. With REVEAL 2.0, risk of death was 2.9 and 9.3 times higher for intermediate and high risk, respectively vs low risk. Similarly with COMPERA, risk of death was 3.2 and 11.4 times higher in intermediate and high risk, respectively vs low risk.
Conclusions
Of the first 500 pts in SPHERE, the vast majority were prevalent PAH cases in FC II or III. Around one-quarter of pts had improved FC and/or risk; the majority of pts remained stable risk. Higher risk was associated with increased mortality risk. Over 50% of pts completed 18 months of selexipag. Discontinuations were most commonly for AEs and/or PAH progression.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Actelion Pharmaceuticals US, Inc.
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Affiliation(s)
- V McLaughlin
- University of Michigan, Division of Cardiovascular Medicine, Ann Arbor, United States of America
| | - K.B Highland
- Cleveland Clinic, Cleveland, United States of America
| | - A.R Hemnes
- Vanderbilt University Medical Center, Nashville, United States of America
| | - N.H Kim
- University of California, San Diego, La Jolla, United States of America
| | - K.M Chin
- University of Texas Southwestern Medical Center, Dallas, United States of America
| | - H.W Farber
- Tufts Medical Center, Boston, United States of America
| | - C Zhao
- Actelion Pharmaceuticals, Inc., South San Francisco, United States of America
| | - V Narayan
- Actelion Pharmaceuticals, Inc., South San Francisco, United States of America
| | - M.M Chakinala
- Washington University School of Medicine, St. Louis, United States of America
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Simblett S, Matcham F, Curtis H, Greer B, Polhemus A, Novák J, Ferrao J, Gamble P, Hotopf M, Narayan V, Wykes T. Patients' Measurement Priorities for Remote Measurement Technologies to Aid Chronic Health Conditions: Qualitative Analysis. JMIR Mhealth Uhealth 2020; 8:e15086. [PMID: 32519975 PMCID: PMC7315360 DOI: 10.2196/15086] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/31/2019] [Accepted: 12/15/2019] [Indexed: 01/19/2023] Open
Abstract
Background Remote measurement technology (RMT), including the use of mobile phone apps and wearable devices, may provide the opportunity for real-world assessment and intervention that will streamline clinical input for years to come. In order to establish the benefits of this approach, we need to operationalize what is expected in terms of a successful measurement. We focused on three clinical long-term conditions where a novel case has been made for the benefits of RMT: major depressive disorder (MDD), multiple sclerosis (MS), and epilepsy. Objective The aim of this study was to conduct a consultation exercise on the clinical end point or outcome measurement priorities for RMT studies, drawing on the experiences of people with chronic health conditions. Methods A total of 24 participants (16/24 women, 67%), ranging from 28 to 65 years of age, with a diagnosis of one of three chronic health conditions―MDD, MS, or epilepsy―took part in six focus groups. A systematic thematic analysis was used to extract themes and subthemes of clinical end point or measurement priorities. Results The views of people with MDD, epilepsy, and MS differed. Each group highlighted unique measurements of importance, relevant to their specific needs. Although there was agreement that remote measurement could be useful for tracking symptoms of illness, some symptoms were specific to the individual groups. Measuring signs of wellness was discussed more by people with MDD than by people with MS and epilepsy. However, overlap did emerge when considering contextual factors, such as life events and availability of support (MDD and epilepsy) as well as ways of coping (epilepsy and MS). Conclusions This is a unique study that puts patients’ views at the forefront of the design of a clinical study employing novel digital resources. In all cases, measuring symptom severity is key; people want to know when their health is getting worse. Second, symptom severity needs to be placed into context. A holistic approach that, in some cases, considers signs of wellness as well as illness, should be the aim of studies employing RMT to understand the health of people with chronic conditions.
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Affiliation(s)
- Sara Simblett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Faith Matcham
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Hannah Curtis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ben Greer
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ashley Polhemus
- Merck Research Labs IT, Merck Sharpe & Dohme, Prague, Czech Republic
| | - Jan Novák
- Merck Research Labs IT, Merck Sharpe & Dohme, Prague, Czech Republic
| | - Jose Ferrao
- Merck Research Labs IT, Merck Sharpe & Dohme, Prague, Czech Republic
| | - Peter Gamble
- Merck Research Labs IT, Merck Sharpe & Dohme, Prague, Czech Republic
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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- RADAR-CNS, London, United Kingdom
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Verpoort PC, Narayan V. Chirality relaxation in low-temperature strongly Rashba-coupled systems. J Phys Condens Matter 2020; 32:355704. [PMID: 32240992 DOI: 10.1088/1361-648x/ab85f3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We study the relaxation dynamics of non-equilibrium chirality distributions of charge carriers in Rashba systems. We find that at low temperature inter-Rashba band transitions become suppressed due to the combined effect of the Rashba momentum split and the chiral spin texture of a Rashba system. Specifically, we show that momentum exchange between carriers and the phonon bath is effectively absent at temperatures where the momentum of thermal phonons is less than twice the Rashba momentum. This allows us to identify inter-carrier scattering as the dominant process by which non-equilibrium chirality distributions relax. We show that the magnitude of inter-carrier scattering is strongly influenced by the opposing spin structure of the Rashba bands. Finally, we provide an explicit result for the inter-band relaxation timescale associated with inter-carrier Coulomb scattering. We develop a general framework and assess its implications for GeTe, a bulk Rashba semiconductor with a strong Rashba momentum split.
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McLaughlin V, Kim NH, Hemnes AR, Highland KB, Chin KM, Farber HW, Zhao C, Narayan V, Shah M, Chakinala MM. P3671Selexipag dosing and titration in the first 500 patients enrolled in SPHERE (SelexiPag: tHe UsErs dRug rEgistry). Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0526] [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
Introduction
SPHERE is an ongoing US-based, multicentre, prospective, registry collecting data on use of the oral selective IP prostacyclin receptor agonist selexipag in real-world settings. Here, we report selexipag dosing and titration in the first 500 patients.
Methods
SPHERE, initiated in November 2016, will enrol 800 patients newly initiated on or already treated with selexipag at enrolment who have a documented titration regimen. Patients are followed for up to 18 months. Patients were considered “newly initiated” on selexipag if they were enrolled in SPHERE ≤60 days after starting selexipag and were considered “previously initiated” if they enrolled >60 days after starting selexipag. The highest dose is the maximum dose reached during up-titration within 6 months since initiation. Selexipag “maintenance dose” is defined as the first dose received for ≥14 days without interruption or change; “titration speed” is defined as the highest dose reached within the first 6 months after initiation divided by the time (in weeks) to reach it.
Results
The data cut-off for this analysis was December 20, 2018. Most patients had Group 1 pulmonary hypertension (PH) (95.4%), which was primarily idiopathic (49.6%) or connective tissue disease associated (26.0%). At selexipag initiation 49.8% of patients had functional class III symptoms. At the time of selexipag initiation, 19.2% of patients were on PH therapy containing a prostacyclin pathway agent (PPA) (8.5% with a parenteral PPA). The median maintenance dose of selexipag was 1200 μg BID (IQR: 800–1600 μg BID) and the median time to reach it was 8.1 wks (IQR: 5.3–11.0 wks). Low (≤400 μg BID), medium (600–1000 μg BID), and high (≥1200 μg BID) maintenance doses were attained by 15.1%, 30.8%, and 49.5% of patients, respectively (and in 23.2%, 31.2%, and 36.2%, respectively, in GRIPHON). The median titration speed was 175 μg BID/wk (IQR: 110.5–195.3 μg BID/wk), slower than the protocol-outlined 200 μg BID/wk in GRIPHON. In SPHERE, most patients titrated at speeds <200 μg BID/wk, regardless of whether they were newly (175 μg BID/wk; IQR 118.6, 195.3) or previously (175 μg BID/wk; IQR 109.8, 195.3) initiated. As expected, more patients discontinued due to adverse events in the newly (29.0%) versus previously (14.1%) initiated groups. The most common adverse events leading to selexipag discontinuation were worsening pulmonary hypertension (2.2%), headache (2.0%), myalgia (1.4%), and nausea (1.0%).
Conclusion
The median maintenance selexipag dose in SPHERE was 1200 μg BID. While the median titration speed was 175 μg BID/wk, there was marked variation and the vast majority of patients titrated slower than 200 μg BID/wk. No new safety signals were observed.
Acknowledgement/Funding
Actelion Pharmaceuticals US, Inc.
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Affiliation(s)
- V McLaughlin
- University of Michigan, Ann Arbor, United States of America
| | - N H Kim
- University of San Diego, La Jolla, United States of America
| | - A R Hemnes
- Vanderbilt University, Nashville, United States of America
| | - K B Highland
- Cleveland Clinic, Cleveland, United States of America
| | - K M Chin
- University of Texas Southwestern Medical School, Dallas, United States of America
| | - H W Farber
- Tufts Medical Center, Boston, United States of America
| | - C Zhao
- Actelion Pharmaceuticals US, Inc., South San Francisco, United States of America
| | - V Narayan
- Actelion Pharmaceuticals US, Inc., South San Francisco, United States of America
| | - M Shah
- Actelion Pharmaceuticals US, Inc., South San Francisco, United States of America
| | - M M Chakinala
- Washington University School of Medicine, St. Louis, United States of America
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Matcham F, Barattieri di San Pietro C, Bulgari V, de Girolamo G, Dobson R, Eriksson H, Folarin AA, Haro JM, Kerz M, Lamers F, Li Q, Manyakov NV, Mohr DC, Myin-Germeys I, Narayan V, BWJH P, Ranjan Y, Rashid Z, Rintala A, Siddi S, Simblett SK, Wykes T, Hotopf M. Remote assessment of disease and relapse in major depressive disorder (RADAR-MDD): a multi-centre prospective cohort study protocol. BMC Psychiatry 2019; 19:72. [PMID: 30777041 PMCID: PMC6379954 DOI: 10.1186/s12888-019-2049-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 02/01/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND There is a growing body of literature highlighting the role that wearable and mobile remote measurement technology (RMT) can play in measuring symptoms of major depressive disorder (MDD). Outcomes assessment typically relies on self-report, which can be biased by dysfunctional perceptions and current symptom severity. Predictors of depressive relapse include disrupted sleep, reduced sociability, physical activity, changes in mood, prosody and cognitive function, which are all amenable to measurement via RMT. This study aims to: 1) determine the usability, feasibility and acceptability of RMT; 2) improve and refine clinical outcome measurement using RMT to identify current clinical state; 3) determine whether RMT can provide information predictive of depressive relapse and other critical outcomes. METHODS RADAR-MDD is a multi-site prospective cohort study, aiming to recruit 600 participants with a history of depressive disorder across three sites: London, Amsterdam and Barcelona. Participants will be asked to wear a wrist-worn activity tracker and download several apps onto their smartphones. These apps will be used to either collect data passively from existing smartphone sensors, or to deliver questionnaires, cognitive tasks, and speech assessments. The wearable device, smartphone sensors and questionnaires will collect data for up to 2-years about participants' sleep, physical activity, stress, mood, sociability, speech patterns, and cognitive function. The primary outcome of interest is MDD relapse, defined via the Inventory of Depressive Symptomatology- Self-Report questionnaire (IDS-SR) and the World Health Organisation's self-reported Composite International Diagnostic Interview (CIDI-SF). DISCUSSION This study aims to provide insight into the early predictors of major depressive relapse, measured unobtrusively via RMT. If found to be acceptable to patients and other key stakeholders and able to provide clinically useful information predictive of future deterioration, RMT has potential to change the way in which depression and other long-term conditions are measured and managed.
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Affiliation(s)
- F. Matcham
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - C. Barattieri di San Pietro
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Univeristy of Milan-Bicocca, Milan, Italy
| | - V. Bulgari
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - G. de Girolamo
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - R. Dobson
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | - A. A. Folarin
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - M. Kerz
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - F. Lamers
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Q. Li
- Janssen Research and Development, LLC, Titusville, NJ USA
| | | | - D. C. Mohr
- Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL USA
| | - I. Myin-Germeys
- Department for Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - V. Narayan
- Janssen Research and Development, LLC, Titusville, NJ USA
| | - Penninx BWJH
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Y. Ranjan
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Z. Rashid
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - A. Rintala
- Department for Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - S. Siddi
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - S. K. Simblett
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - T. Wykes
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - M. Hotopf
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Taku N, Narayan V, Vapiwala N. Overall Survival for Men with High Risk Prostate Cancer and Co-Morbidities after Treatment with External Beam Radiation Therapy and Androgen Deprivation Therapy Versus External Beam Radiation Therapy Alone. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Taku N, Narayan V, Bellamy S, Vapiwala N. Prevalence and Predictors of Active Surveillance Utilization Among Hispanic, Black, and White Men Diagnosed With Favorable Intermediate-Risk Prostate Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1600] [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: 12/01/2022]
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16
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Mackin S, Morrison R, Insel P, Mosca K, Finley S, Truran‐Sacrey D, Flenniken D, Nosheny R, Li H, Seabrook G, Narayan V, Weiner M. [O2–16–05]: VALIDATION OF A COMPUTERIZED NEUROPSYCHOLOGICAL TEST BATTERY INCLUDING VERBAL MEMORY USING SPEECH RECOGNITION SOFTWARE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.239] [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: 10/18/2022]
Affiliation(s)
- Scott Mackin
- University of California, San FranciscoSan FranciscoCAUSA
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
- Mental Health ServiceDepartment of Veterans Affairs Medical CenterSan FranciscoCAUSA
- Janssen Research and Development LLCTitusvilleNJUSA
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco Veterans Affairs Medical CenterSan FranciscoCAUSA
| | | | - Philip Insel
- University of California, San FranciscoSan FranciscoCAUSA
| | - Kenneth Mosca
- University of California, San FranciscoSan FranciscoCAUSA
| | - Shannon Finley
- University of California, San FranciscoSan FranciscoCAUSA
| | | | | | - Rachel Nosheny
- University of California, San FranciscoSan FranciscoCAUSA
| | - Han Li
- University of California, San FranciscoSan FranciscoCAUSA
| | - Guy Seabrook
- University of California, San FranciscoSan FranciscoCAUSA
| | | | - Michael Weiner
- University of California, San FranciscoSan FranciscoCAUSA
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17
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Coroller T, Agrawal V, Narayan V, Grossmann P, Hou Y, Lee S, Mak R, Aerts H. Radiomics Predict Pathological Response in Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Vapiwala N, Narayan V, Subramanian P, Christodouleas J, Bekelman J, Mick R, Rajendran R, Haas N. Phase I Trial of Everolimus in Combination with Salvage Radiation Therapy (RT) for Post-prostatectomy Biochemical Recurrence (BCR) in Prostate Cancer (PC) Patients. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rios Velazquez E, Liu Y, Parmar C, Narayan V, Gillies R, Aerts H. MO-DE-207B-08: Radiomic CT Features Complement Semantic Annotations to Predict EGFR Mutations in Lung Adenocarcinomas. Med Phys 2016. [DOI: 10.1118/1.4957257] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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20
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Coroller T, Agrawal V, Narayan V, Lee S, Mak R, Aerts H. TU-D-207B-06: Pathological Response Prediction by Radiomic Data From Primary and Lymph Nodes in NSCLC. Med Phys 2016. [DOI: 10.1118/1.4957514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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21
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Huynh E, Coroller T, Narayan V, Agrawal V, Romano J, Franco I, Hou Y, Mak R, Aerts H. SU-F-R-52: A Comparison of the Performance of Radiomic Features From Free Breathing and 4DCT Scans in Predicting Disease Recurrence in Lung Cancer SBRT Patients. Med Phys 2016. [DOI: 10.1118/1.4955823] [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: 11/07/2022] Open
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22
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Grossmann P, Narayan V, Huang R, Aerts H. TU-D-207B-07: Radiomic Response Assessment for Recurrent Glioblastoma Treated with Bevacizumab in the BRAIN Trial. Med Phys 2016. [DOI: 10.1118/1.4957515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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23
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Huynh E, Coroller T, Narayan V, Agrawal V, Hou Y, Romano J, Franco I, Mak R, Aerts H. SU-F-R-53: CT-Based Radiomics Analysis of Non-Small Cell Lung Cancer Patients Treated with Stereotactic Body Radiation Therapy. Med Phys 2016. [DOI: 10.1118/1.4955824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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24
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Velazquez ER, Narayan V, Grossmann P, Dunn W, Gutman D, Aerts H. TU-CD-BRB-04: Automated Radiomic Features Complement the Prognostic Value of VASARI in the TCGA-GBM Dataset. Med Phys 2015. [DOI: 10.1118/1.4925589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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25
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Burnham S, Raghavan N, Wilson B, Baker D, Ropacki MT, Novak G, Ames D, Ellis KA, Martins R, Maruff P, Masters CL, Romano G, Rowe CC, Savage G, Twyman R, Macaulay L, Narayan V, AIBL Research Group. P4‐293: COMPARISON OF THREE NORMATIVE DATA CORRECTION APPROACHES: A CROSS‐SECTIONAL EVALUATION IN THE AIBL STUDY. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.07.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | | | | | | | - David Ames
- National Ageing Research Institute Inc. (NARI)ParkvilleAustralia
| | | | | | | | | | | | | | | | - Roy Twyman
- JanssenTitusvilleNew JerseyUnited States
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26
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Sinha L, Prasad O, Karabacak M, Mishra HN, Narayan V, Asiri AM. Quantum-chemical (DFT, MP2) and spectroscopic studies (FT-IR and UV) of monomeric and dimeric structures of 2(3H)-Benzothiazolone. Spectrochim Acta A Mol Biomol Spectrosc 2013; 120:126-136. [PMID: 24177879 DOI: 10.1016/j.saa.2013.09.125] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/26/2013] [Accepted: 09/27/2013] [Indexed: 06/02/2023]
Abstract
Molecular geometry and vibrational wavenumbers of 2(3H)-Benzothiazolone (C7H5NSO, HBT) was investigated using density functional (DFT/B3LYP) method with 6-311+G(d,p) basis set. The vibrational wavenumbers are found to be in good agreement with experimental FT-IR spectra. Hydrogen-bonded dimer of HBT, optimized by counterpoise correction, was studied by MP2 and DFT/B3LYP at the 6-311+G(d,p) level and the effects of molecular association through NH---O hydrogen bonding were discussed. A detailed analysis of the nature of the hydrogen bonding, using topological parameters, such as electronic charge density, Laplacian, kinetic and potential energy density evaluated at bond critical points (BCP) has also been presented. The UV absorption spectra of the compound dissolved in ethanol and chloroform solutions were recorded in the range of 200-600 nm. The UV-vis spectrum of the title molecule was also calculated using TD-DFT method. The calculated energy and oscillator strength almost exactly reproduce the experimental data. Total and partial density of state (TDOS, PDOS) of the HBT in terms of HOMOs and LUMOs and molecular electrostatic potential (MEP) were calculated and analyzed. The electric dipole moment, polarizability and the first static hyper-polarizability values for HBT were calculated at the DFT/B3LYP with 6-311+G(d,p) basis set. The results also show that the HBT molecule may have nonlinear optical (NLO) comportment with non-zero values. Stability of the molecule arising from hyper-conjugative interactions and charge delocalization was analyzed using natural bond orbital (NBO) analysis.
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Affiliation(s)
- L Sinha
- Department of Physics, University of Lucknow, 226007 Lucknow, India
| | - O Prasad
- Department of Physics, University of Lucknow, 226007 Lucknow, India
| | - M Karabacak
- Department of Mechatronics Engineering, H.F.T. Technology Faculty, Celal Bayar University, 45400 Turgutlu, Manisa, Turkey.
| | - H N Mishra
- Department of Physics, University of Lucknow, 226007 Lucknow, India
| | - V Narayan
- Department of Physics, University of Lucknow, 226007 Lucknow, India
| | - A M Asiri
- Department of Chemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia; Center of Excellence for Advanced Materials Research, King Abdulaziz University, Jeddah, Saudi Arabia
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Tryputsen V, DiBernardo A, Schmidt M, Narayan V, Raghavan N. P1–353: Optimizing region‐of‐interest composites for capturing treatment effects on amyloid in clinical trials. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.580] [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: 11/16/2022]
Affiliation(s)
- Volha Tryputsen
- Janssen, Pharmaceutical Companies of J&J Raritan New Jersey United States
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Yang E, Raghavan N, Tryputsen V, Novak G, Romano G, Narayan V. P4–223: On the selection of cognitive and functional markers of brain volume and atrophy. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.1615] [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: 10/26/2022]
Affiliation(s)
- Eric Yang
- Johnson & Johnson Spring House Pennsylvania United States
| | | | - Volha Tryputsen
- Janssen, Pharmaceutical Companies of J&J Raritan New Jersey United States
| | - Gerald Novak
- Janssen Pharmaceutical Research and Development Titusville New Jersey United States
| | - Gary Romano
- Janssen Pharmaceutical R&D Titusville New Jersey United States
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29
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Leung YY, Toledo J, Nefedov A, Polikar R, Raghavan N, Xie S, Farnum M, Schultz T, Baek Y, Lobanov V, DiBernardo A, Van Deerlin V, Kling M, Chen‐Plotkin A, Mailman M, Hu W, Perrin R, Fagan A, Grossman M, Holtzman D, Soares H, Morris J, Baker D, Arnold S, Narayan V, Lee V, Shaw L, Wittenberg G, Wang L, Trojanowski J. O1–02–05: Identifying multi‐analyte CSF biomarkers for Alzheimer's disease in a multi‐cohort study. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.04.059] [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: 11/29/2022]
Affiliation(s)
- Yuk Yee Leung
- University of Pennsylvania Philadelphia Pennsylvania United States
| | - Juan Toledo
- University of Pennsylvania School of Medicine Philadelphia Pennsylvania United States
| | - Alexey Nefedov
- University of Pennsylvania Philadelphia Pennsylvania United States
| | - Robi Polikar
- Rowan University Glassboro New Jersey United States
| | | | - Sharon Xie
- University of Pennsylvania School of Medicine Philadelphia Pennsylvania United States
| | - Michael Farnum
- Janssen Pharmaceuticals Spring House Pennsylvania United States
| | - Tim Schultz
- Janssen Pharmaceuticals Spring House Pennsylvania United States
| | - Young Baek
- University of Pennsylvania School of Medicine Philadelphia Pennsylvania United States
| | - Victor Lobanov
- Janssen Pharmaceuticals Spring House Pennsylvania United States
| | | | | | - Mitchel Kling
- Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania United States
| | | | | | - William Hu
- Emory University Atlanta Georgia United States
| | - Richard Perrin
- Washington University, St. Louis St. Louis Missouri United States
| | - Anne Fagan
- Boston University Boston Massachusetts United States
| | - Murray Grossman
- University of Pennsylvania Philadelphia Pennsylvania United States
| | - David Holtzman
- Washington University, St. Louis St. Louis Missouri United States
| | - Holly Soares
- Bristol Myers Squibb Wallingford Connecticut United States
| | - John Morris
- Washington University, St. Louis St. Louis Missouri United States
| | - David Baker
- Janssen R&D Titusville New Jersey United States
| | - Steven Arnold
- University of Pennsylvania School of Medicine Philadelphia Pennsylvania United States
| | | | - Virginia Lee
- University of Pennsylvania Philadelphia Pennsylvania United States
| | - Leslie Shaw
- University of Pennsylvania Medical Center Philadelphia Pennsylvania United States
| | | | - Li‐San Wang
- University of Pennsylvania School of Medicine Philadelphia Pennsylvania United States
| | - John Trojanowski
- University of Pennsylvania School of Medicine Philadelphia Pennsylvania United States
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30
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Schultz T, Yang E, Farnum M, Lobanov V, Verbeeck R, Raghavan N, Samtani MN, Novak G, Shi Y, Narayan V, DiBernardo A. A novel subject synchronization clinical trial design for Alzheimer's disease. J Alzheimers Dis 2013; 31:507-16. [PMID: 22614878 DOI: 10.3233/jad-2012-120286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
One of the challenges in developing a viable therapy for Alzheimer's disease has been demonstrating efficacy within a clinical trial. Using this as motivation, we sought to re-examine conventional clinical trial practices in order to determine whether efficacy can be better shown through alternative trial designs and novel analysis methods. In this work, we hypothesize that the confounding factors which hamper the ability to discern a treatment signal are the variability in observations as well as the insidious nature of the disease. We demonstrate that a two-phase trial design in which drug dosing is administered after a certain level of disease severity has been reached, coupled with a method to account more accurately for the progression of the disease, may allow us to compensate for these factors, and thus enable us to make treatment effects more apparent. Utilizing data from two previously failed trials which involved the evaluation of galantamine for indication in mild cognitive impairment, we were able to demonstrate that a clear treatment effect can be realized through both visual and statistical means, and propose that future trials may be more likely to show success if similar methods are utilized.
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Affiliation(s)
- Timothy Schultz
- Janssen Pharmaceutical Companies of Johnson and Johnson, Raritan, NJ 08869, USA.
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31
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Sinha L, Karabacak M, Narayan V, Cinar M, Prasad O. Molecular structure, electronic properties, NLO, NBO analysis and spectroscopic characterization of Gabapentin with experimental (FT-IR and FT-Raman) techniques and quantum chemical calculations. Spectrochim Acta A Mol Biomol Spectrosc 2013; 109:298-307. [PMID: 23545435 DOI: 10.1016/j.saa.2013.02.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 02/13/2013] [Accepted: 02/16/2013] [Indexed: 06/02/2023]
Abstract
Gabapentin (GP), structurally related to the neurotransmitter GABA (gamma-aminobutyric acid), mimics the activity of GABA and is also widely used in neurology for the treatment of peripheral neuropathic pain. It exists in zwitterionic form in solid state. The present communication deals with the quantum chemical calculations of energies, geometrical structure and vibrational wavenumbers of GP using density functional (DFT/B3LYP) method with 6-311++G(d,p) basis set. In view of the fact that amino acids exist as zwitterions as well as in the neutral form depending on the environment (solvent, pH, etc.), molecular properties of both the zwitterionic and neutral form of GP have been analyzed. The fundamental vibrational wavenumbers as well as their intensities were calculated and compared with experimental FT-IR and FT-Raman spectra. The fundamental assignments were done on the basis of the total energy distribution (TED) of the vibrational modes, calculated with scaled quantum mechanical (SQM) method. The electric dipole moment, polarizability and the first hyperpolarizability values of the GP have been calculated at the same level of theory and basis set. The nonlinear optical (NLO) behavior of zwitterionic and neutral form has been compared. Stability of the molecule arising from hyper-conjugative interactions and charge delocalization has been analyzed using natural bond orbital analysis. Ultraviolet-visible (UV-Vis) spectrum of the title molecule has also been calculated using TD-DFT method. The thermodynamic properties of both the zwitterionic and neutral form of GP at different temperatures have been calculated.
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Affiliation(s)
- Leena Sinha
- Department of Physics, University of Lucknow, 226 007 Lucknow, India
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Raghavan N, Samtani MN, Farnum M, Yang E, Novak G, Grundman M, Narayan V, DiBernardo A. The ADAS-Cog revisited: novel composite scales based on ADAS-Cog to improve efficiency in MCI and early AD trials. Alzheimers Dement 2013; 9:S21-31. [PMID: 23127469 PMCID: PMC3732822 DOI: 10.1016/j.jalz.2012.05.2187] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 04/15/2012] [Accepted: 05/18/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) has been used widely as a cognitive end point in Alzheimer's Disease (AD) clinical trials. Efforts to treat AD pathology at earlier stages have also used ADAS-Cog, but failure in these trials can be difficult to interpret because the scale has well-known ceiling effects that limit its use in mild cognitive impairment (MCI) and early AD. A wealth of data exists in ADAS-Cog from both historical trials and contemporary longitudinal natural history studies that can provide insights about parts of the scale that may be better suited for MCI and early AD trials. METHODS Using Alzheimer's Disease Neuroimaging Initiative study data, we identified the most informative cognitive measures from the ADAS-Cog and other available scales. We used cross-sectional analyses to characterize trajectories of ADAS-Cog and its individual subscales, as well as other cognitive, functional, or global measures across disease stages. Informative measures were identified based on standardized mean of 2-year change from baseline and were combined into novel composite endpoints. We assessed performance of the novel endpoints based on sample size requirements for a 2-year clinical trial. A bootstrap validation procedure was also undertaken to assess the reproducibility of the standardized mean changes of the selected measures and the corresponding composites. RESULTS All proposed novel endpoints have improved standardized mean changes and thus improved statistical power compared with the ADAS-Cog 11. Further improvements were achieved by using cognitive-functional composites. Combining the novel composites with an enrichment strategy based on cerebral spinal fluid beta-amyloid (Aβ(1-42)) in a 2-year trial yielded gains in power of 20% to 40% over ADAS-Cog 11, regardless of the novel measure considered. CONCLUSION An empirical, data-driven approach with existing instruments was used to derive novel composite scales based on ADAS-Cog 11 with improved performance characteristics for MCI and early AD clinical trials. Together with patient enrichment based on Aβ(1-42) pathology, these modified endpoints may allow more efficient clinical trials in these populations and can be assessed without modifying current test administration procedures in ongoing trials.
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Affiliation(s)
- Nandini Raghavan
- Janssen Pharmaceutical Companies of Johnson & Johnson, Raritan, NJ, USA.
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33
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Yang E, Farnum M, Lobanov V, Schultz T, Verbeeck R, Raghavan N, Samtani MN, Novak G, Narayan V, DiBernardo A. Quantifying the pathophysiological timeline of Alzheimer's disease. J Alzheimers Dis 2012; 26:745-53. [PMID: 21694449 DOI: 10.3233/jad-2011-110551] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hypothetical models of AD progression typically relate clinical stages of AD to sequential changes in CSF biomarkers, imaging, and cognition. However, quantifying the continuous trajectories proposed by these models over time is difficult because of the difficulty in relating the dynamics of different biomarkers during a clinical trial that is significantly shorter than the duration of the disease. We seek to show that through proper synchronization, it is possible to de-convolve these trends and quantify the periods of time associated with different pathophysiological changes associated with Alzheimer's disease (AD). We developed a model that replicated the observed progression of ADAS-Cog 13 scores and used this as a more precise estimate of disease-duration and thus pathologic stage. We then synchronized cerebrospinal fluid (CSF) and imaging biomarkers according to our new disease timeline. By de-convolving disease progression via ADAS-Cog 13, we were able to confirm the predictions of previous hypothetical models of disease progression as well as establish concrete timelines for different pathobiological events. Specifically, our work supports a sequential pattern of biomarker changes in AD in which reduction in CSF Aβ(42) and brain atrophy precede the increases in CSF tau and phospho-tau.
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Samtani MN, Farnum M, Lobanov V, Yang E, Raghavan N, Dibernardo A, Narayan V. An improved model for disease progression in patients from the Alzheimer's disease neuroimaging initiative. J Clin Pharmacol 2011; 52:629-44. [PMID: 21659625 DOI: 10.1177/0091270011405497] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this analysis was to develop a semi-mechanistic nonlinear disease progression model using an expanded set of covariates that captures the longitudinal change of Alzheimer's Disease Assessment Scale (ADAS-cog) scores from the Alzheimer's Disease Neuroimaging Initiative study that consisted of 191 Alzheimer disease patients who were followed for 2 years. The model describes the rate of progression and baseline disease severity as a function of influential covariates. The covariates that were tested fell into 4 categories: (1) imaging volumetric measures, (2) serum biomarkers, (3) demographic and genetic factors, and (4) baseline cognitive tests. Covariates found to affect baseline disease status were years since disease onset, hippocampal volume, and ventricular volume. Disease progression rate in the model was influenced by age, total cholesterol, APOE ε4 genotype, Trail Making Test (part B) score, and current levels of impairment as measured by ADAS-cog. Rate of progression was slower for mild and severe Alzheimer patients compared with moderate Alzheimer patients who exhibited faster rates of deterioration. In conclusion, this model describes disease progression in Alzheimer patients using novel covariates that are important for understanding the worsening of ADAS-cog scores over time and may be useful in the future for optimizing study designs through clinical trial simulations.
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Affiliation(s)
- Mahesh N Samtani
- Johnson & Johnson Pharmaceutical Research & Development, Raritan, NJ, USA.
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35
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Affiliation(s)
- V. Narayan
- Centre for Condensed Matter Theory, Department of Physics, Indian Institute of Science, Bangalore 560012, India
- Department of Physics, University of Massachusetts, Amherst, MA 01003, USA
| | - S. Ramaswamy
- Centre for Condensed Matter Theory, Department of Physics, Indian Institute of Science, Bangalore 560012, India
- Department of Physics, University of Massachusetts, Amherst, MA 01003, USA
| | - N. Menon
- Centre for Condensed Matter Theory, Department of Physics, Indian Institute of Science, Bangalore 560012, India
- Department of Physics, University of Massachusetts, Amherst, MA 01003, USA
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36
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Prathima KM, Harendrakumar ML, Srikantia SH, Maiya GL, Narayan V. Hemangiopericytoma of mesentery: a case report. INDIAN J PATHOL MICR 2003; 46:69-70. [PMID: 15027729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Mesenteric tumors are rare, most commonly encountered lesions are fibromatoses and leiomyoma. A case of hemangiopericytoma of mesentery in a 38 years old female is reported for its rarity. The classical histological findings and recticulin stain to demonstrate blood vessels & recticulin fibers, encircling individual tumor cells aids in the correct diagnosis.
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Affiliation(s)
- K M Prathima
- Department of Pathology, Sri Devraj URS Medical College, Tamaka, Kolar
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Abstract
Serial plain radiographic, ultrasound and CT findings of an unusual case of pulmonary blastoma are described with a review of the literature.
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Affiliation(s)
- N Shyamkumar
- Department of Radiodiagnosis, Christian Medical College Hospital, Vellore, Tamil Nadu 632 004, India.
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38
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Stadler I, Lanzafame RJ, Evans R, Narayan V, Dailey B, Buehner N, Naim JO. 830-nm irradiation increases the wound tensile strength in a diabetic murine model. Lasers Surg Med 2001; 28:220-6. [PMID: 11295756 DOI: 10.1002/lsm.1042] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND OBJECTIVE The purpose of this study was to investigate the effects of low-power laser irradiation on wound healing in genetic diabetes. STUDY DESIGN/MATERIALS AND METHODS Female C57BL/Ksj/db/db mice received 2 dorsal 1 cm full-thickness incisions and laser irradiation (830 nm, 79 mW/cm(2), 5.0 J/cm(2)/wound). Daily low-level laser therapy (LLLT) occurred over 0-4 days, 3-7 days, or nonirradiated. On sacrifice at 11 or 23 days, wounds were excised, and tensile strengths were measured and standardized. RESULTS Nontreated diabetic wound tensile strength was 0.77 +/- 0.22 g/mm(2) and 1.51 +/- 0.13 g/mm(2) at 11 and 23 days. After LLLT, over 0-4 days tensile strength was 1.15 +/- 0.14 g/mm(2) and 2.45 +/- 0.29 g/mm(2) (P = 0.0019). Higher tensile strength at 23 days occurred in the 3- to 7-day group (2.72 +/- 0.56 g/mm(2) LLLT vs. 1.51 +/- 0.13 g/mm(2) nontreated; P < or = 0.01). CONCLUSION Low-power laser irradiation at 830 nm significantly enhances cutaneous wound tensile strength in a murine diabetic model. Further investigation of the mechanism of LLLT in primary wound healing is warranted.
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Affiliation(s)
- I Stadler
- The Laser Center, Rochester General Hospital, Rochester, New York 14621, USA.
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Abstract
BACKGROUND AND OBJECTIVE The effects of low-level laser light irradiation are still highly contested, and the mechanisms of its action still unclear. This study was conducted to test the effects of low-level laser irradiation at 660 nm on human lymphocytes and to investigate the possible mechanisms by which these effects are produced. STUDY DESIGN/MATERIALS AND METHODS Whole blood obtained by phlebotomy was irradiated at 660 nm by using energy fluences between 0 and 5.0 J/cm(2). The lymphocytes were isolated after irradiation of the whole blood. For the control experiment, the lymphocytes were first isolated and then irradiated at the same wavelength and energy fluence for comparison. The proliferation of lymphocytes and the formation of free radicals and lipid peroxides were monitored. Hemoglobin was also irradiated in a cell-free environment to test for the production of lipid peroxides. RESULTS Lymphocyte proliferation was significantly higher (P<0.05) as expressed by a Stimulation Index in samples irradiated in the presence of whole blood compared with lymphocytes irradiated after isolation from whole blood. Free radical and lipid peroxide production also increased significantly when samples were irradiated in the presence of red blood cells. CONCLUSION The present study supports the hypothesis that one mechanism for the photobiostimulation effect after irradiation at 660 nm is the reaction of light with hemoglobin, resulting in oxygen radical production.
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Affiliation(s)
- I Stadler
- The Laser Center and Department of Surgery, Rochester General Hospital, Rochester, New York 14621, USA.
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40
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Uetz P, Giot L, Cagney G, Mansfield TA, Judson RS, Knight JR, Lockshon D, Narayan V, Srinivasan M, Pochart P, Qureshi-Emili A, Li Y, Godwin B, Conover D, Kalbfleisch T, Vijayadamodar G, Yang M, Johnston M, Fields S, Rothberg JM. A comprehensive analysis of protein-protein interactions in Saccharomyces cerevisiae. Nature 2000; 403:623-7. [PMID: 10688190 DOI: 10.1038/35001009] [Citation(s) in RCA: 3099] [Impact Index Per Article: 129.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Two large-scale yeast two-hybrid screens were undertaken to identify protein-protein interactions between full-length open reading frames predicted from the Saccharomyces cerevisiae genome sequence. In one approach, we constructed a protein array of about 6,000 yeast transformants, with each transformant expressing one of the open reading frames as a fusion to an activation domain. This array was screened by a simple and automated procedure for 192 yeast proteins, with positive responses identified by their positions in the array. In a second approach, we pooled cells expressing one of about 6,000 activation domain fusions to generate a library. We used a high-throughput screening procedure to screen nearly all of the 6,000 predicted yeast proteins, expressed as Gal4 DNA-binding domain fusion proteins, against the library, and characterized positives by sequence analysis. These approaches resulted in the detection of 957 putative interactions involving 1,004 S. cerevisiae proteins. These data reveal interactions that place functionally unclassified proteins in a biological context, interactions between proteins involved in the same biological function, and interactions that link biological functions together into larger cellular processes. The results of these screens are shown here.
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Affiliation(s)
- P Uetz
- Department of Genetics, University of Washington, Seattle 98195-7360, USA
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Kriska AM, Gregg EW, Utter AC, Knowler WC, Narayan V, Bennett PH. 674 ASSOCIATION OF PHYSICAL ACTIVITY AND PLASMA INSULIN LEVELS IN A POPULATION AT HIGH RISK FOR NIDDM. Med Sci Sports Exerc 1994. [DOI: 10.1249/00005768-199405001-00676] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Narayan V. Assessing Health Need using the Life Cycle Framework. Br J Soc Med 1993. [DOI: 10.1136/jech.47.5.429-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Murray S, Narayan V, Mitchell M, Witte H. Study of dietetic knowledge among members of the primary health care team. Br J Gen Pract 1993; 43:229-31. [PMID: 8373644 PMCID: PMC1372418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
There is growing emphasis on health promotion in primary care. The success of this endeavour depends in part on the ability of members of the primary health care team to provide appropriate and practical advice and support, relating to lifestyle. A study of 58 primary health care professionals was carried out in the Grampian region of Scotland to assess their nutritional knowledge and their ability to provide practical dietary advice, particularly in relation to the prevention of coronary heart disease. Overall, the primary health care workers had a broad understanding of recommendations for healthy eating, but there was some confusion over specific aspects of these recommendations. Health professionals also found it difficult to translate knowledge into practical dietary advice tailored to an individual case. If health promotion in primary care is to work effectively, the infrastructure necessary for effective training and continuing education has to be addressed.
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Affiliation(s)
- S Murray
- Department of Dietetics, Aberdeen Royal Hospitals NHS Trust
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Abstract
A prospective study of children attending an Accident and Emergency Department was carried out at the Royal Aberdeen Children's Hospital, to determine the association between injury risk and seat restraint usage, and to estimate the likely impact of seat restraint usage at various target levels on the incidence of non-fatal injuries. The subjects were all 91 cases of non-fatal childhood road traffic accidents attending the casualty department between December 1989 and November 1990. The main outcome measures were relative risks of three grades of injury severity and four types of non-fatal injury, population attributable risk fractions and estimated likely reduction in incidence of non-fatal injury at three set target levels of seat restraint usage. It was found that 42 (46 per cent) children presenting to the A&E Department were unrestrained; 78 (85.7 per cent) children sustained some injury. The relative risk for children travelling unrestrained in a car for all injuries combined is 1.7 (95 per cent confidence interval (CI) 1.17-2.45), the relative risk for head injury is 3.13 (1.78-5.51) and for face injury 3.03 (1.44-6.37). The risk of sustaining any moderate or worse injury was 3.25 (1.05-10.07). It is estimated that 24.4 per cent (minimum 5.5 per cent; maximum 45 per cent) of all non-fatal injuries sustained by a child car passenger can be prevented if all children are restrained in a child safety seat or seat restraint; 49.5 per cent of head injuries (minimum 43.4 per cent; maximum 71.9 per cent) and 48.4 per cent of face injuries (minimum 21.9 per cent; maximum 75.3 per cent) are preventable.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- D Ruta
- Department of Public Health, Aberdeen University
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Costello AM, Kumar A, Narayan V, Akbar MS, Ahmed S, Abou-Zeid C, Rook GA, Stanford J, Moreno C. Does antibody to mycobacterial antigens, including lipoarabinomannan, limit dissemination in childhood tuberculosis? Trans R Soc Trop Med Hyg 1992; 86:686-92. [PMID: 1287946 DOI: 10.1016/0035-9203(92)90192-f] [Citation(s) in RCA: 86] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Serum immunoglobulin (Ig) G responses to a variety of mycobacterial antigens were measured in children from the UK, in children with tuberculosis from Hyderabad, India and Dhaka, Bangladesh, classified according to whether the disease was disseminated or localized, and in non-tuberculous controls. Anti-lipoarabinomannan (LAM) IgG responses in UK children showed a marked trough between 6 months and 3 years coincident with the reported peak incidence of disseminated tuberculosis. Geometric mean IgG responses to sonicates of slow-growing mycobacteria (rich in LAM) in 36 children with disseminated tuberculosis were markedly lower than in 99 children with localized tuberculous lesions (for Mycobacterium scrofulaceum P < 0.01, for M. tuberculosis P < 0.01, and for M. vaccae P < 0.01). Responses to purified LAM were also lower in the disseminated tuberculosis group (P < 0.05) but there was no difference between the groups in their response to mycobacterial 65 kDa protein. Multiple regression analysis showed that the reduced response to sonicated mycobacterial antigens and to LAM in children with disseminated disease was independent of age, nutritional status, skin test reactivity, duration of previous symptoms, and city of origin. There was no evidence for sequestration of antibody to immune complexes. These findings are compatible with the hypothesis that children with low levels of antibody to sonicated mycobacterial antigen and to LAM, or those who cannot mount an antibody response, are predisposed to dissemination. A role for antibody in preventing disseminated forms of tuberculosis in childhood has implications for the development of improved vaccines and for the optimum timing of vaccination with bacille Calmette-Guérin.
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Affiliation(s)
- A M Costello
- Department of Child Health, Niloufer Hospital, Hyderabad, Bangladesh
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Abstract
A population-based cohort study identified 915 deaths in 4186 patients with diabetes mellitus over a 5-year period. Ischaemic heart disease, cerebrovascular disease and malignant neoplasms were the major causes of death and accounted for 40%, 16%, and 14% of deaths, respectively, compared with 27%, 14%, and 25% of deaths in the non-diabetic population. Diabetic patients had a standardized mortality ratio (SMR) of 1.15 (95% Cl 1.08-1.22) (p less than 0.001). This excess risk of death was largely due to the excess death from ischaemic heart disease (SMR 1.55 (1.40-1.71); p less than 0.001) and the impact was greatest in middle-aged female patients. Stroke mortality was not significantly increased (SMR 1.09 (0.92-1.29)) while cancer mortality was reduced (SMR 0.75 (0.63-0.89); p less than 0.01). Death rates in diabetic male patients (SMR 1.04 (0.96-1.13)) did not differ significantly from those in non-diabetic male patients because the increased risk of ischaemic heart disease deaths (SMR 1.41 (1.22-1.62); p less than 0.001) was offset by the reduced risk of deaths from malignant neoplasms (SMR 0.65 (0.51-0.82); p less than 0.001). The reduction in cancer mortality did not reach statistical significance in diabetic women (SMR 0.82 (0.64-1.05)). Diabetic nephropathy and metabolic disasters were uncommon as causes of death.
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Affiliation(s)
- J S Wong
- Diabetic Clinic, Grampian Health Board, Aberdeen, UK
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Abstract
Apparent motion was investigated as a stimulus for optokinetic nystagmus (OKN) and self-motion perception (vection). Apparent motion was stimulated by stroboscopically illuminating vertical stripes on the interior of a large drum that rotated about the observer at 20, 40 and 60 deg/sec. We determined threshold stroboscopic frequencies (f) for the appearance of smooth continuous apparent motion and measured responses of pursuit, OKN, optokinetic after nystagmus (OKAN) and vection, to stroboscopic frequencies at, above and below f. Pursuit occurred for all of these stimuli. However OKN, OKAN and vection only occurred for frequencies equal to or greater than the threshold for continuous apparent motion. Our results suggest that pursuit can occur as a response to apparent motion generated by both small and large image displacements, while OKN and vection are responses to apparent motion generated by small image displacements only. These results suggest that different afferent sources are utilized for the control of pursuit and of the slow phase of OKN.
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Abstract
During the first few months of life after birth human infants when tested monocularly move their unoccluded eye nasalward in darkness after viewing a large textured visual field moving either nasalward or temporalward. The eye movements in darkness are optokinetic after nystagmus (OKAN) which is an aftereffect of a reflex horizontal following eye movement, optokinetic nystagmus (OKN). Not until 4-5 months of age did temporalward field motion evoke OKAN with temporalward slow phase. The nasalward slow phase of OKAN that responded earlier to temporalward field motion appears to underlie the delayed development of reflex following eye movements in the temporalward direction.
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Abstract
A new form of graphical case analysis is described which quantifies static interactions between accommodative convergence, convergence accommodation, and prism adaptation. A clinical gradient measure of the CA/C ratio is compared to haploscopic measures to demonstrate the validity of the new clinical technique for measuring convergence accommodation. Graphical and computational methods are illustrated which predict the quantitative interactions between accommodation and convergence that occur after the phoria is partially corrected by lenses or prisms. Complete correction of convergence accommodation errors with spherical lenses or elimination of the stimulus to convergence accommodation by full correction of the associated phoria with prism will simplify the correction of binocular disorders by preventing the complex interactions of accommodative convergence with convergence accommodation. The new form of graphical analysis quantifies the predicted stress upon binocular vision induced by convergence accommodation.
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