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Lenin RR, Koh YH, Zhang Z, Yeo YZ, Parikh BH, Seah I, Wong W, Su X. Dysfunctional Autophagy, Proteostasis, and Mitochondria as a Prelude to Age-Related Macular Degeneration. Int J Mol Sci 2023; 24:ijms24108763. [PMID: 37240109 DOI: 10.3390/ijms24108763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Retinal pigment epithelial (RPE) cell dysfunction is a key driving force of AMD. RPE cells form a metabolic interface between photoreceptors and choriocapillaris, performing essential functions for retinal homeostasis. Through their multiple functions, RPE cells are constantly exposed to oxidative stress, which leads to the accumulation of damaged proteins, lipids, nucleic acids, and cellular organelles, including mitochondria. As miniature chemical engines of the cell, self-replicating mitochondria are heavily implicated in the aging process through a variety of mechanisms. In the eye, mitochondrial dysfunction is strongly associated with several diseases, including age-related macular degeneration (AMD), which is a leading cause of irreversible vision loss in millions of people globally. Aged mitochondria exhibit decreased rates of oxidative phosphorylation, increased reactive oxygen species (ROS) generation, and increased numbers of mitochondrial DNA mutations. Mitochondrial bioenergetics and autophagy decline during aging because of insufficient free radical scavenger systems, the impairment of DNA repair mechanisms, and reductions in mitochondrial turnover. Recent research has uncovered a much more complex role of mitochondrial function and cytosolic protein translation and proteostasis in AMD pathogenesis. The coupling of autophagy and mitochondrial apoptosis modulates the proteostasis and aging processes. This review aims to summarise and provide a perspective on (i) the current evidence of autophagy, proteostasis, and mitochondrial dysfunction in dry AMD; (ii) current in vitro and in vivo disease models relevant to assessing mitochondrial dysfunction in AMD, and their utility in drug screening; and (iii) ongoing clinical trials targeting mitochondrial dysfunction for AMD therapeutics.
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Affiliation(s)
- Raji Rajesh Lenin
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore 119228, Singapore
- Department of Medical Research, SRM Institute of Science and Technology, Kattankulathur 603203, Tamil Nadu, India
| | - Yi Hui Koh
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore 119228, Singapore
| | - Zheting Zhang
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore 119228, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University (NTU), 11 Mandalay Road, Experimental Medicine Building, Singapore 308232, Singapore
| | - Yan Zhuang Yeo
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology, and Research (A*STAR), 61 Biopolis Drive, Proteos, Singapore 138673, Singapore
| | - Bhav Harshad Parikh
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology, and Research (A*STAR), 61 Biopolis Drive, Proteos, Singapore 138673, Singapore
| | - Ivan Seah
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore 119228, Singapore
| | - Wendy Wong
- Department of Ophthalmology, National University Hospital (NUH), 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore 119228, Singapore
| | - Xinyi Su
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore 119228, Singapore
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology, and Research (A*STAR), 61 Biopolis Drive, Proteos, Singapore 138673, Singapore
- Department of Ophthalmology, National University Hospital (NUH), 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore 119228, Singapore
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6 Discovery Tower, Singapore 169856, Singapore
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Gamlin CR, Schneider-Mizell CM, Mallory M, Elabbady L, Gouwens N, Williams G, Mukora A, Dalley R, Bodor A, Brittain D, Buchanan J, Bumbarger D, Kapner D, Kinn S, Mahalingam G, Seshamani S, Takeno M, Torres R, Yin W, Nicovich PR, Bae JA, Castro MA, Dorkenwald S, Halageri A, Jia Z, Jordan C, Kemnitz N, Lee K, Li K, Lu R, Macrina T, Mitchell E, Mondal SS, Mu S, Nehoran B, Popovych S, Silversmith W, Turner NL, Wong W, Wu J, Yu S, Berg J, Jarsky T, Lee B, Seung HS, Zeng H, Reid RC, Collman F, da Costa NM, Sorensen SA. Integrating EM and Patch-seq data: Synaptic connectivity and target specificity of predicted Sst transcriptomic types. bioRxiv 2023:2023.03.22.533857. [PMID: 36993629 PMCID: PMC10055412 DOI: 10.1101/2023.03.22.533857] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Neural circuit function is shaped both by the cell types that comprise the circuit and the connections between those cell types 1 . Neural cell types have previously been defined by morphology 2, 3 , electrophysiology 4, 5 , transcriptomic expression 6-8 , connectivity 9-13 , or even a combination of such modalities 14-16 . More recently, the Patch-seq technique has enabled the characterization of morphology (M), electrophysiology (E), and transcriptomic (T) properties from individual cells 17-20 . Using this technique, these properties were integrated to define 28, inhibitory multimodal, MET-types in mouse primary visual cortex 21 . It is unknown how these MET-types connect within the broader cortical circuitry however. Here we show that we can predict the MET-type identity of inhibitory cells within a large-scale electron microscopy (EM) dataset and these MET-types have distinct ultrastructural features and synapse connectivity patterns. We found that EM Martinotti cells, a well defined morphological cell type 22, 23 known to be Somatostatin positive (Sst+) 24, 25 , were successfully predicted to belong to Sst+ MET-types. Each identified MET-type had distinct axon myelination patterns and synapsed onto specific excitatory targets. Our results demonstrate that morphological features can be used to link cell type identities across imaging modalities, which enables further comparison of connectivity in relation to transcriptomic or electrophysiological properties. Furthermore, our results show that MET-types have distinct connectivity patterns, supporting the use of MET-types and connectivity to meaningfully define cell types.
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Mendoza J, Punsalan G, Wong W. 113 A Novel Video Laryngoscope Device (IVOS Boss G4) for Minimizing Aspiration Events. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.137] [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: 11/17/2022]
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Wong W, Loh K, Wang X. Lead-free layered organic–inorganic double perovskite with novel interlayer halide structure. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322092282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Ruan E, Nemeth E, Moffitt R, Sandoval L, Machiela MJ, Freedman ND, Huang WY, Wong W, Chen KL, Park B, Jiang K, Hicks B, Liu J, Russ D, Minasian L, Pinsky P, Chanock SJ, Garcia-Closas M, Almeida JS. PLCOjs, a FAIR GWAS web SDK for the NCI Prostate, Lung, Colorectal and Ovarian Cancer Genetic Atlas project. Bioinformatics 2022; 38:4434-4436. [PMID: 35900159 PMCID: PMC9890300 DOI: 10.1093/bioinformatics/btac531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/11/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023] Open
Abstract
MOTIVATION The Division of Cancer Epidemiology and Genetics (DCEG) and the Division of Cancer Prevention (DCP) at the National Cancer Institute (NCI) have recently generated genome-wide association study (GWAS) data for multiple traits in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Genomic Atlas project. The GWAS included 110 000 participants. The dissemination of the genetic association data through a data portal called GWAS Explorer, in a manner that addresses the modern expectations of FAIR reusability by data scientists and engineers, is the main motivation for the development of the open-source JavaScript software development kit (SDK) reported here. RESULTS The PLCO GWAS Explorer resource relies on a public stateless HTTP application programming interface (API) deployed as the sole backend service for both the landing page's web application and third-party analytical workflows. The core PLCOjs SDK is mapped to each of the API methods, and also to each of the reference graphic visualizations in the GWAS Explorer. A few additional visualization methods extend it. As is the norm with web SDKs, no download or installation is needed and modularization supports targeted code injection for web applications, reactive notebooks (Observable) and node-based web services. AVAILABILITY AND IMPLEMENTATION code at https://github.com/episphere/plco; project page at https://episphere.github.io/plco.
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Affiliation(s)
- Eric Ruan
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY 11794, USA
| | - Erika Nemeth
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY 11794, USA
| | - Richard Moffitt
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY 11794, USA
| | - Lorena Sandoval
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
| | - Mitchell J Machiela
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
| | - Wendy Wong
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
| | - Kai-Ling Chen
- Center for Biomedical Informatics and Information Technology (CBIIT), National Cancer Institute, Rockville, MD 20850, USA
| | - Brian Park
- Center for Biomedical Informatics and Information Technology (CBIIT), National Cancer Institute, Rockville, MD 20850, USA
| | - Kevin Jiang
- Center for Biomedical Informatics and Information Technology (CBIIT), National Cancer Institute, Rockville, MD 20850, USA
| | - Belynda Hicks
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
| | - Jia Liu
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
| | - Daniel Russ
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
| | - Lori Minasian
- Division of Cancer Prevention, National Cancer Institute, Rockville, MD 20850, USA
| | - Paul Pinsky
- Division of Cancer Prevention, National Cancer Institute, Rockville, MD 20850, USA
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
| | - Montserrat Garcia-Closas
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Rockville, MD 20850, USA
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Zhao X, Seah I, Xue K, Wong W, Tan QSW, Ma X, Lin Q, Lim JYC, Liu Z, Parikh BH, Mehta KN, Lai JW, Yang B, Tran KC, Barathi VA, Cheong KH, Hunziker W, Su X, Loh XJ. Antiangiogenic Nanomicelles for the Topical Delivery of Aflibercept to Treat Retinal Neovascular Disease. Adv Mater 2022; 34:e2108360. [PMID: 34726299 DOI: 10.1002/adma.202108360] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 10/19/2021] [Indexed: 06/13/2023]
Abstract
The traditional intravitreal injection delivery of antivascular endothelial growth factor (anti-VEGF) to the posterior segment of the eye for treatment of retinal diseases is invasive and associated with sight-threatening complications. To avoid such complications, there has been significant interest in developing polymers for topical drug delivery to the retina. This study reports a nanomicelle drug delivery system made of a copolymer EPC (nEPCs), which is capable of delivering aflibercept to the posterior segment topically through corneal-scleral routes. EPC is composed of poly(ethylene glycol) (PEG), poly(propylene glycol) (PPG), and polycaprolactone (PCL) segments. In this study, aflibercept-loaded nEPCs (nEPCs + A) are capable of penetrating the cornea in ex vivo porcine eye models and deliver a clinically significant amount of aflibercept to the retina in laser-induced choroidal neovascularization (CNV) murine models, causing CNV regression. nEPCs + A also demonstrate biocompatibility in vitro and in vivo. Interestingly, this study also suggests that nEPCs have intrinsic antiangiogenic properties. The ability to deliver anti-VEGF drugs and the intrinsic antiangiogenic properties of nEPCs may result in synergistic effects, which can be harnessed for effective therapeutics. nEPCs may be a promising topical anti-VEGF delivery platform for the treatment of retinal diseases.
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Affiliation(s)
- Xinxin Zhao
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Singapore, 138 673, Singapore
| | - Ivan Seah
- Department of Ophthalmology, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119 228, Singapore
| | - Kun Xue
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Singapore, 138 634, Singapore
| | - Wendy Wong
- Department of Ophthalmology, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119 228, Singapore
| | - Queenie Shu Woon Tan
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Singapore, 138 673, Singapore
| | - Xiaoxiao Ma
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Singapore, 138 673, Singapore
| | - Qianyu Lin
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Singapore, 138 634, Singapore
| | - Jason Y C Lim
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Singapore, 138 634, Singapore
| | - Zengping Liu
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Singapore, 138 673, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119 228, Singapore
| | - Bhav Harshad Parikh
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Singapore, 138 673, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119 228, Singapore
| | - Karishma N Mehta
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Singapore, 138 673, Singapore
- Singapore Institute of Technology (SIT), SIT@Dover, 10 Dover Drive, Singapore, 138 683, Singapore
| | - Joel Weijia Lai
- Science, Mathematics and Technology Cluster, Singapore University of Technology and Design (SUTD), 8 Somapah Road, Singapore, 487 372, Singapore
| | - Binxia Yang
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Singapore, 138 673, Singapore
| | - Kim Chi Tran
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119 228, Singapore
| | - Veluchamy Amutha Barathi
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6 Discovery Tower, Singapore, 169856, Singapore
- Academic Clinical Program in Ophthalmology, Duke-NUS Medical School, 8 College Road, Singapore, 169 857, Singapore
| | - Kang Hao Cheong
- Science, Mathematics and Technology Cluster, Singapore University of Technology and Design (SUTD), 8 Somapah Road, Singapore, 487 372, Singapore
- SUTD-Massachusetts Institute of Technology International Design Centre, 8 Somapah Road, Singapore, 487 372, Singapore
| | - Walter Hunziker
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Singapore, 138 673, Singapore
| | - Xinyi Su
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Singapore, 138 673, Singapore
- Department of Ophthalmology, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119 228, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119 228, Singapore
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6 Discovery Tower, Singapore, 169856, Singapore
| | - Xian Jun Loh
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, Singapore, 138 634, Singapore
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Dasgupta B, Unizony S, Warrington KJ, Sloane Lazar J, Giannelou A, Nivens C, Akinlade B, Wong W, Lin Y, Buttgereit F, Devauchelle-Pensec V, Rubbert-Roth A, Spiera R. LB0006 SARILUMAB IN PATIENTS WITH RELAPSING POLYMYALGIA RHEUMATICA: A PHASE 3, MULTICENTER, RANDOMIZED, DOUBLE BLIND, PLACEBO CONTROLLED TRIAL (SAPHYR). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5004a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundInterleukin-6 (IL-6) is elevated in patients with active polymyalgia rheumatica (PMR) and is associated with disease activity, relapse and severity. Clinical trials with IL-6 receptor (IL-6R) inhibitors in PMR showed higher remission rates and reduced glucocorticoid (GC) use vs GC alone.1-4ObjectivesThe SAPHYR study (NCT03600818) assessed the efficacy and safety of sarilumab (SAR), a fully human anti IL-6Rα monoclonal antibody, with a 14 week (wk) GC taper in patients with steroid resistant active PMR who flared on ≥7.5 mg/day prednisone or equivalent.MethodsPatients were randomized (1:1) to 52 wks of treatment with SAR 200 mg every 2 wks (Q2W) + 14 wk GC tapered regimen (SAR arm) OR placebo Q2W + 52 wk GC tapered regimen (comparator arm). The primary endpoint was the proportion of patients achieving sustained remission at wk 52, defined as disease remission by wk 12, absence of disease flare, CRP normalization from wks 12 to 52 and adherence to the per protocol GC taper from wks 12 to 52.ResultsThe study was terminated early due to protracted recruitment timelines during the COVID-19 pandemic, resulting in 118 of the intended 280 patients recruited between Oct 2018 and Jul 2020, and 117 were treated (SAR n=59, comparator n=58). The demographics were balanced; patients were primarily female, Caucasian, and a median age of ~70 years (Table 1). Overall, 78 patients completed the treatment (SAR n=42; comparator n=36). Primary reasons for treatment discontinuation were adverse events (AEs; SAR n=7, comparator n=4) and lack of efficacy (SAR n=4, comparator n=9). Sustained remission rate was significantly higher in the SAR arm vs the comparator arm (28.3% vs 10.3%; P=0.0193). Results of a sensitivity analysis excluding CRP from the sustained remission definition was consistent with the primary analysis (31.7% vs 13.8%; P=0.0280). All sustained remission components favored SAR (Figure 1). Patients in the SAR arm were 44% less likely to have a flare after achieving clinical remission vs the comparator arm (16.7% vs 29.3%; HR 0.56; 95% CI 0.35–0.90; P=0.0158). The comparator arm required more additional GCs vs the SAR arm, mainly due to PMR flare (median difference in actual and expected cumulative dose 199.5 mg vs 0.0 mg; P=0.0189). The cumulative GC toxicity index scores numerically favored SAR but the difference was not statistically significant. PMR activity scores improved in the SAR arm vs the comparator arm (LS mean -15.57 vs -10.27, nominal P=0.0002). Patient reported outcomes (eg, physical and mental health component scores, disability index, etc) favored SAR (Figure 1). Incidence of treatment-emergent AEs (TEAEs) was numerically higher in the SAR arm vs the comparator arm (94.9% vs 84.5%) and included neutropenia (15.3%) and arthralgia (15.3%) in the SAR arm, and insomnia (15.5%) in the comparator arm. Conversely, the frequency of serious AEs was higher in the comparator arm vs the SAR arm (20.7% vs 13.6%). No deaths were reported.Table 1.Demographics and baseline characteristicsParameterSAR + 14 wk GC taperPlacebo + 52 wk GC taper(n=60)(n=58)Age, median years (range)69 (51–88)70 (52–88)Sex (female), n (%)45 (75.0)37 (63.8)Race, n (%) Caucasian50 (83.3)48 (82.8) Asian1 (1.7)2 (3.4) Not reported9 (15.0)8 (13.8)PMR duration (diagnosis date to baseline),* median days (range)292 (78–3992)310 (66–2784)Any prior disease modifying anti rheumatic drugs, n (%) Methotrexate5 (8.3)10 (17.2) Leflunomide2 (3.3)1 (1.7) Azathioprine01 (1.7) Hydroxychloroquine1 (1.7)1 (1.7) Adalimumab1 (1.7)0 Tocilizumab01 (1.7)CRP (mg/L), median (range)6.8 (0.5–38.2)5.7 (0.1–62.3)Erythrocyte sedimentation rate (mm/h), median (range)25.0 (2.0–115.0)22.0 (5.0–85.0)*SAR n = 54; comparator n= 50.ConclusionSAR + 14 wk GC taper demonstrated significant efficacy vs the comparator arm in steroid refractory PMR patients, including clinically meaningful improvement in quality of life. Safety was consistent with the known safety profile of SAR.References[1]Mori 2016;[2]Akiyama 2020;[3]Lally 2016,[4]Devauchelle Pensec 2015AcknowledgementsMedical writing support was provided by Vijay Kadasi of Sanofi and funded by Sanofi.Disclosure of InterestsBhaskar Dasgupta Consultant of: Sanofi, Roche Chugai, Speakers bureau: Roche Chugai, Cipla, Grant/research support from: Sanofi, Roche, Abbvie, Sebastian Unizony Consultant of: Sanofi, Kiniksa, Janssen, Grant/research support from: Genentech, Kenneth J Warrington Paid instructor for: Chemocentryx, Grant/research support from: Eli Lilly, Kiniksa, GSK, Jennifer Sloane Lazar Employee of: Sanofi, Angeliki Giannelou Shareholder of: Regeneron, Employee of: Regeneron, Chad Nivens Shareholder of: Regeneron, Employee of: Regeneron, Bolanle Akinlade Shareholder of: Regeneron, Employee of: Regeneron, Wanling Wong Employee of: Sanofi, Yong Lin Employee of: Sanofi, Frank Buttgereit Consultant of: Sanofi, Horizon Pharma, Roche, Galapagos, Abbvie, Novartis, Grant/research support from: Sanofi, Horizon Pharma, Roche, Galapagos, Abbvie, Novartis, Valerie Devauchelle-Pensec: None declared, Andrea Rubbert-Roth Consultant of: Sanofi, Speakers bureau: Sanofi, Roche, Robert Spiera Consultant of: Sanofi, GSK, Novartis, Chemocentryx, Roche-Genetech, Abbvie, Vera, Grant/research support from: GSK, Chemocentryx, Corbus, Inflarx, Boehringer Ingelheim
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Pun J, Wong W. Navigating communication between conventional medicine and traditional Chinese medicine: a case study of cancer patients in Hong Kong. Support Care Cancer 2022; 30:5729-5735. [PMID: 35325313 DOI: 10.1007/s00520-022-06986-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/13/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Traditional Chinese medicine (TCM) is a growing phenomenon worldwide. Despite its historical role in Chinese society, however, few studies have explored the nature of communication among patients with cancer who receive TCM care in addition to conventional medicine. If TCM practitioners acquire adequate knowledge to understand the needs and communication issues for their patients with cancer, particularly those who are simultaneously receiving conventional medicine, this will lead to better quality of care and clinical outcomes, such as high patient satisfaction and treatment compliance. OBJECTIVES To fill this knowledge gap, this study explored the nature of communication among patients with cancer in Hong Kong who receive TCM treatment in addition to conventional medicine. PARTICIPANTS We conducted in-depth interviews with 20 patients, 5 oncologists and 5 TCM practitioners to elicit their views on TCM treatments. METHOD We adopted a qualitative approach using an interpretative phenomenological analysis. RESULTS Based on the themes that emerged from our interview transcripts, we outlined communication priorities when advising patients with cancer who are receiving both TCM and conventional medical care. We developed a framework to train TCM practitioners to better integrate their patients' conventional medical history when delivering patient care. CONCLUSIONS Our study findings inform communication priorities when caring for patients who opt for TCM care in addition to conventional treatments. In addition, they provide useful information for developing future clinical research studies to explore integrated approaches between TCM and conventional medicine in treating patients with cancer.
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Affiliation(s)
- Jack Pun
- Department of English, City University of Hong Kong, Hong Kong, SAR, China.
| | - Wendy Wong
- School of Chinese Medicine, Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
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Hufschmidt P, Schmidt S, Haag D, Beisser F, Eberle F, Roth J, Fuhg C, Behrens R, Hupe O, Zutz H, Ballabriga R, Campbell M, Llopart X, Tlustos L, Wong W, Michel T. DOSIMETRY IN HIGH DOSE RATE PHOTON FIELDS USING THE DOSEPIX DETECTOR. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01615-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Schmidt S, Haag D, Hufschmidt P, Ballabriga R, Campbell M, Llopart X, Tlustos L, Wong W, Michel T. DOSEPIX: A FAST X-RAY SPECTROMETER. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01717-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Haag D, Schmidt S, Hufschmidt P, Beisser F, Eberle F, Roth J, Fuhg C, Behrens R, Hupe O, Zutz H, Ballabriga R, Campbell M, Llopart X, Tlustos L, Wong W, Michel T. DOSIMETRY IN PULSED PHOTON FIELDS WITH DOSEPIX. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01614-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Wong CHL, Chung VC, Wong W, Lin WL, Au DK, Wong EL. Identifying Chinese medicine research priorities in cancer palliative care using JLA approach. Eur J Integr Med 2021. [DOI: 10.1016/j.eujim.2021.102048] [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]
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Wong W, Naing T, Bhargava M, Chee C, Lingam G, Holder GE. ACUTE SYPHILITIC POSTERIOR PLACOID CHORIORETINITIS: MULTIMODAL IMAGING AND ELECTROPHYSIOLOGIC FINDINGS BEFORE AND AFTER TREATMENT. Retin Cases Brief Rep 2021; 15:662-669. [PMID: 31356370 DOI: 10.1097/icb.0000000000000896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE To describe the clinical course of acute syphilitic posterior placoid chorioretinitis (ASPPC) in the preplacoid stage, placoid stage, and after treatment with penicillin. METHOD A retrospective case report of serial multimodal imaging and electrophysiology studies of a patient with ASPPC, with 18 months of follow-up. RESULTS A 47-year-old man presented with bilateral panuveitis. The patient defaulted follow-up and returned when his vision deteriorated. Tests for neurosyphilis and retroviral disease were positive, and treatment was initiated. The earliest change on serial optical coherence tomography was loss of the signal from the reflective band corresponding to the ellipsoid zone. In the placoid stage, there was nodular thickening of the retinal pigment epithelium. The ellipsoid zone signals reappeared after treatment. Fundus fluorescein angiogram at presentation showed peripapillary vasculitis and disk leakage; indocyanine green angiography revealed multiple hypofluorescent spots in the peripapillary region and posterior pole that was not visible clinically. The angiographic abnormalities resolved after treatment. Electrophysiology demonstrated bilateral maculopathy and reduction of both a- and b-waves from dark-adapted and light-adapted responses at presentation. The b-waves (inner retina) recovered partially with treatment. CONCLUSION To the best of our knowledge, this is the first case report of the multimodal imaging and electrophysiology findings in a patient with acute syphilitic posterior placoid chorioretinitis, before the development of the classic placoid lesion. Improvement of structural and functional pathology after systemic treatment is demonstrated.
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Affiliation(s)
- Wendy Wong
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Thet Naing
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Mayuri Bhargava
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Caroline Chee
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Gopal Lingam
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
- Medical Research Foundation, Sankaranethralaya, Chennai, India; and
| | - Graham E Holder
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
- Institute of Ophthalmology, University College London, London, United Kingdom
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14
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Mugabe M, Ho KE, Ruhangaza D, Milner D, Rugwizangoga B, Chu VC, Wu NC, Rizo A, Weidler JM, Wong W, Bates M, Brock JE. Use of the Xpert Breast Cancer STRAT4 for Biomarker Evaluation in Tissue Processed in a Developing Country. Am J Clin Pathol 2021; 156:766-776. [PMID: 34050358 PMCID: PMC8512210 DOI: 10.1093/ajcp/aqab016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives Breast cancer immunohistochemistry (IHC) biomarker testing is limited in low-resource settings, and an alternative solution is needed. A point-of-care mRNA STRAT4 breast cancer assay for ESR1, PGR, ERBB2, and MKi67, for use on the GeneXpert platform, has been recently validated on tissues from internationally accredited laboratories, showing excellent concordance with IHC. Methods We evaluated STRAT4/IHC ESR1/estrogen receptor (ER), ERBB2/human epidermal growth factor receptor 2 (HER2) concordance rates of 150 breast cancer tissues processed in Rwanda, with undocumented cold ischemic and fixation time. Results Assay fail/indeterminate rate was 2.6% for ESR1 and ERBB2. STRAT4 agreement with ER IHC was 92.5% to 93.3% and 97.8% for HER2, for standard (1x) and concentrated (4x) reagent-conserving protocols, respectively. Eleven of 12 discordant ER/ESR1 cases were ESR1- negative/IHC-positive. These had low expression of ER by IHC in mostly very small tumor areas tested (7/12; <25 mm2). In two of three discordant HER2 cases, the STRAT4-ERBB2 result correlated with the subsequent fluorescence in situ hybridization (FISH) result. STRAT4-ERBB2 results in 9 of 10 HER2-IHC equivocal cases were concordant with FISH. Conclusions The STRAT4 assay is an alternative for providing quality-controlled breast cancer biomarker data in laboratories unable to provide quality and/or cost-efficient IHC services.
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Affiliation(s)
| | - Kenneth E Ho
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | | | - Dan Milner
- American Society for Clinical Pathology, Chicago, IL, USA
| | | | - Victor C Chu
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Natalie C Wu
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Annaliza Rizo
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Jodi M Weidler
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Wendy Wong
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Michael Bates
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Jane E Brock
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
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15
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Wong JYH, Choi EPH, Lo HHM, Wong W, Chio JHM, Choi AWM, Fong DYT. Intimate Partner Sexual Violence and Mental Health Indicators Among Chinese Emerging Adults. J Interpers Violence 2021; 36:NP10229-NP10254. [PMID: 31478438 DOI: 10.1177/0886260519872985] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intimate partner sexual violence (IPSV) among emerging adults, including heterosexuals and sexual minorities in the Chinese population, is poorly understood. Focusing on college students, the objectives of the present study were to estimate the prevalence of IPSV among Chinese emerging adults, examine the association between sexual orientation and IPSV, and evaluate the mental health and quality of life of survivors of IPSV. Data were collected from four university campuses in Hong Kong. A total of 1,015 participants were included in the data analysis. The prevalence of IPSV as identified by Conflict Tactics Scale (CTS)-2 was 12.1%. There was no gender difference in the prevalence of IPSV. Multiple logistic regression found that being older; having experienced childhood sexual abuse and having a smoking habit; and belonging to a sexual minority were factors associated with IPSV. Multiple linear regression found that IPSV survivors were more likely to have higher levels of anxiety and depression, more severe psychosomatic symptoms, and poorer quality of life in three domains: psychological, social relationships, and environment when compared with those without IPSV experience. The documented factors underscored the importance of awareness that men and sexual minorities might incur IPSV, which should receive more attention in IPSV prevention programs. Also, interventions for IPSV survivors should be targeted at improving their mental health and quality of life and sex education should place more emphasis on sexual consent and sexual health in dating relationships.
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Affiliation(s)
| | | | | | - Wendy Wong
- The Chinese University of Hong Kong, Hong Kong
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16
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Lingam S, Liu Z, Yang B, Wong W, Parikh BH, Ong JY, Goh D, Wong DSL, Tan QSW, Tan GSW, Holder GE, Regha K, Barathi VA, Hunziker W, Lingam G, Zeng X, Su X. cGMP-grade human iPSC-derived retinal photoreceptor precursor cells rescue cone photoreceptor damage in non-human primates. Stem Cell Res Ther 2021; 12:464. [PMID: 34412697 PMCID: PMC8375124 DOI: 10.1186/s13287-021-02539-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/31/2021] [Indexed: 12/21/2022] Open
Abstract
Background Retinal regenerative therapies hold great promise for the treatment of inherited retinal degenerations (IRDs). Studies in preclinical lower mammal models of IRDs have suggested visual improvement following retinal photoreceptor precursors transplantation, but there is limited evidence on the ability of these transplants to rescue retinal damage in higher mammals. The purpose of this study was to evaluate the therapeutic potential of photoreceptor precursors derived from clinically compliant induced pluripotent stem cells (iPSCs). Methods Photoreceptor precursors were sub-retinally transplanted into non-human primates (Macaca fascicularis). The cells were transplanted both in naïve and cobalt chloride-induced retinal degeneration models who had been receiving systemic immunosuppression for one week prior to the procedure. Optical coherence tomography, fundus autofluorescence imaging, electroretinography, ex vivo histology and immunofluorescence staining were used to evaluate retinal structure, function and survival of transplanted cells. Results There were no adverse effects of iPSC-derived photoreceptor precursors on retinal structure or function in naïve NHP models, indicating good biocompatibility. In addition, photoreceptor precursors injected into cobalt chloride-induced retinal degeneration NHP models demonstrated an ability both to survive and to mature into cone photoreceptors at 3 months post-transplant. Optical coherence tomography showed restoration of retinal ellipsoid zone post-transplantation. Conclusions These findings demonstrate the safety and therapeutic potential of clinically compliant iPSC-derived photoreceptor precursors as a cell replacement source for future clinical trials. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02539-8.
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Affiliation(s)
- Swathi Lingam
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Zengping Liu
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore.,Singapore Eye Research Institute (SERI), Singapore, 169856, Singapore
| | - Binxia Yang
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore
| | - Wendy Wong
- Department of Ophthalmology, National University Hospital, Singapore, 119074, Singapore
| | - Bhav Harshad Parikh
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Jun Yi Ong
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore
| | - Debbie Goh
- Department of Ophthalmology, National University Hospital, Singapore, 119074, Singapore
| | - Daniel Soo Lin Wong
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Queenie Shu Woon Tan
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore
| | - Gavin S W Tan
- Singapore Eye Research Institute (SERI), Singapore, 169856, Singapore.,Academic Clinical Program in Ophthalmology, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Graham E Holder
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore.,Department of Ophthalmology, National University Hospital, Singapore, 119074, Singapore.,UCL Institute of Ophthalmology, London, WC1E 6BT, UK
| | - Kakkad Regha
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Veluchamy Amutha Barathi
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore.,Singapore Eye Research Institute (SERI), Singapore, 169856, Singapore.,Academic Clinical Program in Ophthalmology, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Walter Hunziker
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore
| | - Gopal Lingam
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore.,Singapore Eye Research Institute (SERI), Singapore, 169856, Singapore.,Department of Ophthalmology, National University Hospital, Singapore, 119074, Singapore
| | - Xianmin Zeng
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117593, Singapore.,RxCell Inc, Novato, CA, 94949, USA
| | - Xinyi Su
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore. .,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore. .,Singapore Eye Research Institute (SERI), Singapore, 169856, Singapore. .,Department of Ophthalmology, National University Hospital, Singapore, 119074, Singapore.
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17
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Manian A, Shaw RA, Lyskov I, Wong W, Russo SP. Modeling radiative and non-radiative pathways at both the Franck-Condon and Herzberg-Teller approximation level. J Chem Phys 2021; 155:054108. [PMID: 34364347 DOI: 10.1063/5.0058643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Here, we present a concise model that can predict the photoluminescent properties of a given compound from first principles, both within and beyond the Franck-Condon approximation. The formalism required to compute fluorescence, Internal Conversion (IC), and Inter-System Crossing (ISC) is discussed. The IC mechanism, in particular, is a difficult pathway to compute due to difficulties associated with the computation of required bosonic configurations and non-adiabatic coupling elements. Here, we offer a discussion and breakdown on how to model these pathways at the Density Functional Theory (DFT) level with respect to its computational implementation, strengths, and current limitations. The model is then used to compute the photoluminescent quantum yield (PLQY) of a number of small but important compounds: anthracene, tetracene, pentacene, diketo-pyrrolo-pyrrole (DPP), and Perylene Diimide (PDI) within a polarizable continuum model. Rate constants for fluorescence, IC, and ISC compare well for the most part with respect to experiment, despite triplet energies being overestimated to a degree. The resulting PLQYs are promising with respect to the level of theory being DFT. While we obtained a positive result for PDI within the Franck-Condon limit, the other systems require a second order correction. Recomputing quantum yields with Herzberg-Teller terms yields PLQYs of 0.19, 0.08, 0.04, 0.70, and 0.99 for anthracene, tetracene, pentacene, DPP, and PDI, respectively. Based on these results, we are confident that the presented methodology is sound with respect to the level of quantum chemistry and presents an important stepping stone in the search for a tool to predict the properties of larger coupled systems.
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Affiliation(s)
- A Manian
- ARC Centre of Excellence in Exciton Science, School of Science, RMIT Univeristy, Melbourne 3000, Australia
| | - R A Shaw
- Department of Chemistry, University of Sheffield, Sheffield S3 7HF, United Kingdom
| | - I Lyskov
- ARC Centre of Excellence in Exciton Science, School of Science, RMIT Univeristy, Melbourne 3000, Australia
| | - W Wong
- ARC Centre of Excellence in Exciton Science, School of Chemistry, The University of Melbourne, Parkville VIC 3052, Australia
| | - S P Russo
- ARC Centre of Excellence in Exciton Science, School of Science, RMIT Univeristy, Melbourne 3000, Australia
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18
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Wong CHL, Wong W, Lin WL, Au DKY, Wu JCY, Leung TH, Wu IXY, Chung VCH. Prioritizing Chinese medicine clinical research questions in cancer palliative care from patient and caregiver perspectives. Health Expect 2021; 24:1487-1497. [PMID: 34107142 PMCID: PMC8369121 DOI: 10.1111/hex.13289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/14/2021] [Accepted: 05/12/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Chinese medicine (CM) modalities, including acupuncture and Chinese herbal medicine (CHM), are popular palliative interventions among patients with cancer, but further clinical research is required to assess their effectiveness and safety. OBJECTIVE To prioritize top ten important CM clinical research questions from patients with cancer, cancer survivors and caregivers' perspectives via a face-to-face prioritization workshop in Hong Kong. METHODS A list of 25 CM clinical research questions for cancer palliative care, which were identified from existing systematic reviews (SRs) and overview of SRs, was presented to 17 participants (patients with cancer [n = 5], cancer survivors [n = 6] and caregivers [n = 6]). The participants were then invited to establish consensus on prioritizing top ten research questions. RESULTS Among the top ten priorities, five (50%) focused on acupuncture and related therapies, while five (50%) were on CHM. The three most important research priorities were (i) manual acupuncture plus opioids for relieving pain; (ii) CHM for improving quality of life among patients receiving chemotherapy; and (iii) concurrent use of CHM plus loperamide for reducing stomatitis. CONCLUSION The top ten participant-endorsed CM clinical research priorities for cancer palliative care can guide local researchers on future direction. They can also inform local research funders on patient-centred allocation of limited funding. Under limited research funding, the most important co-prioritized research question from professional and patient perspectives may be addressed first. PATIENT OR PUBLIC CONTRIBUTION Patients with cancer, cancer survivors and caregivers participated in conduct of the study to prioritize CM clinical research questions.
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Affiliation(s)
- Charlene H. L. Wong
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongShatinHong Kong
- Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongShatinHong Kong
| | - Wendy Wong
- National Institution of TCM Constitution and Preventive MedicineBeijing University of Chinese MedicineBeijingChina
- Yat Hei Hong Kong Company LimitedCentralHong Kong
| | - Wai Ling Lin
- Hong Kong Institute of Integrative MedicineThe Chinese University of Hong KongShatinHong Kong
| | - David K. Y. Au
- Hong Kong Institute of Integrative MedicineThe Chinese University of Hong KongShatinHong Kong
| | - Justin C. Y. Wu
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongShatinHong Kong
| | - Ting Hung Leung
- Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongShatinHong Kong
- School of Chinese MedicineThe Chinese University of Hong KongShatinHong Kong
| | - Irene X. Y. Wu
- Department of Epidemiology and Health StatisticsXiangya School of Public HealthCentral South UniversityChangshaChina
| | - Vincent C. H. Chung
- Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongShatinHong Kong
- School of Chinese MedicineThe Chinese University of Hong KongShatinHong Kong
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19
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Siva S, Bressel M, Mai T, Le H, Vinod S, de Silva H, Macdonald S, Skala M, Hardcastle N, Rezo A, Pryor D, Gill S, Higgs B, Wagenfuehr K, Montgomery R, Awad R, Chesson B, Eade T, Wong W, Sasso G, De Abreu Lourenco R, Kron T, Ball D, Neeson P. OC-0335 Final results of TROG 13.01 SAFRON II: Single vs multi-fraction SABR for pulmonary oligometastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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DeWees T, Abraha F, Corbin K, Brown P, Hallemeier C, Davis B, Petersen I, Martenson J, Ahmed S, Olivier K, Vern-Gross T, Rule W, Wong W, Vora S, Patel S, Ashman J, Schild S, Trifiletti D, Vargas C, Ma D. PO-1498 Clinical Sensitivity of PROMIS-10 Physical and Mental Quality of Life Domains to Radiation Therapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07949-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Seah I, Liu Z, Soo Lin Wong D, Wong W, Holder GE, Amutha Barathi V, Lingam G, Su X, Stanzel BV. Retinal Pigment Epithelium Transplantation in a Non-human Primate Model for Degenerative Retinal Diseases. J Vis Exp 2021. [PMID: 34180899 DOI: 10.3791/62638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Retinal pigment epithelial (RPE) transplantation holds great promise for the treatment of inherited and acquired retinal degenerative diseases. These conditions include retinitis pigmentosa (RP) and advanced forms of age-related macular degeneration (AMD), such as geographic atrophy (GA). Together, these disorders represent a significant proportion of currently untreatable blindness globally. These unmet medical needs have generated heightened academic interest in developing methods of RPE replacement. Among the animal models commonly utilized for preclinical testing of therapeutics, the non-human primate (NHP) is the only animal model that has a macula. As it shares this anatomical similarity with the human eye, the NHP eye is an important and appropriate preclinical animal model for the development of advanced therapy medicinal products (ATMPs) such as RPE cell therapy. This manuscript describes a method for the submacular transplantation of an RPE monolayer, cultured on a polyethylene terephthalate (PET) cell carrier, underneath the macula onto a surgically created RPE wound in immunosuppressed NHPs. The fovea-the central avascular portion of the macula-is the site of the greatest mechanical weakness during the transplantation. Foveal trauma will occur if the initial subretinal fluid injection generates an excessive force on the retina. Hence, slow injection under perfluorocarbon liquid (PFCL) vitreous tamponade is recommended with a dual-bore subretinal injection cannula at low intraocular pressure (IOP) settings to create a retinal bleb. Pretreatment with an intravitreal plasminogen injection to release parafoveal RPE-photoreceptor adhesions is also advised. These combined strategies can reduce the likelihood of foveal tears when compared to conventional techniques. The NHP is a key animal model in the preclinical phase of RPE cell therapy development. This protocol addresses the technical challenges associated with the delivery of RPE cellular therapy in the NHP eye.
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Affiliation(s)
- Ivan Seah
- Department of Ophthalmology, National University Hospital, Singapore
| | - Zengping Liu
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR); Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore; Singapore Eye Research Institute (SERI)
| | - Daniel Soo Lin Wong
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Wendy Wong
- Department of Ophthalmology, National University Hospital, Singapore
| | - Graham E Holder
- Department of Ophthalmology, National University Hospital, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore; UCL Institute of Ophthalmology
| | - Veluchamy Amutha Barathi
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore; Singapore Eye Research Institute (SERI); Academic Clinical Program in Ophthalmology, Duke-NUS Medical School
| | - Gopal Lingam
- Department of Ophthalmology, National University Hospital, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore; Singapore Eye Research Institute (SERI)
| | - Xinyi Su
- Department of Ophthalmology, National University Hospital, Singapore; Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR); Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore; Singapore Eye Research Institute (SERI);
| | - Boris V Stanzel
- Department of Ophthalmology, National University Hospital, Singapore; Macula Center Saar, Eye Clinic Sulzbach, Knappschaft Hospital Saar; Department of Ophthalmology, University of Bonn;
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22
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Wong JYH, Zhang W, Wu Y, Choi EPH, Lo HHM, Wong W, Chio JHM, Tam HLC, Ngai FW, Tarrant M, Wang MP, Ngan HYS, Fong DYT. An Interactive Web-Based Sexual Health Literacy Program for Safe Sex Practice for Female Chinese University Students: Multicenter Randomized Controlled Trial. J Med Internet Res 2021; 23:e22564. [PMID: 33709941 PMCID: PMC7998327 DOI: 10.2196/22564] [Citation(s) in RCA: 3] [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: 07/22/2020] [Revised: 11/27/2020] [Accepted: 12/12/2020] [Indexed: 11/16/2022] Open
Abstract
Background Sexual health concerns among young adults worldwide help to motivate preventative practices against sexually transmitted infections. To foster better sexual health, sexual health literacy must be enhanced. Little research has been conducted on the impact of gender power dynamics on sexual health, such as sexual coercion, even though the prevalence of sexual coercion remains high in China. Objective This study describes the development and systematic evaluation of a web-based sexual health literacy intervention called “Smart Girlfriend” for female Chinese university students. Methods A multicenter randomized controlled trial was conducted with 781 female university students at 5 universities with dormitories in Hong Kong. Inclusion criteria were used to select unmarried, female, Chinese university students who were ≥18 years old and had not received a sexual health intervention in the past 12 months. Participants were randomly assigned to 2 groups: one group received an interactive web-based sexual health literacy intervention and the other group received a single webpage of online information about condom use. The intervention content was based on the Health Belief Model and the Continuum of Conflict and Control theory. The primary outcome was self-reported consistency of condom use with every partner at 3-month and 6-month follow-up assessments, analyzed using zero/one inflated beta (ZOIB) regression. The secondary outcome was an appraisal of the knowledge, attitudes, norms, and self-efficacy of condom use using the 25-item Multidimensional Condom Attitudes Scale (MCAS). The intention to treat was applied in analyses. Results Of 1503 individuals that were screened, 781 (52%) were randomized into 2 groups. The retention rates at the 3-month and 6-month follow-ups were 92% and 91%, respectively. Most participants were born locally (536/746, 72%), and 18% (134/746) self-reported as a sexual minority. ZOIB results regarding the consistency of condom use were not significant [model 1: odds ratio (OR) 2.25 with a 95% credible interval (CrI) of 0.84-6.36; model 2: OR 8.03 (95% CrI 0.22-330.31); model 3: OR 1.21 (95% CrI 0.78-1.86)]. Consistency in the intervention group was 5% higher (95% CI −1.90 to 11.63) than the control group at the 3-month follow-up, and 1% higher (95% CI −5.81 to 8·02) at the 6-month follow-up. MCAS scores at the 3-month follow-up were significantly higher in the intervention group (mean 122.51, SD 15.97) than the control group (mean 119.86, SD 15.85; P=.02). Conclusions An interactive web-based sexual health literacy program did not significantly increase the consistency of condom use compared to a single webpage of condom use information; however, it did temporarily improve knowledge, attitudes, norms, and self-efficacy regarding condom use. Future revisions of this intervention should be personalized and delivered with a proactive approach. Trial Registration ClinicalTrials.gov NCT03695679; https://clinicaltrials.gov/ct2/show/NCT03695679
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Affiliation(s)
| | - Wen Zhang
- School of Nursing, University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Yongda Wu
- School of Nursing, University of Hong Kong, Hong Kong SAR, Hong Kong
| | | | - Herman Hay Ming Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong
| | - Wendy Wong
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Jasmine Hin Man Chio
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong SAR, Hong Kong
| | - Hau Lin Cherry Tam
- Department of Social and Behavioural Science, City University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Fei Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong SAR, Hong Kong
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23
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Affiliation(s)
- Wendy Wong
- Department of Ophthalmology (Wong), National University Hospital; Department of Ophthalmology (Wong, Gopal, Yip), Khoo Teck Puat Hospital, Singapore
| | - Lekha Gopal
- Department of Ophthalmology (Wong), National University Hospital; Department of Ophthalmology (Wong, Gopal, Yip), Khoo Teck Puat Hospital, Singapore
| | - Chee Chew Yip
- Department of Ophthalmology (Wong), National University Hospital; Department of Ophthalmology (Wong, Gopal, Yip), Khoo Teck Puat Hospital, Singapore
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Siva S, Bressel M, Kron T, Mai T, Le H, Montgomery R, Hardcastle N, Rezo A, Gill S, Higgs B, Pryor D, De Abreu Lourenco R, Awad R, Chesson B, Eade T, Skala M, Sasso G, Wong W, Vinod S, Ball D. Stereotactic Ablative Fractionated Radiotherapy versus Radiosurgery for Oligometastatic Neoplasia to the Lung: A Randomized Phase II Trial. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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BettolI P, Liu Z, Jara N, Fong C, Wong W, Terlizzi M, Sargos P, Zillie T, Thariat J, Ploussard G, Goyal S, Chung P, Berlin A, Sole C. PO-1219: Primary Bladder Sarcoma: a multiinstitutional experience from the Rare Cancer Network. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01237-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Wong W, Bryen S, Bournazos A, Bommireddipall S, Waddell L, Menezes M, Webster R, Davis M, Liang C, Cooper S, Jones K. MITOCHONDRIAL DISEASES & METABOLIC MYOPATHIES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.320] [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: 10/23/2022]
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Chan HW, Yang B, Wong W, Blakeley P, Seah I, Tan QSW, Wang H, Bhargava M, Lin HA, Chai CHC, Mangunkusumo EA, Thet N, Yuen YS, Sethi R, Wang S, Hunziker W, Lingam G, Su X. A Pilot Study on MicroRNA Profile in Tear Fluid to Predict Response to Anti-VEGF Treatments for Diabetic Macular Edema. J Clin Med 2020; 9:E2920. [PMID: 32927780 PMCID: PMC7564365 DOI: 10.3390/jcm9092920] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) is an established treatment for center-involving diabetic macular edema (ci-DME). However, the clinical response is heterogeneous. This study investigated miRNAs as a biomarker to predict treatment response to anti-VEGF in DME. (2) Methods: Tear fluid, aqueous, and blood were collected from patients with treatment-naïve DME for miRNA expression profiling with quantitative polymerase chain reaction. Differentially expressed miRNAs between good and poor responders were identified from tear fluid. Bioinformatics analysis with the miEAA tool, miRTarBase Annotations, Gene Ontology categories, KEGG, and miRWalk pathways identified interactions between enriched miRNAs and biological pathways. (3) Results: Of 24 participants, 28 eyes received bevacizumab (15 eyes) or aflibercept (13 eyes). Tear fluid had the most detectable miRNA species (N = 315), followed by serum (N = 309), then aqueous humor (N = 134). MiRNAs that correlated with change in macular thickness were miR-214-3p, miR-320d, and hsa-miR-874-3p in good responders; and miR-98-5p, miR-196b-5p, and miR-454-3p in poor responders. VEGF-related pathways and the angiogenin-PRI complex were enriched in good responders, while transforming growth factor-β and insulin-like growth factor pathways were enriched in poor responders. (4) Conclusions: We reported a panel of novel miRNAs that provide insight into biological pathways in DME. Validation in larger independent cohorts is needed to determine the predictive performance of these miRNA candidate biomarkers.
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Affiliation(s)
- Hwei Wuen Chan
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (P.B.); (S.W.)
| | - Binxia Yang
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore 138673, Singapore; (B.Y.); (Q.S.W.T.); (H.W.); (R.S.); (W.H.)
| | - Wendy Wong
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
| | - Paul Blakeley
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (P.B.); (S.W.)
| | - Ivan Seah
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
| | - Queenie Shu Woon Tan
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore 138673, Singapore; (B.Y.); (Q.S.W.T.); (H.W.); (R.S.); (W.H.)
| | - Haofei Wang
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore 138673, Singapore; (B.Y.); (Q.S.W.T.); (H.W.); (R.S.); (W.H.)
| | - Mayuri Bhargava
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
| | - Hazel Anne Lin
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (P.B.); (S.W.)
| | - Charmaine HC Chai
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (P.B.); (S.W.)
| | - Erlangga Ariadarma Mangunkusumo
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
| | - Naing Thet
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
| | - Yew Sen Yuen
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (P.B.); (S.W.)
| | - Raman Sethi
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore 138673, Singapore; (B.Y.); (Q.S.W.T.); (H.W.); (R.S.); (W.H.)
| | - Si Wang
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (P.B.); (S.W.)
| | - Walter Hunziker
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore 138673, Singapore; (B.Y.); (Q.S.W.T.); (H.W.); (R.S.); (W.H.)
| | - Gopal Lingam
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (P.B.); (S.W.)
| | - Xinyi Su
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore; (H.W.C.); (W.W.); (I.S.); (M.B.); (H.A.L.); (C.H.C.); (E.A.M.); (N.T.); (Y.S.Y.); (G.L.)
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (P.B.); (S.W.)
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore 138673, Singapore; (B.Y.); (Q.S.W.T.); (H.W.); (R.S.); (W.H.)
- Singapore Eye Research Institute (SERI), Singapore National Eye Centre, Singapore 169856, Singapore
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Abbas Y, Abdelkader M, Adams M, Addison A, Advani R, Ahmed T, Alexander V, Alexander V, Alli B, Alvi S, Amiraraghi N, Ashman A, Balakumar R, Bewick J, Bhasker D, Bola S, Bowles P, Campbell N, Can Guru Naidu N, Caton N, Chapman J, Chawdhary G, Cherko M, Coates M, Conroy K, Coyle P, Cozar O, Cresswell M, Dalton L, Danino J, Daultrey C, Davies K, Carrie S, Dick D, Dimitriadis PA, Doddi N, Dowling M, Easto R, Edmiston R, Ellul D, Erskine S, Evans A, Farboud A, Forde C, Fussey J, Gaunt A, Gilchrist J, Gohil R, Gosnell E, Grech Marguerat D, Green R, Grounds R, Hall A, Hardman J, Harris A, Harrison L, Hone R, Hoskison E, Howard J, Ioannidis D, Iqbal I, Janjua N, Jolly K, Kamal S, Kanzara T, Keates N, Kelly A, Khan H, Korampalli T, Kuet M, Kul‐loo P, Lakhani R, Lambert A, Lancer H, Leonard C, Lloyd G, Lowe E, Mair J, Maughan E, Gao C, Mayberry T, McCadden L, McClenaghan F, McKenzie G, Mcleod R, Meghji S, Mian M, Millington A, Mirza O, Mistry S, Molena E, Morris J, Myuran T, Navaratnam A, Noon E, Okonkwo O, Oremule B, Pabla L, Papesch E, Puranik V, Roplekar R, Ross E, Rudd J, Schechter E, Senior A, Sethi N, Sharma S, Sharma R, Shelton F, Sherazi Z, Tahir A, Tikka T, Tkachuk Hlinicanova O, To K, Tse A, Toll E, Ubayasiri K, Unadkat S, Upile N, Vijendren A, Walijee H, Wilkie M, Williams R, Williams M, Wilson G, Wong W, Wong G, Xie C, Yao A, Zhang H, Ellis M, Mehta N, Milinis K, Tikka T, Slovick A, Swords C, Hutson K, Smith ME, Hopkins C, Ng Kee Kwong F. Nasal Packs for Epistaxis: Predictors of Success. Clin Otolaryngol 2020; 45:659-666. [DOI: 10.1111/coa.13555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 03/08/2020] [Accepted: 04/13/2020] [Indexed: 11/30/2022]
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Tate J, Jaksic M, Wong W, Lewis J, Byrnes C. P266 Retinol-binding protein in urine, an indicator of early kidney damage in children with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30598-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shivji S, Wong W, Fischer CE, Fornazzari LR, Masellis M, Keith J. Parkinsonism in C9orf72 expansion without co-existing Lewy body pathology; a case report and review of the literature. Neuropathol Appl Neurobiol 2020; 46:786-789. [PMID: 32339329 DOI: 10.1111/nan.12623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/03/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022]
Affiliation(s)
- S Shivji
- Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - W Wong
- Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - C E Fischer
- Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - L R Fornazzari
- Department of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - M Masellis
- Department of Medicine, Division of Neurology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - J Keith
- Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
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Wong W, Chen BZ, Lee AKY, Chan AHC, Wu JCY, Lin Z. Chinese Herbal Medicine Effectively Prolongs the Overall Survival of Pancreatic Cancer Patients: A Case Series. Integr Cancer Ther 2019; 18:1534735419828836. [PMID: 30791742 PMCID: PMC6432679 DOI: 10.1177/1534735419828836] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background and Aims: Pancreatic cancer has the lowest survival rate of all cancers (4%), and it accounts for 1.9% of new cancer cases in Hong Kong. Combined treatment with Chinese herbal medicine (CHM) and Western medicine has yielded promising results, leading to improved prognosis and overall survival. This retrospective case series aimed to illustrate the improved survival and quality of life outcomes of pancreatic cancer patients administered CHM based on traditional Chinese medicine theory. Methods: To investigate the effectiveness of CHM in prolonging overall survival, 182 patients diagnosed with pancreatic cancer who received CHM treatment were observed from 2005 to 2015. Results: One hundred eighty-two pancreatic cancer patients were treated with CHM; 21 patients died. The mean and median survival of these patients were 29.6 and 15.2 months, respectively; the 1-year survival rate was 76% (range = 4 months to 9 years). These results are better than those reported in patients treated with Western medicine, suggesting the need for further study of CHM. Conclusion: A superior clinical outcome may be obtained with CHM treatment. The case series illustrates the potential benefits and safety issues of CHM in pancreatic cancer patients that could be relevant for developing strategies to increase individualization of pancreatic cancer treatment and improve survival. This study may facilitate interprofessional communication and improved clinical management of pancreatic cancer patients.
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Affiliation(s)
- Wendy Wong
- 1 The Chinese University of Hong Kong, Shatin New Town, Hong Kong
| | - Bing Zhong Chen
- 1 The Chinese University of Hong Kong, Shatin New Town, Hong Kong
| | | | | | | | - Zhixiu Lin
- 1 The Chinese University of Hong Kong, Shatin New Town, Hong Kong
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Krebs M, Perez L, Surinach A, Doebele R, Martina R, Martinec M, Riehl T, Meropol N, Wong W, Crane G. Brain metastases, treatment patterns and outcomes in ROS1-positive NSCLC patients from US oncology community centers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz420.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Doebele R, Perez L, Trinh H, Martinec M, Martina R, Riehl T, Krebs M, Meropol N, Wong W, Crane G. P1.01-83 Comparative Efficacy Analysis Between Entrectinib Trial and Crizotinib Real-World ROS1 Fusion-Positive (ROS1+) NSCLC Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Krebs M, Perez L, Surinach A, Doebele R, Martina R, Martinec M, Riehl T, Meropol N, Wong W, Crane G. Brain metastases, treatment patterns and outcomes in ROS1-positive NSCLC patients from US oncology community centers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gupta S, Neumeister V, McGuire J, Song YS, Acs B, Ho K, Weidler J, Wong W, Rhees B, Bates M, Rimm DL, Bossuyt V. Quantitative assessments and clinical outcomes in HER2 equivocal 2018 ASCO/CAP ISH group 4 breast cancer. NPJ Breast Cancer 2019; 5:28. [PMID: 31482108 PMCID: PMC6715641 DOI: 10.1038/s41523-019-0122-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/29/2019] [Indexed: 12/17/2022] Open
Abstract
We quantified human epidermal growth factor receptor 2 (HER2) RNA and protein expression in 2018 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) in situ hybridization (ISH) group 4 (HER2/centromeric probe 17 (CEP17) ratio <2.0, average HER2 copy number ≥4.0 and <6.0, and 2013 ASCO/CAP ISH equivocal) breast cancers. Breast cancers in 2018 ASCO/CAP ISH group 4 between 2014 and 2017 were identified from the Yale archives. Sixty-three patients (34 with HER2 immunohistochemistry (IHC) 0/1+ and 29 with HER2 IHC 2+) were included. We compared patient characteristics, systemic treatments, and outcomes. We assessed HER2 by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) and quantitative immunofluorescence (QIF). Among ISH group 4 cancers, higher HER2 mRNA (P < 0.0001) but similar HER2 protein levels were observed in IHC 2+ compared to IHC 0/1+ cancers. The distribution of RT-qPCR and QIF scores were independent of fluorescence in situ hybridization (FISH) ratio/copy number. Concordance between HER2 RT-qPCR and QIF was 69.8% (r = 0.52). Among 29 patients with IHC2+ results, 16 were HER2 positive by RT-qPCR and 12 were HER2 positive by QIF. Systemic treatment, recurrence, and survival outcomes were comparable among ISH group 4 cancers regardless of IHC 0/1+ or 2+ results. ISH group 4 cancers appear to form a distinct group with intermediate levels of RNA/protein expression, close to positive/negative cut points. Therefore, adjudication into positive or negative categories may not be meaningful. Our results support the 2018 ASCO/CAP recommendation to refrain from routine additional testing of these samples. Additional outcome information after trastuzumab treatment for patients in this special group might help to guide treatment decisions in these patients.
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Affiliation(s)
- Swati Gupta
- Department of Pathology, Yale University School of Medicine, New Haven, CT USA
| | - Veronique Neumeister
- Department of Pathology, Yale University School of Medicine, New Haven, CT USA
- Indivumed Inc, Frederick, MD USA
| | - John McGuire
- Department of Pathology, Yale University School of Medicine, New Haven, CT USA
| | - Yan S. Song
- Department of Pathology, Yale University School of Medicine, New Haven, CT USA
| | - Balazs Acs
- Department of Pathology, Yale University School of Medicine, New Haven, CT USA
- Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - Kenneth Ho
- Division of Oncology Research and Development, Cepheid, Sunnyvale, CA USA
| | - Jodi Weidler
- Medical and Scientific Affairs and Strategy, Oncology, Cepheid, Sunnyvale, CA USA
| | - Wendy Wong
- Division of Oncology Research and Development, Cepheid, Sunnyvale, CA USA
| | - Brian Rhees
- Division of Oncology Research and Development, Cepheid, Sunnyvale, CA USA
| | - Michael Bates
- Medical and Scientific Affairs and Strategy, Oncology, Cepheid, Sunnyvale, CA USA
| | - David L. Rimm
- Department of Pathology, Yale University School of Medicine, New Haven, CT USA
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Weststrate H, Wong W, Ronaldson J, Lalji R, Dickens A, Prestidge C. SUN-114 BARRRIERS TO PRE-EMPTIVE KIDNEY TRANSPLANT IN NEW ZEALAND CHILDREN. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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LALJI R, Bailey E, Dickens A, Wong W, Prestidge C. MON-309 THE NEW ZEALAND PAEDIATRIC EXPERIENCE OF DIFFUSE MESANGIAL SCLEROSIS 1991-2018. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Wong W, Sundar G, Chee C, Zhao PS, Rajagopalan R, Gopal L. Clinical spectrum, treatment and outcomes of uveal melanoma in a tertiary centre. Singapore Med J 2019; 60:474-478. [PMID: 31197380 DOI: 10.11622/smedj.2019054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION We aimed to describe the clinical characteristics, diagnostic challenges, treatment patterns and outcomes of uveal melanoma (UM) in a tertiary care centre. METHODS This is a retrospective case series of 11 consecutive patients with UM who were managed in a tertiary referral centre between 2002 and 2017. Epidemiological, clinical, pathological and radiological characteristics were reviewed. Classification of choroidal melanoma as small, medium or large was based on the criteria established by the Collaborative Ocular Melanoma Study. RESULTS Mean age at presentation was 42.9 (range 27‒67) years. In 7 (64%) patients, a definitive diagnosis of UM was made after a mean follow-up period of 6.4 (range 1‒17) months. There were one, six and four patients with small-, medium- and large-sized choroidal melanomas, respectively. Treatment was enucleation in 5 (45.5%) patients, plaque brachytherapy in 4 (36.4%) patients, transpupillary thermotherapy in 1 (9.1%) patient, and observation in 1 (9.1%) patient. Median follow-up was 29 months. Metastatic disease developed in 5 (45.5%) patients at the mean age of 46.6 (range 38‒56) years, with median overall survival of 20 months. Genetic mutations in three patients were monosomy 3 (n = 2), and gain of 3q and 8q (n = 1). CONCLUSION Our study supports the finding that UM in Chinese and Asian Indian patients presents at a younger age than in Caucasians. Although it is rare, ophthalmologists should remain mindful of this life-threatening disease. We propose establishing a national and regional registry for ocular tumours with genetic information to characterise the disease spectrum in Southeast Asia.
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Affiliation(s)
- Wendy Wong
- Department of Ophthalmology, National University Hospital, National University of Singapore, Singapore
| | - Gangadhara Sundar
- Department of Ophthalmology, National University Hospital, National University of Singapore, Singapore
| | - Caroline Chee
- Department of Ophthalmology, National University Hospital, National University of Singapore, Singapore
| | - Paul Songbo Zhao
- Department of Ophthalmology, National University Hospital, National University of Singapore, Singapore
| | - Rajesh Rajagopalan
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Lingam Gopal
- Department of Ophthalmology, National University Hospital, National University of Singapore, Singapore.,Medical Research Foundation, Sankara Nethralaya, Chennai, India
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Wong W, Loong H, Lee A, To AYT. Oncologists’ Philosophy of Care: a Qualitative Study in Colorectal Cancer Care in the Chinese population. Advances in Integrative Medicine 2019. [DOI: 10.1016/j.aimed.2019.03.244] [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: 10/27/2022]
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Jiamsakul A, Kiertiburanakul S, Ng OT, Chaiwarith R, Wong W, Ditangco R, Nguyen KV, Avihingsanon A, Pujari S, Do CD, Lee MP, Ly PS, Yunihastuti E, Kumarasamy N, Kamarulzaman A, Tanuma J, Zhang F, Choi JY, Kantipong P, Sim B, Ross J, Law M, Merati TP. Long-term loss to follow-up in the TREAT Asia HIV Observational Database (TAHOD). HIV Med 2019; 20:439-449. [PMID: 30980495 DOI: 10.1111/hiv.12734] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES With earlier antiretroviral therapy (ART) initiation, time spent in HIV care is expected to increase. We aimed to investigate loss to follow-up (LTFU) in Asian patients who remained in care 5 years after ART initiation. METHODS Long-term LTFU was defined as LTFU occurring after 5 years on ART. LTFU was defined as (1) patients not seen in the previous 12 months; and (2) patients not seen in the previous 6 months. Factors associated with LTFU were analysed using competing risk regression. RESULTS Under the 12-month definition, the LTFU rate was 2.0 per 100 person-years (PY) [95% confidence interval (CI) 1.8-2.2 among 4889 patients included in the study. LTFU was associated with age > 50 years [sub-hazard ratio (SHR) 1.64; 95% CI 1.17-2.31] compared with 31-40 years, viral load ≥ 1000 copies/mL (SHR 1.86; 95% CI 1.16-2.97) compared with viral load < 1000 copies/mL, and hepatitis C coinfection (SHR 1.48; 95% CI 1.06-2.05). LTFU was less likely to occur in females, in individuals with higher CD4 counts, in those with self-reported adherence ≥ 95%, and in those living in high-income countries. The 6-month LTFU definition produced an incidence rate of 3.2 per 100 PY (95% CI 2.9-3.4 and had similar associations but with greater risks of LTFU for ART initiation in later years (2006-2009: SHR 2.38; 95% CI 1.93-2.94; and 2010-2011: SHR 4.26; 95% CI 3.17-5.73) compared with 2003-2005. CONCLUSIONS The long-term LTFU rate in our cohort was low, with older age being associated with LTFU. The increased risk of LTFU with later years of ART initiation in the 6-month analysis, but not the 12-month analysis, implies that there was a possible move towards longer HIV clinic scheduling in Asia.
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Affiliation(s)
- A Jiamsakul
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - S Kiertiburanakul
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - O T Ng
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
| | - R Chaiwarith
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - W Wong
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - R Ditangco
- Research Institute for Tropical Medicine, Manila, Philippines
| | - K V Nguyen
- National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - A Avihingsanon
- HIV-NAT, The Thai Red Cross AIDS Research Centre and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S Pujari
- Institute of Infectious Diseases, Pune, India
| | - C D Do
- Bach Mai Hospital, Hanoi, Vietnam
| | - M-P Lee
- Queen Elizabeth Hospital, Hong Kong, China
| | - P S Ly
- National Center for HIV/AIDS, Dermatology & STDs, University of Health Sciences, Phnom Penh, Cambodia
| | - E Yunihastuti
- Working Group on AIDS, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - N Kumarasamy
- Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), The Voluntary Health Services (VHS), Chennai, India
| | - A Kamarulzaman
- University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - J Tanuma
- National Center for Global Health and Medicine, Tokyo, Japan
| | - F Zhang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - J Y Choi
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - P Kantipong
- Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
| | - Blh Sim
- Hospital Sungai Buloh, Sungai Buloh, Malaysia
| | - J Ross
- TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
| | - M Law
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - T P Merati
- Faculty of Medicine, Udayana University & Sanglah Hospital, Bali, Indonesia
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Sit RWS, Chan DCC, Wong W, Yip BHK, Chow LLY, Wong SYS. Translation, cross-cultural adaptation and validation of the traditional Chinese intermittent and constant osteoarthritis pain (ICOAP) questionnaire for knee osteoarthritis. BMJ Open 2019; 9:e026006. [PMID: 30928946 PMCID: PMC6475224 DOI: 10.1136/bmjopen-2018-026006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 02/05/2019] [Accepted: 02/12/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To translate and culturally adapt the Intermittent and Constant Osteoarthritis and Pain (ICOAP) measure to a traditional Chinese version, and to study its psychometric properties in patients with knee osteoarthritis (KOA). METHOD The ICOAP was translated and cross-culturally adapted into traditional Chinese according to the recommended international guidelines. A total of 110 participants with KOA in Hong Kong were invited to complete the traditional Chinese ICOAP (tChICOAP), the Chinese Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and the Chinese Short form of Health Survey (SF-12v2). Psychometric evaluations included content validity, construct validity, internal consistency and test and retest reliability. RESULTS All participants completed the tChICOAP questionnaire without missing items. The content validity index of all items ranged from 80% to 100%. The tChICOAP total pain and subscale scores had excellent internal consistency with Cronbach's alpha value (0.902-0.948) and good corrected item-total subscale correlations. It had high test and retest reliability (intra-class correlations 0.924-0.960). The tChICOAP constant, intermittent and total pain scores correlate strongly with the WOMAC pain subscale (r=0.671, 0.678 and 0.707, respectively, p<0.001). The tChICOAP intermittent and total scores correlate strongly with SF-12v2 physical component score (r=-0.590 and -0.558, respectively, p<0.001). CONCLUSIONS The tChICOAP is a reliable and valid instrument to measure the pain experience of Chinese patients with KOA.
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Affiliation(s)
- Regina Wing Shan Sit
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Dicken Cheong Chun Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Wendy Wong
- The School of Chinese Medicine, The Chinese Unviersity of Hong Kong, Hong Kong
| | - Benjamin Hon Kei Yip
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Lyan Lai Yan Chow
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Samuel Y S Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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Tait CA, Abdillahi I, Wong W, Smith-Cannoy H, Siddiqi A. Can the health effects of widely-held societal norms be evaluated? An analysis of the United Nations convention on the elimination of all forms of discrimination against women (UN-CEDAW). BMC Public Health 2019; 19:279. [PMID: 30850025 PMCID: PMC6408842 DOI: 10.1186/s12889-019-6607-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/28/2019] [Indexed: 11/21/2022] Open
Abstract
Background Female life expectancy and mortality rates have been improving over the course of many decades. Many global changes offer potential explanations. In this paper, we examined whether the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) has, in part, been responsible for the observed improvements in these key population metrics of women’s health. Methods Data were obtained from the United Nations Treaty Series Database, the World Bank World Development Indicators database and, the Polity IV database. Because CEDAW is nearly universally ratified, it was not feasible to compare ratifying countries to non-ratifying countries. We therefore applied interrupted times series analyses, which creates a comparator (counterfactual) scenario by using the trend in the health outcome before the policy exposure to mathematically determine what the trend in the health outcome would have been after the policy exposure, had the policy exposure not occurred. Analyses were stratified by country-level income and democratization. Results Among low-income countries, CEDAW improved outcomes in democratic, but not non-democratic countries. In middle-income countries, CEDAW largely had no effect and, among high-income countries, had largely positive effects. Conclusions While population indicators of women’s health have improved since CEDAW ratification, the impact of CEDAW ratification itself on these improvements varies across countries with differing levels of income and democratization. Electronic supplementary material The online version of this article (10.1186/s12889-019-6607-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christopher A Tait
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Ifrah Abdillahi
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Wendy Wong
- Department of Political Science, University of Toronto, 100 St George Street, Toronto, ON, M5S 3G3, Canada
| | - Heather Smith-Cannoy
- Department of International Affairs, Lewis & Clark College, 0615 S.W. Palatine Hill Road, Portland, OR, 97219, USA
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. .,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
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Liu X, Li J, Schild SE, Schild MH, Wong W, Vora S, Herman MG, Fatyga M. Modeling of Acute Rectal Toxicity to Compare Two Patient Positioning Methods for Prostate Cancer Radiotherapy: Can Toxicity Modeling be Used for Quality Assurance? ACTA ACUST UNITED AC 2019; 7. [PMID: 30775161 PMCID: PMC6376967 DOI: 10.4172/2167-7964.1000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose: Intensity Modulated Radiation Therapy (IMRT) allows for significant dose reductions to organs at risk in prostate cancer patients. However, the accurate delivery of IMRT plans can be compromised by patient positioning errors. The purpose of this study was to determine if the modeling of grade ≥ 2 acute rectal toxicity could be used to monitor the quality of IMRT protocols. Materials and Methods: 79 patients treated with Image and Fiducial Markers Guided IMRT (FMIGRT) and 302 patients treated with trans-abdominal ultrasound guided IMRT (USGRT) was selected for this study. Treatment plans were available for the FMIGRT group, and hand recorded dosimetric indices were available for both groups. We modeled toxicity in the FMIGRT group using the Lyman Kutcher Burman (LKB) and Univariate Logistic Regression (ULR) models, and we modeled toxicity in USGRT group using the ULR model. We performed Receiver Operating Characteristics (ROC) analysis on all of the models and compared the Area under the ROC curve (AUC) for the FMIGRT and the USGRT groups. Results: The observed Incidence of grade ≥ 2 rectal toxicity was 20% in FMIGRT patients and 54% in USGRT patients. LKB model parameters in the FMIGRT group were TD50=56.8 Gy, slope m=0.093, and exponent n=0.131. The most predictive indices in the ULR model for the FMIGRT group were D25% and V50 Gy. AUC for both models in the FMIGRT group was similar (AUC=0.67). The FMIGRT URL model predicted less than a 37% incidence of grade ≥ 2 acute rectal toxicity in the USGRT group. A fit of the ULR model to USGRT data did not yield a predictive model (AUC=0.5). Conclusion: Modeling of acute rectal toxicity provided a quantitative measure of the correlation between planning dosimetry and this clinical endpoint. Our study suggests that an unusually weak correlation may indicate a persistent patient positioning error.
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Affiliation(s)
- X Liu
- School of Computing, Informatics and Decision Systems Engineering, Arizona State University, USA
| | - J Li
- School of Computing, Informatics and Decision Systems Engineering, Arizona State University, USA
| | - S E Schild
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
| | - M H Schild
- Department of Pathology, Duke University School of Medicine, USA
| | - W Wong
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
| | - S Vora
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
| | - M G Herman
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
| | - M Fatyga
- Department of Radiation Oncology, Mayo Clinic Arizona, USA
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Virk MK, Hotz JC, Wong W, Khemani RG, Newth CJL, Ross PA. Minimal Change in Cardiac Index With Increasing PEEP in Pediatric Acute Respiratory Distress Syndrome. Front Pediatr 2019; 7:9. [PMID: 30761278 PMCID: PMC6361833 DOI: 10.3389/fped.2019.00009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/11/2019] [Indexed: 01/11/2023] Open
Abstract
Objective: To determine if increasing positive end expiratory pressure (PEEP) leads to a change in cardiac index in children with Pediatric Acute Respiratory Distress Syndrome ranging from mild to severe. Design: Prospective interventional study. Setting: Multidisciplinary Pediatric Intensive Care Unit in a University teaching hospital. Patients: Fifteen intubated children (5 females, 10 males) with a median age of 72 months (IQR 11, 132) and a median weight of 19.3 kg (IQR 7.5, 53.6) with a severity of Pediatric Acute Respiratory Distress Syndrome that ranged from mild to severe with a median lung injury score of 2.3 (IQR 2.0, 2.7). Measurements: Cardiac index (CI) and stroke volume (SV) were measured on baseline ventilator settings and subsequently with a PEEP 4 cmH2O higher than baseline. Change in CI and SV from baseline values was evaluated using Wilcoxon signed rank test. Results: A total of 19 paired measurements obtained. The median baseline PEEP was 8 cmH2O (IQR 8, 10) Range 6-14 cmH2O. There was no significant change in cardiac index or stroke volume with change in PEEP. Baseline median CI 4.4 L/min/m2 (IQR 3.4, 4.8) and PEEP 4 higher median CI of 4.3 L/min/m2 (IQR 3.6, 4.8), p = 0.65. Baseline median SV 26 ml (IQR 13, 44) and at PEEP 4 higher median SV 34 ml (IQR 12, 44) p = 0.63. Conclusion: There is no significant change in cardiac index or stroke volume with increasing PEEP by 4 cmH2O in a population of children with mild to severe PARDS. Clinical Trial Registration: The study is registered on Clinical trails.gov under the Identifier: NCT02354365.
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Affiliation(s)
- Manpreet K Virk
- Section of Critical Care, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States
| | - Justin C Hotz
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Wendy Wong
- Critical Care Medicine, Valley Children's Hospital, Madera, CA, United States
| | - Robinder G Khemani
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Christopher J L Newth
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Patrick A Ross
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
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Hon KL, Liu S, Chow JC, Tsang KY, Lam HS, So KW, Cheng YK, Leung AK, Wong W. Mortality and morbidity of extremely low birth weight infants in Hong Kong, 2010-2017: a single-centre review. Hong Kong Med J 2018; 24:460-465. [PMID: 30262674 DOI: 10.12809/hkmj177181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Extremely low birth weight (ELBW) infants exhibit high rates of mortality and morbidity. We retrospectively assessed factors associated with mortality and morbidity among ELBW infants. METHODS Perinatal demographic data were reviewed for all ELBW infants born between 2010 and 2017 at a tertiary neonatal unit. RESULTS For non-survivors (21% of ELBW infants) and survivors, the median gestational ages were 24.1 and 26.2 weeks, respectively, and median birth weights were 650 g and 780 g, respectively (all P<0.001). Regression analyses showed that non-survival was positively associated with lower gestational age (adjusted odds ratio [aOR]=6.71 for every 1-week decrease; 95% confidence interval [CI]=1.73-26.00; P=0.006) and grade 3 or 4 intraventricular haemorrhage (aOR=29.23; 95% CI=1.39-613.84; P=0.030); non-survival was negatively associated with the presence of bronchopulmonary dysplasia (aOR=0.01; 95% CI= <0.001-0.23; P=0.005); length of neonatal intensive care unit stay for survivors was positively associated with the presence of necrotising enterocolitis (B-coefficient=89.60; 95% CI=43.86-135.34; P<0.001); and length of hospital stay for survivors was positively associated with the presence of necrotising enterocolitis (B-coefficient=2.08; 95% CI=0.43-3.73; P=0.015) and a low Apgar score at 1 minute (B-coefficient=-0.63; 95% CI=-1.04 to -0.22; P=0.003). CONCLUSION Extremely low birth weight infants exhibited significant mortality and morbidity; there was no survival prior to 23.6 weeks' gestation or below 550 g birth weight. The presence of grade 3 or 4 intraventricular haemorrhage was independently associated with non-survival. Survivors were significantly more likely to exhibit bronchopulmonary dysplasia; survivors with necrotising enterocolitis were more likely to require longer stays in the neonatal intensive care unit and in hospital.
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Affiliation(s)
- K L Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S Liu
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J Cy Chow
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K Yc Tsang
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - H S Lam
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K W So
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - Y Ky Cheng
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - A Kc Leung
- Department of Pediatrics, University of Calgary, Canada
| | - W Wong
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong
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Iyer A, Petterson J, Wong W, Wong G, Gniadecki R. LB1479 Identifying intratumor heterogeneity in mycosis fungoides using high throughput DNA sequencing. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Qadri M, Jay GD, Zhang LX, Wong W, Reginato AM, Sun C, Schmidt TA, Elsaid KA. Recombinant human proteoglycan-4 reduces phagocytosis of urate crystals and downstream nuclear factor kappa B and inflammasome activation and production of cytokines and chemokines in human and murine macrophages. Arthritis Res Ther 2018; 20:192. [PMID: 30157934 PMCID: PMC6116363 DOI: 10.1186/s13075-018-1693-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 08/01/2018] [Indexed: 01/29/2023] Open
Abstract
Background Gout is an inflammatory arthritis caused by monosodium urate monohydrate (MSU) crystals’ joint deposition. MSU phagocytosis by resident macrophages is a key step in gout pathogenesis. MSU phagocytosis triggers nuclear factor kappa B (NFκB) activation and production of cytokines and chemokines. Proteoglycan-4 (PRG4) is a glycoprotein produced by synovial fibroblasts and exerts an anti-inflammatory effect in the joint mediated by its interaction with cell surface receptor CD44. PRG4 also binds and antagonizes TLR2 and TLR4. The objective of this study is to evaluate the efficacy of recombinant human PRG4 (rhPRG4) in suppressing MSU-induced inflammation and mechanical allodynia in vitro and in vivo. Methods THP-1 macrophages were incubated with MSU crystals ± rhPRG4 or bovine submaxillary mucin (BSM), and crystal phagocytosis, cytokines and chemokines expression and production were determined. NFκB p65 subunit nuclear translocation, NLRP3 induction, caspase-1 activation and conversion of proIL-1β to mature IL-1β were studied. MSU phagocytosis by Prg4+/+ and Prg4−/− peritoneal macrophages was determined in the absence or presence of rhPRG4, BSM, anti-CD44, anti-TLR2, anti-TLR4 and isotype control antibodies. Rhodamine-labeled rhPRG4 was incubated with murine macrophages and receptor colocalization studies were performed. Lewis rats underwent intra-articular injection of MSU crystals followed by intra-articular treatment with PBS or rhPRG4. Weight bearing and SF myeloperoxidase activities were determined. Results rhPRG4 reduced MSU crystal phagocytosis at 4 h (p < 0.01) and IL-1β, TNF-α, IL-8 and MCP-1 expression and production at 6 h (p < 0.05). BSM did not alter MSU phagocytosis or IL-1β production in human and murine macrophages. rhPRG4 treatment reduced NFκB nuclear translocation, NLRP3 expression, caspase-1 activation and generation of mature IL-1β (p < 0.05). MSU-stimulated IL-1β production was higher in Prg4−/− macrophages compared to Prg4+/+ macrophages (p < 0.001). rhPRG4, anti-CD44, anti-TLR2 and anti-TLR4 antibody treatments reduced MSU phagocytosis and IL-1β production in murine macrophages (p < 0.05). rhPRG4 preferentially colocalized with CD44 on Prg4−/− peritoneal macrophages compared to TLR2 or TLR4 (p < 0.01). rhPRG4 normalized weight bearing and reduced SF myeloperoxidase activity compared to PBS in vivo. Conclusion rhPRG4 inhibits MSU crystal phagocytosis and exhibits an anti-inflammatory and anti-nociceptive activity in vitro and in vivo. rhPRG4’s anti-inflammatory mechanism may be due to targeting CD44 on macrophages.
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Affiliation(s)
- Marwa Qadri
- Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Rinker Health Sciences Campus, 9401 Jeronimo Road, Irvine, CA, 92618, USA
| | - Gregory D Jay
- Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, USA.,Department of Biomedical Engineering, Brown University, Providence, RI, USA
| | - Ling X Zhang
- Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, USA
| | - Wendy Wong
- Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, USA
| | - Anthony M Reginato
- Division of Rheumatology and Department of Dermatology, Rhode Island Hospital, Providence, RI, USA
| | - Changqi Sun
- Division of Rheumatology and Department of Dermatology, Rhode Island Hospital, Providence, RI, USA
| | - Tannin A Schmidt
- Biomedical Engineering Department, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Khaled A Elsaid
- Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Rinker Health Sciences Campus, 9401 Jeronimo Road, Irvine, CA, 92618, USA.
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Wu NC, Wong W, Ho KE, Chu VC, Rizo A, Davenport S, Kelly D, Makar R, Jassem J, Duchnowska R, Biernat W, Radecka B, Fujita T, Klein JL, Stonecypher M, Ohta S, Juhl H, Weidler JM, Bates M, Press MF. Comparison of central laboratory assessments of ER, PR, HER2, and Ki67 by IHC/FISH and the corresponding mRNAs (ESR1, PGR, ERBB2, and MKi67) by RT-qPCR on an automated, broadly deployed diagnostic platform. Breast Cancer Res Treat 2018; 172:327-338. [PMID: 30120700 PMCID: PMC6208911 DOI: 10.1007/s10549-018-4889-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/13/2018] [Indexed: 01/08/2023]
Abstract
Purpose The methods (IHC/FISH) typically used to assess ER, PR, HER2, and Ki67 in FFPE specimens from breast cancer patients are difficult to set up, perform, and standardize for use in low and middle-income countries. Use of an automated diagnostic platform (GeneXpert®) and assay (Xpert® Breast Cancer STRAT4) that employs RT-qPCR to quantitate ESR1, PGR, ERBB2, and MKi67 mRNAs from formalin-fixed, paraffin-embedded (FFPE) tissues facilitates analyses in less than 3 h. This study compares breast cancer biomarker analyses using an RT-qPCR-based platform with analyses using standard IHC and FISH for assessment of the same biomarkers. Methods FFPE tissue sections from 523 patients were sent to a College of American Pathologists-certified central reference laboratory to evaluate concordance between IHC/FISH and STRAT4 using the laboratory’s standard of care methods. A subset of 155 FFPE specimens was tested for concordance with STRAT4 using different IHC antibodies and scoring methods. Results Concordance between STRAT4 and IHC was 97.8% for ESR1, 90.4% for PGR, 93.3% for ERBB2 (IHC/FISH for HER2), and 78.6% for MKi67. Receiver operating characteristic curve (ROC) area under the curve (AUC) values of 0.99, 0.95, 0.99, and 0.85 were generated for ESR1, PGR, ERBB2, and MKi67, respectively. Minor variabilities were observed depending on the IHC antibody comparator used. Conclusion Evaluation of breast cancer biomarker status by STRAT4 was highly concordant with central IHC/FISH in this blinded, retrospectively analyzed collection of samples. STRAT4 may provide a means to cost-effectively generate standardized diagnostic results for breast cancer patients in low- and middle-income countries. Electronic supplementary material The online version of this article (10.1007/s10549-018-4889-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Natalie C Wu
- Division of Oncology Research and Development, Cepheid, Sunnyvale, CA, USA
| | - Wendy Wong
- Division of Oncology Research and Development, Cepheid, Sunnyvale, CA, USA
| | - Kenneth E Ho
- Division of Oncology Research and Development, Cepheid, Sunnyvale, CA, USA
| | - Victor C Chu
- Division of Oncology Research and Development, Cepheid, Sunnyvale, CA, USA
| | - Annaliza Rizo
- Division of Oncology Research and Development, Cepheid, Sunnyvale, CA, USA
| | - Simon Davenport
- Department of Pathology, Keck School of Medicine, USC/Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Avenue, STE. 5409, Los Angeles, CA, 90033-0800, USA
| | - Devon Kelly
- Oregon Health and Science University/Knight Cancer Institute, Portland, OR, USA
| | - Rosemary Makar
- Oregon Health and Science University/Knight Cancer Institute, Portland, OR, USA
| | | | | | | | | | - Tomoyuki Fujita
- Tokyo Medical University Ibaraki Medical Center, Ami, Ibaraki, Japan
| | | | | | - Shoichiro Ohta
- Department of Human Life Science, School of Nursing, Josai University, Sakado, Japan
| | | | - Jodi M Weidler
- Medical and Scientific Affairs and Strategy, Oncology, Cepheid, Sunnyvale, CA, USA
| | - Michael Bates
- Medical and Scientific Affairs and Strategy, Oncology, Cepheid, Sunnyvale, CA, USA
| | - Michael F Press
- Department of Pathology, Keck School of Medicine, USC/Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Avenue, STE. 5409, Los Angeles, CA, 90033-0800, USA.
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Madsen PL, Joerg L, Khurana S, Wong W, De Pasquale C, Selvanayagam J. P1791The decreasing limb of frank and starlings law of the heart is associated with an increase in left ventricular end-diastolic volume. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1791] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- P L Madsen
- Herlev Hospital - Copenhagen University Hospital, Dept. of Cardiology, Copenhagen, Denmark
| | - L Joerg
- Cantonal Hospital St. Gallen, Dept of Cardiology, St. Gallen, Switzerland
| | - S Khurana
- Flinders Medical Centre and Flinders University, Dept of Cardiology, Adelaide, Australia
| | - W Wong
- Flinders Medical Centre and Flinders University, Dept of Cardiology, Adelaide, Australia
| | - C De Pasquale
- Flinders Medical Centre and Flinders University, Dept of Cardiology, Adelaide, Australia
| | - J Selvanayagam
- Flinders Medical Centre and Flinders University, Dept of Cardiology, Adelaide, Australia
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