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Ghazal SS, Alshahry RM, Mills MP, Martin W, Aghaloo TL, Cochran DL. Bone-level Tapered Implants for Single Tooth Replacement. Immediate vs Delayed Placement: A Randomized, Controlled, Multi-center One-year No-inferiority Clinical Study. Int J Oral Maxillofac Implants 2024; 0:1-46. [PMID: 38607360 DOI: 10.11607/jomi.10504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
MATERIALS AND METHODS Post-market, prospective, randomized, controlled, multi-center study with a primary endpoint of one year. 53 subjects were randomized to receive either immediate implant placement (test group) or delayed implant placement (control group). The mean crestal bone-level changes from implant loading to 12 months post-implant loading were measured using standardized, digital periapical radiographs. Changes in facial plate thickness measured on cone-beam computed tomography (CBCT) images, implant success and survival, implant stability, soft tissue changes, patient-centered outcomes, and adverse effects were measured to assess outcomes between the test and control treatments at 12 months post-loading. RESULTS 46 subjects completed the study (23 in each group). Mean bone changes from loading to the 12 month follow-up were recorded with no statistically significant difference (p=0.950) between both groups. The hypothesis was confirmed that immediate implant placement (Test) in extraction sockets is similar to delayed placement (Control). The test group was found to be similar to the control group (P=0.022) in terms of mean changes in facial plate thickness. Implant survival and success were 95.8% in the test group and 92% in the control group. Stability in the control group was superior at the time of surgery, but there was no difference between both groups at implant loading, producing a non-significant p-value of (0.563). CONCLUSION This randomized, controlled, multi-center one-year study showed comparable outcomes 1-year after prosthetic loading in the immediate and delayed placement groups.
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Johnson TS, MacDonald TJ, Pacholczyk R, Aguilera D, Al-Basheer A, Bajaj M, Bandopadhayay P, Berrong Z, Bouffet E, Castellino RC, Dorris K, Eaton BR, Esiashvili N, Fangusaro JR, Foreman N, Fridlyand D, Giller C, Heger IM, Huang C, Kadom N, Kennedy EP, Manoharan N, Martin W, McDonough C, Parker RS, Ramaswamy V, Ring E, Rojiani A, Sadek RF, Satpathy S, Schniederjan M, Smith A, Smith C, Thomas BE, Vaizer R, Yeo KK, Bhasin MK, Munn DH. Indoximod-based chemo-immunotherapy for pediatric brain tumors: A first-in-children phase I trial. Neuro Oncol 2024; 26:348-361. [PMID: 37715730 PMCID: PMC10836763 DOI: 10.1093/neuonc/noad174] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Recurrent brain tumors are the leading cause of cancer death in children. Indoleamine 2,3-dioxygenase (IDO) is a targetable metabolic checkpoint that, in preclinical models, inhibits anti-tumor immunity following chemotherapy. METHODS We conducted a phase I trial (NCT02502708) of the oral IDO-pathway inhibitor indoximod in children with recurrent brain tumors or newly diagnosed diffuse intrinsic pontine glioma (DIPG). Separate dose-finding arms were performed for indoximod in combination with oral temozolomide (200 mg/m2/day x 5 days in 28-day cycles), or with palliative conformal radiation. Blood samples were collected at baseline and monthly for single-cell RNA-sequencing with paired single-cell T cell receptor sequencing. RESULTS Eighty-one patients were treated with indoximod-based combination therapy. Median follow-up was 52 months (range 39-77 months). Maximum tolerated dose was not reached, and the pediatric dose of indoximod was determined as 19.2 mg/kg/dose, twice daily. Median overall survival was 13.3 months (n = 68, range 0.2-62.7) for all patients with recurrent disease and 14.4 months (n = 13, range 4.7-29.7) for DIPG. The subset of n = 26 patients who showed evidence of objective response (even a partial or mixed response) had over 3-fold longer median OS (25.2 months, range 5.4-61.9, p = 0.006) compared to n = 37 nonresponders (7.3 months, range 0.2-62.7). Four patients remain free of active disease longer than 36 months. Single-cell sequencing confirmed emergence of new circulating CD8 T cell clonotypes with late effector phenotype. CONCLUSIONS Indoximod was well tolerated and could be safely combined with chemotherapy and radiation. Encouraging preliminary evidence of efficacy supports advancing to Phase II/III trials for pediatric brain tumors.
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Affiliation(s)
- Theodore S Johnson
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- Department of Pediatrics, Augusta University, Augusta, Georgia, USA
| | - Tobey J MacDonald
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Rafal Pacholczyk
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts, USA
| | - Dolly Aguilera
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Ahmad Al-Basheer
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- Department of Radiation Oncology, Augusta University, Augusta, Georgia, USA
| | - Manish Bajaj
- Department of Radiology, Augusta University, Augusta, Georgia, USA
| | | | - Zuzana Berrong
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
| | - Eric Bouffet
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Robert C Castellino
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Kathleen Dorris
- Department of Pediatrics, Children’s Hospital Colorado, Aurora, Colorado, USA
| | - Bree R Eaton
- Department of Radiation Oncology and Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Natia Esiashvili
- Department of Radiation Oncology and Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Jason R Fangusaro
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Nicholas Foreman
- Department of Pediatrics, Children’s Hospital Colorado, Aurora, Colorado, USA
| | - Diana Fridlyand
- Department of Pediatrics, Augusta University, Augusta, Georgia, USA
| | - Cole Giller
- Department of Neurosurgery, Augusta University, Augusta, Georgia, USA
| | - Ian M Heger
- Department of Neurosurgery, Augusta University, Augusta, Georgia, USA
| | - Chenbin Huang
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA
- Department of Biomedical Informatics, Emory University, Atlanta, Georgia, USA
| | - Nadja Kadom
- Department of Radiology and Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Eugene P Kennedy
- Lumos Pharma, Inc. (formerly NewLink Genetics Corporation), Austin, Texas, USA
| | - Neevika Manoharan
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts, USA
| | - William Martin
- Department of Radiation Oncology, Augusta University, Augusta, Georgia, USA
| | - Colleen McDonough
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- Department of Pediatrics, Augusta University, Augusta, Georgia, USA
| | - Rebecca S Parker
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- Department of Pediatrics, Augusta University, Augusta, Georgia, USA
| | - Vijay Ramaswamy
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Eric Ring
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- Department of Pediatrics, Augusta University, Augusta, Georgia, USA
| | - Amyn Rojiani
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- Department of Pathology, Augusta University, Augusta, Georgia, USA
| | - Ramses F Sadek
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- Department of Population Health Sciences, Augusta University, Augusta, Georgia, USA
| | - Sarthak Satpathy
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA
- Department of Biomedical Informatics, Emory University, Atlanta, Georgia, USA
| | - Matthew Schniederjan
- Children’s Healthcare of Atlanta and Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA
| | - Amy Smith
- Department of Pediatrics, Arnold Palmer Hospital for Children, Orlando, Florida, USA
| | - Christopher Smith
- Lumos Pharma, Inc. (formerly NewLink Genetics Corporation), Austin, Texas, USA
| | - Beena E Thomas
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Rachel Vaizer
- Department of Pediatrics, Augusta University, Augusta, Georgia, USA
| | - Kee Kiat Yeo
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts, USA
| | - Manoj K Bhasin
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA
- Department of Biomedical Informatics, Emory University, Atlanta, Georgia, USA
| | - David H Munn
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
- Department of Pediatrics, Augusta University, Augusta, Georgia, USA
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Ferone D, Martin W, Williams J, Houchard A, Pommie C, Ribeiro-Oliveira A, Grossman AB. An international simulated-use study to assess nurses' preferences between two lanreotide syringes for patients with neuroendocrine tumours or acromegaly (PRESTO 3). J Endocrinol Invest 2024; 47:421-432. [PMID: 37550552 PMCID: PMC10859340 DOI: 10.1007/s40618-023-02158-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/13/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE PRESTO 3 evaluated nurses' preference for the Somatuline® Autogel® syringe versus the Lanreotide Pharmathen syringe after injection-pad testing. METHODS This international simulated-use study included oncology/endocrinology nurses with ≥ 1 years' experience in managing neuroendocrine tumours (NETs) and/or acromegaly. Each nurse tested both syringes twice in a randomised order before completing an electronic survey. The primary objective was to assess overall preference (%, 95% confidence interval [CI]) for the Somatuline Autogel syringe versus the Lanreotide Pharmathen syringe. Secondary objectives included rating syringe performance and ranking the importance of syringe attributes. RESULTS Ninety-four nurses were enrolled: mean age, 41.0 (SD, 11.5) years. The percentage of nurses stating a preference ("strong" or "slight") for the Somatuline Autogel syringe (86.2% [95% CI 77.5-92.4%]) was significantly higher than 50% (p < 0.0001). Performance rating was significantly higher for the Somatuline Autogel syringe versus Lanreotide Pharmathen syringe for 10 of the 11 attributes tested (p < 0.05). The syringe attributes considered most important when injecting patients in routine clinical practice were "easy to use from preparation to injection" (30.9%) and "comfortable to handle during use from preparation to injection" (16.0%). The attribute most commonly rated as least important was "fast administration from preparation to injection" (26.6%). CONCLUSION Nurses strongly preferred the user experience of the Somatuline Autogel syringe over the Lanreotide Pharmathen syringe. "Ease of use" and "comfortable to handle" were the most important syringe attributes, and performance rating was significantly higher with Somatuline Autogel versus Lanreotide Pharmathen syringe for all but one attribute.
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Affiliation(s)
- D Ferone
- Endocrinology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Internal Medicine and Medical Specialties, University of Genova, Genoa, Italy
| | - W Martin
- Kings College Hospital Foundation Trust, ENETS Centre of Excellence, London, UK
| | - J Williams
- Oregon Health and Science University Pituitary Center, Portland, OR, USA
| | | | - C Pommie
- Ipsen, Boulogne-Billancourt, France
| | | | - A B Grossman
- Green Templeton College, University of Oxford, Oxford, UK.
- Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, UK.
- Centre for Endocrinology, Barts and the London School of Medicine, London, UK.
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Haltaufderhyde K, Roberts BJ, Khan S, Terry F, Boyle CM, McAllister M, Martin W, Rosenberg A, De Groot AS. Correction to: Immunoinformatic Risk Assessment of Host Cell Proteins During Process Development for Biologic Therapeutics. AAPS J 2023; 26:6. [PMID: 38114731 DOI: 10.1208/s12248-023-00868-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Affiliation(s)
| | - Brian J Roberts
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | - Sundos Khan
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | - Frances Terry
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | | | | | - William Martin
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | - Amy Rosenberg
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | - Anne S De Groot
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA.
- Center for Vaccines and Immunology, University of Georgia, Athens, Georgia, USA.
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Ricotti S, Garay AS, Etcheverrigaray M, Amadeo GI, De Groot AS, Martin W, Mufarrege EF. Development of IFNβ-1a versions with reduced immunogenicity and full in vitro biological activity for the treatment of multiple sclerosis. Clin Immunol 2023; 257:109831. [PMID: 37931868 DOI: 10.1016/j.clim.2023.109831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/18/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023]
Abstract
IFNβ (recombinant interferon Beta) has been widely used for the treatment of Multiple sclerosis for the last four decades. Despite the human origin of the IFNβ sequence, IFNβ is immunogenic, and unwanted immune responses in IFNβ-treated patients may compromise its efficacy and safety in the clinic. In this study, we applied the DeFT (De-immunization of Functional Therapeutics) approach to producing functional, de-immunized versions of IFNβ-1a. Two de-immunized versions of IFNβ-1a were produced in CHO cells and designated as IFNβ-1a(VAR1) and IFNβ-1a(VAR2). First, the secondary and tertiary protein structures were analyzed by circular dichroism spectroscopy. Then, the variants were also tested for functionality. While IFNβ-1a(VAR2) showed similar in vitro antiviral activity to the original protein, IFNβ-1a(VAR1) exhibited 40% more biological potency. Finally, in vivo assays using HLA-DR transgenic mice revealed that the de-immunized variants showed a markedly reduced immunogenicity when compared to the originator.
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Affiliation(s)
- Sonia Ricotti
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168, Km 472.4, C.C. 242, Santa Fe S3000ZAA, Argentina
| | - Alberto Sergio Garay
- Laboratory of Molecular Modeling, FBCB (School of Biochemistry and Biological Sciences), Ciudad Universitaria, Ruta Nacional 168, Km 472.4, C.C. 242, Santa Fe S3000ZAA, Argentina
| | - Marina Etcheverrigaray
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168, Km 472.4, C.C. 242, Santa Fe S3000ZAA, Argentina
| | - Gabriel Ignacio Amadeo
- Ciudad Universitaria, Ruta Nacional 168, Km 472.4, C.C. 242, Santa Fe S3000ZAA, Argentina
| | - Anne S De Groot
- EpiVax, Inc., Providence, RI 02903, USA; Center for Vaccines and Immunology, University of Georgia, Athens, GA, United States of America
| | | | - Eduardo Federico Mufarrege
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168, Km 472.4, C.C. 242, Santa Fe S3000ZAA, Argentina.
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Jungbluth S, Martin W, Slezak M, Depraetere H, Guzman CA, Ussi A, Morrow D, Van Heuverswyn F, Arnouts S, Carrondo MJT, Olesen O, Ottenhoff TH, Dockrell HM, Ho MM, Dobly A, Christensen D, Segalés J, Laurent F, Lantier F, Stockhofe-Zurwieden N, Morelli F, Langermans JA, Verreck FA, Le Grand R, Sloots A, Medaglini D, Lawrenz M, Collin N. Potential business model for a European vaccine R&D infrastructure and its estimated socio-economic impact. F1000Res 2023; 12:1401. [PMID: 38298529 PMCID: PMC10828550 DOI: 10.12688/f1000research.141399.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 02/02/2024] Open
Abstract
Background Research infrastructures are facilities or resources that have proven fundamental for supporting scientific research and innovation. However, they are also known to be very expensive in their establishment, operation and maintenance. As by far the biggest share of these costs is always borne by public funders, there is a strong interest and indeed a necessity to develop alternative business models for such infrastructures that allow them to function in a more sustainable manner that is less dependent on public financing. Methods In this article, we describe a feasibility study we have undertaken to develop a potentially sustainable business model for a vaccine research and development (R&D) infrastructure. The model we have developed integrates two different types of business models that would provide the infrastructure with two different types of revenue streams which would facilitate its establishment and would be a measure of risk reduction. For the business model we are proposing, we have undertaken an ex ante impact assessment that estimates the expected impact for a vaccine R&D infrastructure based on the proposed models along three different dimensions: health, society and economy. Results Our impact assessment demonstrates that such a vaccine R&D infrastructure could achieve a very significant socio-economic impact, and so its establishment is therefore considered worthwhile pursuing. Conclusions The business model we have developed, the impact assessment and the overall process we have followed might also be of interest to other research infrastructure initiatives in the biomedical field.
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Affiliation(s)
| | - William Martin
- European Vaccine Initiative (EVI), Heidelberg, 69115, Germany
| | - Monika Slezak
- European Vaccine Initiative (EVI), Heidelberg, 69115, Germany
| | | | - Carlos A. Guzman
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, 38124, Germany
| | - Anton Ussi
- EATRIS- European Research Infrastructure for Translational Medicine, Amsterdam, 1081 HZ, The Netherlands
| | - David Morrow
- EATRIS- European Research Infrastructure for Translational Medicine, Amsterdam, 1081 HZ, The Netherlands
| | | | - Sven Arnouts
- provaxs - Ghent University, Merelbeke, 9820, Belgium
| | | | - Ole Olesen
- European Vaccine Initiative (EVI), Heidelberg, 69115, Germany
| | - Tom H.M. Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, 2300RC, The Netherlands
| | - H. M. Dockrell
- London School of Hygiene & Tropical Medicine (LSHTM), London, WC1E 7HT, UK
| | - Mei Mei Ho
- Medicines and Healthcare products Regulatory Agency (MHRA), Potters Bar, Hertfordshire, EN6 3QG, UK
| | | | | | - Joaquim Segalés
- Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Bellaterra, 08193, Spain
| | - Fabrice Laurent
- Université François Rabelais de Tours, Centre Val de Loire, UMR1282 ISP, INRAE, Nouzilly, 37380, France
| | - Frédéric Lantier
- Université François Rabelais de Tours, Centre Val de Loire, UMR1282 ISP, INRAE, Nouzilly, 37380, France
| | - Norbert Stockhofe-Zurwieden
- Wageningen Bioveterinary Research, Wageningen University & Research (SWR), Wageningen, 6700 HB, The Netherlands
| | | | - Jan A.M. Langermans
- Biomedical Primate Research Centre (BPRC), Rijswijk, 2288 GJ, The Netherlands
| | - Frank A.W. Verreck
- Biomedical Primate Research Centre (BPRC), Rijswijk, 2288 GJ, The Netherlands
| | - Roger Le Grand
- IDMIT Infrastructure, CEA, Université Paris-Saclay, Inserm, Fontenay-aux-Roses, 92265, Cedex, France
| | | | | | - Maria Lawrenz
- Vaccine Formulation Institute (VFI), Plan-les-Ouates, Geneva, 1228, Switzerland
| | - Nicolas Collin
- Vaccine Formulation Institute (VFI), Plan-les-Ouates, Geneva, 1228, Switzerland
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Haltaufderhyde K, Roberts BJ, Khan S, Terry F, Boyle CM, McAllister M, Martin W, Rosenberg A, De Groot AS. Immunoinformatic Risk Assessment of Host Cell Proteins During Process Development for Biologic Therapeutics. AAPS J 2023; 25:87. [PMID: 37697150 DOI: 10.1208/s12248-023-00852-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/19/2023] [Indexed: 09/13/2023] Open
Abstract
The identification and removal of host cell proteins (HCPs) from biologic products is a critical step in drug development. Despite recent improvements to purification processes, biologics such as monoclonal antibodies, enzyme replacement therapies, and vaccines that are manufactured in a range of cell lines and purified using diverse processes may contain HCP impurities, making it necessary for developers to identify and quantify impurities during process development for each drug product. HCPs that contain sequences that are less conserved with human homologs may be more immunogenic than those that are more conserved. We have developed a computational tool, ISPRI-HCP, that estimates the immunogenic potential of HCP sequences by evaluating and quantifying T cell epitope density and relative conservation with similar T cell epitopes in the human proteome. Here we describe several case studies that support the use of this method for classifying candidate HCP impurities according to their immunogenicity risk.
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Affiliation(s)
| | - Brian J Roberts
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | - Sundos Khan
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | - Frances Terry
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | | | | | - William Martin
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | - Amy Rosenberg
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA
| | - Anne S De Groot
- EpiVax, Inc, 188 Valley St #424, Providence, Rhode Island, USA.
- Center for Vaccines and Immunology, University of Georgia, Athens, Georgia, USA.
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8
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Hamilton A, Gonzaga L, Amorim K, Wittneben JG, Martig L, Morton D, Martin W, Gallucci GO, Wismeijer D. Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:304-348. [PMID: 37750515 DOI: 10.1111/clr.14109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. MATERIALS AND METHODS An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool. RESULTS A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004). CONCLUSIONS Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Luiz Gonzaga
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Karina Amorim
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | | | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - William Martin
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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9
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Morton D, Wismeijer D, Chen S, Hamilton A, Wittneben J, Casentini P, Gonzaga L, Lazarin R, Martin W, Molinero-Mourelle P, Obermailer B, Polido WD, Tahmaseb A, Thoma D, Zembic A. Group 5 ITI Consensus Report: Implant placement and loading protocols. Clin Oral Implants Res 2023; 34 Suppl 26:349-356. [PMID: 37750529 DOI: 10.1111/clr.14137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/06/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES Working Group 5 was convened to discuss and find consensus on the topics of implant placement and loading protocols associated with single missing teeth in the anterior maxilla (aesthetic zone). Consensus statements, clinical recommendations, patient perspectives and future research suggestions were developed and presented to the plenary for discussion and approval. MATERIALS AND METHODS Two systematic reviews were developed and submitted prior to the conference. The group considered in detail the systematic reviews and developed statements, clinical recommendations, patient perspectives and future research suggestions based on the findings of the reviews and experience of group members. Definitive versions were developed after presentation to and discussion by the plenary. RESULTS Five consensus statements were developed and approved from each systematic review. Twelve clinical recommendations were developed by the group based on both reviews and experience. Three patient perspectives were developed, and five suggestions made for future research. CONCLUSIONS Based on the findings of the systematic reviews and experience of group members, the Type 1A protocol (immediate placement and immediate loading), when utilized in the anterior maxilla under favorable conditions, is considered predictable and is associated with high survival rates. The procedure is considered clinically viable and is associated with aesthetic outcomes, although surgical, technical, and biological complications can occur.
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Affiliation(s)
- Dean Morton
- Department of Prosthodontics, Center for Implant, Esthetic and Innovative Dentistry, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | | | - Stephen Chen
- Periodontics, Melbourne Dental School, Faculty of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Julia Wittneben
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | | | - Luiz Gonzaga
- Department of Oral and Maxillofacial Surgery, Center for Implant Dentistry, University of Florida, College of Dentistry, Gainesville, Florida, USA
| | - Rafael Lazarin
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - William Martin
- Department of Oral and Maxillofacial Surgery, Center for Implant Dentistry, University of Florida, College of Dentistry, Gainesville, Florida, USA
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | | | - Waldemar D Polido
- Department of Oral and Maxillofacial Surgery, Center for Implant, Esthetic and Innovative Dentistry, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Ali Tahmaseb
- Department of Oral and Maxillofacial Surgery, Erasmus University, Rotterdam, The Netherlands
| | - Daniel Thoma
- Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Anja Zembic
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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10
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Ntovas P, Spanopoulou M, Martin W, Sykaras N. Superimposition of intraoral scans of an edentulous arch with implants and implant-supported provisional restoration, implementing a novel implant prosthetic scan body. J Prosthodont Res 2023; 67:475-480. [PMID: 36244761 DOI: 10.2186/jpr.jpr_d_21_00328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Purpose To describe a technique utilizing a novel prosthetic scan body, that assists the accurate merging of multiple scans (intra- and extraoral) of the interim prosthesis and edentulous arch with dental implants, during rehabilitation with a fixed implant-supported prosthesis.Methods Intraoral scanning (Trios 3, 3Shape) of an interim implant-supported prosthesis was performed, subsequently followed by another scan, using five scan bodies, placed onto the implant abutments (SRA, Bone level, Straumann AG). Successively, the newly designed prosthetic scan bodies were attached to the abutment copings of the interim prosthesis, for extraoral scanning. Utilizing an implant library designed for the prosthetic scan body, the three scans were merged, providing all the necessary information for the digital design and fabrication of the fixed implant-supported prosthesis.Conclusions The described clinical technique enabled effective and accurate superimposition of intra- and extraoral scans of the implant prosthesis. Superimposed data, including that of the position of dental implants and anatomy of soft tissue, provided essential information for the fabrication of a definitive implant-supported prosthesis. The novel prosthetic scan bodies attached to the implant prosthesis, assisted in merging intra- and extraoral scans, thus facilitating the rehabilitation of maxillary and/or mandibular edentulous dental arches. Further research is required to assess the accuracy of the proposed technique.
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Affiliation(s)
| | | | - William Martin
- Department of Oral and Maxillofacial Surgery, Center for Implant Dentistry, University of Florida, USA
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11
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Mufarrege EF, Peña LC, Etcheverrigaray M, De Groot AS, Martin W. Specific sequence mutations in a long-lasting rhIFN-α2b version reduce in vitro and in vivo immunogenicity and increase in vitro protein stability. Heliyon 2023; 9:e14670. [PMID: 37020947 PMCID: PMC10068115 DOI: 10.1016/j.heliyon.2023.e14670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/08/2023] [Accepted: 03/15/2023] [Indexed: 03/22/2023] Open
Abstract
For decades, recombinant human interferon alpha (rhIFN-α2b) has been used to treat emerging and chronic viral diseases. However, rhIFN-α2b is immunogenic and has a short in vivo half-life. To solve these limitations, two long-lasting hyperglycosylated proteins with reduced immunogenicity were developed and designated as 4N-IFN(VAR1) and 4N-IFN(VAR3). Here, we continue to study the relevant characteristics of these therapeutic candidates. Thus, we demonstrated that both de-immunized IFN versions elicited significantly lower neutralizing antibody responses than the original molecule in HLA-DR1 transgenic mice, confirming our previous in vitro protein immunogenicity data. Also, we found that these biobetters exhibited remarkable stability when exposed to different physical factors that the protein product may encounter during its production process and storage, such as low pH, thermal stress, and repeated freezing/thawing cycles. Taking into consideration our previous and present results, 4N-IFN(VAR1) and 4N-IFN-4N(VAR3) appear to be valuable candidates for the treatment of human viral diseases.
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Affiliation(s)
- Eduardo Federico Mufarrege
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168, Km 472.4, C.C. 242, S3000ZAA, Santa Fe, Argentina
- Corresponding author. Ciudad Universitaria, Paraje “El Pozo” – c.c 242, S3000ZAA, Santa Fe, Argentina.
| | - Lucía Carolina Peña
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168, Km 472.4, C.C. 242, S3000ZAA, Santa Fe, Argentina
| | - Marina Etcheverrigaray
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168, Km 472.4, C.C. 242, S3000ZAA, Santa Fe, Argentina
| | - Anne S. De Groot
- EpiVax, Inc., Providence, RI, 02903, USA
- Institute for Immunology and Informatics, University of Rhode Island, Providence, RI, 02903, USA
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12
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Jones KA, Paterson CA, Ray S, Motherwell DW, Hamilton DJ, Small AD, Martin W, Goodfield NER. Beta-blockers and mechanical dyssynchrony in heart failure assessed by radionuclide ventriculography. J Nucl Cardiol 2023; 30:193-200. [PMID: 36417121 PMCID: PMC9984517 DOI: 10.1007/s12350-022-03142-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/08/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Radionuclide ventriculography (RNVG) can be used to quantify mechanical dyssynchrony and may be a valuable adjunct in the assessment of heart failure with reduced ejection fraction (HFrEF). The study aims to investigate the effect of beta-blockers on mechanical dyssynchrony using novel RNVG phase parameters. METHODS A retrospective study was carried out in a group of 98 patients with HFrEF. LVEF and dyssynchrony were assessed pre and post beta-blockade. Dyssynchrony was assessed using synchrony, entropy, phase standard deviation, approximate entropy, and sample entropy from planar RNVG phase images. Subgroups split by ischemic etiology were also investigated. RESULTS An improvement in dyssynchrony and LVEF was measured six months post beta-blockade for both ischemic and non-ischemic groups. CONCLUSIONS A significant improvement in dyssynchrony and LVEF was measured post beta-blockade using novel measures of dyssynchrony.
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Affiliation(s)
- K A Jones
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK.
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK.
| | - C A Paterson
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - S Ray
- School of Mathematics and Statistics, University of Glasgow, Glasgow , UK
| | - D W Motherwell
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
| | - D J Hamilton
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - A D Small
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - W Martin
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - N E R Goodfield
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
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13
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Iftikhar S, Martin W, Wang X, Liu J, Gao Y, Li F. Ru-promoted perovskites as effective redox catalysts for CO 2 splitting and methane partial oxidation in a cyclic redox scheme. Nanoscale 2022; 14:18094-18105. [PMID: 36448707 DOI: 10.1039/d2nr04437d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The current study reports AxA'1-xByB'1-yO3-δ perovskite redox catalysts (RCs) for CO2-splitting and methane partial oxidation (POx) in a cyclic redox scheme. Strontium (Sr) and iron (Fe) were chosen as A and B site elements with A' being lanthanum (La), samarium (Sm) or yttrium (Y), and B' being manganese (Mn) or titanium (Ti) to tailor their equilibrium oxygen partial pressures (PO2s) for CO2-splitting and methane partial oxidation. DFT calculations were performed for predictive optimization of the oxide materials whereas experimental investigation confirmed the DFT-predicted redox performance. The redox kinetics of the RCs improved significantly by 1 wt% ruthenium (Ru) impregnation without affecting their redox thermodynamics. Ru-impregnated LaFe0.375Mn0.625O3 (A = 0, A' = La, B = Fe, and B' = Mn) was the most promising RC in terms of its superior redox performance (CH4/CO2 conversion >90% and CO selectivity ∼95%) at 800 °C. Long-term redox testing over Ru-impregnated LaFe0.375Mn0.625O3 indicated a stable performance during the first 30 cycles followed by an ∼25% decrease in the activity during the last 70 cycles. Air treatment was effective to reactivate the redox catalyst. Detailed characterizations revealed the underlying mechanism of the redox catalyst deactivation and reactivation. This study not only validated a DFT-guided mixed oxide design strategy for CO2 utilization but also provides potentially effective approaches to enhance redox kinetics and long-term redox catalyst performance.
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Affiliation(s)
- Sherafghan Iftikhar
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC 27695-7905, USA.
| | - William Martin
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC 27695-7905, USA.
| | - Xijun Wang
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC 27695-7905, USA.
| | - Junchen Liu
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC 27695-7905, USA.
| | - Yunfei Gao
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC 27695-7905, USA.
- Key Laboratory of Coal Gasification and Energy Chemical Engineering of Ministry of Education, Shanghai Engineering Research Center of Coal Gasification, East China University of Science and Technology, Shanghai 200237, PR China
| | - Fanxing Li
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC 27695-7905, USA.
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14
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Johnson T, Pacholczyk R, Aguilera D, Al-Basheer A, Bajaj M, Bandopadhayay P, Berrong Z, Bouffet E, Castellino R, Dorris K, Eaton B, Esiashvili N, Foreman N, Fridlyand D, Giller C, Heger I, Kadom N, Kennedy E, Manoharan N, Martin W, McDonough C, Parker R, Ramaswamy V, Ring E, Rojiani A, Sadek R, Smith A, Smith C, Vaizer R, Yeo KK, MacDonald T, Munn D. CTIM-32. FIRST-IN-CHILDREN PHASE 1 TRIAL OF INDOXIMOD-BASED CHEMO-IMMUNOTHERAPY FOR PATIENTS WITH PEDIATRIC BRAIN TUMORS: ANALYSIS OF SAFETY, TOLERABILITY, AND 5-YEAR OUTCOME. Neuro Oncol 2022. [PMCID: PMC9660775 DOI: 10.1093/neuonc/noac209.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
BACKGROUND
Recurrent brain tumors are the leading cause of cancer death in children. We conducted a first-in-children, two-institution, Phase 1 open-label dose-confirmation study using a 3 + 3 design, with expansion cohorts, to determine the recommended pediatric dose of the IDO pathway-inhibitor indoximod (NCT02502708). DESIGN/
METHODS
Eligible patients were 3-22 years old with either recurrent malignant brain tumor or newly-diagnosed diffuse intrinsic pontine glioma (DIPG). Palliative radiation, surgery or dexamethasone were allowed as needed for patient management. Separate dose-finding arms were performed for indoximod plus temozolomide (200 mg/m2/day orally for 5 days of each 28-day cycle) and for indoximod plus conformal radiation (in patients for whom re-irradiation was planned as standard-of-care). At progression, patients who were otherwise clinically stable were offered crossover to indoximod plus a second-line chemotherapy regimen (cyclophosphamide 2.5 mg/kg/day orally and etoposide 50 mg/m2/day orally for 21 days of each 28-day cycle).
RESULTS
Between December 2015 and January 2019, the study enrolled 81 brain tumor patients, including newly-diagnosed DIPG (n = 13) or recurrent ependymoma (n = 27), glioblastoma/high-grade glioma (n = 19), medulloblastoma (n = 13), or other CNS tumors ( n= 9). Median follow-up was 52 months (range 39-77 months). No dose-limiting toxicities were observed, and the pediatric indoximod dose was determined (19.2 mg/kg/dose, given twice daily). Indoximod was well tolerated and did not affect the ability to deliver chemotherapy or radiation as planned. Median overall survival was 13.6 months (n = 81). Median overall survival was 34.7 months for the subset of patients who continued indoximod with second-line chemotherapy after progression on indoximod plus temozolomide (n = 18).
CONCLUSIONS
Indoximod was well tolerated and could be combined with a variety of standard treatments for pediatric brain tumors. Preliminary anti-tumor activity and overall survival suggest that indoximod with standard therapy should be further evaluated in pediatric brain tumors, and potentially other pediatric solid tumors.
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Affiliation(s)
- Theodore Johnson
- Georgia Cancer Center and Department of Pediatrics, Augusta University, Augusta, GA , Augusta, GA , USA
| | - Rafal Pacholczyk
- Georgia Cancer Center, Augusta University, Augusta, GA , Augusta , USA
| | - Dolly Aguilera
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, GA , Atlanta , USA
| | - Ahmad Al-Basheer
- Georgia Cancer Center and Department of Radiation Oncology, Augusta University, Augusta, GA , Augusta , USA
| | - Manish Bajaj
- Department of Radiology, Augusta University, Augusta, GA (current address: Children’s Healthcare of Atlanta and Department of Radiology, Emory University, Atlanta, GA) , Augusta , USA
| | - Pratiti Bandopadhayay
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston MA , Boston, MA , USA
| | - Zuzana Berrong
- Georgia Cancer Center, Augusta University, Augusta, GA , Augusta , USA
| | - Eric Bouffet
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada , Toronto , Canada
| | - Robert Castellino
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, GA , Atlanta , USA
| | - Kathleen Dorris
- Department of Pediatrics, Children’s Hospital Colorado, Aurora, CO , Aurora , USA
| | - Bree Eaton
- Department of Radiation Oncology and Winship Cancer Institute of Emory University, Atlanta, GA , Atlanta, GA , USA
| | - Natia Esiashvili
- Department of Radiation Oncology and Winship Cancer Institute of Emory University, Atlanta, GA , Atlanta , USA
| | - Nicholas Foreman
- Department of Pediatrics, Children’s Hospital Colorado, Aurora, CO , Aurora , USA
| | - Diana Fridlyand
- Department of Pediatrics, Augusta University, Augusta, GA (current address: Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, GA) , Atlanta , USA
| | - Cole Giller
- Department of Neurosurgery, Augusta University, Augusta, GA , Augusta , USA
| | - Ian Heger
- Department of Neurosurgery, Augusta University, Augusta, GA (current address: Pediatric Neurosurgery Program, Medical City Children’s Hospital, Dallas, TX) , Augusta , USA
| | - Nadja Kadom
- Department of Radiology and Winship Cancer Institute of Emory University, Atlanta, GA , Atlanta , USA
| | - Eugene Kennedy
- Lumos Pharma (formerly NewLink Genetics Corporation), Ames, IA , Ames , USA
| | - Neevika Manoharan
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston MA (current address: Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia) , Boston , USA
| | - William Martin
- Department of Radiation Oncology, Augusta University, Augusta, GA , Augusta , USA
| | - Colleen McDonough
- Georgia Cancer Center and Department of Pediatrics, Augusta University, Augusta, GA , Augusta , USA
| | - Rebecca Parker
- Department of Pediatrics, Augusta University, Augusta, GA (current address: Cancer and Blood Diseases Institute, Children's Hospital Los Angeles, Los Angeles, CA) , Augusta , USA
| | - Vijay Ramaswamy
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada , Toronto , Canada
| | - Eric Ring
- Georgia Cancer Center and Department of Pediatrics, Augusta University, Augusta, GA , Augusta , USA
| | - Amyn Rojiani
- Georgia Cancer Center and Department of Pathology, Augusta University, Augusta, GA (current address: Department of Pathology, Penn State Health/College of Medicine, Hershey, PA) , Hershey , USA
| | - Ramses Sadek
- Georgia Cancer Center and Department of Population Health Sciences, Augusta University, Augusta, GA , Augusta , USA
| | - Amy Smith
- Department of Pediatrics, Arnold Palmer Hospital for Children, Orlando, FL , Orlando , USA
| | - Chris Smith
- Lumos Pharma (formerly NewLink Genetics Corporation), Ames, IA , Ames , USA
| | - Rachel Vaizer
- Department of Pediatrics, Augusta University, Augusta, GA (current address: Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA) , Augusta , USA
| | - Kee Kiat Yeo
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston MA , Boston , USA
| | - Tobey MacDonald
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, GA , Atlanta , USA
| | - David Munn
- Georgia Cancer Center and Department of Pediatrics, Augusta University, Augusta, GA , Augusta , USA
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15
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Bedir A, Nageye F, Cherek P, Godley C, Ghani S, Cheong J, D'Souza S, Cecaro F, Petzer E, Martin W, Kabunga P. Single-chamber versus dual-chamber pacing in very elderly patients with sinus node disease and AV block: a real-world study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Elderly patients with sinus-node disease, have been reported to have better clinical outcomes with dual-chamber pacing compared with single chamber pacing. In contrast, randomized studies have shown no clinical benefit of dual-chamber pacing compared to single-chamber pacing in the elderly with high grade AV block., For truly elderly patients (>80 years), the optimal choice of pacing mode remains uncertain. In this real-world observational study, we analysed the clinical outcomes in a cohort of very elderly patients.
Methods
We analysed retrospective data of all new pacemaker implantations for sinus node disease or high-grade atrioventricular block in patients ≥80 years a district general hospital in south-east England, UK over a 7-year period. Patients with an existing diagnosis of stroke, congestive cardiac failure and/or atrial fibrillation (AF) were excluded from the study. Patients were categorised into two analysis cohorts based on pacing mode, i.e dual chamber (DDD) pacing versus single chamber (VVI) pacing. Clinical outcome data including all-cause mortality, new onset AF and CCF were recorded.
Results
A total of 208 patients were included in the study, of which 117 received (DDD) pacing vs 91 who underwent VVI pacing. The mean age was 85.8 years (84.63 DDD, 87.3 VVI, p=0.01). Single chamber pacing was associated with greater all-cause mortality (51.7% vs 31.5%, p=0.01). 23.1% of patients who underwent DDD pacing developed AF, vs 21.9% who underwent VVI pacing (p=0.85). Congestive cardiac failure was observed in 6.48% of patients who received DDD pacing vs 8.14% of patients who received VVI pacing, (p=0.66).
Conclusions
In this real-world observational study of very elderly patients with sinus node disease and/or high-grade AV block, single chamber pacing was associated with a greater all-cause mortality. However, the pacing mode did not affect the incidence of atrial fibrillation and congestive cardiac failure.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Bedir
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - F Nageye
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - P Cherek
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - C Godley
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - S Ghani
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - J Cheong
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - S D'Souza
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - F Cecaro
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - E Petzer
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - W Martin
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
| | - P Kabunga
- Darent Valley Hospital, Cardiology , Dartford , United Kingdom
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16
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Salenger R, Martin W. Physician Leadership in the Employed Universe. Hosp Top 2022; 100:151-158. [PMID: 34635036 DOI: 10.1080/00185868.2021.1938768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Physicians are increasingly becoming employed by hospitals and health systems. While associated with less professional autonomy, such employment offers physicians the opportunity to become leaders within a vertically integrated healthcare environment. Multidisciplinary care teams, led by physician champions, can impact care for a large swath of patients and establish clinical excellence. Successful teams can improve outcomes, increase professional satisfaction, and potentially set physicians on a path to becoming leaders within their health system.
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Affiliation(s)
- Rawn Salenger
- Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Division of Cardiac Surgery, University of Maryland Saint Joseph Medical Center, Towson, Maryland, USA
| | - William Martin
- Department of Management, Depaul University, Chicago, Illinois, USA
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17
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Patel N, Teh W, Omoniyi O, Martin W, Weir-McCall J, D’Errico L, O’Sullivan M, Davies W, Costopoulos C, Costanzo P. 1069 ESSENTIAL FRAILTY TOOLSET AS A PREDICTOR OF PROLONGED LENGTH OF STAY AND DISCHARGE DESTINATION AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac125.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Frailty is associated with poor outcomes following transcatheter aortic valve implantation (TAVI). Rockwood is the widely used score for this population. In a recent trial, a more objective score, the Essential Frailty Toolset (EFT) outperformed Rockwood’s in predicting mortality and disability 1-year post-TAVI. Whether it predicts in-hospital length of stay (LOS) and discharge destination post-TAVI remains unclear.
Method
A cohort of patients undergoing TAVI for aortic stenosis was recruited, demographic characteristics collected, and frailty assessed with EFT and Rockwood scores. Primary outcomes were LOS post-TAVI, categorised as ‘not prolonged’ (≤2 days) or ‘prolonged’ (>2 days) and discharge destination, characterised as ‘home’ or ‘non-home’.
Results
86 patients were recruited, with median age 82 years (IQR 78–86). 54% were male. EFT identified 35% and Rockwood 11% as frail. 19% were cognitively impaired. 5 chair rises were completed by 70%, with 30% managing under 15 seconds. Median haemoglobin was 121 g/L (IQR 109.5–136). Median albumin was 36 g/L (IQR 33–39). 84% of procedures were transfemoral. 20% had moderate–severe left ventricular systolic dysfunction. Median LOS post-TAVI was 2 days (IQR 2–5). 94% were discharged home, 6% to referring local hospital or rehabilitation centre. 46% were NYHA class III-IV. A model for prolonged LOS including comorbidities, showed frailty determined by EFT (OR 4.80, CI 95% 1.52–15.2, p = 0.008) but not Rockwood (OR 5.00, CI 95% 0.865–29.0, p = 0.072) was the only significant independent predictor for prolonged LOS. A model adjusting for comorbidities also showed EFT to be an independent predictor for non-home discharge destination of borderline significance (OR 2.57 CI 95% 0.994–6.66, p = 0.051) but Rockwood was not (OR 1.38 CI95% 0.485–3.91, p = 0.548).
Conclusion
In a real-world elderly population, EFT score was a stronger, more independent predictor of prolonged LOS and non-home discharge post-TAVI, than Rockwood’s. EFT would be an effective pre-operative assessment tool for LOS and discharge destination for TAVI.
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Affiliation(s)
- N Patel
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - W Teh
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - O Omoniyi
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - W Martin
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - J Weir-McCall
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - L D’Errico
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - M O’Sullivan
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - W Davies
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - C Costopoulos
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
| | - P Costanzo
- Department of Interventional Cardiology and Radiology, Royal Papworth Hospital, Cambridge Biomedical Campus , UK
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18
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Brodin NP, Schulte L, Velten C, Martin W, Shen S, Shen J, Basavatia A, Ohri N, Garg MK, Carpenter C, Tomé WA. Organ-at-risk dose prediction using a machine learning algorithm: Clinical validation and treatment planning benefit for lung SBRT. J Appl Clin Med Phys 2022; 23:e13609. [PMID: 35460150 PMCID: PMC9195027 DOI: 10.1002/acm2.13609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/22/2022] [Accepted: 02/25/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To quantify the clinical performance of a machine learning (ML) algorithm for organ-at-risk (OAR) dose prediction for lung stereotactic body radiation therapy (SBRT) and estimate the treatment planning benefit from having upfront access to these dose predictions. METHODS ML models were trained using multi-center data consisting of 209 patients previously treated with lung SBRT. Two prescription levels were investigated, 50 Gy in five fractions and 54 Gy in three fractions. Models were generated using a gradient-boosted regression tree algorithm using grid searching with fivefold cross-validation. Twenty patients not included in the training set were used to test OAR dose prediction performance, ten for each prescription. We also performed blinded re-planning based on OAR dose predictions but without access to clinically delivered plans. Differences between predicted and delivered doses were assessed by root-mean square deviation (RMSD), and statistical differences between predicted, delivered, and re-planned doses were evaluated with one-way analysis of variance (ANOVA) tests. RESULTS ANOVA tests showed no significant differences between predicted, delivered, and replanned OAR doses (all p ≥ 0.36). The RMSD was 2.9, 3.9, 4.3, and 1.7Gy for max dose to the spinal cord, great vessels, heart, and trachea, respectively, for 50 Gy in five fractions. Average improvements of 1.0, 1.4, and 2.0 Gy were seen for spinal cord, esophagus, and trachea max doses in blinded replans compared to clinically delivered plans with 54 Gy in three fractions, and 1.8, 0.7, and 1.5 Gy, respectively, for the esophagus, heart and bronchus max doses with 50 Gy in five fractions. Target coverage was similar with an average PTV V100% of 94.7% for delivered plans compared to 97.3% for blinded re-plans for 50 Gy in five fractions, and respectively 98.4% versus 99.2% for 54 Gy in three fractions. CONCLUSION This study validated ML-based OAR dose prediction for lung SBRT, showing potential for improved OAR dose sparing and more consistent plan quality using dose predictions for patient-specific planning guidance.
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Affiliation(s)
- N Patrik Brodin
- Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
| | | | - Christian Velten
- Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - William Martin
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - Sydney Shen
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Jin Shen
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - Amar Basavatia
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - Nitin Ohri
- Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - Madhur K Garg
- Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA.,Department of Urology, Montefiore Medical Center, Bronx, NY, USA.,Department of Otorhinolaryngology-Head & Neck Surgery, Montefiore Medical Center, Bronx, NY, USA
| | | | - Wolfgang A Tomé
- Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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19
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Dawson JE, Smith IN, Martin W, Khan K, Cheng F, Eng C. Shape shifting: The multiple conformational substates of the
PTEN
N‐terminal
PIP
2
‐binding domain. Protein Sci 2022; 31:e4308. [PMID: 35481646 PMCID: PMC9004235 DOI: 10.1002/pro.4308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/12/2022] [Accepted: 03/20/2022] [Indexed: 12/14/2022]
Abstract
The Phosphatase and TENsin homolog deleted on chromosome 10 (PTEN) is a chief regulator of a variety of cellular processes including cell proliferation, migration, growth, and death. It is also a major tumor suppressor gene that is frequently mutated or lost under cancerous conditions. PTEN encodes a dual‐specificity (lipid and protein) phosphatase that negatively regulates the PI3K/AKT/mTOR signaling pathway where the PIP2‐binding domain (PBD) regulates the lipid phosphatase function. Unfortunately, despite two decades of research, a full‐length structure of PTEN remains elusive, leaving open questions regarding PTEN's disordered regions that mediate protein stability, post‐translational modifications, protein–protein interactions, while also hindering the design of small molecules that can regulate PTEN's function. Here, we utilized a combination of crosslinking mass spectrometry, in silico predicted structural modeling (including AlphaFold2), molecular docking, molecular dynamics simulations, and residue interaction network modeling to obtain structural details and molecular insight into the behavior of the PBD of PTEN. Our study shows that the PBD exists in multiple conformations which suggests its ability to regulate PTEN's variety of functions. Studying how these specific conformational substates contribute to PTEN function is imperative to defining its function in disease pathogenesis, and to delineate ways to modulate its tumor suppressor activity.
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Affiliation(s)
- Jennifer E. Dawson
- Genomic Medicine Institute, Lerner Research Institute Cleveland Clinic Cleveland Ohio USA
- Cleveland Clinic Lerner College of Medicine Case Western Reserve University Cleveland Ohio USA
| | - Iris Nira Smith
- Genomic Medicine Institute, Lerner Research Institute Cleveland Clinic Cleveland Ohio USA
- Cleveland Clinic Lerner College of Medicine Case Western Reserve University Cleveland Ohio USA
| | - William Martin
- Genomic Medicine Institute, Lerner Research Institute Cleveland Clinic Cleveland Ohio USA
| | - Krishnendu Khan
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute Cleveland Clinic Cleveland Ohio USA
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute Cleveland Clinic Cleveland Ohio USA
- Cleveland Clinic Lerner College of Medicine Case Western Reserve University Cleveland Ohio USA
- Case Comprehensive Cancer Center Case Western Reserve University School of Medicine Cleveland Ohio USA
| | - Charis Eng
- Genomic Medicine Institute, Lerner Research Institute Cleveland Clinic Cleveland Ohio USA
- Cleveland Clinic Lerner College of Medicine Case Western Reserve University Cleveland Ohio USA
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute Cleveland Clinic Cleveland Ohio USA
- Taussig Cancer Institute Cleveland Clinic Cleveland Ohio USA
- Department of Genetics and Genome Sciences Case Western Reserve University School of Medicine Cleveland Ohio USA
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20
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Jones KA, Small AD, Ray S, Hamilton DJ, Martin W, Robinson J, Goodfield NER, Paterson CA. Radionuclide ventriculography phase analysis for risk stratification of patients undergoing cardiotoxic cancer therapy. J Nucl Cardiol 2022; 29:581-589. [PMID: 32748278 PMCID: PMC8993717 DOI: 10.1007/s12350-020-02277-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/29/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Accurate diagnostic tools to identify patients at risk of cancer therapy-related cardiac dysfunction (CTRCD) are critical. For patients undergoing cardiotoxic cancer therapy, ejection fraction assessment using radionuclide ventriculography (RNVG) is commonly used for serial assessment of left ventricular (LV) function. METHODS In this retrospective study, approximate entropy (ApEn), synchrony, entropy, and standard deviation from the phase histogram (phase SD) were investigated as potential early markers of LV dysfunction to predict CTRCD. These phase parameters were calculated from the baseline RNVG phase image for 177 breast cancer patients before commencing cardiotoxic therapy. RESULTS Of the 177 patients, 11 had a decline in left ventricular ejection fraction (LVEF) of over 10% to an LVEF below 50% after treatment had commenced. This patient group had a significantly higher ApEn at baseline to those who maintained a normal LVEF throughout treatment. Of the parameters investigated, ApEn was superior for predicting the risk of CTRCD. Combining ApEn with the baseline LVEF further improved the discrimination between the groups. CONCLUSIONS The results suggest that RNVG phase analysis using approximate entropy may aid in the detection of sub-clinical LV contraction abnormalities, not detectable by baseline LVEF measurement, predicting a subsequent decline in LVEF.
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Affiliation(s)
- K A Jones
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK.
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK.
| | - A D Small
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
| | - S Ray
- School of Mathematics & Statistics, University of Glasgow, Glasgow, UK
| | - D J Hamilton
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - W Martin
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - J Robinson
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - N E R Goodfield
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
| | - C A Paterson
- Department of Nuclear Cardiology, Glasgow Royal Infirmary, Glasgow, UK
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
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21
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Li Y, Ruperao P, Batley J, Edwards D, Martin W, Hobson K, Sutton T. Genomic prediction of preliminary yield trials in chickpea: Effect of functional annotation of SNPs and environment. Plant Genome 2022; 15:e20166. [PMID: 34786880 DOI: 10.1002/tpg2.20166] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Achieving yield potential in chickpea (Cicer arietinum L.) is limited by many constraints that include biotic and abiotic stresses. Combining next-generation sequencing technology with advanced statistical modeling has the potential to increase genetic gain efficiently. Whole genome resequencing data was obtained from 315 advanced chickpea breeding lines from the Australian chickpea breeding program resulting in more than 298,000 single nucleotide polymorphisms (SNPs) discovered. Analysis of population structure revealed a distinct group of breeding lines with many alleles that are absent from recently released Australian cultivars. Genome-wide association studies (GWAS) using these Australian breeding lines identified 20 SNPs significantly associated with grain yield in multiple field environments. A reduced level of nucleotide diversity and extended linkage disequilibrium suggested that some regions in these chickpea genomes may have been through selective breeding for yield or other traits. A large introgression segment that introduced from C. echinospermum for phytophthora root rot resistance was identified on chromosome 6, yet it also has unintended consequences of reducing yield due to linkage drag. We further investigated the effect of genotype by environment interaction on genomic prediction of yield. We found that the training set had better prediction accuracy when phenotyped under conditions relevant to the targeted environments. We also investigated the effect of SNP functional annotation on prediction accuracy using different subsets of SNPs based on their genomic locations: regulatory regions, exome, and alternative splice sites. Compared with the whole SNP dataset, a subset of SNPs did not significantly decrease prediction accuracy for grain yield despite consisting of a smaller number of SNPs.
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Affiliation(s)
- Yongle Li
- School of Agriculture, Food and Wine, The Univ. of Adelaide, Adelaide, SA, 5064, Australia
| | - Pradeep Ruperao
- Statistics, Bioinformatics and Data Management, ICRISAT, Hyderabad, 502324, India
| | - Jacqueline Batley
- School of Biological Sciences, The Univ. of Western Australia, Perth, WA, 6001, Australia
| | - David Edwards
- School of Biological Sciences, The Univ. of Western Australia, Perth, WA, 6001, Australia
| | - William Martin
- Dep. of Agriculture and Fisheries, Warwick, Qld, 4370, Australia
| | - Kristy Hobson
- NSW Dep. of Primary Industries, Tamworth, NSW, 2340, Australia
| | - Tim Sutton
- School of Agriculture, Food and Wine, The Univ. of Adelaide, Adelaide, SA, 5064, Australia
- South Australian Research and Development Institute, Adelaide, SA, 5064, Australia
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22
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Wang X, Liu Y, Martin W. The gamma deposition matrix method for gamma heating calculations for LWRs. ANN NUCL ENERGY 2022. [DOI: 10.1016/j.anucene.2021.108831] [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: 11/01/2022]
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23
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Martin W, Sheynkman G, Lightstone FC, Nussinov R, Cheng F. Interpretable artificial intelligence and exascale molecular dynamics simulations to reveal kinetics: Applications to Alzheimer's disease. Curr Opin Struct Biol 2022; 72:103-113. [PMID: 34628220 PMCID: PMC8860862 DOI: 10.1016/j.sbi.2021.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 02/03/2023]
Abstract
The rapid increase in computing power, especially with the integration of graphics processing units, has dramatically increased the capabilities of molecular dynamics simulations. To date, these capabilities extend from running very long simulations (tens to hundreds of microseconds) to thousands of short simulations. However, the expansive data generated in these simulations must be made interpretable not only by the investigator who performs them but also by others as well. Here, we demonstrate how integrating learning techniques, such as artificial intelligence, machine learning, and neural networks, into analysis pipelines can reveal the kinetics of Alzheimer's disease (AD) protein aggregation. We review select AD targets, describe current simulation methods, and introduce learning concepts and their application in AD, highlighting limitations and potential solutions.
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Affiliation(s)
- William Martin
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Gloria Sheynkman
- Department of Molecular Physiology and Biological Physics, University of Virginia, Charlottesville, VA 22903
| | - Felice C. Lightstone
- Biosciences and Biotechnology Division, Physical and Life Sciences Directorate, Lawrence Livermore National Lab, Livermore, CA 94550, USA
| | - Ruth Nussinov
- Computational Structural Biology Section, Frederick National Laboratory for Cancer Research in the Laboratory of Cancer Immunometabolism, National Cancer Institute, Frederick, MD 21702, USA,Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA,Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA,Correspondence to: Feixiong Cheng, PhD, Lerner Research Institute, Cleveland Clinic, Tel: +1-216-444-7654; Fax: +1-216-636-0009,
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24
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Donskoy I, Loghmanee D, Fields BG, Troester M, Martin W. Telemedicine-based sleep services for a complex child: optimizing care during a pandemic and beyond. J Clin Sleep Med 2022; 18:325-327. [PMID: 34402782 PMCID: PMC8807920 DOI: 10.5664/jcsm.9616] [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] [Indexed: 01/03/2023]
Abstract
A 12-year-old male with nonverbal autism and morbid obesity was referred to a pediatric sleep center during the SARS-CoV-2 pandemic for complaints of snoring with tonsillar hypertrophy and difficulty falling asleep. Due to social challenges, the family had not sought in-person care in the past. Through telemedicine consultation and home sleep apnea testing, the patient was diagnosed with obstructive sleep apnea as well as an irregular sleep-wake disorder. This unique utilization of the health care system in the care of a complex patient with multiple sleep disorders demonstrates the utility of remote care and testing. There is a great benefit to continuing to provide pediatric sleep care in this way beyond the pandemic.
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Affiliation(s)
- Innessa Donskoy
- Advocate Children’s Hospital, Park Ridge, Illinois;,Address correspondence to: Innessa Donskoy, MD, FAAP, FAASM, 1675 Dempster Street, Park Ridge, IL 60068;
| | | | - Barry G. Fields
- Emory University School of Medicine, Atlanta, Georgia;,Atlanta VA Medical Center, North Druid Hills, Georgia
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25
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Giorgetti SI, Etcheverrigaray M, Terry F, Martin W, De Groot AS, Ceaglio N, Oggero M, Mufarrege EF. Development of highly stable and de-immunized versions of recombinant alpha interferon: Promising candidates for the treatment of chronic and emerging viral diseases. Clin Immunol 2021; 233:108888. [PMID: 34798238 PMCID: PMC8595249 DOI: 10.1016/j.clim.2021.108888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/04/2021] [Accepted: 11/13/2021] [Indexed: 12/23/2022]
Abstract
Human interferon alpha (hIFN-α) administration constitutes the current FDA approved therapy for chronic Hepatitis B and C virus infections. Additionally, hIFN-α treatment efficacy was recently demonstrated in patients with COVID-19. Thus, hIFN-α constitutes a therapeutic alternative for those countries where vaccination is inaccessible and for people who did not respond effectively to vaccination. However, hIFN-α2b exhibits a short plasma half-life resulting in the occurrence of severe side effects. To optimize the cytokine's pharmacokinetic profile, we developed a hyperglycosylated IFN, referred to as GMOP-IFN. Given the significant number of reports showing neutralizing antibodies (NAb) formation after hIFN-α administration, here we applied the DeFT (De-immunization of Functional Therapeutics) approach to develop functional, de-immunized versions of GMOP-IFN. Two GMOP-IFN variants exhibited significantly reduced ex vivo immunogenicity and null antiproliferative activity, while preserving antiviral function. The results obtained in this work indicate that the new de-immunized GMOP-IFN variants constitute promising candidates for antiviral therapy.
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Affiliation(s)
- Sofía Inés Giorgetti
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168 Km 472.4, C.C. 242. (S3000ZAA), Santa Fe, Argentina
| | - Marina Etcheverrigaray
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168 Km 472.4, C.C. 242. (S3000ZAA), Santa Fe, Argentina
| | | | | | - Anne Searls De Groot
- EpiVax, Inc., Providence, RI, USA; Institute for Immunology and Informatics, University of Rhode Island, RI, USA
| | - Natalia Ceaglio
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168 Km 472.4, C.C. 242. (S3000ZAA), Santa Fe, Argentina
| | - Marcos Oggero
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168 Km 472.4, C.C. 242. (S3000ZAA), Santa Fe, Argentina
| | - Eduardo Federico Mufarrege
- UNL, CONICET, FBCB (School of Biochemistry and Biological Sciences), CBL (Biotechnological Center of Litoral), Ciudad Universitaria, Ruta Nacional 168 Km 472.4, C.C. 242. (S3000ZAA), Santa Fe, Argentina.
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26
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Richard G, Princiotta M, Steinberg G, Martin W, Groot AD. 313 Stealthier mutanomes are induced after nivolumab immunotherapy. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.313] [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] Open
Abstract
BackgroundAs tumor genomes are shaped by their interaction with the immune system, a phenomenon known as immunoediting, it is critical to understand how immunotherapies impact this process. Checkpoint inhibitors directly influence T cells responding to neoantigens, as such, these therapies drastically affect the genomes of surviving tumor clones. Similar to the concept of immune camouflage, observed in infectious diseases, where genomes of pathogens evolve in a way to avoid immune detection, we hypothesized that tumor clones surviving checkpoint inhibition therapy harbor mutations more prone to immune avoidance.MethodsWe analyzed a cohort of nivolumab-treated melanoma patients (n=41) for which tumor samples were collected from the same site prior (”Pre” samples) and during (”On” samples) nivolumab therapy.1 The immunogenic and tolerance potential of mutations from the Pre and On samples were evaluated with the Ancer neoantigen screening platform,2 which includes the EpiMatrix algorithm to identify HLA-I and HLA-II neoepitopes and the JanusMatrix algorithm to evaluate neoepitopes homology with self. Prior work with JanusMatrix showed epitopes highly homologous to self can be inhibitory.3 Matching Pre and On therapy samples were compared to identify mutations deleted (unique to the Pre samples), maintained (found in both the Pre and On samples), and induced while on therapy (unique to the On samples).ResultsMutations from the On therapy samples had a lower immunogenic potential than mutations found in the Pre therapy samples (figure 1A, Mann-Whitney test, p=0.0001). After further distinguishing mutations deleted, maintained, and induced while on therapy, we observed that newly induced mutations had a significantly lower immunogenic potential compared to other mutations (Kruskal-Wallis test, p<0.0001). In addition, newly induced mutations were more homologous to self than other mutations (figure 1B, Kruskal-Wallis test, p<0.0001), indicating a greater likelihood for these new mutations to be tolerated by the immune system. In summary, we showed that mutations generated after nivolumab therapy are less immunogenic and more tolerated than mutations found prior to therapy.Abstract 313 Figure 1Immunogenicity (A) and tolerance (B) potentials of mutations found in matching melanoma tumor samples collected before (Pre) and during (On) nivolumab therapy.ConclusionsOur Ancer analysis suggests that nivolumab therapy affects the immunogenicity and tolerance profiles of newly generated mutations in a manner that is consistent with the concepts of immunoediting and immune camouflaging. Mutations induced after therapy appear less immunogenic and more self-like, illustrating a potential mechanism tumors employ to avoid immune surveillance. Furthermore, our approach highlights in silico tools can distinguish effector from tolerance inducing neoepitopes, a critical feature for designing novel neoantigen-based precision immunotherapies.ReferencesRiaz N, Havel JJ, Makarov V, et al. Tumor and microenvironment evolution during immunotherapy with nivolumab. Cell 2017 November 2;171(4):934–949.Richard G, De Groot AS, Steinberg GD, et al. Multi-step screening of neoantigens’ HLA- and TCR-interfaces improves prediction of survival. Sci Rep 2021 May 11;11(1):9983.De Groot AS, Rosenberg AS, Miah SMS, et al. Identification of a potent regulatory T cell epitope in factor V that modulates CD4+ and CD8+ memory T cell responses. Clin Immunol 2021 Mar;224:108661
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27
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Kretzmer L, Damola A, Sandher M, Martin W, Ehsanullah SA, Jones A, Manirajan S, Cakir S, Gao J, Ginepri A, Singh S, Apakama I. 1498 A Ten-Year Observational Study of The Use of Two-Way Catheters Post-Transurethral Resection of The Prostate Without the Use of Post-Op Irrigation. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Over 15,000 transurethral resections of the prostate (TURP) are performed yearly in the UK. It is therefore vital that peri-operative care is optimised. Our centre favours the use of two-way catheters post-operatively without continuous bladder irrigation (CBI).
Aim
To evaluate our practice of using two-way catheters without irrigation post-TURP and to determine impact on patient care compared to standard three-way catheterization. Our primary outcome was duration of admission, but multiple secondary outcomes were also analysed.
Method
This was a prospective observational study. Every patient undergoing TURP at our centre from 2009 to 2019 was included. Prospective patient data were collected pertaining to peri-operative factors. This data was then compared with data published in the NICE guidance pertaining to TURP.
Results
687 patients underwent TURP at our centre between 2009-2019. The average age of patients was 71.42 (±7.89). 87.17% (n = 598) had two-way catheters placed post-operatively. Average duration of admission was 1.61 (±1.35) days. TWOC was successful in 93.74% (n = 644). Complication rate was 8.73% (n = 60), reduced in comparison to other units. Furthermore, when compared to other centres, our method reduced lengths of admission and transfusion rates (1.6 days vs. 3.1 days and 0.87% vs. 2.83% respectively).
Conclusions
Our method preserves patient safety and is associated with reduced length of admission. It also has cost-saving benefits and a reduced post-operative period of catheterisation. We recommend this practice to the wider urological community.
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Affiliation(s)
- L Kretzmer
- George Eliot Hospital, Nuneaton, United Kingdom
| | - A Damola
- George Eliot Hospital, Nuneaton, United Kingdom
| | - M Sandher
- George Eliot Hospital, Nuneaton, United Kingdom
| | - W Martin
- George Eliot Hospital, Nuneaton, United Kingdom
- Warwick Medical School, Warwick, United Kingdom
| | | | - A Jones
- George Eliot Hospital, Nuneaton, United Kingdom
| | - S Manirajan
- George Eliot Hospital, Nuneaton, United Kingdom
- Warwick Medical School, Warwick, United Kingdom
| | - S Cakir
- George Eliot Hospital, Nuneaton, United Kingdom
- Warwick Medical School, Warwick, United Kingdom
| | - J Gao
- George Eliot Hospital, Nuneaton, United Kingdom
- Warwick Medical School, Warwick, United Kingdom
| | - A Ginepri
- George Eliot Hospital, Nuneaton, United Kingdom
| | - S Singh
- George Eliot Hospital, Nuneaton, United Kingdom
| | - I Apakama
- George Eliot Hospital, Nuneaton, United Kingdom
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28
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Morris NT, Brook J, Ben-Artzi A, Martin W, Kermani TA, Avedikian-Tatosyan L, Karpouzas G, Nagam H, Navarro G, Choi S, Taylor MB, Elashoff D, Kaeley GS, Ranganath VK. Doppler ultrasound impacts response to intravenous tocilizumab in rheumatoid arthritis patients. Clin Rheumatol 2021; 40:5055-5065. [PMID: 34269927 DOI: 10.1007/s10067-021-05857-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Within rheumatoid arthritis (RA) patients treated with intravenous tocilizumab (IV-TCZ), it is unclear if power Doppler ultrasonography (PDUS) can predict future clinical response. This study sought to determine if baseline PDUS or its early changes can predict 12-week and 24-week disease activity outcomes, and quantify the need for dose escalation (4 to 8 mg/kg). METHODS Fifty-four RA patients starting IV-TCZ were evaluated at baseline, 4, 6, 12, 16, and 24 weeks using 34-joint PDUS (US34-PDUS), clinical disease activity index (CDAI), 28-joint disease activity score using erythrocyte sedimentation rate (DAS28-ESR), ACR 20/50/70, health assessment questionnaire-disability index (HAQ-DI), and PDUS 20/50/70, a novel measure. Logistic regression models evaluated the predictive utility of US34-PDUS of DAS28-ESR response after adjusting for covariates. RESULTS Ninety-four percent of patients required dose escalation to 8 mg/kg. US34-PDUS, CDAI, and DAS28-ESR improved significantly over 24 weeks (p < 0.001). Baseline PDUS and 12-week PDUS change correlated with CDAI at 24 weeks (p < 0.05). Logistic regression demonstrated baseline US34-PDUS was independently associated with DAS28-ESR ≥ 1.2 response, even after adjusting for baseline DAS28-ESR (p = 0.03). CDAI, DAS28-ESR, and their components increased across PDUS 20/50/70 categories; however, HAQ-DI did not. CONCLUSION RA patients treated with IV-TCZ for 24 weeks demonstrated significant improvement, and baseline/early changes in PDUS were predictive of later clinical response. The PDUS 20/50/70 measure is a novel metric of response. This study suggests that IV-TCZ 4 mg/kg may not be sufficient to attain low RA disease activity at 12 weeks, in RA patients with moderate to severe disease (DAS28 ≥ 4.4 and US34-PDUS ≥ 10). TRIAL REGISTRATION ClinicalTrials.gov NCT01717859 Key Points • Over 90% of RA patients with baseline DAS28-ESR ≥ 4.4 and PDUS34 ≥ 10 required intravenous tocilizumab dose escalation from 4 to 8 mg/kg at 12 weeks. • Reduction in power Doppler ultrasonography (US34-PDUS) scores correlate with DAS28-ESR and CDAI over 24 weeks in rheumatoid arthritis patients with moderate to severe disease activity. • Baseline US34-PDUS predicts future improvements in clinical disease activity outcomes, independent of baseline DAS28-ESR. • Clinical response measures, DAS28-ESR and CDAI, improved across US34-PDUS 20/50/70 categories, while patient-reported outcomes did not.
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Affiliation(s)
- Nicolette T Morris
- Division of Rheumatology, David Geffen School of Medicine, University of California, Los Angeles, 1000 Veteran Avenue, Box 32-59, Los Angeles, CA, 90024, USA
| | - Jenny Brook
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ami Ben-Artzi
- Division of Rheumatology, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - William Martin
- Division of Rheumatology, David Geffen School of Medicine, University of California, Los Angeles, 1000 Veteran Avenue, Box 32-59, Los Angeles, CA, 90024, USA
| | - Tanaz A Kermani
- Division of Rheumatology, David Geffen School of Medicine, University of California, Los Angeles, 1000 Veteran Avenue, Box 32-59, Los Angeles, CA, 90024, USA
| | | | - George Karpouzas
- Division of Rheumatology, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Himakar Nagam
- University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Geraldine Navarro
- Division of Rheumatology, David Geffen School of Medicine, University of California, Los Angeles, 1000 Veteran Avenue, Box 32-59, Los Angeles, CA, 90024, USA
| | - Soo Choi
- Division of Rheumatology, School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Mihaela B Taylor
- Division of Rheumatology, David Geffen School of Medicine, University of California, Los Angeles, 1000 Veteran Avenue, Box 32-59, Los Angeles, CA, 90024, USA
| | - David Elashoff
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Gurjit S Kaeley
- Division of Rheumatology and Clinical Immunology, College of Medicine, University of Florida, Jacksonville, Jacksonville, FL, USA
| | - Veena K Ranganath
- Division of Rheumatology, David Geffen School of Medicine, University of California, Los Angeles, 1000 Veteran Avenue, Box 32-59, Los Angeles, CA, 90024, USA.
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S. Johnson T, Pacholczyk R, Aguilera D, Al-Basheer A, Bajaj M, Berrong Z, Castellino RC, Eaton BR, Esiashvili N, Foreman N, Heger IM, Kennedy EP, Martin W, Ring E, Sadek RF, Smith A, Smith C, Vaizer R, MacDonald TJ, Munn DH. IMMU-04. FIRST-IN-CHILDREN PHASE 1B STUDY USING THE IDO PATHWAY INHIBITOR INDOXIMOD IN COMBINATION WITH RADIATION AND CHEMOTHERAPY FOR CHILDREN WITH NEWLY DIAGNOSED DIPG (NCT02502708, NLG2105). Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab090.112] [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: 11/13/2022] Open
Abstract
Abstract
Background
Diffuse intrinsic pontine glioma (DIPG) is a uniformly fatal brain tumor with no available cure. Indoximod blocks the IDO (indoleamine 2,3-dioxygenase) pathway, thereby reversing IDO-mediated immune suppression in the tumor microenvironment.
Methods
Patients aged 3 to 21 years with treatment-naive DIPG were eligible for this phase 1b dose-confirmation study of indoximod. The treatment regimen comprised continuous oral indoximod (38.4 mg/kg/day divided twice daily) with conformal photon radiation (54 Gy in 30 fractions), followed by cycles of indoximod with temozolomide (200 mg/m2/day, days 1–5 in 28-day cycles).
Results
Thirteen patients (median age 9 years, range 5 to 20 years) with DIPG were treated. Median OS was 14.5 months (follow-up ranged 4.8 to 29.3 months), 12-month OS was 61.5% (8/13), and 18-month OS was 30.8% (4/13), with 1 patient remaining in follow-up at the data cutoff. This compared favorably to expected median OS of approximately 10.8 months, 12-month OS of 45.3%, and 18-month OS of 16.2% taken from published historical data from the Pediatric Brain Tumor Consortium. Two patients showed near-complete responses lasting until relapsing after 7.6 months and 13.3 months of study therapy, respectively. Many patients had increased circulating non-classical monocytes (nc-Monos, CD16+, CD14neg, CD33+, HLA-DR+) within the first 3 treatment cycles, and elevation of this early pharmacodynamic marker was predictive of subsequent OS. Patients with nc-Monos >10% (n=7) had median OS of 19 months, whereas patients with nc-Monos below 10% (n=5) had median OS of 7 months (p=0.0047). No patients stopped therapy for toxicity. The most common indoximod-attributed adverse events were thrombocytopenia, neutropenia, nausea, vomiting, dizziness, and fatigue.
Conclusions
Adding indoximod immunotherapy to conventional radiation and chemotherapy for front-line treatment of pediatric patients with DIPG was well-tolerated. Improved outcomes were observed in patients having evidence of pharmacodynamic response. A follow-on phase 2 study is in progress (NCT04049669).
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Affiliation(s)
- Theodore S. Johnson
- Georgia Cancer Center, Augusta University, Augusta, GA, USA
- Department of Pediatrics, Augusta University, Augusta, GA, USA
| | | | - Dolly Aguilera
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Ahmad Al-Basheer
- Georgia Cancer Center, Augusta University, Augusta, GA, USA
- Department of Radiation Oncology, Augusta University, Augusta, GA, USA
| | - Manish Bajaj
- Georgia Cancer Center, Augusta University, Augusta, GA, USA
- Department of Radiology, Augusta University, Augusta, GA, USA
| | - Zuzana Berrong
- Georgia Cancer Center, Augusta University, Augusta, GA, USA
| | - Robert C Castellino
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Bree R Eaton
- Department of Radiation Oncology and Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Natia Esiashvili
- Department of Radiation Oncology and Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Nicholas Foreman
- Department of Pediatrics, Children’s Hospital Colorado, Aurora, CO, USA
| | - Ian M Heger
- Pediatric Neurosurgery Program, Medical City Children’s Hospital, Dallas, TX, USA
| | - Eugene P Kennedy
- Lumos Pharma (formerly NewLink Genetics Corporation), Ames, IA, USA
| | - William Martin
- Department of Radiation Oncology, Augusta University, Augusta, GA, USA
| | - Eric Ring
- Georgia Cancer Center, Augusta University, Augusta, GA, USA
- Department of Pediatrics, Augusta University, Augusta, GA, USA
| | - Ramses F Sadek
- Georgia Cancer Center, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Augusta University, Augusta, GA, USA
| | - Amy Smith
- Department of Pediatrics, Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Chris Smith
- Lumos Pharma (formerly NewLink Genetics Corporation), Ames, IA, USA
| | - Rachel Vaizer
- Georgia Cancer Center, Augusta University, Augusta, GA, USA
- Department of Pediatrics, Augusta University, Augusta, GA, USA
| | - Tobey J MacDonald
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - David H Munn
- Georgia Cancer Center, Augusta University, Augusta, GA, USA
- Department of Pediatrics, Augusta University, Augusta, GA, USA
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30
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Shamim-Uzzaman QA, Bae CJ, Ehsan Z, Setty AR, Devine M, Dhankikar S, Donskoy I, Fields B, Hearn H, Hwang D, Jain V, Kelley D, Kirsch DB, Martin W, Troester M, Trotti LM, Won CH, Epstein LJ. The use of telemedicine for the diagnosis and treatment of sleep disorders: an American Academy of Sleep Medicine update. J Clin Sleep Med 2021; 17:1103-1107. [PMID: 33599202 DOI: 10.5664/jcsm.9194] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
NONE The COVID-19 pandemic led to widespread use of telemedicine and highlighted its importance in improving access to sleep care and advocating for sleep health. This update incorporates the lessons learned from such widespread utilization of telehealth to build on the American Academy of Sleep Medicine's 2015 position paper on the use of telemedicine for diagnosing and treating sleep disorders. Important key factors in this update include an emphasis on quality and value, privacy and safety, health advocacy through sleep telemedicine, and future directions.
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Affiliation(s)
- Qurratul Afifa Shamim-Uzzaman
- Sleep Disorders Center, Department of Neurology, University of Michigan, Ann Arbor, Michigan.,Sleep Medicine Section/Ambulatory Care Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Charles J Bae
- Division of Sleep Medicine/Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Zarmina Ehsan
- Division of Pulmonary and Sleep Medicine, Children's Mercy-Kansas City, Kansas City, Missouri.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | | | | | | | | | - Barry Fields
- Emory University School of Medicine, Atlanta, Georgia and Atlanta VA Medical Center, Decatur, Georgia
| | - Hunter Hearn
- Carl R. Darnall Army Medical Center, Fort Hood, Texas
| | | | | | - Dennis Kelley
- Veterans Affairs Northeast Ohio Health System, Cleveland, Ohio
| | | | | | | | - Lynn Marie Trotti
- Department of Neurology, Emory University School of Medicine, and Emory Sleep Center, Emory Healthcare, Atlanta, Georgia
| | - Christine H Won
- Yale Center for Sleep Medicine, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Lawrence J Epstein
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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31
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Adrian PJ, Frenje J, Aguirre B, Bachmann B, Birkel A, Johnson MG, Kabadi NV, Lahmann B, Li CK, Mannion OM, Martin W, Mohamed ZL, Regan SP, Rinderknecht HG, Scheiner B, Schmitt MJ, Séguin FH, Shah RC, Sio H, Sorce C, Sutcliffe GD, Petrasso RD. An x-ray penumbral imager for measurements of electron-temperature profiles in inertial confinement fusion implosions at OMEGA. Rev Sci Instrum 2021; 92:043548. [PMID: 34243391 DOI: 10.1063/5.0041038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/03/2021] [Indexed: 06/13/2023]
Abstract
Hot-spot shape and electron temperature (Te) are key performance metrics used to assess the efficiency of converting shell kinetic energy into hot-spot thermal energy in inertial confinement fusion implosions. X-ray penumbral imaging offers a means to diagnose hot-spot shape and Te, where the latter can be used as a surrogate measure of the ion temperature (Ti) in sufficiently equilibrated hot spots. We have implemented a new x-ray penumbral imager on OMEGA. We demonstrate minimal line-of-sight variations in the inferred Te for a set of implosions. Furthermore, we demonstrate spatially resolved Te measurements with an average uncertainty of 10% with 6 μm spatial resolution.
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Affiliation(s)
- P J Adrian
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
| | - J Frenje
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
| | - B Aguirre
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - B Bachmann
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A Birkel
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
| | - M Gatu Johnson
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
| | - N V Kabadi
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
| | - B Lahmann
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
| | - C K Li
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
| | - O M Mannion
- Laboratory for Laser Energetics: University of Rochester, Rochester, New York 14623, USA
| | - W Martin
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - Z L Mohamed
- Laboratory for Laser Energetics: University of Rochester, Rochester, New York 14623, USA
| | - S P Regan
- Laboratory for Laser Energetics: University of Rochester, Rochester, New York 14623, USA
| | - H G Rinderknecht
- Laboratory for Laser Energetics: University of Rochester, Rochester, New York 14623, USA
| | - B Scheiner
- Los Alamos National Laboratory, Los Alamos, New Mexico 87544, USA
| | - M J Schmitt
- Los Alamos National Laboratory, Los Alamos, New Mexico 87544, USA
| | - F H Séguin
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
| | - R C Shah
- Laboratory for Laser Energetics: University of Rochester, Rochester, New York 14623, USA
| | - H Sio
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - C Sorce
- Laboratory for Laser Energetics: University of Rochester, Rochester, New York 14623, USA
| | - G D Sutcliffe
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
| | - R D Petrasso
- Plasma Science and Fusion Center: MIT, Cambridge, Massachusetts 02139, USA
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32
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Graetz S, Martin W, Washuck N, Anderson J, Sibley PK, Prosser RS. Deterministic risk assessment of firefighting water additives to terrestrial organisms. Environ Sci Pollut Res Int 2021; 28:20883-20893. [PMID: 33405173 DOI: 10.1007/s11356-020-12061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 12/10/2020] [Indexed: 06/12/2023]
Abstract
Firefighting water additives are used to increase the rate at which fires can be extinguished. The majority of ecotoxicological research has focused on firefighting formulations containing perfluorinated compounds as additives, due to the persistence and bioaccumulative nature of the perfluorinated constituents. A number of relatively new additives have come on the market to replace the products containing perfluorinated compounds. The potential effect of these new additives on the environment has been largely unstudied. This study investigated the toxicity of six firefighting water additives: Eco-Gel™, ThermoGel 200L™, FireAde™, Fire-Brake™, Novacool Foam™, and F-500™ to terrestrial biota. Terrestrial organisms could be exposed to firefighting water additives through leaching into soil and/or runoff following a firefighting event or through direct aerial application during a forest fire. Toxicity to three plant species was assessed through seedling germination and emergence tests: Fagopyrum esculentum (buckwheat), Raphanus raphanistrum subsp. sativus (radish), and Rudbeckia hirta (black-eyed Susan). The effects of firefighting water additives on three soil invertebrates, the collembolan Folsomia candida, the earthworms Eisenia andrei, and Dendrodrilus rubidus, were also investigated using static acute tests to estimate EC50/LC50s. The concentration that resulted in a 50% reduction in survival (LC50) for the acute toxicity tests conducted with F. candida ranged from 3 (Eco-Gel) to 0.175% (Novacool) by volume. Comparatively, the acute toxicity of two firefighting water additives to D. rubidus could not be determined, as a 50% reduction in survival was not observed. A number of firefighting water additives were found to pose a hazard to terrestrial organisms based on a worst-case exposure scenario of direct application at the greatest recommended application rate for a class A fire (e.g., wood, paper). The firefighting water additive F-500 was found to pose a hazard (HQ ≥ 1) for all species tested, except for the acute test conducted with D. rubidus. Comparatively, Eco-Gel posed a hazard for only the acute and chronic tests with F. candida. This study represents the first comparative deterministic risk assessment of firefighting water additives to terrestrial ecosystems.
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Affiliation(s)
- Sarah Graetz
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada
| | - William Martin
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada
| | - Nicole Washuck
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada
| | - Jenna Anderson
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada
| | - Paul K Sibley
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada
| | - Ryan S Prosser
- School of Environmental Sciences, University of Guelph, Guelph, ON, Canada.
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33
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Liu Y, Salko R, Kim KS, Wang X, Kabelitz M, Choi S, Kochunas B, Collins B, Martin W. Improved MPACT energy deposition and explicit heat generation coupling with CTF. ANN NUCL ENERGY 2021. [DOI: 10.1016/j.anucene.2020.107999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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34
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Gatu Johnson M, Aguirre B, Armstrong J, Fooks JA, Forrest C, Frenje JA, Glebov VY, Hoppe M, Katz J, Knauer JP, Martin W, Parker CE, Reynolds HG, Schoff ME, Séguin FH, Sorce C, Sperry B, Stoeckl C, Petrasso RD. Using millimeter-sized carbon-deuterium foils for high-precision deuterium-tritium neutron spectrum measurements in direct-drive inertial confinement fusion at the OMEGA laser facility. Rev Sci Instrum 2021; 92:023503. [PMID: 33648107 DOI: 10.1063/5.0040549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/23/2021] [Indexed: 06/12/2023]
Abstract
Millimeter-sized CD foils fielded close (order mm) to inertial confinement fusion (ICF) implosions have been proposed as a game-changer for improving energy resolution and allowing time-resolution in neutron spectrum measurements using the magnetic recoil technique. This paper presents results from initial experiments testing this concept for direct drive ICF at the OMEGA Laser Facility. While the foils are shown to produce reasonable signals, inferred spectral broadening is seen to be high (∼5 keV) and signal levels are low (by ∼20%) compared to expectation. Before this type of foil is used for precision experiments, the foil mount must be improved, oxygen uptake in the foils must be better characterized, and impact of uncontrolled foil motion prior to detection must be investigated.
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Affiliation(s)
- M Gatu Johnson
- Massachusetts Institute of Technology Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | - B Aguirre
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - J Armstrong
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - J A Fooks
- General Atomics, San Diego, California 92186, USA
| | - C Forrest
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - J A Frenje
- Massachusetts Institute of Technology Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | - V Yu Glebov
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - M Hoppe
- General Atomics, San Diego, California 92186, USA
| | - J Katz
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - J P Knauer
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - W Martin
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - C E Parker
- Massachusetts Institute of Technology Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | - H G Reynolds
- General Atomics, San Diego, California 92186, USA
| | - M E Schoff
- General Atomics, San Diego, California 92186, USA
| | - F H Séguin
- Massachusetts Institute of Technology Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | - C Sorce
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - B Sperry
- Massachusetts Institute of Technology Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | - C Stoeckl
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623, USA
| | - R D Petrasso
- Massachusetts Institute of Technology Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
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Zhou Y, Zhao J, Fang J, Martin W, Li L, Nussinov R, Chan TA, Eng C, Cheng F. My personal mutanome: a computational genomic medicine platform for searching network perturbing alleles linking genotype to phenotype. Genome Biol 2021; 22:53. [PMID: 33514395 PMCID: PMC7845113 DOI: 10.1186/s13059-021-02269-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 01/13/2021] [Indexed: 12/12/2022] Open
Abstract
Massive genome sequencing data have inspired new challenges in personalized treatments and facilitated oncological drug discovery. We present a comprehensive database, My Personal Mutanome (MPM), for accelerating the development of precision cancer medicine protocols. MPM contains 490,245 mutations from over 10,800 tumor exomes across 33 cancer types in The Cancer Genome Atlas mapped to 94,563 structure-resolved/predicted protein-protein interaction interfaces ("edgetic") and 311,022 functional sites ("nodetic"), including ligand-protein binding sites and 8 types of protein posttranslational modifications. In total, 8884 survival results and 1,271,132 drug responses are obtained for these mapped interactions. MPM is available at https://mutanome.lerner.ccf.org .
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Affiliation(s)
- Yadi Zhou
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Junfei Zhao
- Department of Systems Biology, Herbert Irving Comprehensive Center, Columbia University, New York, NY, 10032, USA
- Department of Biomedical Informatics, Columbia University, New York, NY, 10032, USA
| | - Jiansong Fang
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - William Martin
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Lang Li
- Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, OH, 43210, USA
| | - Ruth Nussinov
- Computational Structural Biology Section, Basic Science Program, Frederick National Laboratory for Cancer Research, National Cancer Institute at Frederick, Frederick, MD, 21702, USA
- Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Timothy A Chan
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Center for Immunotherapy and Precision Immuno-Oncology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Charis Eng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA.
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA.
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Zheng ZK, Staubitz JE, Weitlauf AS, Staubitz J, Pollack M, Shibley L, Hopton M, Martin W, Swanson A, Juárez P, Warren ZE, Sarkar N. A Predictive Multimodal Framework to Alert Caregivers of Problem Behaviors for Children with ASD (PreMAC). Sensors (Basel) 2021; 21:s21020370. [PMID: 33430371 PMCID: PMC7826816 DOI: 10.3390/s21020370] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/17/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022]
Abstract
Autism Spectrum Disorder (ASD) impacts 1 in 54 children in the US. Two-thirds of children with ASD display problem behavior. If a caregiver can predict that a child is likely to engage in problem behavior, they may be able to take action to minimize that risk. Although experts in Applied Behavior Analysis can offer caregivers recognition and remediation strategies, there are limitations to the extent to which human prediction of problem behavior is possible without the assistance of technology. In this paper, we propose a machine learning-based predictive framework, PreMAC, that uses multimodal signals from precursors of problem behaviors to alert caregivers of impending problem behavior for children with ASD. A multimodal data capture platform, M2P3, was designed to collect multimodal training data for PreMAC. The development of PreMAC integrated a rapid functional analysis, the interview-informed synthesized contingency analysis (IISCA), for collection of training data. A feasibility study with seven 4 to 15-year-old children with ASD was conducted to investigate the tolerability and feasibility of the M2P3 platform and the accuracy of PreMAC. Results indicate that the M2P3 platform was well tolerated by the children and PreMAC could predict precursors of problem behaviors with high prediction accuracies.
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Affiliation(s)
- Zhaobo K. Zheng
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37240, USA;
- Correspondence:
| | - John E. Staubitz
- Treatment and Research Institute of Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.E.S.); (A.S.W.); (L.S.); (M.H.); (W.M.); (A.S.); (P.J.); (Z.E.W.)
| | - Amy S. Weitlauf
- Treatment and Research Institute of Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.E.S.); (A.S.W.); (L.S.); (M.H.); (W.M.); (A.S.); (P.J.); (Z.E.W.)
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37240, USA
| | - Johanna Staubitz
- Department of Special Education, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.S.); (M.P.)
| | - Marney Pollack
- Department of Special Education, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.S.); (M.P.)
| | - Lauren Shibley
- Treatment and Research Institute of Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.E.S.); (A.S.W.); (L.S.); (M.H.); (W.M.); (A.S.); (P.J.); (Z.E.W.)
| | - Michelle Hopton
- Treatment and Research Institute of Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.E.S.); (A.S.W.); (L.S.); (M.H.); (W.M.); (A.S.); (P.J.); (Z.E.W.)
| | - William Martin
- Treatment and Research Institute of Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.E.S.); (A.S.W.); (L.S.); (M.H.); (W.M.); (A.S.); (P.J.); (Z.E.W.)
| | - Amy Swanson
- Treatment and Research Institute of Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.E.S.); (A.S.W.); (L.S.); (M.H.); (W.M.); (A.S.); (P.J.); (Z.E.W.)
| | - Pablo Juárez
- Treatment and Research Institute of Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.E.S.); (A.S.W.); (L.S.); (M.H.); (W.M.); (A.S.); (P.J.); (Z.E.W.)
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37240, USA
- Department of Special Education, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.S.); (M.P.)
| | - Zachary E. Warren
- Treatment and Research Institute of Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.E.S.); (A.S.W.); (L.S.); (M.H.); (W.M.); (A.S.); (P.J.); (Z.E.W.)
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37240, USA
- Department of Special Education, Vanderbilt University Medical Center, Nashville, TN 37240, USA; (J.S.); (M.P.)
| | - Nilanjan Sarkar
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37240, USA;
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN 37240, USA
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Abstract
This paper presents the most recent progress on the development of gamma transport capability for the CASL neutronics code MPACT: (1) 3D gamma transport and (2) explicit gamma heating capabilities. The 3D gamma calculation capability was implemented by leveraging the 2D/1D solver originally developed for neutron calculations. The results were verified by MCNP6 on a small assembly with 5 × 5 pins. Generally, errors were lower than 0.5% on each axial mesh as long as MPACT was running with enough axial meshes. The gamma heating calculation considered the energy deposition from photoelectric absorption, Compton scattering, and pair production. Verification with MCNP6 for both 2D and 3D benchmarks showed that the errors of energy depositions are comparable with those of gamma fluxes, proving the proper implementation of the energy deposition.
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Liu Y, Salko R, Kim KS, Wang X, Kabelitz M, Kochunas B, Collins B, Martin W. AN IMPROVED ENERGY DEPOSITION MODEL IN MPACT AND EXPLICIT HEAT GENERATION COUPLING WITH CTF. EPJ Web Conf 2021. [DOI: 10.1051/epjconf/202124702033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The default energy deposition model in the CASL neutronics code MPACT assumes all fission energy is deposited locally in fuel rods. Furthermore, equilibrium delayed energy release is assumed for both steady-state and transient calculations. These approximations limit the accurate representation of the heat generation distribution in space and its variations over time, which are essential for power distribution and thermal-hydraulic coupling calculations. In this paper, an improved energy deposition model is presented in both the spatial and time domains. Spatially, the energy deposition through fission, neutron capture, and slowing-down reactions are explicitly modeled to account for the heat generation from all regions of a reactor core, and a gamma smearing scheme is developed that utilizes the gamma sources from neutron fission and capture. In the time domain, the delayed energy release is modeled by solving an additional equation of delayed heat emitters, similar to the equation of delayed neutron precursors. To allow the explicit heat generation coupling, the interfaces between MPACT and CTF were updated to transfer separate heat sources for different material regions (fuel, clad, moderator and guide tube). The results show that the distributions of the energy deposition between MPACT and MCNP agree very well for various 2-D assembly and quarter-core problems without TH feedback. The MPACT/CTF coupled calculation for the hot full power quarter-core case exhibited a reduced peak pin power by 2.3% and a reduced peak fuel centerline temperature by 17 K when using the explicit energy deposition and heat transfer. The new model also shows a maximum 100 pcm keff effect on assembly depletion problems and an increased overall energy release by 7% in a PWR reactivity-initiated accident (RIA) problem.
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Kellum AH, Qiu DY, Voehler MW, Martin W, Gates KS, Stone MP. Structure of a Stable Interstrand DNA Cross-Link Involving a β- N-Glycosyl Linkage Between an N6-dA Amino Group and an Abasic Site. Biochemistry 2020; 60:41-52. [PMID: 33382597 DOI: 10.1021/acs.biochem.0c00596] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abasic (AP) sites are one of the most common forms of DNA damage. The deoxyribose ring of AP sites undergoes anomerization between α and β configurations, via an electrophilic aldehyde intermediate. In sequences where an adenine residue is located on the opposing strand and offset 1 nt to the 3' side of the AP site, the nucleophilic N6-dA amino group can react with the AP aldehyde residue to form an interstrand cross-link (ICL). Here, we present an experimentally determined structure of the dA-AP ICL by NMR spectroscopy. The ICL was constructed in the oligodeoxynucleotide 5'-d(T1A2T3G4T5C6T7A8A9G10T11T12C13A14T15C16T17A18)-3':5'-d(T19A20G21A22T23G24A25A26C27X28T29A30G31A32C33A34T35A36)-3' (X=AP site), with the dA-AP ICL forming between A8 and X28. The NMR spectra indicated an ordered structure for the cross-linked DNA duplex and afforded detailed spectroscopic resonance assignments. Structural refinement, using molecular dynamics calculations restrained by NOE data (rMD), revealed the structure of the ICL. In the dA-AP ICL, the 2'-deoxyribosyl ring of the AP site was ring-closed and in the β configuration. Juxtapositioning the N6-dA amino group and the aldehydic C1 of the AP site within bonding distance while simultaneously maintaining two flanking unpaired A9 and T29 bases stacked within the DNA is accomplished by the unwinding of the DNA at the ICL. The structural data is discussed in the context of recent studies describing the replication-dependent unhooking of the dA-AP ICL by the base excision repair glycosylase NEIL3.
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Affiliation(s)
- Andrew H Kellum
- Department of Chemistry, Vanderbilt University Center for Structural Biology, and the Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee 37235, United States
| | - David Y Qiu
- Department of Chemistry, Vanderbilt University Center for Structural Biology, and the Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee 37235, United States
| | - Markus W Voehler
- Department of Chemistry, Vanderbilt University Center for Structural Biology, and the Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee 37235, United States
| | - William Martin
- Department of Biochemistry, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Kent S Gates
- Departments of Chemistry and Biochemistry, University of Missouri, Columbia, Missouri 65221, United States
| | - Michael P Stone
- Department of Chemistry, Vanderbilt University Center for Structural Biology, and the Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee 37235, United States
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40
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Hou Y, Zhao J, Martin W, Kallianpur A, Chung MK, Jehi L, Sharifi N, Erzurum S, Eng C, Cheng F. New insights into genetic susceptibility of COVID-19: an ACE2 and TMPRSS2 polymorphism analysis. BMC Med 2020; 18:216. [PMID: 32664879 PMCID: PMC7360473 DOI: 10.1186/s12916-020-01673-z] [Citation(s) in RCA: 291] [Impact Index Per Article: 72.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has now been confirmed worldwide. Yet, COVID-19 is strangely and tragically selective. Morbidity and mortality due to COVID19 rise dramatically with age and co-existing health conditions, including cancer and cardiovascular diseases. Human genetic factors may contribute to the extremely high transmissibility of SARS-CoV-2 and to the relentlessly progressive disease observed in a small but significant proportion of infected individuals, but these factors are largely unknown. MAIN BODY In this study, we investigated genetic susceptibility to COVID-19 by examining DNA polymorphisms in ACE2 and TMPRSS2 (two key host factors of SARS-CoV-2) from ~ 81,000 human genomes. We found unique genetic susceptibility across different populations in ACE2 and TMPRSS2. Specifically, ACE2 polymorphisms were found to be associated with cardiovascular and pulmonary conditions by altering the angiotensinogen-ACE2 interactions, such as p.Arg514Gly in the African/African-American population. Unique but prevalent polymorphisms (including p.Val160Met (rs12329760), an expression quantitative trait locus (eQTL)) in TMPRSS2, offer potential explanations for differential genetic susceptibility to COVID-19 as well as for risk factors, including those with cancer and the high-risk group of male patients. We further discussed that polymorphisms in ACE2 or TMPRSS2 could guide effective treatments (i.e., hydroxychloroquine and camostat) for COVID-19. CONCLUSION This study suggested that ACE2 or TMPRSS2 DNA polymorphisms were likely associated with genetic susceptibility of COVID-19, which calls for a human genetics initiative for fighting the COVID-19 pandemic.
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Affiliation(s)
- Yuan Hou
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Junfei Zhao
- Department of Systems Biology and Department of Biomedical Informatics, Herbert Irving Comprehensive Center, Columbia University, New York, NY, 10032, USA
| | - William Martin
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Asha Kallianpur
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA
| | - Mina K Chung
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Lara Jehi
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Nima Sharifi
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Serpil Erzurum
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Charis Eng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA
- Department of Genetics and Genome Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA
- Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, 44195, USA.
- Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA.
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41
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Abstract
The purpose of this ex post facto study was to determine what personality factors and demographic characteristics are related to acceptance or rejection of mobility training for adventitiously blind adults. The sample consisted of 79 subjects who had accepted mobility training and 60 subjects who had rejected training. The results indicated that the groups varied significantly on 7 of the 13 personality scales of the MMPI. No significant differences were found for any of the demographic variables. Different approaches to service for resistant clients are suggested.
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Affiliation(s)
- K. White
- Northern Arizona University (NAU)
| | - R. Carroll
- Institute for Human Development at Northern Arizona University, NAU/IHD, Box 563, Flagstaff, AZ 86011-5630
| | - W. Martin
- Institute for Human Development and NAU
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42
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Peña Ibagon JC, Yanez C, Benavidez L, Garcia J, Martin W, Castillo C. Acute Response Of Blood Glucose After Two Resistance Training Protocols With Different Execution Velocities. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000675852.40804.fc] [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: 11/21/2022]
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Zhou Y, Hou Y, Shen J, Huang Y, Martin W, Cheng F. Network-based drug repurposing for novel coronavirus 2019-nCoV/SARS-CoV-2. Cell Discov 2020; 6:14. [PMID: 32194980 PMCID: PMC7073332 DOI: 10.1038/s41421-020-0153-3] [Citation(s) in RCA: 962] [Impact Index Per Article: 240.5] [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: 02/05/2020] [Accepted: 03/02/2020] [Indexed: 02/07/2023] Open
Abstract
Human coronaviruses (HCoVs), including severe acute respiratory syndrome coronavirus (SARS-CoV) and 2019 novel coronavirus (2019-nCoV, also known as SARS-CoV-2), lead global epidemics with high morbidity and mortality. However, there are currently no effective drugs targeting 2019-nCoV/SARS-CoV-2. Drug repurposing, representing as an effective drug discovery strategy from existing drugs, could shorten the time and reduce the cost compared to de novo drug discovery. In this study, we present an integrative, antiviral drug repurposing methodology implementing a systems pharmacology-based network medicine platform, quantifying the interplay between the HCoV-host interactome and drug targets in the human protein-protein interaction network. Phylogenetic analyses of 15 HCoV whole genomes reveal that 2019-nCoV/SARS-CoV-2 shares the highest nucleotide sequence identity with SARS-CoV (79.7%). Specifically, the envelope and nucleocapsid proteins of 2019-nCoV/SARS-CoV-2 are two evolutionarily conserved regions, having the sequence identities of 96% and 89.6%, respectively, compared to SARS-CoV. Using network proximity analyses of drug targets and HCoV-host interactions in the human interactome, we prioritize 16 potential anti-HCoV repurposable drugs (e.g., melatonin, mercaptopurine, and sirolimus) that are further validated by enrichment analyses of drug-gene signatures and HCoV-induced transcriptomics data in human cell lines. We further identify three potential drug combinations (e.g., sirolimus plus dactinomycin, mercaptopurine plus melatonin, and toremifene plus emodin) captured by the "Complementary Exposure" pattern: the targets of the drugs both hit the HCoV-host subnetwork, but target separate neighborhoods in the human interactome network. In summary, this study offers powerful network-based methodologies for rapid identification of candidate repurposable drugs and potential drug combinations targeting 2019-nCoV/SARS-CoV-2.
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Affiliation(s)
- Yadi Zhou
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195 USA
| | - Yuan Hou
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195 USA
| | - Jiayu Shen
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195 USA
| | - Yin Huang
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195 USA
| | - William Martin
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195 USA
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195 USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195 USA
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106 USA
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44
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Johnson T, Aguilera D, Al-Basheer A, Berrong Z, Castellino R, Eaton B, Esiashvili N, Foreman N, Heger I, Kennedy E, Vahanian N, Martin W, Pacholczyk R, Ring E, Sadek R, Smith A, Shimoda M, Macdonald T, Munn D. Results of the NLG2105 Phase I Trial Using the IDO Pathway Inhibitor Indoximod, in Combination with Radiation and Chemotherapy, for Children with Newly Diagnosed DIPG. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz451.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Thase ME, Stanford AD, Memisoglu A, Martin W, Claxton A, Bodkin JA, Trivedi MH, Fava M, Yu M, Pathak S. Results from a long-term open-label extension study of adjunctive buprenorphine/samidorphan combination in patients with major depressive disorder. Neuropsychopharmacology 2019; 44:2268-2276. [PMID: 31254971 PMCID: PMC6897901 DOI: 10.1038/s41386-019-0451-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/22/2019] [Accepted: 06/11/2019] [Indexed: 12/19/2022]
Abstract
Buprenorphine/samidorphan (BUP/SAM; ALKS 5461) is an investigational opioid system modulator for the adjunctive treatment of patients with major depressive disorder (MDD), who did not respond adequately to prior antidepressant therapy (ADT). FORWARD-2, an open-label extension study, assessed long-term safety and tolerability of adjunctive BUP/SAM treatment in these patients. Patients from four short-term trials and de novo patients were enrolled; all had confirmed MDD and a current major depressive episode lasting 2-24 months. Patients were treated with an established ADT for ≥8 weeks before receiving sublingual, adjunctive BUP/SAM 2 mg/2 mg for up to 52 weeks. Safety (primary objective) was assessed via adverse events (AEs), the Columbia-Suicide Severity Rating Scale, and the Clinical Opiate Withdrawal Scale (COWS). Exploratory evaluation of efficacy was done using the Montgomery-Åsberg Depression Rating Scale (MADRS). Of 1485 patients, 50% completed the study and 11% discontinued due to AEs. AEs of nausea, headache, constipation, dizziness, and somnolence, each occurred in ≥10% of patients. There was no evidence of increased suicidal ideation or behavior. Euphoria-related AEs were uncommon (1.2%). Following abrupt BUP/SAM discontinuation, "drug withdrawal" AEs were infrequent (0.4%), and the incidence of COWS categorical worsening after abrupt drug discontinuation was low (6.5%). Improvements in mean MADRS scores were maintained until study end, suggesting durability of antidepressant effect in patients continuing treatment. BUP/SAM was generally well tolerated, with a low risk of abuse and an AE profile consistent with those seen in placebo-controlled studies. Withdrawal reports were uncommon and of limited clinical impact.
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Affiliation(s)
- Michael E. Thase
- 0000 0004 1936 8972grid.25879.31Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania School of Medicine, 3535 Market Street, Suite 670, Philadelphia, PA 19104-3309 USA
| | | | | | | | - Amy Claxton
- grid.422303.4Alkermes, Inc., Waltham, MA USA
| | - J. Alexander Bodkin
- 0000 0000 8795 072Xgrid.240206.2McLean Hospital, Belmont, MA USA ,000000041936754Xgrid.38142.3cHarvard Medical School, Boston, MA USA
| | - Madhukar H. Trivedi
- 0000 0000 9482 7121grid.267313.2University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Maurizio Fava
- 000000041936754Xgrid.38142.3cHarvard Medical School, Boston, MA USA ,0000 0004 0386 9924grid.32224.35Massachusetts General Hospital, Boston, MA USA
| | - Miao Yu
- grid.422303.4Alkermes, Inc., Waltham, MA USA
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Parize H, Bohner L, Gama L, Porporatti A, Mezzomo L, Martin W, Gonçalves T. Narrow-Diameter Implants in the Anterior Region: A Meta-analysis. Int J Oral Maxillofac Implants 2019; 34:1347–1358. [DOI: 10.11607/jomi.7526] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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47
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Peña J, Yanez C, Gomez C, Martin W, Castillo C, Granados J, Riveros M. The Relationship between strength and academic performance: A new reason to promote physical activity. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Experimental studies have determined that higher strength values are associated with more efficient cognitive function and better academic performance. In spite of this, the universities in Colombia are decreasing the time available for physical activity in favour of increasing the time devoted to theoretical subjects. This is one of the reasons why in Colombia, only 18% of young people complied with the world recommendations of physical activity. To examine this problem, the objective of this research was to establish the relationship between strength and academic performance in university students.
Methods
A cross-sectional study was developed in 135 (21.8 ± 4.5 yr; 78.69 ± 9.1kg) students of the fifth semester of the Areandina University in Bogota, Colombia. Each participant developed incremental protocols to determine the maximum weight that he or she could move in six different exercises: squat in smith machine, leg press, leg extension, bench press, pull down and military press. The average of the results of these tests was taken as the value of maximum strength. To determine academic performance, the average of the scores accumulated in the five semesters of their university studies was evaluated. Pearson correlation coefficient was used to find the linear relationship between strength and academic performance.
Results
Overall, 70.3 % of the participants were men and 29.7% were women. The results of the maximum strength tests were significantly higher in the male group than in the female group (P < 0.05). Academic performance was similar in both genders (P > 0.05). A positive correlation was established between maximum strength and academic performance. (r = 0.64 P < 0.05).
Conclusions
The conclusion of this research was that there is a significant relationship between strength and academic performance. These results are fundamental to justify the inclusion of spaces for the promotion of physical activity in public and private universities.
Key messages
Universities are institutions that only focus on academic training and generate contexts in which sedentary behaviours are promoted. Sedentary lifestyles are a public health problem in Colombia.
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Affiliation(s)
- J Peña
- IMED, Fundación Universitaria del Área Andina, Bogota, Colombia
| | - C Yanez
- IMED, Fundación Universitaria del Área Andina, Bogota, Colombia
| | - C Gomez
- IMED, Fundación Universitaria del Área Andina, Bogota, Colombia
| | - W Martin
- IMED, Fundación Universitaria del Área Andina, Bogota, Colombia
| | - C Castillo
- IMED, Fundación Universitaria del Área Andina, Bogota, Colombia
| | - J Granados
- IMED, Fundación Universitaria del Área Andina, Bogota, Colombia
| | - M Riveros
- IMED, Fundación Universitaria del Área Andina, Bogota, Colombia
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Gallardo YNR, da Silva-Olivio IR, Gonzaga L, Sesma N, Martin W. A Systematic Review of Clinical Outcomes on Patients Rehabilitated with Complete-Arch Fixed Implant-Supported Prostheses According to the Time of Loading. J Prosthodont 2019; 28:958-968. [PMID: 31433096 DOI: 10.1111/jopr.13104] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To perform a systematic review on studies assessing clinical outcomes in patients rehabilitated with complete-arch fixed implant-supported prostheses according to the time of loading. MATERIALS AND METHODS Data obtained from patient and clinical outcomes, as implant failure, success rate, survival rate, biological complications, technical complications, mechanical complications, and marginal bone loss, were included on this review. The search was performed on databases PubMed, Scopus, and Cochrane. Cochrane Collaboration tool was used to assess the risk of bias of randomized controlled studies, and an adapted version of Newcastle-Ottawa scale was used for observational studies. All data were tabulated according to the time of loading: (1) immediate restoration/loading, (2) early loading, and (3) conventional loading. RESULTS From a total of 4027 studies identified through the three databases, six of them were randomized controlled trials, five of them were prospective observational studies, and another five were retrospective observational studies. In total, 5954 implants, 1294 patients and 1305 full-arch fixed implant-supported prostheses were included in this review. There was a wide heterogeneity among clinical studies regarding the study design and treatment procedures. Thus, pooled estimates were not performed in order to avoid potential biases. The methodological assessment by the Modified Newcastle-Ottawa scale showed a moderate quality of observational studies. Regarding the RCTs studies, all of them presented at least one element of bias according to the Cochrane Collaboration tool for assessing risk of bias. CONCLUSION There is evidence of high survival-success implant rate (95-100%) for either loading protocols (immediate restoration/loading, early loading, and conventional loading). However, careful attention must be taken by clinician when interpreting the results reported in clinical studies. Future studies should be performed using standardized methodology in order to determine the true predictability regarding immediate, early, and conventional loading protocols.
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Affiliation(s)
| | | | - Luiz Gonzaga
- Department of Oral Surgery, College of Dentistry, University of Florida (UFL), Gainesville, FL
| | - Newton Sesma
- Department of Prosthodontics, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - William Martin
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida (UFL), Gainesville, FL
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Richard G, Biron B, Boyle C, Ardito M, Moise L, Martin W, Berdugo G, Groot ASD. Abstract 943: Filtering out self-like neoantigens improves immune response to cancer vaccines. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Clinical studies have highlighted the potential of precision cancer immunotherapy to effectively control the tumor of patients across cancer indications. However, recent studies showcase the difficulty of establishing robust CD8 and CD4 T cell responses. We hypothesize that poor cancer vaccine performance may be due in part to the inadvertent inclusion of suppressive T cell neo-epitopes in neoantigen vaccines that may be recognized by regulatory T cells (Tregs).
To test this hypothesis, we used the Ancer™ system to identify and select neo-epitopes from the CT26 syngeneic mouse model. Ancer™ leverages EpiMatrix® and JanusMatrix™, state-of-the-art predictive algorithms that have been extensively validated in prospective vaccine studies for infectious diseases (Moise et al., Hum. Vaccines Immunother 2015; Wada et al., Sci. Rep. 2017). Distinctive features of Ancer™ over other in silico pipelines are its ability to accurately predict CD4 T cell epitopes and to identify tolerated or Treg epitopes.
In a first experiment, optimally selected CT26 neoantigen vaccine candidates were identified with Ancer™ and ranked according to tumor expression level and predicted Class I- and Class II-restricted immunogenicity. Self-like, putative Treg epitopes were removed in this process. Naïve Balb/c mice were immunized subcutaneously with a peptide pool comprised of the 20 highest ranking neoantigens delivered with PolyICLC (Oncovir). Immunization with Ancer™-derived neoantigens induced strong IFNg ELISpot responses compared to controls (p < 0.001). Flow cytometry confirmed the vaccine stimulated multifunctional CD4+ and CD8+ T cells.
In a follow-on experiment, ten self-like neoantigens, from the same CT26 genome, were selected with Ancer™. These neoantigens may be recognized by Tregs due to their high degree of similarity with self, based on JanusMatrix™. Co-administration of the CT26 self-like neoantigens with our optimally designed neoantigen vaccine in naïve Balb/c mice diminished IFNg ELISpot responses by 5-fold compared to vaccination without the self-like neoantigens (p = 0.003).
While it has been well known that Tregs are present in tumors, these results suggest the possibility that tumor-derived neo-epitopes may be recruiting Tregs to the tumor. More importantly, the inadvertent inclusion of Treg driving neoantigens in vaccine formulations may hinder efforts to induce strong T cell-mediated tumor control. In silico screening of neoantigen sequences using specialized tools offers the possibility of enriching and designing new vaccines with higher quality candidates. Efforts are ongoing to determine the effect of Ancer™-derived self-like neoantigens on CD4+ and CD8+ T cells and how the inclusion of self-like neoantigens in vaccines affects their efficacy.
Citation Format: Guilhem Richard, Bethany Biron, Christine Boyle, Matthew Ardito, Leonard Moise, William Martin, Gad Berdugo, Anne S. De Groot. Filtering out self-like neoantigens improves immune response to cancer vaccines [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 943.
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Degli Esposti M, Mentel M, Martin W, Sousa FL. Oxygen Reductases in Alphaproteobacterial Genomes: Physiological Evolution From Low to High Oxygen Environments. Front Microbiol 2019; 10:499. [PMID: 30936856 PMCID: PMC6431628 DOI: 10.3389/fmicb.2019.00499] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/27/2019] [Indexed: 01/24/2023] Open
Abstract
Oxygen reducing terminal oxidases differ with respect to their subunit composition, heme groups, operon structure, and affinity for O2. Six families of terminal oxidases are currently recognized, all of which occur in alphaproteobacterial genomes, two of which are also present in mitochondria. Many alphaproteobacteria encode several different terminal oxidases, likely reflecting ecological versatility with respect to oxygen levels. Terminal oxidase evolution likely started with the advent of O2 roughly 2.4 billion years ago and terminal oxidases diversified in the Proterozoic, during which oxygen levels remained low, around the Pasteur point (ca. 2 μM O2). Among the alphaproteobacterial genomes surveyed, those from members of the Rhodospirillaceae reveal the greatest diversity in oxygen reductases. Some harbor all six terminal oxidase types, in addition to many soluble enzymes typical of anaerobic fermentations in mitochondria and hydrogenosomes of eukaryotes. Recent data have it that O2 levels increased to current values (21% v/v or ca. 250 μM) only about 430 million years ago. Ecological adaptation brought forth different lineages of alphaproteobacteria and different lineages of eukaryotes that have undergone evolutionary specialization to high oxygen, low oxygen, and anaerobic habitats. Some have remained facultative anaerobes that are able to generate ATP with or without the help of oxygen and represent physiological links to the ancient proteobacterial lineage at the origin of mitochondria and eukaryotes. Our analysis reveals that the genomes of alphaproteobacteria appear to retain signatures of ancient transitions in aerobic metabolism, findings that are relevant to mitochondrial evolution in eukaryotes as well.
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Affiliation(s)
| | - Marek Mentel
- Faculty of Natural Sciences, Department of Biochemistry, Comenius University in Bratislava, Bratislava, Slovakia
| | - William Martin
- Institute of Molecular Evolution, University of Düsseldorf, Düsseldorf, Germany
| | - Filipa L Sousa
- Division of Archaea Biology and Ecogenomics, Department of Ecogenomics and Systems Biology, University of Vienna, Vienna, Austria
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