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Hall VG, Lim C, Saunders NR, Klimevski E, Nguyen THO, Kedzierski L, Seymour JF, Wadhwa V, Thursky KA, Yong MK, Kedzierska K, Slavin MA, Teh BW. Breakthrough COVID-19 is mild in vaccinated patients with hematological malignancy receiving tixagevimab-cilgavimab as pre-exposure prophylaxis. Leuk Lymphoma 2023; 64:1600-1604. [PMID: 37341732 DOI: 10.1080/10428194.2023.2224472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 06/22/2023]
Affiliation(s)
- V G Hall
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Department of Hematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Australia
| | - C Lim
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - N R Saunders
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - E Klimevski
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - T H O Nguyen
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Australia
| | - L Kedzierski
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Australia
| | - J F Seymour
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Department of Hematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Australia
| | - V Wadhwa
- Department of Ambulatory Services, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - K A Thursky
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - M K Yong
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - K Kedzierska
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Australia
| | - M A Slavin
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - B W Teh
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
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Tan JKT, Wong JSM, Seo CJ, Lim C, Zhu HY, Ong CAJ, Chia CS. Incidence and outcomes of delayed presentation and surgery in peritoneal surface malignancies. Front Oncol 2023; 13:1137785. [PMID: 37324005 PMCID: PMC10265672 DOI: 10.3389/fonc.2023.1137785] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/18/2023] [Indexed: 06/17/2023] Open
Abstract
Background Peritoneal surface malignancies (PSM) present insidiously and often pose diagnostic challenges. There is a paucity of literature quantifying the frequency and extent of therapeutic delays in PSM and its impact on oncological outcomes. Methods A review of a prospectively maintained registry of PSM patients undergoing Cytoreductive Surgery and Hyperthermic Intra-peritoneal Chemotherapy (CRS-HIPEC) was conducted. Causes for treatment delays were identified. We evaluate the impact of delayed presentation and treatment delays on oncological outcomes using Cox proportional hazards models. Results 319 patients underwent CRS-HIPEC over a 6-years duration. 58 patients were eventually included in this study. Mean duration between symptom onset and CRS-HIPEC was 186.0 ± 37.1 days (range 18-1494 days) and mean duration of between patient-reported symptom onset and initial presentation was 56.7 ± 16.8 days. Delayed presentation (> 60 days between symptom onset and presentation) was seen in 20.7% (n=12) of patients and 50.0% (n=29) experienced a significant treatment delay of > 90 days between 1st presentation and CRS-HIPEC. Common causes for treatment delays were healthcare provider-related i.e. delayed or inappropriate referrals (43.1%) and delayed presentation to care (31.0%). Delayed presentation was a significantly associated with poorer disease free survival (DFS) (HR 4.67, 95% CI 1.11-19.69, p=0.036). Conclusion Delayed presentation and treatment delays are common and may have an impact on oncological outcomes. There is an urgent need to improve patient education and streamline healthcare delivery processes in the management of PSM.
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Affiliation(s)
- Jun Kiat Thaddaeus Tan
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
| | - Jolene Si Min Wong
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Chin Jin Seo
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Cindy Lim
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Hong-Yuan Zhu
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
| | - Chin-Ann Johnny Ong
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Laboratory of Applied Human Genetics, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Institute of Molecular and Cell Biology, A*STAR Research Entitie, Singapore, Singapore
| | - Claramae Shulyn Chia
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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Sommat K, Tong AKT, Ong ALK, Hu J, Sin SY, Lam WWC, Xie W, Khor YM, Lim C, Lim TW, Selvarajan S, Wang F, Tan TWK, Wee JTS, Soong YL, Fong KW, Hennedige T, Hua TC. 18F-FMISO PET-guided dose escalation with multifield optimization intensity-modulated proton therapy in nasopharyngeal carcinoma. Asia Pac J Clin Oncol 2023. [PMID: 37157884 DOI: 10.1111/ajco.13953] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/13/2023] [Accepted: 03/22/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the radiotherapy planning feasibility of dose escalation with intensity-modulated proton therapy (IMPT) to hypoxic tumor regions identified on 18F-Fluoromisonidazole (FMISO) positron emission tomography and computed tomography (PET-CT) in NPC. MATERIALS AND METHODS Nine patients with stages T3-4N0-3M0 NPC underwent 18F-FMISO PET-CT before and during week 3 of radiotherapy. The hypoxic volume (GTVhypo) is automatically generated by applying a subthresholding algorithm within the gross tumor volume (GTV) with a tumor to muscle standardized uptake value (SUV) ratio of 1.3 on the 18F-FMISO PET-CT scan. Two proton plans were generated for each patient, a standard plan to 70 Gy and dose escalation plan with upfront boost followed by standard 70GyE plan. The stereotactic boost was planned with single-field uniform dose optimization using two fields to deliver 10 GyE in two fractions to GTVhypo. The standard plan was generated with IMPT with robust optimization to deliver 70GyE, 60GyE in 33 fractions using simultaneous integrated boost technique. A plan sum was generated for assessment. RESULTS Eight of nine patients showed tumor hypoxia on the baseline 18F-FMISO PET-CT scan. The mean hypoxic tumor volume was 3.9 cm3 (range .9-11.9cm3 ). The average SUVmax of the hypoxic volume was 2.2 (range 1.44-2.98). All the dose-volume parameters met the planning objectives for target coverage. Dose escalation was not feasible in three of eight patients as the D0.03cc of temporal lobe was greater than 75GyE. CONCLUSIONS The utility of boost to the hypoxic volume before standard course of radiotherapy with IMPT is dosimetrically feasible in selected patients. Clinical trials are warranted to determine the clinical outcomes of this approach.
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Affiliation(s)
- Kiattisa Sommat
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Aaron Kian Ti Tong
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
| | - Ashley Li Kuan Ong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jing Hu
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Sze Yarn Sin
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Winnie Wing Chuen Lam
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
| | - Wanying Xie
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
| | - Yiu Ming Khor
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
| | - Cindy Lim
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Tze Wei Lim
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Sathiyamoorthy Selvarajan
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
| | - Fuqiang Wang
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Terence Wee Kiat Tan
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Joseph Tien Seng Wee
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Yoke Lim Soong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Kam Weng Fong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Tiffany Hennedige
- Division of Oncologic Imaging, National Cancer Centre Singapore, Singapore, Singapore
| | - Thng Choon Hua
- Division of Oncologic Imaging, National Cancer Centre Singapore, Singapore, Singapore
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Lim C, Kang E, Jung JJ, Yeoh H, Chun J, Kim HK, Lee HB, Moon HG, Han W. P187 Comparison of long term oncologic outcome of sentinel lymph node mapping methods, dye-only versus dye and radioisotope in breast cancer following neoadjuvant chemotherapy. Breast 2023. [DOI: 10.1016/s0960-9776(23)00305-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
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Lim C, Jensen ED, Poirier BF, Sethi S, Smart G, Peña AS. Molar-incisor hypomineralisation prevalence in a cohort of Australian children with type 1 diabetes. Eur Arch Paediatr Dent 2023; 24:117-123. [PMID: 36348176 PMCID: PMC9992226 DOI: 10.1007/s40368-022-00765-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Systemic diseases or drugs administered early in life may cause a disruption in amelogenesis and contribute to the qualitative defect of enamel described as molar-incisor hypomineralisation (MIH). Therefore, an increase in prevalence of MIH in children with type 1 diabetes (T1D) may be expected as this systemic disorder is commonly diagnosed in early childhood. The aim of this study was to determine the prevalence of MIH in a cohort of children with T1D and investigate diagnosis of MIH with T1D factors. METHODS Cross-sectional study of children with T1D recruited from paediatric diabetes clinics at the Women's and Children's Hospital (South Australia). A detailed medical history, comprehensive dental and MIH examination according to the European Academy of Paediatric Dentistry (EAPD) long form classification was collected for each child. All upper and lower first permanent molars and central incisors were scored. RESULTS A total number of 73 participants; 35 (47.95%) males were examined including 584 teeth. The mean age of the participants was 13.25 ± 2.58 years, with a mean age of diagnosis 7.75 ± 3.58 years, and a mean HbA1c of 8.5 ± 1.6%. 42 out of 73 children (54.8%) had enamel defects on at least one of the teeth examined. However, 19.2% met the criteria for MIH. Univariate and bivariate analyses were conducted but no significant associations were noted between MIH and risk factors including diabetes control (p > 0.1). CONCLUSION There was a high prevalence of enamel defects and MIH amongst children with T1D. More research is required to establish association between T1D and MIH.
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Affiliation(s)
- C Lim
- Adelaide Dental School, University of Adelaide, 4 North Terrace, Adelaide, SA, 5000, Australia
| | - E D Jensen
- Adelaide Dental School, University of Adelaide, 4 North Terrace, Adelaide, SA, 5000, Australia.
- Department of Paediatric Dentistry, Women's and Children's Hospital, Adelaide, SA, Australia.
| | - B F Poirier
- Adelaide Dental School, University of Adelaide, 4 North Terrace, Adelaide, SA, 5000, Australia
| | - S Sethi
- Adelaide Dental School, University of Adelaide, 4 North Terrace, Adelaide, SA, 5000, Australia
| | - G Smart
- Department of Paediatric Dentistry, Women's and Children's Hospital, Adelaide, SA, Australia
| | - A S Peña
- Discipline of Paediatrics and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
- Department of Diabetes and Endocrinology, Women's and Children's Hospital, Adelaide, SA, Australia
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Chew LL, Chua BJG, Busmanis I, Tay AZE, Lim C, Chan JJ, Sommat K, Tay SK, Ho TH, Kwek JW. Diagnostic accuracy of multiparametric MRI in endometrial cancer and its adjunctive value in identifying high-risk women requiring surgical staging. Ann Acad Med Singap 2022. [DOI: 10.47102/annals-acadmedsg.2022125] [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] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | | | | | | | - Cindy Lim
- National Cancer Centre Singapore, Singapore
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Chew LL, Chua BJG, Busmanis I, Tay AZE, Lim C, Chan JJ, Sommat K, Tay SK, Ho TH, Kwek JW. Diagnostic accuracy of multiparametric MRI in endometrial cancer and its adjunctive value in identifying high-risk women requiring surgical staging. Ann Acad Med Singap 2022; 51:801-803. [PMID: 36592151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Lee Lian Chew
- Division of Oncologic Imaging, National Cancer Centre Singapore, Singapore
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D’Silva M, Han HS, Liu R, Kingham TP, Choi GH, Syn NLX, Prieto M, Choi SH, Sucandy I, Chiow AKH, Marino MV, Efanov M, Lee JH, Sutcliffe RP, Chong CCN, Tang CN, Cheung TT, Pratschke J, Wang X, Park JO, Chan CY, Scatton O, Rotellar F, Troisi RI, D’Hondt M, Fuks D, Goh BKP, Gastaca M, Schotte H, De Meyere C, Lai EC, Krenzien F, Schmelzle M, Kadam P, Giglio M, Montalti R, Liu Q, Lee KF, Lee LS, Jang JY, Lim C, Labadie KP. Limited liver resections in the posterosuperior segments: international multicentre propensity score-matched and coarsened exact-matched analysis comparing the laparoscopic and robotic approaches. Br J Surg 2022; 109:1140-1149. [DOI: 10.1093/bjs/znac270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/22/2022] [Accepted: 07/14/2022] [Indexed: 12/07/2022]
Abstract
Abstract
Background
Limited liver resections (LLRs) for tumours located in the posterosuperior segments of the liver are technically demanding procedures. This study compared outcomes of robotic (R) and laparoscopic (L) LLR for tumours located in the posterosuperior liver segments (IV, VII, and VIII).
Methods
This was an international multicentre retrospective analysis of patients who underwent R-LLR or L-LLR at 24 centres between 2010 and 2019. Patient demographics, perioperative parameters, and postoperative outcomes were analysed; 1 : 3 propensity score matching (PSM) and 1 : 1 coarsened exact matching (CEM) were performed.
Results
Of 1566 patients undergoing R-LLR and L-LLR, 983 met the study inclusion criteria. Before matching, 159 R-LLRs and 824 L-LLRs were included. After 1 : 3 PSM of 127 R-LLRs and 381 L-LLRs, comparison of perioperative outcomes showed that median blood loss (100 (i.q.r. 40–200) versus 200 (100–500) ml; P = 0.003), blood loss of at least 500 ml (9 (7.4 per cent) versus 94 (27.6 per cent); P < 0.001), intraoperative blood transfusion rate (4 (3.1 per cent) versus 38 (10.0 per cent); P = 0.025), rate of conversion to open surgery (1 (0.8 per cent) versus 30 (7.9 per cent); P = 0.022), median duration of Pringle manoeuvre when applied (30 (20–46) versus 40 (25–58) min; P = 0.012), and median duration of operation (175 (130–255) versus 224 (155–300); P < 0.001) were lower in the R-LLR group compared with the L-LLR group. After 1 : 1 CEM of 104 R-LLRs with 104 L-LLRs, R-LLR was similarly associated with significantly reduced blood loss and a lower rate of conversion to open surgery.
Conclusion
Based on a matched analysis of well selected patients, both robotic and laparoscopic access could be undertaken safely with good outcomes for tumours in the posterosuperior liver segments.
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Affiliation(s)
- Mizelle D’Silva
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seoul , Korea
| | - Ho Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seoul , Korea
| | - Rong Liu
- Faculty of Hepatopancreatobiliary Surgery , First Medical Centre of Chinese People’s Liberation Army General Hospital, Beijing , China
| | - Thomas Peter Kingham
- Department of Surgery, Memorial Sloan Kettering Cancer Center , New York, New York , USA
| | - Gi Hong Choi
- Division of Hepatopancreatobiliary Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine , Seoul , Korea
| | - Nicholas Li Xun Syn
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore , Singapore
| | - Mikel Prieto
- Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country , Bilbao , Spain
| | - Sung Hoon Choi
- Department of General Surgery, CHA Bundang Medical Centre, CHA University School of Medicine , Seongnam , Korea
| | - Iswanto Sucandy
- AdventHealth Tampa, Digestive Health Institute , Tampa, Florida , USA
| | - Adrian Kah Heng Chiow
- Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital , Singapore
| | - Marco Vito Marino
- General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy and Oncologic Surgery Department, P. Giaccone University Hospital , Palermo , Italy
| | - Mikhail Efanov
- Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Centre , Moscow , Russia
| | - Jae Hoon Lee
- Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Asan Medical Centre, University of Ulsan College of Medicine , Seoul , Korea
| | - Robert Peter Sutcliffe
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust , Birmingham , UK
| | - Charing Ching Ning Chong
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong , New Territories Hong Kong , China
| | - Chung Ngai Tang
- Department of Surgery, Pamela Youde Nethersole Eastern Hospital , Hong Kong , China
| | - Tan To Cheung
- Department of Surgery, Queen Mary Hospital, University of Hong Kong , Hong Kong , China
| | - Johann Pratschke
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, and Berlin Institute of Health , Berlin , Germany
| | - Xiaoying Wang
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University , Shanghai , China
| | - James Oh Park
- Department of Surgery, University of Washington Medical Center and Fred Hutchinson Cancer Center, Seattle , Washington , USA
| | - Chung Yip Chan
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and Duke-National University Singapore Medical School , Singapore
| | - Olivier Scatton
- Department of Digestive, Hepatobiliary–Pancreatic and Liver Transplantation, Hôpital Pitie-Salpetriere, AP-HP, Sorbonne Université , Paris , France
| | - Fernando Rotellar
- Hepatopancreatobiliary and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, Universidad de Navarra and Institute of Health Research of Navarra (IdisNA) , Pamplona , Spain
| | - Roberto Ivan Troisi
- Department of Clinical Medicine and Surgery, Division of Hepatopancreatobiliary, Minimally Invasive and Robotic Surgery, Federico II University Hospital Naples , Naples , Italy
| | - Mathieu D’Hondt
- Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital , Kortrijk , Belgium
| | - David Fuks
- Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes , Paris , France
| | - Brian Kim Poh Goh
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and Duke-National University Singapore Medical School , Singapore
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Lim C, Lim B, Kil DY, Kim JM. Hepatic transcriptome profiling according to growth rate reveals acclimation in metabolic regulatory mechanisms to cyclic heat stress in broiler chickens. Poult Sci 2022; 101:102167. [PMID: 36257074 PMCID: PMC9579409 DOI: 10.1016/j.psj.2022.102167] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 07/17/2022] [Accepted: 08/24/2022] [Indexed: 11/15/2022] Open
Abstract
Climate change has numerous effects on poultry that result in welfare concerns and economic losses in agricultural industries. However, the mechanisms underlying the acclimation to heat stress in poultry have not been comprehensively defined. Therefore, identifying associated patterns of gene regulation and understanding the molecular mechanisms of acclimation to a warmer environment will provide insights into the acclimation system of broiler chickens. We profiled differentially expressed genes (DEGs) associated with differences in growth performance under heat stress conditions in the liver tissues of broilers based on RNA sequencing data. The DEGs were identified by comparison to the gene expression levels of broilers exhibiting average growth at 28 d of age (D28A) and D36A relative to those at D21A. In D36A, 507 and 312 DEGs were up- and downregulated, respectively, whereas 400 and 156 DEGs were up- and downregulated in D28A, respectively. Pathway enrichment analysis further revealed that “fatty acid degradation” and “heat shock protein expression” were upregulated in broilers exhibiting a higher growth and weight, whereas “cell cycle arrest” and “amino acid metabolism” were downregulated. Transcriptome profiling revealed that the acclimatized group supplied fat and energy from the liver to tissues through the breakdown of fatty acids. Furthermore, homeostasis was maintained via heat shock proteins and antioxidant enzymes. The characterized candidate genes and mechanisms associated with the response to heat stress might serve as a foundation for improving the ability of broilers to acclimatize under heat stress conditions.
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Affiliation(s)
- C Lim
- Department of Animal Science and Technology, Chung-Ang University, Anseong-si, Gyeonggi-do 17546, Republic of Korea
| | - B Lim
- Department of Animal Science and Technology, Chung-Ang University, Anseong-si, Gyeonggi-do 17546, Republic of Korea
| | - D Y Kil
- Department of Animal Science and Technology, Chung-Ang University, Anseong-si, Gyeonggi-do 17546, Republic of Korea
| | - J M Kim
- Department of Animal Science and Technology, Chung-Ang University, Anseong-si, Gyeonggi-do 17546, Republic of Korea.
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Laidsaar-Powell R, Butow P, Brown B, Mander K, Young J, Stone E, Chin V, Banks E, Lim C, Rankin N. EP10.01-005 Australian Lung Cancer Survivors Experiences of Novel Treatments, Healthcare, and Ongoing Physical and Psychological Needs. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.882] [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: 11/15/2022]
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Kim T, Girard N, Low G, Zhuo J, Yu D, Yang Y, Murota M, Lim C, Kleinman N, Cho B. 1109P Amivantamab vs real-world (RW) therapy in Japanese patients with advanced non-small cell lung cancer (aNSCLC) epidermal growth factor receptor (EGFR) exon-20 insertion mutation (E20i). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1234] [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] Open
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Linkowski L, Banson K, Corrigan K, Kriegler C, Lim C, Gunther JR, Braunstein S, Ingledew PA. Cancer Careers a ROECSGXLearnOncology podcast: Increasing Accessibility to Information about Oncology Careers. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Jeong T, Kim S, Kim S, Lim C, Chung J. M132 Comparison between polynomial regression and weighted least squares regression analysis for verification of linearity of quantitative measurements. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.231] [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: 11/03/2022]
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14
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Tay T, Somasundaram N, Lim C, Khoo LP, Goh AZK, Lee YS, Liu X, Tao M, Quek R, Farid M, Poon E, Chan JYS, Chang EWY, Yang VSW, Goh YT, Tan D, Diong C, Grigoropoulos NF, Nagarajan C, Poon M, de Mel S, Jeyasekharan A, Chan EHL, Lee J, Chee YL, Lim ST, Tang T. Treatment outcomes of T and natural-killer/T-cell lymphoma with ifosfamide, carboplatin and etoposide chemotherapy. Cancer Rep (Hoboken) 2022; 5:e1552. [PMID: 35481622 PMCID: PMC9458502 DOI: 10.1002/cnr2.1552] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/14/2021] [Accepted: 07/27/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Contemporary data of peripheral T-cell lymphoma (PTCL) and natural-killer/T-cell lymphoma (NKTL) patients treated with ifosfamide, carboplatin and etoposide (ICE) are limited. AIMS We performed a retrospective analysis to estimate outcomes of ICE-treated PTCL and NKTL patients at three tertiary cancer centres in Singapore. METHODS AND RESULTS Patients were identified through lymphoma databases from National Cancer Centre Singapore (NCCS), National University Hospital, Singapore (NUHS), and Singapore General Hospital (SGH). Responses and survival outcomes were determined from electronic medical records. A total of 75 patients with a median age of 50 were included. ICE was used as first-line treatment in 14 patients (19%) and as subsequent lines of treatment in 61 patients (81%). The overall response rates (ORR) for all patients was 63% (40% complete response [CR]). The ORR and CR in the first line were 86% and 64% respectively. At a median follow-up duration of 71.0 months, the median progression-free (PFS) and overall survival (OS) for all patients were 4.4 months (95%CI, 2.7-6.0) and 16 months (95%CI, 8.3-45.4) respectively. CONCLUSION In summary, ICE showed high ORR but poor PFS in relapsed/refractory PTCL and NKTL. ORR of ICE in the first line setting appears better than real-world CHOP data and warrants further study.
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Affiliation(s)
- Tricia Tay
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Cindy Lim
- Division of Clinical Trials & Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Lay Poh Khoo
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Allan Zhi Kai Goh
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Yuh Shan Lee
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Xin Liu
- Department of Haematology-Oncology, National University Hospital Singapore, Singapore, Singapore
| | - Miriam Tao
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Richard Quek
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Mohamad Farid
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Eileen Poon
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jason Y S Chan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Esther W Y Chang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Valerie S W Yang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Yeow Tee Goh
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Daryl Tan
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Colin Diong
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | | | | | - Michelle Poon
- Department of Haematology-Oncology, National University Hospital Singapore, Singapore, Singapore
| | - Sanjay de Mel
- Department of Haematology-Oncology, National University Hospital Singapore, Singapore, Singapore
| | - Anand Jeyasekharan
- Department of Haematology-Oncology, National University Hospital Singapore, Singapore, Singapore
| | - Esther H L Chan
- Department of Haematology-Oncology, National University Hospital Singapore, Singapore, Singapore
| | - Joanne Lee
- Department of Haematology-Oncology, National University Hospital Singapore, Singapore, Singapore
| | - Yen Lin Chee
- Department of Haematology-Oncology, National University Hospital Singapore, Singapore, Singapore
| | - Soon Thye Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Tiffany Tang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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15
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Sim Y, Lim C, Phyu N, Tan KTB, Chew LST, Wong CY, Madhukumar P, Yong WS, Lim SZ, Hamzah JLB, Tan SY, Chay WY, Wong FY, Tan PH, Tan VKM. The Impact of Statin Use and Breast Cancer Recurrence - A Retrospective Study in Singapore. Front Oncol 2022; 12:835320. [PMID: 35433431 PMCID: PMC9008885 DOI: 10.3389/fonc.2022.835320] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Statins, HMG-CoA reductase inhibitors, are commonly used cholesterol-lowering medications which are also increasingly recognized to have anti-cancer properties for various cancers, including breast cancer. Most clinical evidence supports a protective effect of statin on reducing breast cancer recurrence, particularly in hormone-receptor positive breast cancers.This study seeks to study the impact of statin use on breast cancer recurrence in an Asian population. Methods This is a retrospective study of patients diagnosed with breast cancer at the National Cancer Centre and Singapore General Hospital from 2005-2015. Statin use was defined as use after surgery. Associations between statin use, breast cancer recurrence and overall survival were estimated using Cox proportional hazards regression with adjustment for age, TNM stage, grade, ER/HER2 status, and co-morbidities. Associations between statin-use and disease-specific survival were estimated using competing risks regression. Results A total of 7858 females with breast cancer were studied, 1353(17.2%) were statin users, 6505(82.8%) were non-statin users, with a median follow-up of 8.67 years. Distribution of cancer stage, histology, molecular subtypes and grades were similar in both groups. Estrogen receptor(ER) positive (HR 0.57,95%CI 0.43-0.76,p<0.001) and HER2 negative (HR 0.74,95%CI 0.57-0.96,p=0.026) invasive cancers had a lower risk of recurrence in statin users. Statin users trended towards a long term recurrence-risk reduction (all subtypes,HR 0.48,p=0.002; ER-, HR 0.34,p=0.036; HER2+,HR 0.10,p=0.002). The risk-reduction benefit is not appreciated in statin users with DCIS, possibly due to small recurrence event numbers. Disease-specific survival benefit was seen in statin users with ER+ cancers (adjusted SHR 0.71,95%CI 0.53-0.96,p=0.027), especially ER+ invasive cancers (adjusted SHR 0.72, 95%CI 0.53-0.97,p=0.028), but with no statistically significant benefit in overall survival for statin users (all subtypes). Conclusion This is the first known retrospective study on the effect of statin use and breast cancer recurrence in an Asian population. Similar to previous international studies, statin use is associated with a risk reduction in breast cancer recurrence. This is especially beneficial in patients who have ER+ and HER2- invasive breast cancer. Statin use is also associated with a reduced risk of breast cancer recurrence in all subtypes of breast cancer in the long term (>6 years post diagnosis).
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Affiliation(s)
- Yirong Sim
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Cindy Lim
- Clinical Trials and Epidemiological Sciences (CTE), National Cancer Centre Singapore, Singapore, Singapore
| | - Nitar Phyu
- Department of Cancer Informatics, National Cancer Centre Singapore, Singapore, Singapore
| | - Kiat Tee Benita Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore.,Department of General Surgery, Sengkang General Hospital, Singapore, Singapore
| | - Lita Sui Tjien Chew
- Department of Pharmacy, National Cancer Center Singapore, Singapore, Singapore
| | - Chow Yin Wong
- Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Preetha Madhukumar
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Wei Sean Yong
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Sue Zann Lim
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Julie Liana Bte Hamzah
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Si Ying Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Wen Yee Chay
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Fuh Yong Wong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Puay Hoon Tan
- Division of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Veronique Kiak-Mien Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
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16
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Chia CS, Ong CAJ, Zhu HY, Lim C, Wong JSM, Tan GHC, Teo MCC. Can baseline quality of life scores predict for morbidity and survival after CRS and HIPEC: a prospective study of 151 patients. Pleura Peritoneum 2022; 7:63-75. [PMID: 35812011 PMCID: PMC9166269 DOI: 10.1515/pp-2021-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/05/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objectives
Various studies have shown that good quality of life (QoL) can be achieved after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). There is prognostic value of baseline QoL in post-operative outcome in Western setting. Our prospective study aims to validate these observations and elucidate clinical factors that predict poorer QoL in Asian peritoneal carcinomatosis patients.
Methods
European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was administered to patients before CRS and HIPEC and thereafter at 3, 6 and 12 months.
Results
A total of 151 patients underwent 155 surgeries. Four hundred and seventy two questionnaires were completed. Median disease-free survival (DFS) was 16.5 months. Three year DFS and overall survival (OS) were 24.0% and 73.0% respectively. Post-operative global health status significantly increased at 3, 6 and 12 months. The decreases in functional scales recovered to baseline by 1-year post-surgery. Peritoneal carcinomatosis index (PCI), presence of stoma, peritonectomy duration, death within one year, post-operative complication and length of SICU stay negatively influenced QoL. Complication rates were higher in patients with lower global health status, physical and role functioning scores and higher symptom summary scores at baseline. Lower social functioning score, and higher pain, dyspnoea and symptom summary scores at baseline were significantly associated with poorer OS.
Conclusions
Various clinical factors can help us predict a patient’s QoL after surgery. Several baseline factors were also able to predict morbidity and survival. Going forward, we can use these factors to help us better select patients who will have a greater benefit from CRS and HIPEC.
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Affiliation(s)
- Claramae Shulyn Chia
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Chin-Ann Johnny Ong
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Laboratory of Applied Human Genetics, Division of Medical Sciences, National Cancer Centre Singapore, Singapore, Singapore
- Institute of Molecular and Cell Biology, A*STAR Research Entities, Singapore, Singapore
| | - Hong-Yuan Zhu
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- Laboratory of Applied Human Genetics, Division of Medical Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Cindy Lim
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Jolene Si Min Wong
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Grace Hwei Ching Tan
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
| | - Melissa Ching Ching Teo
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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17
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Zhang S, Wang T, Zhang D, Wang X, Zhang Z, Lim C, Lee S. Probiotic characterization of Lactiplantibacillus plantarum HOM3204 and its restoration effect on antibiotic-induced dysbiosis in mice. Lett Appl Microbiol 2022; 74:949-958. [PMID: 35231139 PMCID: PMC9315005 DOI: 10.1111/lam.13683] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to evaluate the probiotic characteristics of Lactiplantibacillus plantarum HOM3204 isolated from homemade pickled cabbage and to examine its restoration effect on antibiotic-induced dysbiosis in mice. Lact. plantarum HOM3204 tolerated simulated gastric and intestinal juices with a 99.38% survival rate. It also showed strong adhesion ability (3.45%) to Caco-2 cells and excellent antimicrobial activity against foodborne pathogens in vitro. For safety (antibiotic susceptibility) of this strain, it was susceptible to all the tested seven antibiotics. Lact. plantarum HOM3204 had good stability during storage, especially in cold and frozen conditions. Furthermore, Lact. plantarum HOM3204 significantly restored the gut microbiota composition by increasing the abundance of Lactobacilli and Bifidobacteria and decreasing Enterococci, and improved antioxidative function by raising the concentrations of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) in serum of antibiotic-induced dysbiosis in mice. These results suggest that Lact. plantarum HOM3204 could be a potential probiotic as a functional food ingredient.
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Affiliation(s)
- S Zhang
- Coree Beijing Co., Ltd, Beijing, China
| | - T Wang
- Beijing Hanmi pharmaceutical Co., Ltd, Beijing, China
| | - D Zhang
- Coree Beijing Co., Ltd, Beijing, China
| | - X Wang
- Beijing Hanmi pharmaceutical Co., Ltd, Beijing, China
| | - Z Zhang
- Beijing Hanmi pharmaceutical Co., Ltd, Beijing, China
| | - C Lim
- Coree Beijing Co., Ltd, Beijing, China.,Coree Pohang Co., Ltd, Pohang, Korea
| | - S Lee
- Coree Beijing Co., Ltd, Beijing, China.,Coree Pohang Co., Ltd, Pohang, Korea
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18
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Lim C, BIDIN M, Yun Jin O, Wee Ven H, Shao Wei Y, Goh B. POS-280 PREGNANCY WITH CHRONIC KIDNEY DISEASE: MATERNAL AND FETAL OUTCOME. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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19
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Wilsmore B, Lim C, Jell C, Sandgren C. Early Experience With New Digital Platform for Cardiac Device Alert Management and Follow-Up. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Lim C, Poaty Ditengou J, Ryu K, Ku J, Park M, Whiting I, Pirgozliev V. Effect of maize replacement with different triticale levels on layers production performance, egg quality, yolk fatty acid profile and blood parameters. J Anim Feed Sci 2021. [DOI: 10.22358/jafs/144848/2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Yang GM, Lim C, Zhuang Q, Ong WY. Prevalence and timing of specialist palliative care access among advanced cancer patients and association with hospital death. Proceedings of Singapore Healthcare 2021. [DOI: 10.1177/20101058211055279] [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: 11/17/2022] Open
Abstract
Background Patients with advanced cancer have poor quality of life and high utilisation of acute healthcare services. Early access to palliative care has been shown to improve quality of life as well as reduce acute healthcare utilisation and costs. Objectives To determine the prevalence and timing of hospital-based specialist palliative care reviews for patients with advanced cancer known to National Cancer Centre Singapore. We also explored the association between specialist palliative care review and place of death. Methods A retrospective study of patients with Stage 4 cancer who died in a 2-year period from 1 January 2016 to 31 December 2017 (regardless of their date of diagnosis) and who received treatment in National Cancer Centre Singapore (NCCS). Results A total of 2572 patients were included, of which 1226 (47.7%) had at least one inpatient or outpatient specialist palliative care consultation. Those who had their first specialist palliative care review 30 days or less before death had a 2.01 (95% CI 1.62 to 2.49, p < 0.001) increased odds of hospital death while those who had the first hospital-based palliative care review more than 30 days before death a 0.76 (95% CI 0.62 to 0.93, p = 0.009) reduced odds of hospital death. Conclusions Our study found inadequate and late access to specialist palliative care among advanced cancer patients. Furthermore, late access to specialist palliative care was associated with hospital death. There is an urgent need to improve access to specialist palliative care in order to improve patient outcomes.
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Affiliation(s)
- Grace Meijuan Yang
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
- Department of General Medicine, Sengkang General Hospital, Singapore
| | - Cindy Lim
- Biostatistics and Epidemiology Unit, National Cancer Centre Singapore, Singapore
| | - Qingyuan Zhuang
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Wah Ying Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
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22
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Ita M, Wang JH, Fanning N, Kaar G, Lim C, Redmond H. 1104 Plasma Circulating Cell-Free Messenger RNA as a Potential Biomarker of Melanoma. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.823] [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]
Abstract
Abstract
Introduction
Blood-borne cell-free nucleic acids are increasingly emerging as significant non-invasive adjuncts to current methods of disease status evaluation in cancer patients. In this study, we sought to examine whether significant differences exist in the plasma transcriptomic profile of advanced melanoma patients with a high disease burden compared to patients with therapeutic response.
Method
Plasma circulating cell-free messenger ribonucleic acid (ccfmRNA) was extracted from twenty patients with stage IV melanoma receiving immunotherapy. Pathway focused gene expression analysis was performed. Patients were assessed with paired blood sample collection and CT scan assessments at baseline and at 3 months follow up. Response Evaluation Criteria in Solid Tumours (RECIST 1.1) was used for tumour burden estimation.
Results
In stage IV melanoma patients, CCL5, GZMB and MYD88 genes were significantly over-expressed (p < 0.05 versus healthy controls). In patients with high disease burden or progressive disease, CCL18, CCR1, CCR4, CD274, CSF2, and GBP1 genes were significantly over-expressed (p < 0.05 versus patients with therapeutic response). Finally, in stage IV melanoma patients with brain metastases, CCL18, CCR1, CCR4, CD274, CSF2, EGF, GBP1, and PTGS2 genes were significantly over-expressed (p < 0.05, versus patients without brain metastasis).
Conclusions
Significant differences were observed in the plasma transcriptomic profile between the various melanoma patient groups, and we postulate that these differences may be exploited to identify novel therapeutic targets or biomarkers relevant to melanoma. CCL4 and CCL5 are prognostic in melanoma, both genes had significantly higher expressions in low disease burden patients compared to patients with a high disease burden.
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Affiliation(s)
- M Ita
- University College Cork, Cork, Ireland
| | - J H Wang
- University College Cork, Cork, Ireland
| | - N Fanning
- University College Cork, Cork, Ireland
| | - G Kaar
- University College Cork, Cork, Ireland
| | - C Lim
- University College Cork, Cork, Ireland
| | - H Redmond
- University College Cork, Cork, Ireland
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23
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Ita M, Wang JH, Toulouse A, Lim C, Fanning N, O’Sullivan M, Nolan Y, Kaar G, Redmond H. 1095 The Utility of Plasma Circulating Cell-Free Messenger RNA as A Biomarker of Glioma: A Pilot Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.028] [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
Introduction
Research into the potential utility of plasma-derived circulating-cell-free nucleic acids as non-invasive adjuncts to radiological imaging has been occasioned by the invasive nature of brain tumour biopsy. Circulating-cell-free messenger RNAs are short fragments of RNA present in blood. The objective of this study was to determine whether significant differences exist in the plasma transcriptomic profile of glioma patients relative to differences in their tumour characteristics, and also whether any observed differences were representative of synchronously obtained glioma samples and TCGA glioma derived RNA.
Method
Blood samples were collected from twenty-nine patients prior to tumour resection. Plasma-ccfmRNA and glioma derived RNA were extracted and profiled.
Results
BCL2L1, CXCL5, GZMB, HLA-A, HLA-C, IRF1, MYD88, TGFB1, TLR2, and TP53 genes were significantly over-expressed in glioma (high-grade-glioma-HGG and low-grade-glioma-LGG) patients (p < 0.05, versus control). BCL2L1, GZMB and HLA-A genes were significantly over-expressed in HGG patients (p < 0.05, versus LGG patients). There was positive correlation between the magnitude of fold change of differentially expressed genes in plasma and glioma derived RNA (Spearman r = 0.6344, n = 14, p = 0.017), and with the mean FPKM of TCGA glioma derived RNA samples (Spearman r = 0.4614, n = 19, p = 0.047). There was positive correlation between glioma radiographic tumour burden and the magnitude of fold change of CSF3 gene (r = 0.9813, n = 20, p < 0.001).
Conclusions
We identified significant differential expression of genes involved in cancer inflammation and immunity among patients with different glioma grades, and we identified positive correlation between the plasma transcriptomic profile and tumour samples, and with TCGA glioma derived RNA.
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Affiliation(s)
- M Ita
- University College Cork, Cork, Ireland
| | - J H Wang
- University College Cork, Cork, Ireland
| | | | - C Lim
- University College Cork, Cork, Ireland
| | - N Fanning
- University College Cork, Cork, Ireland
| | | | - Y Nolan
- University College Cork, Cork, Ireland
| | - G Kaar
- University College Cork, Cork, Ireland
| | - H Redmond
- University College Cork, Cork, Ireland
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24
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Ng KYY, Chow EWX, Jiang B, Lim C, Goh BKP, Lee SY, Teo JY, Tan DMY, Cheow PC, Ooi LLPJ, Chow PKH, Lee JJX, Kam JH, Koh YX, Jeyaraj PR, Tan EK, Choo SP, Chan CY, Chung AYF, Tai D. Resected pancreatic adenocarcinoma: An Asian institution's experience. Cancer Rep (Hoboken) 2021; 4:e1393. [PMID: 33939335 PMCID: PMC8551988 DOI: 10.1002/cnr2.1393] [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: 12/14/2020] [Revised: 03/08/2021] [Accepted: 03/25/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Pancreatic adenocarcinoma (PDAC) is highly lethal. Surgery offers the only chance of cure, but 5-year overall survival (OS) after surgical resection and adjuvant therapy remains dismal. Adjuvant trials were mostly conducted in the West enrolling fit patients. Applicability to a general population, especially Asia has not been described adequately. AIM We aimed to evaluate the clinical outcomes, prognostic factors of survival, pattern, and timing of recurrence after curative resection in an Asian institution. METHODS AND RESULTS The clinicopathologic and survival outcomes of 165 PDAC patients who underwent curative resection between 1998 and 2013 were reviewed retrospectively. Median age at surgery was 62.0 years. 55.2% were male, and 73.3% had tumors involving the head of pancreas. The median OS of the entire cohort was 19.7 months. Median OS of patients who received adjuvant chemotherapy was 23.8 months. Negative predictors of survival include lymph node ratio (LNR) of >0.3 (HR = 3.36, P = .001), tumor site involving the body or tail of pancreas (HR = 1.59, P = .046), presence of perineural invasion (PNI) (HR = 2.36, P = .018) and poorly differentiated/undifferentiated tumor grade (HR = 1.86, P = .058). The median time to recurrence was 8.87 months, with 66.1% and 81.2% of patients developing recurrence at 12 months and 24 months respectively. The most common site of recurrence was the liver. CONCLUSION The survival of Asian patients with resected PDAC who received adjuvant chemotherapy is comparable to reported randomized trials. Clinical characteristics seem similar to Western patients. Hence, geographical locations may not be a necessary stratification factor in RCTs. Conversely, lymph node ratio and status of PNI ought to be incorporated.
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Affiliation(s)
- Kennedy Yao Yi Ng
- Division of Medical OncologyNational Cancer Centre SingaporeSingapore
| | | | - Bochao Jiang
- Division of Medical OncologyNational Cancer Centre SingaporeSingapore
| | - Cindy Lim
- Division of Clinical Trials and Epidemiological SciencesNational Cancer Centre SingaporeSingapore
| | - Brian Kim Poh Goh
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
- Division of Surgical OncologyNational Cancer Centre SingaporeSingapore
- Duke‐NUS Graduate Medical SchoolSingapore
| | - Ser Yee Lee
- Surgical Associates, National Cancer Centre SingaporeSingapore
| | - Jin Yao Teo
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
- Duke‐NUS Graduate Medical SchoolSingapore
| | - Damien Meng Yew Tan
- Duke‐NUS Graduate Medical SchoolSingapore
- Department of Gastroenterology and HepatologySingapore General HospitalSingapore
| | - Peng Chung Cheow
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
- Division of Surgical OncologyNational Cancer Centre SingaporeSingapore
- Duke‐NUS Graduate Medical SchoolSingapore
| | - London Lucien Peng Jin Ooi
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
- Division of Surgical OncologyNational Cancer Centre SingaporeSingapore
- Duke‐NUS Graduate Medical SchoolSingapore
| | - Pierce Kah Hoe Chow
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
- Division of Surgical OncologyNational Cancer Centre SingaporeSingapore
- Duke‐NUS Graduate Medical SchoolSingapore
| | | | - Juinn Huar Kam
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
| | - Ye Xin Koh
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
| | - Prema Raj Jeyaraj
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
| | - Ek Khoon Tan
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
| | - Su Pin Choo
- Division of Medical OncologyNational Cancer Centre SingaporeSingapore
- Curie Oncology, Graduate Medical SchoolSingapore General HospitalSingapore
| | - Chung Yip Chan
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
- Duke‐NUS Graduate Medical SchoolSingapore
| | - Alexander Yaw Fui Chung
- Department of Hepatopancreatobiliary and Transplantation SurgerySingapore General HospitalSingapore
- Division of Surgical OncologyNational Cancer Centre SingaporeSingapore
- Duke‐NUS Graduate Medical SchoolSingapore
| | - David Tai
- Division of Medical OncologyNational Cancer Centre SingaporeSingapore
- Duke‐NUS Graduate Medical SchoolSingapore
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25
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Harper NJ, Lim C, Alqallaf H, Naylor PJ. A case study exploring the 'real world' process of 'naturalizing' school playgrounds. Int J Environ Health Res 2021; 31:298-314. [PMID: 31469316 DOI: 10.1080/09603123.2019.1656174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 08/12/2019] [Indexed: 06/10/2023]
Abstract
Background: The aim of this study was to examine the lived experiences of teachers and administrators at two schools (one elementary Kindergarten-Grade 5 and one middle school, grades 6-8) following the 'naturalizing' of a portion of their schoolyard. Methods: A qualitative case study design was used. Focus groups and interviews allowed participants to express their rationale, identify implementation facilitators and barriers and critical processes/steps for realizing their naturalization goals. Researcher questions explored (1) factors which led to naturalizing the schoolyard, (2) key planning and process steps (3) challenges and successes experienced, and, (4) lessons learned. Findings: Six themes were identified as rationale for naturalizing including: re-integration of outdoor play into children's daily lives, pro-active mental health, opportunity for inclusion, nature as a positive space for learning, it fit with our values and principles, we had a need. Implementation was facilitated by having champions and support from multiple levels, adopting a phased approach, resources and having the buy-in to persevere over time. Significant challenges and 'how to' steps were also identified. Conclusions: Naturalizing schoolyards does not happen without a supportive context, significant time and effort. Implementation steps and issues were those commonly found in other school-based health promotion efforts.
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Affiliation(s)
- N J Harper
- School of Child & Youth Care, University of Victoria , Victoria, Canada
| | - C Lim
- School of Exercise Science, Physical and Health Education, University of Victoria , Victoria, Canada
| | - H Alqallaf
- School of Exercise Science, Physical and Health Education, University of Victoria , Victoria, Canada
| | - P J Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria , Victoria, Canada
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26
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Abba A, Accorsi C, Agnes P, Alessi E, Amaudruz P, Annovi A, Desages FA, Back S, Badia C, Bagger J, Basile V, Batignani G, Bayo A, Bell B, Beschi M, Biagini D, Bianchi G, Bicelli S, Bishop D, Boccali T, Bombarda A, Bonfanti S, Bonivento WM, Bouchard M, Breviario M, Brice S, Brown R, Calvo-Mozota JM, Camozzi L, Camozzi M, Capra A, Caravati M, Carlini M, Ceccanti A, Celano B, Cela Ruiz JM, Charette C, Cogliati G, Constable M, Crippa C, Croci G, Cudmore S, Dahl CE, Dal Molin A, Daley M, Di Guardo C, D'Avenio G, Davignon O, Del Tutto M, De Ruiter J, Devoto A, Diaz Gomez Maqueo P, Di Francesco F, Dossi M, Druszkiewicz E, Duma C, Elliott E, Farina D, Fernandes C, Ferroni F, Finocchiaro G, Fiorillo G, Ford R, Foti G, Fournier RD, Franco D, Fricbergs C, Gabriele F, Galbiati C, Garcia Abia P, Gargantini A, Giacomelli L, Giacomini F, Giacomini F, Giarratana LS, Gillespie S, Giorgi D, Girma T, Gobui R, Goeldi D, Golf F, Gorel P, Gorini G, Gramellini E, Grosso G, Guescini F, Guetre E, Hackman G, Hadden T, Hawkins W, Hayashi K, Heavey A, Hersak G, Hessey N, Hockin G, Hudson K, Ianni A, Ienzi C, Ippolito V, James CC, Jillings C, Kendziora C, Khan S, Kim E, King M, King S, Kittmer A, Kochanek I, Kowalkowski J, Krücken R, Kushoro M, Kuula S, Laclaustra M, Leblond G, Lee L, Lennarz A, Leyton M, Li X, Liimatainen P, Lim C, Lindner T, Lomonaco T, Lu P, Lubna R, Lukhanin GA, Luzón G, MacDonald M, Magni G, Maharaj R, Manni S, Mapelli C, Margetak P, Martin L, Martin S, Martínez M, Massacret N, McClurg P, McDonald AB, Meazzi E, Migalla R, Mohayai T, Tosatti LM, Monzani G, Moretti C, Morrison B, Mountaniol M, Muraro A, Napoli P, Nati F, Natzke CR, Noble AJ, Norrick A, Olchanski K, Ortiz de Solorzano A, Padula F, Pallavicini M, Palumbo I, Panontin E, Papini N, Parmeggiano L, Parmeggiano S, Patel K, Patel A, Paterno M, Pellegrino C, Pelliccione P, Pesudo V, Pocar A, Pope A, Pordes S, Prelz F, Putignano O, Raaf JL, Ratti C, Razeti M, Razeto A, Reed D, Refsgaard J, Reilly T, Renshaw A, Retriere F, Riccobene E, Rigamonti D, Rizzi A, Rode J, Romualdez J, Russel L, Sablone D, Sala S, Salomoni D, Salvo P, Sandoval A, Sansoucy E, Santorelli R, Savarese C, Scapparone E, Schaubel T, Scorza S, Settimo M, Shaw B, Shawyer S, Sher A, Shi A, Skensved P, Slutsky A, Smith B, Smith NJT, Stenzler A, Straubel C, Stringari P, Suchenek M, Sur B, Tacchino S, Takeuchi L, Tardocchi M, Tartaglia R, Thomas E, Trask D, Tseng J, Tseng L, VanPagee L, Vedia V, Velghe B, Viel S, Visioli A, Viviani L, Vonica D, Wada M, Walter D, Wang H, Wang MHLS, Westerdale S, Wood D, Yates D, Yue S, Zambrano V. The novel Mechanical Ventilator Milano for the COVID-19 pandemic. Phys Fluids (1994) 2021; 33:037122. [PMID: 33897243 PMCID: PMC8060010 DOI: 10.1063/5.0044445] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.
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Affiliation(s)
- A. Abba
- Nuclear Instruments S.R.L., Como 22045, Italy
| | - C. Accorsi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - P. Agnes
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - E. Alessi
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - P. Amaudruz
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Annovi
- INFN Sezione di Pisa, Pisa 56127, Italy
| | - F. Ardellier Desages
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - S. Back
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - C. Badia
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - J. Bagger
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - V. Basile
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | | | - A. Bayo
- LSC, Laboratorio Subterráneo de Canfranc, Canfranc-Estación 22880, Spain
| | - B. Bell
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | | | - D. Biagini
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - G. Bianchi
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | - S. Bicelli
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - D. Bishop
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Bombarda
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | - S. Bonfanti
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | | | - M. Bouchard
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - M. Breviario
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - S. Brice
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R. Brown
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - J. M. Calvo-Mozota
- LSC, Laboratorio Subterráneo de Canfranc, Canfranc-Estación 22880, Spain
| | - L. Camozzi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - M. Camozzi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - A. Capra
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M. Caravati
- INFN Sezione di Cagliari, Cagliari 09042, Italy
| | - M. Carlini
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | | | - B. Celano
- INFN Sezione di Napoli, Napoli 80126, Italy
| | - J. M. Cela Ruiz
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C. Charette
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - G. Cogliati
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - M. Constable
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - C. Crippa
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - G. Croci
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - S. Cudmore
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - A. Dal Molin
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - M. Daley
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - C. Di Guardo
- Dipartimento di Scienze Economiche ed Aziendali, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - G. D'Avenio
- National Center for Innovative Technologies in Public Health, ISS (Italy National Institute of Health), Roma 00161, Italy
| | - O. Davignon
- Laboratoire Leprince Ringuet, École Polytechnique, Palaiseau, Cedex 91128, France
| | - M. Del Tutto
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J. De Ruiter
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - A. Devoto
- Dipartimento di Fisica, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | | | - F. Di Francesco
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - M. Dossi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - E. Druszkiewicz
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - C. Duma
- INFN-CNAF, Bologna 40127, Italy
| | - E. Elliott
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - D. Farina
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | | | | | - R. Ford
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | | | | | - D. Franco
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | | | - F. Gabriele
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - P. Garcia Abia
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - A. Gargantini
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | - L. Giacomelli
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | | | - S. Gillespie
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - D. Giorgi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - T. Girma
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - R. Gobui
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | | | - F. Golf
- Department of Physics and Astronomy, University of Nebraska-Lincoln, Lincoln, Nebraska 68508, USA
| | - P. Gorel
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - G. Gorini
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - E. Gramellini
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Grosso
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - F. Guescini
- Max-Planck-Institut für Physik (Werner-Heisenberg-Institut), 80805 München, Germany
| | - E. Guetre
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. Hackman
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Hadden
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - K. Hayashi
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Heavey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Hersak
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - N. Hessey
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. Hockin
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - K. Hudson
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Ianni
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - C. Ienzi
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - C. C. James
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - C. Kendziora
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S. Khan
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - E. Kim
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - M. King
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - S. King
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - A. Kittmer
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - I. Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - J. Kowalkowski
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - M. Kushoro
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - S. Kuula
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | | | - G. Leblond
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - L. Lee
- Department of APT, Faculty of Medicine, University of British Columbia, Vancouver V5Z 1M9, Canada
| | - A. Lennarz
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M. Leyton
- INFN Sezione di Napoli, Napoli 80126, Italy
| | - X. Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - C. Lim
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Lindner
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Lomonaco
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - P. Lu
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R. Lubna
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. A. Lukhanin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Luzón
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
| | - M. MacDonald
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - G. Magni
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - R. Maharaj
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Manni
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - C. Mapelli
- Dipartimento di Meccanica, Politecnico di Milano, Milano 20156, Italy
| | - P. Margetak
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - L. Martin
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Martin
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | | | - N. Massacret
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - P. McClurg
- Department of Respiratory and Anaesthesia Technology, Vanier College, Montréal, Quebec H4L 3X9, Canada
| | | | - E. Meazzi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | - T. Mohayai
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L. M. Tosatti
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | - G. Monzani
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - C. Moretti
- Dipartimento di Pediatria, Sapienza Università di Roma, Roma 00185, Italy
| | | | | | - A. Muraro
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - P. Napoli
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - F. Nati
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - C. R. Natzke
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Norrick
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K. Olchanski
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Ortiz de Solorzano
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
| | - F. Padula
- School of Civil and Mechanical Engineering, Curtin University, Perth (Washington), Australia
| | | | - I. Palumbo
- Azienda Ospedaliera San Gerardo, Monza 20900, Italy
| | - E. Panontin
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - N. Papini
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | | | - K. Patel
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Patel
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - M. Paterno
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | | | | | - A. Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - A. Pope
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - S. Pordes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - F. Prelz
- INFN Sezione di Milano, Milano 20133, Italy
| | - O. Putignano
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - J. L. Raaf
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C. Ratti
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - M. Razeti
- INFN Sezione di Cagliari, Cagliari 09042, Italy
| | - A. Razeto
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - D. Reed
- Equilibar L.L.C., Fletcher, North Carolina 28732, USA
| | - J. Refsgaard
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Reilly
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Renshaw
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - F. Retriere
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - E. Riccobene
- Dipartimento di Informatica, Universitá degli Studi di Milano, Milano 20122, Italy
| | - D. Rigamonti
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | - J. Romualdez
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - L. Russel
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - D. Sablone
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - S. Sala
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | - P. Salvo
- Istituto di Fisiologia Clinica del CNR, IFC-CNR, Pisa 56124, Italy
| | | | - E. Sansoucy
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - R. Santorelli
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C. Savarese
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - T. Schaubel
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - S. Scorza
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - M. Settimo
- SUBATECH, IMT Atlantique, Université de Nantes, CNRS-IN2P3, Nantes 44300, France
| | - B. Shaw
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Shawyer
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - A. Sher
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Shi
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - A. Slutsky
- St. Michael's Hospital, Unity Health Toronto, Ontario M5B 1W8, Canada
| | - B. Smith
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Stenzler
- 12th Man Technologies, Garden Grove, California 92841, USA
| | - C. Straubel
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - P. Stringari
- MINES ParisTech, PSL University, CTP-Centre of Thermodynamics of Processes, 77300 Fontainebleau, France
| | - M. Suchenek
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-614, Poland
| | - B. Sur
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - L. Takeuchi
- Department of Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - M. Tardocchi
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - R. Tartaglia
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - E. Thomas
- Arthur B. McDonald Canadian Astroparticle Research Institute, Kingston, Ontario K7L 3N6, Canada
| | - D. Trask
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - J. Tseng
- Department of Physics, University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - L. Tseng
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - L. VanPagee
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - V. Vedia
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - B. Velghe
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Visioli
- Dipartimento di Ingegneria Meccanica e Industriale, Università degli Studi di Brescia, Brescia 25123, Italy
| | - L. Viviani
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - D. Vonica
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - M. Wada
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-614, Poland
| | - D. Walter
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - H. Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - M. H. L. S. Wang
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - D. Wood
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - D. Yates
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Yue
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - V. Zambrano
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
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Ang MK, Montoya JE, Tharavichitkul E, Lim C, Tan T, Wang LY, Wee J, Soong YL, Fong KW, Ng QS, Tan DSW, Toh CK, Tan EH, Lim WT. Phase II study of nimotuzumab (TheraCim-hR3) concurrent with cisplatin/radiotherapy in patients with locally advanced head and neck squamous cell carcinoma. Head Neck 2021; 43:1641-1651. [PMID: 33547683 DOI: 10.1002/hed.26635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/01/2021] [Accepted: 01/21/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The efficacy of a combination of nimotuzumab, a humanized monoclonal antibody to the epidermal growth factor receptor, with chemoradiation in locally advanced head and neck squamous cell carcinoma (HNSCC) was evaluated in a phase II study. METHODS Patients with stage III/IV HNSCC received 3-weekly cisplatin 100 mg/m2 for three cycles and weekly nimotuzumab 200 mg for 8 weeks concurrently with radiotherapy. Primary endpoint was best overall response (BOR) and secondary endpoint was progression-free survival (PFS). RESULTS Thirty-seven patients were included; the majority were Chinese (76%), male (89%), and had stage IVA/IVB HNSCC (92%). BOR of complete and partial response was seen in 22/37 (59%) and 10/37 (27%) patients, respectively. Median PFS was 17.5 months (95% CI: 11.1-54.5) and 3-year PFS was 40.4% (95% CI: 24.3-55.9). The frequency and type of adverse events observed were similar to standard chemoradiation. CONCLUSION The combination of nimotuzumab with cisplatin and radiotherapy was safe and achieved high response rates in HNSCC.
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Affiliation(s)
- Mei-Kim Ang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | | | - Ekkasit Tharavichitkul
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Cindy Lim
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore
| | - Terence Tan
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Lan Ying Wang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Joseph Wee
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Yoke-Lim Soong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Kam-Weng Fong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Quan Sing Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | | | | | - Eng-Huat Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Wan-Teck Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
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Tang T, Martin P, Somasundaram N, Lim C, Tao M, Poon E, Yunon MJ, Toh SQ, Yan SX, Farid M, Chan JY, Lim ST. Phase I study of selinexor in combination with dexamethasone, ifosfamide, carboplatin, etoposide chemotherapy in patients with relapsed or refractory peripheral T-cell or naturalkiller/T-cell lymphoma. Haematologica 2020; 106:3170-3175. [PMID: 33147935 PMCID: PMC8634181 DOI: 10.3324/haematol.2020.251454] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 02/28/2020] [Indexed: 11/29/2022] Open
Abstract
Selinexor is a selective inhibitor of nuclear export with anti-cancer properties. We performed a phase I study to determine the safety and maximum tolerated dose of selinexor when combined with high-dose dexamethasone, ifosfamide, carboplatin and etoposide (DICE) in relapsed/refractory T-cell lymphoma (TCL) and natural-killer/T-cell lymphoma (NKTL). Patients with relapsed/refractory TCL and NKTL were treated with standard dose ICE, dexamethasone 20 mg on days 3 to 7, and escalating doses of oral selinexor on days 3, 5 and 7 in a 3+3 design. Dose levels (DL) 1, 2 and 3 were 40, 60 and 80 mg, respectively. Eleven patients with a median age of 60 years were enrolled; six at DL1 and five at DL2. Patients had received a median of two (range, 1-4) prior lines of treatment and seven had primary refractory disease at entry into the study. Patients received a median of three cycles (range, 1-6) of selinexor-DICE. The most common grade 1 or 2 toxicities included nausea (64%), fatigue (55%), and anorexia (45%) and the most common grade 3 or 4 toxicities included thrombocytopenia (82%), anemia (82%), neutropenia (73%), and hyponatremia (73%). Two patients developed dose-limiting toxicities at DL2 and one at DL1. Five patients discontinued treatment for reasons other than disease progression or lack of response. Of the ten evaluable patients, the overall and complete response rates were 91% and 82%, respectively. The maximum tolerated dose of selinexor was 40 mg when combined with DICE. The combination showed promising complete response rates in patients with relapsed/refractory TCL and NKTL but was poorly tolerated. (clinicaltrials. gov identifier: NCT03212937).
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Affiliation(s)
- Tiffany Tang
- Division of Medical Oncology, National Cancer Centre Singapore.
| | - Peter Martin
- Division of Medicine, Weill Cornell Medical College, New York
| | | | - Cindy Lim
- Division of Clinical Trials and Epidemiology, National Cancer Centre Singapore
| | - Miriam Tao
- Division of Medical Oncology, National Cancer Centre Singapore
| | - Eileen Poon
- Division of Medical Oncology, National Cancer Centre Singapore
| | - Maica Jd Yunon
- Division of Clinical Trials and Epidemiology, National Cancer Centre Singapore
| | - Shu Q Toh
- Division of Clinical Trials and Epidemiology, National Cancer Centre Singapore
| | - Sean X Yan
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital
| | - Mohamad Farid
- Division of Medical Oncology, National Cancer Centre Singapore
| | - Jason Y Chan
- Division of Medical Oncology, National Cancer Centre Singapore
| | - Soon T Lim
- Division of Medical Oncology, National Cancer Centre Singapore
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Bueno Beti C, Lim C, Protonotarios A, Kiss A, Sheppard M, Szabo P, Behr E, Hamza O, Podesser B, Weichhart T, Asimaki A. Cardiovascular phenotyping of the first mouse model of Sarcoidosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Sarcoidosis is a potentially life-threatening, inflammatory, granulomatous disease that affects multiple organs including the heart. Heretofore, its unknown etiology had hindered the creation of experimental models and the understanding of the molecular mechanisms of pathogenesis behind it.
Purpose
To extensively phenotype the heart of the first mouse model of sarcoidosis created through deletion of the tuberous sclerosis 2 (Tsc2) gene in the CD11c-positive macrophage population.
Methods
Tsc2 fl/fl CD11c Cre+ (Tsc2-KO; n=7) and Tsc2 fl/fl CD11c Cre- (Tsc2-WT; n=7) mice were subjected to echocardiography at 25 weeks of age (woa) to assess myocardial dimensions and function. Hearts of 13 and 25woa animals were subjected to histological and immunological stains to assess tissue changes, subtype inflammatory infiltrates and examine the localization of key proteins shown to be re-distributed in patients.
Results
At 13 woa, Tsc2-KO animals show inflammatory infiltrates; subtyped mainly as macrophages as well as evidence of myocyte destruction. At 25 woa, the number of inflammatory cells is significantly higher and there is heavy fibrotic replacement primarily in the septum and trabeculae. Older animals also show giant cells and non-necrotizing granulomas. The hearts show heterogeneous gap junction remodeling known to constitute an arrhythmogenic substrate and lack of immunoreactive signal for the desmosomal protein plakoglobin from the cell-cell junctions just as described in patients. The left ventricular ejection fraction and LV morphology was not significantly different between the two groups (EF: 64±4% in Tsc2-KO vs 64±2% in Tsc2-WT; LV end-systolic diameter: 4.51±0.54 mm in Tsc2-KO vs 4.59±0.29 mm in Tsc2-WT). However, there was a strong trend towards increasing filling pressure (E/e'ratio; 14.24±4.01 vs 12.15±2.54) and mean pulmonary pressure (21±6 vs 18±3 mmHg) in Tsc2-KO mice compared to controls suggesting diastolic dysfunction.
Conclusion
Hearts of the Tsc2 fl/fl CD11c Cre+ animals show a phenotype highly reminiscent of cardiac sarcoidosis in patients. We anticipate that this model will be very useful in deciphering molecular mechanisms of pathogenesis as well as testing much-needed mechanism-based therapies.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): British Heart Foundation - PG/18/27/33616
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Affiliation(s)
- C Bueno Beti
- St George's University of London, Clinical Cardiology Academic Group, Molecular and Clinical Research Science Institute, London, United Kingdom
| | - C Lim
- Medical University of Vienna, Center for Pathobiochemistry and Genetics, Vienna, Austria
| | - A Protonotarios
- University College London, Institute of Cardiovascular Science, Clinical Science Research Group, London, United Kingdom
| | - A Kiss
- Medical University of Vienna, Center for Biomedical Research, Vienna, Austria
| | - M.N Sheppard
- St George's University of London, Clinical Cardiology Academic Group, Molecular and Clinical Research Science Institute, London, United Kingdom
| | - P.L Szabo
- Medical University of Vienna, Center for Biomedical Research, Vienna, Austria
| | - E Behr
- St George's University of London, Clinical Cardiology Academic Group, Molecular and Clinical Research Science Institute, London, United Kingdom
| | - O Hamza
- Medical University of Vienna, Center for Biomedical Research, Vienna, Austria
| | - B Podesser
- Medical University of Vienna, Center for Biomedical Research, Vienna, Austria
| | - T Weichhart
- Medical University of Vienna, Center for Pathobiochemistry and Genetics, Vienna, Austria
| | - A Asimaki
- St George's University of London, Clinical Cardiology Academic Group, Molecular and Clinical Research Science Institute, London, United Kingdom
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McAuley G, Lim C, Teran A, Slater J, Wroe A. PO-1760: Magnetically focused minibeams for proton therapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01778-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chia BSH, Leong JY, Ong ALK, Lim C, Poon SH, Chua MLK, Chua KLM, Kusumawidjaja G, Chua ET, Wong FY, Lee TS. Randomised prospective phase II trial in multiple brain metastases comparing outcomes between hippocampal avoidance whole brain radiotherapy with or without simultaneous integrated boost: HA-SIB-WBRT study protocol. BMC Cancer 2020; 20:1045. [PMID: 33126867 PMCID: PMC7602352 DOI: 10.1186/s12885-020-07565-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 07/17/2020] [Accepted: 10/23/2020] [Indexed: 12/21/2022] Open
Abstract
Background Recent evidence supports hippocampal avoidance with whole brain radiotherapy (HA-WBRT) as the recommended treatment option in patients with good prognosis and multiple brain metastases as this results in better neurocognitive preservation compared to whole brain radiotherapy. However, there is often poor tumour control with this technique due to the low doses given. Stereotactic Radiosurgery (SRS), a form of focused radiotherapy which is given to patients who have a limited number of brain metastases, delivers a higher radiation dose to the metastases resulting in better target lesion control. With improvements in radiation technology, advanced dose-painting techniques now allow a simultaneous integrated boost (SIB) dose to lesions whilst minimising doses to the hippocampus to potentially improve brain tumour control and preserve cognitive outcomes. This technique is abbreviated to HA-SIB-WBRT or HA-WBRT+SIB. Methods We hypothesise that the SIB in HA-SIB-WBRT (experimental arm) will result in better tumour control compared to HA-WBRT (control arm). This may also lead to better intracranial disease control as well as functional and survival outcomes. We aim to conduct a prospective randomised phase II trial in patients who have good performance status, multiple brain metastases (4–25 lesions) and a reasonable life expectancy (> 6 months). These patients will be stratified according to the number of brain metastases and randomised between the 2 arms. We aim for a recruitment of 100 patients from a single centre over a period of 2 years. Our primary endpoint is target lesion control. These patients will be followed up over the following year and data on imaging, toxicity, quality of life, activities of daily living and cognitive measurements will be collected at set time points. The results will then be compared across the 2 arms and analysed. Discussion Patients with brain metastases are living longer. Maintaining functional independence and intracranial disease control is thus increasingly important. Improving radiotherapy treatment techniques could provide better control and survival outcomes whilst maintaining quality of life, cognition and functional capacity. This trial will assess the benefits and possible toxicities of giving a SIB to HA-WBRT. Trial registration Clinicaltrials.gov identifier: NCT04452084. Date of registration 30th June 2020.
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Affiliation(s)
- Brendan Seng Hup Chia
- Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore.
| | - Jing Yun Leong
- Department of Adult Neuro-developmental Service, Institute of Mental Health Singapore, 10 Buangkok View, Singapore, 539747, Singapore
| | - Ashley Li Kuan Ong
- Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Cindy Lim
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Shi Hui Poon
- Department of Psychiatry, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Melvin Lee Kiang Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Kevin Lee Min Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Grace Kusumawidjaja
- Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Eu Tiong Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Fuh Yong Wong
- Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Tih Shih Lee
- Department of Psychiatry, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
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Chua GP, Pang GSY, Yee ACP, Neo PSH, Zhou S, Lim C, Wong YY, Qu DL, Pan FT, Yang GM. Supporting the patients with advanced cancer and their family caregivers: what are their palliative care needs? BMC Cancer 2020; 20:768. [PMID: 32799834 PMCID: PMC7429720 DOI: 10.1186/s12885-020-07239-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 07/29/2020] [Indexed: 01/08/2023] Open
Abstract
Background The impact and consequences of cancer on the patients and their family caregivers (FCs) are closely intertwined. Caregivers’ burdens can be increased due to the patients’ unmet needs and unresolved problems. Additionally, the caregivers’ unmet needs may adversely affect their own well-being and the patients’ health outcomes. This study aims to determine the palliative care needs and the factors associated with these needs in patients with advanced solid cancer and their FCs. Methods In a cross-sectional survey, 599 patients with advanced solid tumours and 599 FCs were recruited from the largest ambulatory cancer centre and the inpatient ward of the largest hospital in Singapore. Determinants of patients’ and FCs’ needs were assessed by the Comprehensive Needs Assessment Tool (CNAT) and CNAT-C respectively. Clinical characteristics of patients were obtained from medical records. Results The FCs (median age 51 years) were younger than the patients (median age 62 years), and were mostly female (62.6%) whereas the gender distribution of patients was quite balanced (49.2% male and 50.8% female). Both patients and FCs had “information” and “practical support” in their top three domains of palliative care needs. The second highest domain of needs was “psychological problems” (16.4 ± 21.5) in patients and “health-care staff” (23.4 ± 26.5) in FCs. The item that had the highest need score in “information” domain for both patients and FCs was “financial support for patients, either from government and/ or private organizations”. Under clinical setting, the inpatients (19.2 ± 16.4) and their FCs (26.0 ± 19.0) tend to have higher needs than the outpatients (10.5 ± 12.1) and their FCs (14.7 ± 14.3). In terms of palliative care, higher total CNAT score was observed in both patients (16.6 ± 12.9 versus 13.3 ± 15.2) and their FCs (25.1 ± 18.6 versus 17.7 ± 16.7) who received palliative care. In terms of patients’ KPS scores, patients with lower KPS scores tend to have higher needs. Conclusion Overall, the findings confirm that patients with advanced cancer and their FCs have many palliative care needs irrespective of their clinical settings. Initiatives and interventions for the development of a comprehensive support system for both patients with advanced cancer and their FCs are warranted and can be derived from these findings.
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Affiliation(s)
- Gek Phin Chua
- CEIS (Research & Data), National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore, 169610, Singapore.
| | | | - Alethlea Chung Pheng Yee
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Patricia Soek Hui Neo
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Siqin Zhou
- Division of Clinical Trails and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Cindy Lim
- Division of Clinical Trails and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Yin Yee Wong
- Quality department, Assisi Hospice, Singapore, Singapore
| | - Debra Limin Qu
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Grace Meijuan Yang
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
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Shi Z, Lim C, Tran V, Cui K, Zhao K, Chen X. Single-cyst transcriptome analysis of Drosophila male germline stem cell lineage. Development 2020; 147:dev.184259. [PMID: 32122991 DOI: 10.1242/dev.184259] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/23/2020] [Indexed: 12/31/2022]
Abstract
The Drosophila male germline stem cell (GSC) lineage provides a great model to understand stem cell maintenance, proliferation, differentiation and dedifferentiation. Here, we use the Drosophila GSC lineage to systematically analyze the transcriptome of discrete but continuously differentiating germline cysts. We first isolated single cysts at each recognizable stage from wild-type testes, which were subsequently applied for RNA-seq analyses. Our data delineate a high-resolution transcriptome atlas in the entire male GSC lineage: the most dramatic switch occurs from early to late spermatocyte, followed by the change from the mitotic spermatogonia to early meiotic spermatocyte. By contrast, the transit-amplifying spermatogonia cysts display similar transcriptomes, suggesting common molecular features among these stages, which may underlie their similar behavior during both differentiation and dedifferentiation processes. Finally, distinct differentiating germ cell cyst samples do not exhibit obvious dosage compensation of X-chromosomal genes, even considering the paucity of X-chromosomal gene expression during meiosis, which is different from somatic cells. Together, our single cyst-resolution, genome-wide transcriptional profile analyses provide an unprecedented resource to understand many questions in both germ cell biology and stem cell biology fields.
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Affiliation(s)
- Zhen Shi
- Department of Biology, The Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218, USA
| | - Cindy Lim
- Department of Biology, The Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218, USA
| | - Vuong Tran
- Department of Biology, The Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218, USA
| | - Kairong Cui
- Systems Biology Center (SBC), Division of Intramural Research (DIR), National Heart, Lung and Blood Institute, National Institutes of Health, 10 Center Drive, MSC 1674, Building 10, Room 7B05, Bethesda, MD 20892, USA
| | - Keji Zhao
- Systems Biology Center (SBC), Division of Intramural Research (DIR), National Heart, Lung and Blood Institute, National Institutes of Health, 10 Center Drive, MSC 1674, Building 10, Room 7B05, Bethesda, MD 20892, USA
| | - Xin Chen
- Department of Biology, The Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218, USA
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Chong ST, Tan KM, Kok CYL, Guan SP, Lai SH, Lim C, Hu J, Sturgis C, Eng C, Lam PYP, Ngeow J. IL13RA2 Is Differentially Regulated in Papillary Thyroid Carcinoma vs Follicular Thyroid Carcinoma. J Clin Endocrinol Metab 2019; 104:5573-5584. [PMID: 31290966 DOI: 10.1210/jc.2019-00040] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 07/03/2019] [Indexed: 12/19/2022]
Abstract
CONTEXT The interleukin-13 receptor alpha2 (IL13RA2), which is known to be overexpressed in glioblastoma multiforme, plays a role in various cellular processes such as cell migration that may contribute to tumor progression. Studies have attributed IL13RA2 to invasion and metastasis in cancers of the ovary, breast, and pancreas, but the pathological role of IL13RA2 in thyroid cancer is still unclear. OBJECTIVE This study aims to evaluate IL13RA2 expression in thyroid carcinomas and to examine the role of IL13RA2 in the progression of papillary thyroid carcinoma (PTC). METHODS IL13RA2 immunochemical staining was performed on tissue microarrays of 137 thyroid carcinomas from patients, and the differential profile of IL13RA2 was validated in thyroid cancer cell lines. In PTC cell lines, we functionally assessed the effects of IL13RA2 underexpression and overexpression on cell proliferation, cell migration, and epithelial-mesenchymal transition (EMT) by using CCK-8, transwell migration assay, quantitative RT-PCR, and Western blot analysis. RESULTS IL13RA2 expression was significantly correlated with advanced tumor T stage (pT3 or pT4; P = 0.001) and regional lymph node metastasis (pN1; P < 0.001). The staining scores of IL13RA2 were significantly higher in PTC compared with follicular subtypes (P < 0.001) and correlated with advanced tumor stage among PTC samples (pT3 or pT4; P = 0.028). Knockdown of IL13RA2 in B-CPAP cells significantly reduced cell viability, cell migration, and EMT markers including N-cadherin, Vimentin, and Snail. Exogenous overexpression of IL13RA2 in K1 cells increased cell migration and EMT, although cell proliferation was not affected. CONCLUSION IL13RA2 is differentially regulated in PTC and is involved in cell migration by enhancing EMT.
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Affiliation(s)
- Siao Ting Chong
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore
| | - Khee Ming Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Catherine Y L Kok
- Cellular and Molecular Research Division, National Cancer Centre, Singapore
| | - Shou Ping Guan
- Cellular and Molecular Research Division, National Cancer Centre, Singapore
| | - Siang Hui Lai
- Department of Pathology, Singapore General Hospital, Singapore
| | - Cindy Lim
- Department of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore
| | - Jiancheng Hu
- Cellular and Molecular Research Division, National Cancer Centre, Singapore
| | - Charles Sturgis
- Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Charis Eng
- Genomic Medicine Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Genetics and Genome Sciences, and Germline High Risk Cancer Focus Group, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Paula Y P Lam
- Cellular and Molecular Research Division, National Cancer Centre, Singapore
| | - Joanne Ngeow
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Institute of Molecular and Cell Biology, Singapore
- Oncology Academic Clinical Program, Duke-NUS Medical School Singapore, Singapore
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Tan A, Seet A, Choo S, Tai D, Lam Y, Teng W, Lim C, Lim K, Ng M. A phase I study of varlitinib (VAR; ASLAN001) an oral pan-HER tyrosine kinase inhibitor (TKI) combined with mFOLFIRI chemotherapy in advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chong ST, Kok CY, Tan KM, Guan SP, Lai SH, Lim C, Hu J, Sturgis C, Eng C, Lam PY, Ngeow J. Abstract 2780: IL13RA2 is differentially regulated in papillary thyroid carcinoma versus follicular thyroid carcinoma. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-2780] [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
The interleukin-13 receptor alpha2 (IL13RA2), which is known to overexpressed in glioblastoma multiforme, plays a role in various cellular processes such as cell migration that may contribute to tumor progression. Studies have attributed IL13RA2 to invasion and metastasis in cancers of the ovary, breast, and pancreas but the pathological role of IL13RA2 in thyroid cancer is still unclear. This study aims to evaluate the expression of IL13RA2 in thyroid carcinomas and examine the role of IL13RA2 in progression of papillary thyroid cancer (PTC). We performed IL13RA2 immunochemical staining on tissue microarrays of 137 thyroid carcinomas and observed that IL13RA2 expression was significantly correlated with advanced tumor stage (pT3 / pT4; p=0.001) and regional lymph node metastasis (pN1; p<0.001). Moreover, the staining scores of IL13RA2 were significantly higher in PTC compared to follicular and anaplastic subtypes (p<0.02) and correlated with advanced tumor stage amongst PTC samples (pT3 / pT4; p=0.028). This differential profile of IL13RA2 in PTC was further validated in thyroid cancer cell lines overexpressing IL13RA2 to assay the effects on cell proliferation, cell migration and epithelial-mesenchymal transition (EMT) using CCK-8, transwell migration assay, qRT-PCR and western blot analyses. Knockdown of IL13RA2 in the PTC subtype B-CPAP cell line showed significantly reduced cell viability, cell migration and EMT markers including N-cadherin, Vimentin and Snail. Exogenous overexpression of IL13RA2 in another PTC cell line, K1 increased cell migration and EMT although cell proliferation was not affected. In summary, we demonstrated that IL13RA2 is differentially regulated in PTC and is involved in cell migration by enhancing EMT. The underlying molecular mechanisms on how IL13RA2 drives progression of thyroid cancer remains to be further investigated.
Citation Format: Siao Ting Chong, Catherine Y. Kok, Khee Ming Tan, Shou Ping Guan, Siang Hui Lai, Cindy Lim, Jiancheng Hu, Charles Sturgis, Charis Eng, Paula Y. Lam, Joanne Ngeow. IL13RA2 is differentially regulated in papillary thyroid carcinoma versus follicular thyroid carcinoma [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 2780.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Charis Eng
- 4Case Western Reserve University School of Medicine, Cleveland, OH
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Yu JSL, Palano G, Lim C, Moggio A, Drowley L, Plowright AT, Bohlooly‐Y M, Rosen BS, Hansson EM, Wang Q, Yusa K. CRISPR-Knockout Screen Identifies Dmap1 as a Regulator of Chemically Induced Reprogramming and Differentiation of Cardiac Progenitors. Stem Cells 2019; 37:958-972. [PMID: 30932271 PMCID: PMC6767549 DOI: 10.1002/stem.3012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/11/2019] [Accepted: 03/02/2019] [Indexed: 12/12/2022]
Abstract
Direct in vivo reprogramming of cardiac fibroblasts into myocytes is an attractive therapeutic intervention in resolving myogenic deterioration. Current transgene-dependent approaches can restore cardiac function, but dependence on retroviral delivery and persistent retention of transgenic sequences are significant therapeutic hurdles. Chemical reprogramming has been established as a legitimate method to generate functional cell types, including those of the cardiac lineage. Here, we have extended this approach to generate progenitor cells that can differentiate into endothelial cells and cardiomyocytes using a single inhibitor protocol. Depletion of terminally differentiated cells and enrichment for proliferative cells result in a second expandable progenitor population that can robustly give rise to myofibroblasts and smooth muscle. Deployment of a genome-wide knockout screen with clustered regularly interspaced short palindromic repeats-guide RNA library to identify novel mediators that regulate the reprogramming revealed the involvement of DNA methyltransferase 1-associated protein 1 (Dmap1). Loss of Dmap1 reduced promoter methylation, increased the expression of Nkx2-5, and enhanced the retention of self-renewal, although further differentiation is inhibited because of the sustained expression of Cdh1. Our results hence establish Dmap1 as a modulator of cardiac reprogramming and myocytic induction. Stem Cells 2019;37:958-972.
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MESH Headings
- Animals
- Benzamides/pharmacology
- CRISPR-Cas Systems
- Cadherins/genetics
- Cadherins/metabolism
- Cell Differentiation/drug effects
- Cell Proliferation/drug effects
- Cellular Reprogramming/drug effects
- Cellular Reprogramming/genetics
- Dioxoles/pharmacology
- Fibroblasts/cytology
- Fibroblasts/drug effects
- Fibroblasts/metabolism
- Gene Editing/methods
- Homeobox Protein Nkx-2.5/genetics
- Homeobox Protein Nkx-2.5/metabolism
- Humans
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Muscle, Smooth/cytology
- Muscle, Smooth/metabolism
- Myocardium/cytology
- Myocardium/metabolism
- Myocytes, Cardiac/cytology
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Primary Cell Culture
- Pyrazoles/pharmacology
- Pyridines/pharmacology
- RNA, Guide, CRISPR-Cas Systems/genetics
- RNA, Guide, CRISPR-Cas Systems/metabolism
- Repressor Proteins/genetics
- Repressor Proteins/metabolism
- Stem Cells/cytology
- Stem Cells/drug effects
- Stem Cells/metabolism
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Affiliation(s)
- Jason S. L. Yu
- Stem Cell Genetics, Wellcome Sanger InstituteHinxton, CambridgeUnited Kingdom
- Department of Cell BiologyThe Francis Crick InstituteLondonUnited Kingdom
| | - Giorgia Palano
- KI/AZ Integrated CardioMetabolic Center (ICMC), Department of MedicineKarolinska InstitutetHuddingeSweden
| | - Cindy Lim
- Bioscience Heart Failure, Cardiovascular, Renal and Metabolism, IMED Biotech UnitAstraZenecaGothenburgSweden
| | - Aldo Moggio
- KI/AZ Integrated CardioMetabolic Center (ICMC), Department of MedicineKarolinska InstitutetHuddingeSweden
| | - Lauren Drowley
- Bioscience Heart Failure, Cardiovascular, Renal and Metabolism, IMED Biotech UnitAstraZenecaGothenburgSweden
| | - Alleyn T. Plowright
- Medicinal Chemistry, Cardiovascular, Renal and Metabolism, IMED Biotech UnitAstraZenecaGothenburgSweden
| | | | - Barry S. Rosen
- Discovery Sciences, IMED Biotech UnitAstraZenecaGothenburgSweden
| | - Emil M. Hansson
- KI/AZ Integrated CardioMetabolic Center (ICMC), Department of MedicineKarolinska InstitutetHuddingeSweden
| | - Qing‐Dong Wang
- Bioscience Heart Failure, Cardiovascular, Renal and Metabolism, IMED Biotech UnitAstraZenecaGothenburgSweden
| | - Kosuke Yusa
- Stem Cell Genetics, Wellcome Sanger InstituteHinxton, CambridgeUnited Kingdom
- Stem Cell GeneticsInstitute for Frontier Life and Medical Sciences, Kyoto UniversityKyotoJapan
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Lim C, Blaszczyk E, Riazy L, Funk S, Schueler J, Schmacht L, Doganguezel S, Von Knobelsdorff-Brenkenhoff F, Schulz-Menger J. P438Myocardial strain assessed by CMR feature tracking in healthy subjects - normal values and influence of different postprocessing softwares. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Lim
- Charité - Campus Berlin Buch (CBB), Working Group on Cardiac MRI, Berlin, Germany
| | - E Blaszczyk
- Charité - Campus Berlin Buch (CBB), Working Group on Cardiac MRI, Berlin, Germany
| | - L Riazy
- Max Delbruck Center for Molecular Medicine, Berlin Ultrahigh Field Facility (B.U.F.F.), Berlin, Germany
| | - S Funk
- Charité - Campus Berlin Buch (CBB), Working Group on Cardiac MRI, Berlin, Germany
| | - J Schueler
- Charit?? - Universit??tsmedizin Berlin, Berlin, Germany
| | - L Schmacht
- Charité - Campus Berlin Buch (CBB), Working Group on Cardiac MRI, Berlin, Germany
| | - S Doganguezel
- Charité - Campus Berlin Buch (CBB), Working Group on Cardiac MRI, Berlin, Germany
| | | | - J Schulz-Menger
- Charité - Campus Berlin Buch (CBB), Working Group on Cardiac MRI, Berlin, Germany
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Saw S, Lim J, Lim SH, Wong M, Lim C, Yap YS. Patterns of relapse after neoadjuvant chemotherapy in breast cancer: implications for surveillance in clinical practice. Breast Cancer Res Treat 2019; 177:197-206. [PMID: 31147984 DOI: 10.1007/s10549-019-05290-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/20/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to identify patterns of relapse after neoadjuvant chemotherapy (NAC) for breast cancer to refine follow-up recommendations. METHODS Retrospective analysis on 523 breast cancer patients treated with NAC at two public hospitals in Singapore between 2000 and 2014. RESULTS Majority of patients (71.9%) had locally advanced disease. Median follow-up was 55 months. 5-year recurrence rate was significantly higher in triple negative breast cancer (TNBC) than non-TNBC subtypes (38.4% vs. 29.5%; p = 0.042); 85% of recurrences involved distant sites. Among TNBC and HR (hormone receptor)-/HER2+ subtypes, 97.0% and 95.0% of relapses occurred within 3 years from diagnosis respectively while 10.6% of relapses among HR+ subgroup occurred beyond 5 years. Recurrence risk in high-grade tumours decreased with time. Stage III at diagnosis (hazard ratio = 2.94; p < 0.001), grade 3 tumours (hazard ratio = 2.87; p = 0.018), not achieving pathologic complete response (pCR) (hazard ratio = 8.77; p = 0.003) and not receiving adjuvant radiotherapy (hazard ratio = 3.19; p < 0.001) were independent predictors of inferior recurrence-free survival. Serum CA 15-3 was raised in 49% of patients upon relapse; it correlated with inferior post-relapse survival (median 11 months vs. 22 months; p = 0.019). CONCLUSIONS While more intensive follow-up during the first 3 years may be required for patients who do not achieve pCR, especially those with TNBC and HR-/HER2+ tumours, the benefit from blood tests such as CA 15-3 appears limited, and the benefit from intensification of surveillance remains to be addressed in prospective studies on high-risk patients.
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Affiliation(s)
- Stephanie Saw
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
| | - John Lim
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
| | - Swee Ho Lim
- Breast Department, KK Women's and Children's Hospital, Singapore, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Mabel Wong
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
| | - Cindy Lim
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
| | - Yoon Sim Yap
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore.
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Duddy JC, O’Sullivan MGJ, Lim C, Kaar GF. P110 External ventricular drain-related infections: a single centre study. J Neurol Neurosurg Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesTo quantify the External Ventricular Drain-related infection (ERI) rate in a one year period at Cork University Hospital, and to identify any risk factors for infection.DesignA retrospective audit of all External Ventricular Drains (EVDs) inserted in a one year period.SubjectsAll patients who had an EVD inserted between February 2017 and February 2018.MethodsPatients were identified from operating theatre logbooks. All relevant data was obtained from a retrospective review of medical and operative records. ERI was defined as evidence of positive CSF culture.Results41 EVDs were inserted in a total of 30 patients during the study period. The average age was 52.9 years. 46.6% of patients were female. The average length of EVD insertion was 8.85 days. The most common reason for EVD insertion was subarachnoid haemorrhage (31.7%) followed by supratentorial tumour (24.4%). 78% of EVDs were antibiotic-impregnated. Average EVD sampling rate was 0.7. ERI rate was 1/41 (2.4%). The infection occurred in a patient who had an EVD inserted for haemorrhage secondary to an AVM which had remained in situ for 13 days. The patient subsequently developed problems with repeated shunt infections resulting in a nine-month hospital stay.ConclusionsThe ERI rate in our patient cohort was 2.4%. We recommend using a strict EVD sampling protocol to minimise manipulation of EVDs and where possible to limit the length of time an EVD remains in situ. EVD-related infections can result in lengthy hospital stays and increased healthcare costs.
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Sharifi F, Zhou R, Lim C, Jash A, Abbaspourrad A, Rizvi SS. Generation of liposomes using a supercritical carbon dioxide eductor vacuum system: Optimization of process variables. J CO2 UTIL 2019. [DOI: 10.1016/j.jcou.2018.12.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tan WL, Ng QS, Lim C, Tan EH, Toh CK, Ang MK, Kanesvaran R, Jain A, Tan DSW, Lim DWT. Correction to: Influence of afatinib dose on outcomes of advanced EGFR-mutant NSCLC patients with brain metastases. BMC Cancer 2018; 18:1288. [PMID: 30583726 PMCID: PMC6304773 DOI: 10.1186/s12885-018-5215-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- Wan-Ling Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Quan Sing Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Cindy Lim
- Clinical Trials & Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Eng Huat Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Chee Keong Toh
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Mei-Kim Ang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Ravindran Kanesvaran
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Amit Jain
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Daniel S W Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Genome Institute of Singapore, A*STAR, Singapore, Singapore
| | - Darren Wan-Teck Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore. .,Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore.
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Tan WL, Ng QS, Lim C, Tan EH, Toh CK, Ang MK, Kanesvaran R, Jain A, Tan DSW, Lim DWT. Influence of afatinib dose on outcomes of advanced EGFR-mutant NSCLC patients with brain metastases. BMC Cancer 2018; 18:1198. [PMID: 30509246 PMCID: PMC6276185 DOI: 10.1186/s12885-018-5110-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 08/30/2018] [Accepted: 11/20/2018] [Indexed: 12/12/2022] Open
Abstract
Background Afatinib is an oral irreversible epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitor (TKI) indicated in first-line treatment of advanced EGFR-mutant (EGFRm+) non-small cell lung cancer (NSCLC). Dose dependent side effects can limit drug exposure, which may impact on extracranial and central nervous system (CNS) disease control. Methods We performed a retrospective study of 125 patients diagnosed with advanced EGFRm+ NSCLC treated with first-line afatinib at a tertiary Asian cancer center, exploring clinicopathological factors that may influence survival outcomes. Median progression free survival (PFS) was estimated using the Kaplan-Meier method. Comparison of PFS between subgroups of patients was done using log-rank tests and Cox proportional hazards models. Results Out of 125 patients, 62 (49.6%) started on 40 mg once daily (OD) afatinib, 61 (48.8%) on 30 mg OD and 1 (0.8%) on 20 mg OD. After median follow-up of 13.8 months from afatinib initiation, the observed response rate was 70.4% and median PFS 11.9 months (95% CI 10.3–19.3). 42 (33.6%) patients had baseline brain metastases (BM) and PFS of those who started on 40 mg OD (n = 17) vs. 30 mg OD (n = 25) was 13.3 months vs. 5.3 months (HR 0.39, 95% CI 0.15–0.99). BM+ patients who started on 40 mg had similar PFS to patients with no BM (13.3 months vs. 15.0 months; HR 0.79, 95% CI 0.34–1.80). Conclusion In patients with advanced EGFRm+ NSCLC with BM+, initiating patients on afatinib 40 mg OD was associated with improved PFS compared to 30 mg OD, underscoring the potential importance of dose intensity in control of CNS disease.
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Affiliation(s)
- Wan-Ling Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Quan Sing Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Cindy Lim
- Clinical Trials & Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Eng Huat Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Chee Keong Toh
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Mei-Kim Ang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Ravindran Kanesvaran
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Amit Jain
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Daniel S W Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Genome Institute of Singapore, A*STAR, Singapore, Singapore
| | - Darren Wan-Teck Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore. .,Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore.
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Vilkins A, Till S, Lim C, Howard R, Sahara M, Onishchenko R, Brummett C, Waljee J, As-Sanie S. Reduction in Opioid Prescribing through Implementation of Shared Decision Making. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Velikova G, Williams LJ, Willis S, Dixon JM, Loncaster J, Hatton M, Clarke J, Kunkler IH, Russell NS, Alhasso A, Adamson D, Algurafi H, Allerton R, Anandadas C, Bahl A, Barraclough L, Barrett-Lee P, Barthakur U, Bedi C, Beresford M, Bishop J, Blackman G, Bliss P, Bloomfield D, Blunt M, Branson T, Brazil L, Brunt A, Chakrabarti A, Chittalie A, Churn M, Clarke J, Cleator S, Crellin P, Danwata F, De-Silva-Minor S, Dhadda A, Eicholz A, Fernando I, Forrest J, Fraser J, Geropantas K, Goodman A, Grieve R, Griffin M, Hadaki M, Hall A, Hatton M, Hicks J, Hignett S, Hogg M, Jyothirmayi R, Khan M, Kumar S, Lawton P, Lee D, Lewinski C, Lim C, Locke I, Loncaster J, Lumsden G, Lupton S, Magee B, Marshall J, Masinghe S, McGregor C, McLennan M, Memtsa P, Milanovic D, Misra V, Mithal N, Mukesh MB, Neal A, Needleman S, Persic M, Quigley M, Raj S, Riddle P, Ritchie D, Roberts F, Robson P, Roe H, Rolles M, Shah N, Sharma R, Sherwin E, Simmonds P, Skailles G, Skaria S, Soe W, Sripadam R, Stevens A, Stockdale A, Storey N, Storey N, Syndikus I, Thorp N, Thorp N, Upadhyay S, Varughese M, Walji N, Welch R, Wells T, Wolstenholme V, Wolstenholme V, Woodings P, Yuille F. Quality of life after postmastectomy radiotherapy in patients with intermediate-risk breast cancer (SUPREMO): 2-year follow-up results of a randomised controlled trial. Lancet Oncol 2018; 19:1516-1529. [DOI: 10.1016/s1470-2045(18)30515-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/29/2018] [Accepted: 07/02/2018] [Indexed: 11/12/2022]
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Low K, Singh SJ, Hashim HM, Lim C, Junazli N, Choo S, Munisamy M. Prevalence and Characteristics of Smoking Among School-Going Adolescents in Kuala Lumpur, Malaysia. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.47600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: According to the World Health Organization (WHO) (2014), noncommunicable diseases (NCDs) such as cancer, cardiovascular disease and respiratory disease account for a majority of premature deaths in the Malaysian population. Tobacco smoking remains a leading risk factor for these diseases. Although there have been previous population-level studies which have highlighted adolescent smokers in Malaysia, little has been done to specifically ascertain smoking prevalence within a school-going population using objective measurement tools. Aim: This study aimed to identify the prevalence of school-going adolescent smokers in Kuala Lumpur via an objective measurement - expired carbon monoxide (CO) in parts per million (ppm). Methods: This study was a cross-sectional study that involved 2,679 high school-going adolescents aged between 13 to 18 years old in Kuala Lumpur, Malaysia. The level of exhaled CO (Smokerlyzer test) of all the participants was measured. Participants were also administered with a survey conducted right after the Smokerlyzer test to determine i) whether they smoked or not; ii) type of tobacco products used if smoked; iii) vaping or shisha usage; and iv) exposure to secondhand smoke. The categorization of smoking status was based on CO-ppm reading: ≤ 3 ppm (nonsmoker); 3 < ppm ≤ 6 (light smoker or nonsmoker breathing in poor air quality or passive smoke inhalation); ≥ 7 ppm (regular smoker with higher levels of CO in blood). Descriptive analysis was conducted to determine the demographics of the study population. Inferential analysis was carried out utilizing χ2 tests or Student t-tests to test associations between smoking status and other independent variables. One-way ANOVA test was conducted to compare the differences in CO-ppm readings. Results: The mean age of the adolescents (n=2,679) was 14.5 ± 1.2 years old (median: 14) and 55.1% were male. Interestingly, vaping was the most commonly used method of tobacco use among the studied adolescents, regardless of gender, followed by cigarettes and shisha. The mean CO-ppm reading for male adolescents was significantly higher than female adolescents. Passive smoke inhalation (exposure to secondhand smoke) was significantly associated with higher readings of CO-ppm. A significant association was determined between status of exposure to secondhand smoke and a history of usage of any form of tobacco products. Conclusion: The prevalence of smoking adolescents, regardless of gender, in Kuala Lumpur remains at a worrying state. Objective measurements such as Smokerlyzer test can be coupled with self-reported questionnaire in targeting adolescent smokers within a structured setting such as a school and can help form part of an effective school-based smoking cessation intervention program targeting adolescents in Malaysia. This is in line with efforts to make Malaysia a smoke-free nation by 2045.
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Affiliation(s)
- K.Y. Low
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - S.J. Jag Singh
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | | | - C. Lim
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - N.I. Junazli
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - S.L. Choo
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - M. Munisamy
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
- Chulalongkorn University, College of Public Health Sciences, Bangkok, Thailand
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Choo S, Kamaruddin D, Sabu S, Lim C, b. N, Low K, Hashim HM, Munisamy M. Losing Themselves From Following Up: Barriers to Accessing Further Clinical Investigations for Women With Abnormal Clinical Breast Examination (CBE) Findings in Klang Valley, Malaysia. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.42000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Clinical breast examination (CBE) is one of the most accessible screening methods for breast cancer and widely used in the Malaysian public health system due to the wide availability of trained healthcare personnel and low costs; especially in government hospitals. However, discovery of an abnormal finding from the CBE does not necessarily translate into action for further clinical investigations. An understanding of the patients' motivations in decision making, which causes them to ignore the need for further clinical investigations despite abnormal findings in CBEs may be an important element to improve holistic cancer prevention efforts; of which early detection is a key strategy. Aim: The aim of this study was to investigate the barriers for women to receive follow-up care upon obtaining abnormal results for CBE. Methods: The National Cancer Society of Malaysia has an active ongoing public outreach program in which trained healthcare personnel conduct CBEs at various screening campaigns throughout the Klang Valley with a total of 1017 women screened in 2017. Women who were screened and found to have an abnormal finding from the CBE were referred for further investigations at a center of their choice. Women found to have an abnormal CBE finding were reached via a phone call to determine whether they had proceeded to i) get an appointment for further clinical examination; or ii) had already undergone a further clinical examination. Those who had done neither were interviewed via phone to determine their reasons for not proceeding with further clinical investigations despite an abnormal CBE finding. Results: Out of the 1017 women screened, 38 were found to have an abnormal CBE finding. Of them, 16 women had not sought further investigations. Qualitative interviews revealed that there strong issues that posed barriers to these women pursuing further investigations. These barriers included a lack of knowledge and understanding about breast cancer or rationale of undergoing a CBE; a lack of urgency pertaining to CBE results and feeling of embarrassment engaging with family members on facilitating attendance to the investigation. Conclusion: Significant barriers remain which deter women who have abnormal CBE findings from pursuing further clinical investigations which ultimately reduces the effectiveness of current breast cancer screening strategies. These findings may prove to be important for designing effective methods to encourage confirmatory clinical examination among those already found to have abnormal findings from tests such as the CBE.
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Affiliation(s)
- S.L. Choo
- National Cancer Society, Kuala Lumpur, Malaysia
| | | | - S.S. Sabu
- National Cancer Society, Kuala Lumpur, Malaysia
| | - C. Lim
- National Cancer Society, Kuala Lumpur, Malaysia
| | - N.I. b.
- National Cancer Society, Kuala Lumpur, Malaysia
| | - K.Y. Low
- National Cancer Society, Kuala Lumpur, Malaysia
| | | | - M. Munisamy
- National Cancer Society, Kuala Lumpur, Malaysia
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Muniasamy M, Hashim HM, Lim C, Junazli NB, Choo S, Low K. Would You Like A Free Mammogram? Effectiveness of Utilizing WhatsApp As a Social Marketing Tool in Improving Uptake for a Free Mammography Service in Kuala Lumpur Malaysia. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.29100] [Citation(s) in RCA: 2] [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: 11/20/2022] Open
Abstract
Background: Social media and messaging services are increasingly targeted by health providers as an avenue to spread health messages, increase awareness and also for social marketing. WhatsApp is a social media application which has wide penetration in Malaysia, with more than half the population relying on WhatsApp for news. Aim: This study aimed to determine the effectiveness of WhatsApp as a social marketing tool to increase uptake for a free mammography service for underprivileged women. Methods: This was a randomized clinical trial conducted in Kuala Lumpur, Malaysia. Individuals from the National Cancer Society of Malaysia database were randomized into 1 of 3 arms receiving a WhatsApp message; i) a poster of a free mammography service for underprivileged women; ii) a poster of the free mammography service for underprivileged women with a personal message from the Director of the National Cancer Society of Malaysia; and iii) the poster, personal message from the director and a specific Saturday screening date with the exhortation that there were only 40 places available for that date on a first-come first-serve basis. The outcomes of the trial were i) number of women who returned a call or WhatsApp message to the designated numbers; ii) number of women who booked an appointment for the mammography service; and iii) numbers of women who attended the appointment. Results: The number of calls and inquiries to designated numbers increased by more than 200% as a result of the WhatsApp messages. There were statistically significant differences between the three delivery arms; with the highest percentages of women booking and attending their mammography appointments coming from the arm which had a designated screening date with limited availability. Conclusion: WhatsApp was highly effective at increasing community penetration and marketing a free mammography service for underprivileged women in Kuala Lumpur. Messages with an appeal from a personage and with a specific date of “expiry” were more effective at getting the targeted group to avail themselves of the service.
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Affiliation(s)
- M. Muniasamy
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | | | - C. Lim
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | | | - S.L. Choo
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - K.Y. Low
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
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Junazli N, Kamaruddin D, Sabu S, Ahmad ZB, Hashim HM, Lim C, Choo S, Low K, Munisamy M. Factors Associated With an Abnormal Mammogram Finding in Women Undergoing Screening in Kuala Lumpur, Malaysia. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.47500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Breast cancer is the most common cancer among Malaysian women, with a rising incidence from 16.5% in 2006%–17.7% in 2011. One of the key strategies in breast cancer control is early screening; of which mammography is a highly accurate tool, having been shown to reduce the number of mortality rates due to breast cancer up to 30%. However, mammography is often not as widely available in Malaysia; and in many local settings, healthcare providers have to limit screenings to only particular groups such as those with abnormal clinical breast examinations due to limited resources. Knowledge of other predictive factors may assist in further decision-making to prioritize patients for screening mammography in a low-resource setting. Aim: This study aimed to determine such predictive factors for abnormal mammogram findings among women who underwent mammography examination at a center in Kuala Lumpur, Malaysia. Methods: This was a cross-sectional study of women (n = 5491) who underwent a three-dimensional tomosynthesis mammography procedure at the Cancer and Health Screening Clinic, National Cancer Society of Malaysia (NCSM) in Kuala Lumpur, from Jan 2016 until Dec 2017 (2 years). Patients were surveyed on: i) age, ii) ethnicity, iii) family history of breast or any cancers, if any, iv) reproductive history (age of menarche, age of first delivery, age of menopause); and v) history of postmenopausal estrogen and hormone replacement therapy (HRT). Bivariate analysis was conducted by using χ2 tests in determining associations between variables and a multiple logistic regression model built to identify factors which were predictive of an abnormal mammogram finding (BI-RADS 4 & 5). Results: From the bivariate analysis; nulliparous status ( P = 0.02), a family history of breast cancer ( P = 0.04), and a history of postmenopausal hormone replacement therapy (HRT) ( P = 0.01) were determined to significantly associated with an abnormal mammogram finding. There were also significant ethnic differences between women who had abnormal mammogram findings; with Chinese women having highest odds of this (OR:3.22; 95% CI 1.86-5.74). Women within the age group of 45-54 (OR:1.84, 95% CI 1.19-3.12), a family history of breast cancer (OR 2.03, 95% CI 1.31-3.27) or any cancer (OR 1.56, 95% CI 1.06-2.94), age of menopause (OR 2.86; 95% CI 1.43-4.02) and age of first delivery above 30 (OR 1.73, 95% CI 1.26-3.45) were significantly associated with abnormal mammogram findings. Conclusion: Factors which predict abnormal mammogram findings in a Malaysian setting can be used as baseline evidence to formulate criteria which can be used to carry out targeted screening programs or even as cutoff criteria for focusing screening resources in resource-limited settings. This data may be of benefit in aiding healthcare providers in provisioning of services at a macro level as well as for frontline healthcare personnel in helping them profile women who should be focused on to be screened for the disease.
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Affiliation(s)
- N.I. Junazli
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - D. Kamaruddin
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - S.S. Sabu
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | | | | | - C. Lim
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - S.L. Choo
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - K.Y. Low
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - M. Munisamy
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
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Lim C, Ho T, Stephen M, Hashim HM, Junazli NB, Choo S, Low K, Muniasamy M. Hi, I Have Cancer, What Can I Do? An Analysis of Caller Characteristics of a Malaysian Cancer-Specific Information Hotline. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.28800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Despite the advancement of technology in information dissemination, patients and caregivers often cite difficulties in getting the right cancer information, care and psychosocial support. It is crucial to optimize the availability of cancer information to increase knowledge among the public and for better decision making by patients and their families. In line with these strategies, the National Cancer Society of Malaysia (NCSM) established a toll-free, Cancer Information Service Helpline (CIS) in 2016 to act as a tool for provision of cancer-related information and psychosocial support. Aim: This study aimed to analyze caller characteristics and trends of calls received by the CIS between January 1 to December 31, 2017. Methods: A cross sectional study was conducted on the CIS call logs for the ascertained study period. Descriptive analysis was carried out to determine characteristics of callers including i) socio-demographics; ii) geographical location; iii) caller's cancer disease status or relationship with cancer patient and iv) reason(s) for calling the helpline. ANOVA was used to determine possible associations between the different variables and reasons for calling the helpline. Results: A total of 1613 calls were received during the study period. Majority of the callers were female (72%) and almost half of the callers were healthcare professionals (43%). 36% of the calls were inquiries on availability of screening services and this was significantly associated with calls from healthcare professionals ( P = 0.04). Callers of Malay ethnicity ( P = 0.03) and newly diagnosed cancer patients ( P = 0.001) were significantly associated with calling to seek for financial help. Conclusion: While being used as a source of some aspects of information pertaining to cancer, the CIS's capabilities in providing psychosocial support is not being maximized as yet. These results provide insight that targeted promotional efforts to raise awareness about CIS's psychosocial support capabilities is required to further maximize its potential among Malaysian patients, families and the public at large.
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Affiliation(s)
- C. Lim
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - T.L. Ho
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - M.T. Stephen
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | | | | | - S.L. Choo
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - K.Y. Low
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
| | - M. Muniasamy
- National Cancer Society of Malaysia, Kuala Lumpur, Malaysia
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