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Spears BM, Harpham Q, Brown E, Barnett CL, Barwell L, Collell MR, Davison M, Dixon H, Elliott JA, Garbutt A, Hazlewood C, Hofmann B, Lanyon J, Lofts S, MacKechnie C, Medinets S, Noble J, Ramsbottom D, Redhead JW, Riera A, Spurgeon DJ, Svendsen C, Taylor P, Thackeray SJ, Turvey K, Wood MD. A rapid environmental risk assessment of the Kakhovka Dam breach during the Ukraine conflict. Nat Ecol Evol 2024; 8:834-836. [PMID: 38499872 DOI: 10.1038/s41559-024-02373-0] [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] [Indexed: 03/20/2024]
Affiliation(s)
| | | | | | - Catherine L Barnett
- UK Centre for Ecology & Hydrology, Lancaster Environment Centre, Lancaster, UK
| | | | | | | | - Harry Dixon
- UK Centre for Ecology & Hydrology, Wallingford, UK
| | - J Alex Elliott
- UK Centre for Ecology & Hydrology, Lancaster Environment Centre, Lancaster, UK
| | - Angus Garbutt
- UK Centre for Ecology & Hydrology, Environment Centre Wales, Bangor, UK
| | | | | | | | - Stephen Lofts
- UK Centre for Ecology & Hydrology, Lancaster Environment Centre, Lancaster, UK
| | | | - Sergiy Medinets
- UK Centre for Ecology & Hydrology, Penicuik, UK
- Odesa National I.I. Mechnikov University, Odesa, Ukraine
| | | | | | | | | | | | - Claus Svendsen
- UK Centre for Ecology & Hydrology, Lancaster Environment Centre, Lancaster, UK
| | | | - Stephen J Thackeray
- UK Centre for Ecology & Hydrology, Lancaster Environment Centre, Lancaster, UK
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Kim S, Currao A, Brown E, Milberg WP, Fortier CB. Importance of validity testing in psychiatric assessment: evidence from a sample of multimorbid post-9/11 veterans. J Int Neuropsychol Soc 2024; 30:410-419. [PMID: 38014547 DOI: 10.1017/s1355617723000711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE Performance validity (PVTs) and symptom validity tests (SVTs) are necessary components of neuropsychological testing to identify suboptimal performances and response bias that may impact diagnosis and treatment. The current study examined the clinical and functional characteristics of veterans who failed PVTs and the relationship between PVT and SVT failures. METHOD Five hundred and sixteen post-9/11 veterans participated in clinical interviews, neuropsychological testing, and several validity measures. RESULTS Veterans who failed 2+ PVTs performed significantly worse than veterans who failed one PVT in verbal memory (Cohen's d = .60-.69), processing speed (Cohen's d = .68), working memory (Cohen's d = .98), and visual memory (Cohen's d = .88-1.10). Individuals with 2+ PVT failures had greater posttraumatic stress (PTS; β = 0.16; p = .0002), and worse self-reported depression (β = 0.17; p = .0001), anxiety (β = 0.15; p = .0007), sleep (β = 0.10; p = .0233), and functional outcomes (β = 0.15; p = .0009) compared to veterans who passed PVTs. 7.8% veterans failed the SVT (Validity-10; ≥19 cutoff); Multiple PVT failures were significantly associated with Validity-10 failure at the ≥19 and ≥23 cutoffs (p's < .0012). The Validity-10 had moderate correspondence in predicting 2+ PVTs failures (AUC = 0.83; 95% CI = 0.76, 0.91). CONCLUSION PVT failures are associated with psychiatric factors, but not traumatic brain injury (TBI). PVT failures predict SVT failure and vice versa. Standard care should include SVTs and PVTs in all clinical assessments, not just neuropsychological assessments, particularly in clinically complex populations.
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Affiliation(s)
- Sahra Kim
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA
| | - Alyssa Currao
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA
| | - Emma Brown
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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DeGutis J, Sullivan DR, Agnoli S, Stumps A, Logue M, Brown E, Verfaellie M, Milberg W, McGlinchey R, Esterman M. Less is more: Smaller hippocampal subfield volumes predict greater improvements in posttraumatic stress disorder symptoms over 2 years. Behav Neurosci 2024; 138:94-107. [PMID: 38661669 DOI: 10.1037/bne0000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Posttraumatic stress disorder (PTSD) is a heterogeneous disorder, and symptom severity varies over time. Neurobiological factors that predict PTSD symptoms and their chronicity remain unclear. This study investigated whether the volume of the hippocampus and its subfields, particularly cornu ammonis (CA) 1, CA3, and dentate gyrus, are associated with current PTSD symptoms and whether they predict PTSD symptom changes over 2 years. We examined clinical and structural magnetic resonance imaging measures from 252 trauma-exposed post-9/11 veterans (159 with Time 1 PTSD diagnosis) during assessments approximately 2 years apart. Automated hippocampal subfield segmentation was performed with FreeSurfer Version 7.1, producing 19 bilateral subfields. PTSD symptoms were measured at each assessment using the Clinician-Administered PTSD Scale-IV (CAPS). All models included total intracranial volume as a covariate. First, similar to previous reports, we showed that smaller overall hippocampal volume was associated with greater PTSD symptom severity at Time 1. Notably, when examining regions of interest (CA1, CA3, dentate gyrus), we found that smaller Time 1 hippocampal volumes in the bilateral CA1-body and CA2/3-body predicted decreased PTSD symptom severity at Time 2. These findings were not accounted for by combat exposure or treatment history. Additionally, both Time 1 CA1-body and CA2/3-body volume showed unique associations with changes in avoidance/numbing, but not with changes in reexperiencing or hyperarousal symptoms. This supports a more complex and nuanced relationship between hippocampal structure and PTSD symptoms, where during the posttrauma years bigger may not always mean better, and suggests that the CA1-body and CA2/3-body are important factors in the maintenance of PTSD symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Joseph DeGutis
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, VA Boston Healthcare System
| | - Danielle R Sullivan
- National Center for Posttraumtic Stress Disorder, VA Boston Healthcare System
| | - Sam Agnoli
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, VA Boston Healthcare System
| | - Anna Stumps
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, VA Boston Healthcare System
| | - Mark Logue
- National Center for Posttraumtic Stress Disorder, VA Boston Healthcare System
| | - Emma Brown
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, VA Boston Healthcare System
| | | | - William Milberg
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, VA Boston Healthcare System
| | - Regina McGlinchey
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, VA Boston Healthcare System
| | - Michael Esterman
- Boston Attention and Learning Laboratory, VA Boston Healthcare System
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4
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Ellis J, Brown E, Colenutt C, Schley D, Gubbins S. Inferring transmission routes for foot-and-mouth disease virus within a cattle herd using approximate Bayesian computation. Epidemics 2024; 46:100740. [PMID: 38232411 DOI: 10.1016/j.epidem.2024.100740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 12/06/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
To control an outbreak of an infectious disease it is essential to understand the different routes of transmission and how they contribute to the overall spread of the pathogen. With this information, policy makers can choose the most efficient methods of detection and control during an outbreak. Here we assess the contributions of direct contact and environmental contamination to the transmission of foot-and-mouth disease virus (FMDV) in a cattle herd using an individual-based model that includes both routes. Model parameters are inferred using approximate Bayesian computation with sequential Monte Carlo sampling (ABC-SMC) applied to data from transmission experiments and the 2007 epidemic in Great Britain. This demonstrates that the parameters derived from transmission experiments are applicable to outbreaks in the field, at least for closely related strains. Under the assumptions made in the model we show that environmental transmission likely contributes a majority of infections within a herd during an outbreak, although there is a lot of variation between simulated outbreaks. The accumulation of environmental contamination not only causes infections within a farm, but also has the potential to spread between farms via fomites. We also demonstrate the importance and effectiveness of rapid detection of infected farms in reducing transmission between farms, whether via direct contact or the environment.
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Affiliation(s)
- John Ellis
- The Pirbright Institute, Pirbright, Surrey, UK.
| | - Emma Brown
- The Pirbright Institute, Pirbright, Surrey, UK
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5
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Beard KR, Borca F, Phan H, Brown E, Fenton PA, Stansby J, Defty J, Clark TW. Routine, molecular point-of-care testing for SARS-CoV-2 and other respiratory viruses within an acute oncology service improves patient care. J Infect 2023; 87:516-523. [PMID: 37802471 DOI: 10.1016/j.jinf.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES COVID-19 has caused significant challenges for infection prevention measures and patient flow in hospital admission pathways. We aimed to assess the impact of replacing laboratory PCR with molecular point-of-care testing (mPOCT) for respiratory viruses including SARS-CoV-2, within an Acute Oncology Service (AOS). METHODS This pre- and post-implementation study took place in the AOS of a large teaching hospital, in Southampton, UK. We collected data from two periods: November 25th, 2019 to November 24th, 2020, when respiratory virus testing utilised laboratory PCR, and December 1st, 2020 to May 31st, 2021 following the introduction of mPOCT. The primary outcome was the time to results. RESULTS 2189 patients were tested in the pre-implementation period and 1540 in the post implementation period. Median (IQR) time to results was 5.8 h (4.2-10.6) pre-implementation and 1.9 h (1.5-3.0) post-implementation (difference -3.6 h [95%CI to -3.8 to -3.5]; p < 0.0001). Median time spent in assessment areas was 6.0 h (4.1-7.9) pre-implementation and 5.5 h (3.8-7.4) post-implementation (p < 0.0001). 20 (0.9%) patients admitted via AOS assessment unit developed hospital-acquired respiratory virus infection pre-implementation versus 0 (0%) post-implementation (p = 0.031). CONCLUSIONS Routine mPOCT for respiratory viruses, including SARS-CoV-2, was associated with a reduced time to results, reduced time in assessment areas, and a reduction in the rates of hospital-acquired respiratory virus infection in an acute oncology assessment unit.
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Affiliation(s)
- Kate R Beard
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Florina Borca
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Clinical Informatics Research Unit, University of Southampton, Southampton, UK
| | - Hang Phan
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Clinical Informatics Research Unit, University of Southampton, Southampton, UK
| | - Emma Brown
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Paul A Fenton
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jessica Stansby
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - John Defty
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Health Sciences, University of Southampton, Southampton, UK
| | - Tristan W Clark
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK Trust, Southampton, UK
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Brown E, Jr GAF, Shelton A, Johnson T, Chen C, Shaheen S, Holden TL, Dao VA, Bien JYE, King D, Vitzthum L, Kirilcuk N, Morris A, Kin C, Dawes A, Sheth V, Chang DT, Pollom E. A Technology-Informed Approach to Clinical Trial Equity. Int J Radiat Oncol Biol Phys 2023; 117:e8. [PMID: 37786184 DOI: 10.1016/j.ijrobp.2023.06.664] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Despite efforts to increase participation of diverse communities in clinical trials, ethnic/racial minorities remain underrepresented. One such determinant may be lack of access to a comprehensive cancer center that conducts clinical research. Historically, our institution has had low accrual from rural regions further away from our cancer center, with Hispanic or Latino (HL) patients (pts) being especially underrepresented in our clinical research. In this study, we explored the impact of a clinical trial that allowed pts to receive chemotherapy (chemo) with their local oncologist. We hypothesize that allowing pts to receive chemo locally will lead to higher rates of enrollment from populations under-represented in clinical trials. MATERIALS/METHODS We conducted a study for pts with rectal cancer to undergo short-course radiation followed by 4 months of chemo with the option to pursue watch and wait if pts achieve a clinical complete response. Radiation was administered at our institution while pts could receive standard-of-care chemo closer to home with their local oncologist. For pts who received chemo locally, the research coordinator and co-investigators held video visits with the pts prior to each chemo infusion to review adverse events (AE), labs, and chemo dosing. We compared demographic data of pts on this trial with that of pts enrolled across all adult therapeutic oncologic clinical trials over the same time period at our institution. Distance to our institution was calculated based on pts' primary residence zip code. Protocol compliance with AE reporting for pts who received chemo locally was assessed by chart review. RESULTS Between May 2020 and January 2023, 24/35 enrolled pts completed both radiation and chemo on trial. 13/24 pts (54%) received chemo locally. Of the 24 pts, 16 were White (67%), 7 Asian (29%), 1 Native Hawaiian/ Pacific Islander (4%). Of all enrolled patients, 4 were HL (16.7%), compared to our institutional average of 16.5%. All enrolled HL pts received their chemo locally. The average distance traveled by non-HL pts from their home to our institution was 87.7 miles (range 5.1 - 308). In contrast, HL pts traveled an average of 147.8 miles (range 110 - 249), 68% further than their non-HL counterparts. There was 100% compliance with AE reporting among those pts who received their chemo locally. CONCLUSION Although the percentage of HL participation in our study was consistent with our institutional average, all HL pts enrolled on the trial received treatment locally and lived substantially further from our institution than non-HL. By allowing pts to receive this part of treatment locally, we provided pts who live further away an opportunity to engage in clinical research without the associated financial and time toxicities related with traveling for treatment. By decentralizing clinical trials and leveraging telemedicine, we can promote the participation of under-represented groups in clinical trials.
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Affiliation(s)
- E Brown
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - G A Fisher Jr
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - A Shelton
- Department of Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - T Johnson
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - C Chen
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - S Shaheen
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - T L Holden
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - V A Dao
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - J Y E Bien
- Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA
| | - D King
- Department of Medical Oncology/Hematology, Northwell Health Cancer Institute, New Hyde Park, NY
| | - L Vitzthum
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - N Kirilcuk
- Department of Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - A Morris
- Department of Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - C Kin
- Department of Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - A Dawes
- Department of Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - V Sheth
- Department of Radiology, Stanford University School of Medicine, Palo Alto, CA
| | - D T Chang
- Department of Radiation Oncology, Michigan Medicine, Ann Arbor, MI
| | - E Pollom
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
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Le TN, Brown E, Zhang W. Sense of Meaning and Purpose Making Mitigates the Experience of Stress Among Hawai'i Farmers. J Agromedicine 2023; 28:746-755. [PMID: 37198954 DOI: 10.1080/1059924x.2023.2215238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Farming is widely acknowledged as being extremely challenging and stressful, yet also potentially very meaningful as farming is an important element of any society and connected to our cultural heritage. Only a few studies have empirically examined the association between sense of purpose in farming and well-being/happiness. This study explored whether a sense of meaning and purpose in being a farmer could mitigate the experience of stress. A cross-sectional survey between November 2021-September 2022 was conducted with a sample of 408 Hawai'i agricultural producers. Descriptive statistics and logistic regressions were conducted to explore factors that predicted farmers' endorsement of high meaning and purpose, and whether meaning and purpose could dampen the impact of stressors on the experience of stress. Results revealed that Hawai'i farmers were highly stressed but also had high sense of meaning and purpose. Predictors of meaning and purpose included operating smaller farms of 1-9 acres and having 51% or greater percentage of income from farming. Meaning and purpose in turn decreased odds of stress, and showed an interaction with stressor intensity such that the stress buffering effect of meaning was more salient for those with lower stressors than those with higher stressors OR = 1.12 (CI = 1.06,1.19). One possible stress management and resilience technique is to highlight and strengthen farmers' sense of meaning and purpose in the farming endeavor.
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Affiliation(s)
- Thao N Le
- Family Consumer Sciences Department, University of Hawai'i Manoa, Honolulu, Hawaii, USA
| | - Emma Brown
- Family Consumer Sciences Department, University of Hawai'i Manoa, Honolulu, Hawaii, USA
| | - Wei Zhang
- Department of Sociology, University of Hawai'i Manoa, Honolulu, Hawaii, USA
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Saad F, Clarke NW, Oya M, Shore N, Procopio G, Guedes JD, Arslan C, Mehra N, Parnis F, Brown E, Schlürmann F, Joung JY, Sugimoto M, Sartor O, Liu YZ, Poehlein C, Barker L, Del Rosario PM, Armstrong AJ. Olaparib plus abiraterone versus placebo plus abiraterone in metastatic castration-resistant prostate cancer (PROpel): final prespecified overall survival results of a randomised, double-blind, phase 3 trial. Lancet Oncol 2023; 24:1094-1108. [PMID: 37714168 DOI: 10.1016/s1470-2045(23)00382-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND PROpel met its primary endpoint showing statistically significant improvement in radiographic progression-free survival with olaparib plus abiraterone versus placebo plus abiraterone in patients with first-line metastatic castration-resistant prostate cancer (mCRPC) unselected by homologous recombination repair mutation (HRRm) status, with benefit observed in all prespecified subgroups. Here we report the final prespecified overall survival analysis. METHODS This was a randomised, double-blind, phase 3 trial done at 126 centres in 17 countries worldwide. Patients with mCRPC aged at least 18 years, Eastern Cooperative Oncology Group performance status 0-1, a life expectancy of at least 6 months, with no previous systemic treatment for mCRPC and unselected by HRRm status were randomly assigned (1:1) centrally by means of an interactive voice response system-interactive web response system to abiraterone acetate (orally, 1000 mg once daily) plus prednisone or prednisolone with either olaparib (orally, 300 mg twice daily) or placebo. The patients, the investigator, and study centre staff were masked to drug allocation. Stratification factors were site of metastases and previous docetaxel at metastatic hormone-sensitive cancer stage. Radiographic progression-free survival was the primary endpoint and overall survival was a key secondary endpoint with alpha-control (alpha-threshold at prespecified final analysis: 0·0377 [two-sided]), evaluated in the intention-to-treat population. Safety was evaluated in all patients who received at least one dose of a study drug. This study is registered with ClinicalTrials.gov, NCT03732820, and is completed and no longer recruiting. FINDINGS Between Oct 31, 2018 and March 11, 2020, 1103 patients were screened, of whom 399 were randomly assigned to olaparib plus abiraterone and 397 to placebo plus abiraterone. Median follow-up for overall survival in patients with censored data was 36·6 months (IQR 34·1-40·3) for olaparib plus abiraterone and 36·5 months (33·8-40·3) for placebo plus abiraterone. Median overall survival was 42·1 months (95% CI 38·4-not reached) with olaparib plus abiraterone and 34·7 months (31·0-39·3) with placebo plus abiraterone (hazard ratio 0·81, 95% CI 0·67-1·00; p=0·054). The most common grade 3-4 adverse event was anaemia reported in 64 (16%) of 398 patients in the olaparib plus abiraterone and 13 (3%) of 396 patients in the placebo plus abiraterone group. Serious adverse events were reported in 161 (40%) in the olaparib plus abiraterone group and 126 (32%) in the placebo plus abiraterone group. One death in the placebo plus abiraterone group, from interstitial lung disease, was considered treatment related. INTERPRETATION Overall survival was not significantly different between treatment groups at this final prespecified analysis. FUNDING Supported by AstraZeneca and Merck Sharp & Dohme.
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Affiliation(s)
- Fred Saad
- Centre Hospitalier de l'Université de Montréal, Montreal, Canada.
| | - Noel W Clarke
- The Christie and Salford Royal Hospital NHS Foundation Trusts and University of Manchester, Manchester, UK.
| | | | - Neal Shore
- Carolina Urologic Research Center, Myrtle Beach, SC, USA
| | - Giuseppe Procopio
- Programma Prostata Fondazione Istituto Nazionale Tumori Milano, Milan, Italy
| | - João Daniel Guedes
- Hospital de Base de São José do Rio Preto, São José do Rio Preto, Brazil
| | - Cagatay Arslan
- Izmir Economy University Medical Point Hospital, Karsiyaka, Izmir, Turkey
| | - Niven Mehra
- Radboud Universitair Medisch Centrum, Nijmegen, Netherlands
| | | | - Emma Brown
- University Hospital Southampton, Southampton, UK
| | | | | | | | | | - Yu-Zhen Liu
- Precision Medicine, Oncology R&D, AstraZeneca, Cambridge, UK
| | | | - Laura Barker
- Global Medicines Development, Oncology R&D, AstraZeneca, Cambridge, UK
| | | | - Andrew J Armstrong
- Duke Cancer Institute Center for Prostate and Urologic Cancer, Duke University, Durham, NC, USA
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Le TN, Zhang W, Brown E, Crum J, Wong A. Risks & Protective Factors for Depression & Suicide Among Hawai'i Agricultural Producers. J Agromedicine 2023; 28:734-745. [PMID: 37767730 DOI: 10.1080/1059924x.2023.2226131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Studies have consistently shown that agricultural producers in the continental United States have disproportionately high rates of depression and suicide as compared to other occupations. It is not known whether this is true in Hawai'i, which is both geographically distinct and ethnically diverse. To examine rates of depression and suicide as well as potential risk and protective factors, a state-wide mental health needs assessment was conducted from November 2021 to September 2022. We conducted a survey with a nonprobability-based convenience sample targeting agricultural producers across Hawai'i, and performed descriptive statistics and logistic regression analyses. In a sample of 408 respondents, 35% (n = 143) had clinical depression symptomatology, and 8% (n = 33) had suicidal ideation based on the Patient Health Questionnaire-9. Older age was slightly protective in that every year of increase in age was associated with 0.98 times (95% CI: 0.96, 0.99) reduced odds of depression symptomatology, and 0.96 times (95% CI:0.94, 0.98) reduced odds of suicidal ideation. Identifying as East Asian had 2.04 times (95% CI: 1.16, 3.61) higher odds of depression symptomatology, and Southeast Asian had 3.04 times odds (95% CI:1.15, 8.00) of suicidal ideation. However, in the presence of stress and coping variables, the demographic factors became statistically non-significant. Instead, feeling stressed, uncertainty as the stressor, and media-focused coping were significant risk factors in increasing two to eight times the odds of depressive symptoms. For suicidal ideation, depression symptomatology increased odds by 31.95 (95% CI: 5.60-182.32), using media-focused coping increased 5.20 odds (95% CI: 1.66, 16.27), but problem-focused coping decreased 0.32 times odds (0.10, 0.99). Culturally specific prevention and intervention measures should be tailored for Hawai'i agricultural producers with an emphasis toward younger, East, and Southeast Asian producers and attention toward providing skillful coping strategies for effective stress regulation and management.
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Affiliation(s)
- Thao N Le
- Family Consumer Sciences Department, University of Hawai'i, Honolulu, USA
| | - Wei Zhang
- Department of Sociology, University of Hawai'i, Honolulu, USA
| | - Emma Brown
- Family Consumer Sciences Department, University of Hawai'i, Honolulu, USA
| | - Jim Crum
- Family Consumer Sciences Department, University of Hawai'i, Honolulu, USA
| | - Alex Wong
- Family Consumer Sciences Department, University of Hawai'i, Honolulu, USA
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O'Donoghue B, Sexton S, Lyne JP, Roche E, Mifsud N, Brown E, Renwick L, Behan C, Clarke M. Socio-demographic and clinical characteristics of migrants to Ireland presenting with a first episode of psychosis. Ir J Psychol Med 2023; 40:336-342. [PMID: 33632349 DOI: 10.1017/ipm.2020.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES When presenting with a first episode of psychosis (FEP), migrants can have different demographic and clinical characteristics to the native-born population and this was examined in an Irish Early Intervention for Psychosis service. METHODS All cases of treated FEP from three local mental health services within a defined catchment area were included. Psychotic disorder diagnoses were determined using the SCID and symptom and functioning domains were measured using validated and reliable measures. RESULTS From a cohort of 612 people, 21.1% were first-generation migrants and there was no difference in the demographic characteristics, diagnoses, symptoms or functioning between migrants and those born in the Republic of Ireland, except that migrants from Africa presented with less insight. Of those admitted, 48.6% of admissions for migrants were involuntary compared to 37.7% for the native-born population (p = 0.09). CONCLUSIONS First-generation migrants now make up a significant proportion of people presenting with a FEP to an Irish EI for psychosis service. Broadly the demographic and clinical characteristics of migrants and those born in the Republic of Ireland are similar, except for less insight in migrants from Africa and a trend for a higher proportion of involuntary admissions in the total migrant group.
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Affiliation(s)
- B O'Donoghue
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - S Sexton
- Linndara, Child and Adolescent Mental Health Services, Health Service Executive, Kildare, Ireland
| | - J P Lyne
- Wicklow Mental Health Services, Newcastle Hospital, Greystones, Co. Wicklow, Ireland
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland
| | - E Roche
- Cluain Mhuire Mental Health Services, Newtownpark Avenue, Blackrock, Co Dublin, Ireland
| | - N Mifsud
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - E Brown
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - L Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, England, UK
| | - C Behan
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
| | - M Clarke
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
- Department of Psychiatry, University College Dublin, Dublin, Ireland
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11
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Panikar SS, Keltee N, Berry NK, Shmuel S, Fisher ZT, Brown E, Zidel A, Mabry A, Pereira PMR. Metformin-Induced Receptor Turnover Alters Antibody Accumulation in HER-Expressing Tumors. J Nucl Med 2023; 64:1195-1202. [PMID: 37268425 PMCID: PMC10394312 DOI: 10.2967/jnumed.122.265248] [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: 11/23/2022] [Revised: 03/30/2023] [Indexed: 06/04/2023] Open
Abstract
Metformin has effects beyond its antihyperglycemic properties, including altering the localization of membrane receptors in cancer cells. Metformin decreases human epidermal growth factor receptor (HER) membrane density. Depletion of cell-surface HER decreases antibody-tumor binding for imaging and therapeutic approaches. Here, we used HER-targeted PET to annotate antibody-tumor binding in mice treated with metformin. Methods: Small-animal PET annotated antibody binding in HER-expressing xenografts on administration of an acute versus a daily dose schedule of metformin. Analyses at the protein level in the total, membrane, and internalized cell extracts were performed to determine receptor endocytosis, HER surface and internalized protein levels, and HER phosphorylation. Results: At 24 h after injection of radiolabeled anti-HER antibodies, control tumors had higher antibody accumulation than tumors treated with an acute dose of metformin. These differences were temporal, and by 72 h, tumor uptake in acute cohorts was similar to uptake in control. Additional PET imaging revealed a sustained decrease in tumor uptake on daily metformin treatment compared with control and acute metformin cohorts. The effects of metformin on membrane HER were reversible, and after its removal, antibody-tumor binding was restored. The time- and dose-dependent effects of metformin-induced HER depletion observed preclinically were validated with immunofluorescence, fractionation, and protein analysis cell assays. Conclusion: The findings that metformin decreases cell-surface HER receptors and reduces antibody-tumor binding may have significant implications for the use of antibodies targeting these receptors in cancer treatment and molecular imaging.
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Affiliation(s)
- Sandeep Surendra Panikar
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Nai Keltee
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Na-Keysha Berry
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Shayla Shmuel
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Zachary T Fisher
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Emma Brown
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Abbey Zidel
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
- Department of Biology, Washington University School of Medicine, St. Louis, Missouri; and
| | - Alex Mabry
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
- Department of Biological and Biomedical Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Patrícia M R Pereira
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri;
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12
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Buehler A, Brown E, Paulus L, Eckstein M, Thoma O, Oraiopoulou M, Rother U, Hoerning A, Hartmann A, Neurath MF, Woelfle J, Friedrich O, Waldner MJ, Knieling F, Bohndiek SE, Regensburger AP. Transrectal Absorber Guide Raster-Scanning Optoacoustic Mesoscopy for Label-Free In Vivo Assessment of Colitis. Adv Sci (Weinh) 2023; 10:e2300564. [PMID: 37083262 PMCID: PMC10288266 DOI: 10.1002/advs.202300564] [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] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/21/2023] [Indexed: 05/03/2023]
Abstract
Optoacoustic imaging (OAI) enables microscale imaging of endogenous chromophores such as hemoglobin at significantly higher penetration depths compared to other optical imaging technologies. Raster-scanning optoacoustic mesoscopy (RSOM) has recently been shown to identify superficial microvascular changes associated with human skin pathologies. In animal models, the imaging depth afforded by RSOM can enable entirely new capabilities for noninvasive imaging of vascular structures in the gastrointestinal tract, but exact localization of intra-abdominal organs is still elusive. Herein the development and application of a novel transrectal absorber guide for RSOM (TAG-RSOM) is presented to enable accurate transabdominal localization and assessment of colonic vascular networks in vivo. The potential of TAG-RSOM is demonstrated through application during mild and severe acute colitis in mice. TAG-RSOM enables visualization of transmural vascular networks, with changes in colon wall thickness, blood volume, and OAI signal intensities corresponding to colitis-associated inflammatory changes. These findings suggest TAG-RSOM can provide a novel monitoring tool in preclinical IBD models, refining animal procedures and underlines the capabilities of such technologies to address inflammatory bowel diseases in humans.
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Affiliation(s)
- Adrian Buehler
- Department of Pediatrics and Adolescent MedicineUniversity Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91054ErlangenGermany
| | - Emma Brown
- Department of Physics and Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeCB2 0REUK
| | - Lars‐Philip Paulus
- Department of Pediatrics and Adolescent MedicineUniversity Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91054ErlangenGermany
| | - Markus Eckstein
- Institute of PathologyFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91054ErlangenGermany
| | - Oana‐Maria Thoma
- Department of Medicine 1University Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91052ErlangenGermany
| | - Mariam‐Eleni Oraiopoulou
- Department of Physics and Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeCB2 0REUK
| | - Ulrich Rother
- Department of Vascular SurgeryUniversity Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91054ErlangenGermany
| | - André Hoerning
- Department of Pediatrics and Adolescent MedicineUniversity Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91054ErlangenGermany
| | - Arndt Hartmann
- Institute of PathologyFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91054ErlangenGermany
| | - Markus F. Neurath
- Department of Medicine 1University Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91052ErlangenGermany
| | - Joachim Woelfle
- Department of Pediatrics and Adolescent MedicineUniversity Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91054ErlangenGermany
| | - Oliver Friedrich
- Institute of Medical BiotechnologyDepartment of Chemical and Biological EngineeringFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91052ErlangenGermany
| | - Maximilian J. Waldner
- Department of Medicine 1University Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91052ErlangenGermany
| | - Ferdinand Knieling
- Department of Pediatrics and Adolescent MedicineUniversity Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91054ErlangenGermany
| | - Sarah E. Bohndiek
- Department of Physics and Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeCB2 0REUK
| | - Adrian P. Regensburger
- Department of Pediatrics and Adolescent MedicineUniversity Hospital ErlangenFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg91054ErlangenGermany
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13
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Johnson-Ulrich L, Demartsev V, Johnson L, Brown E, Strandburg-Peshkin A, Manser MB. Directional speakers as a tool for animal vocal communication studies. R Soc Open Sci 2023; 10:230489. [PMID: 37234494 PMCID: PMC10206473 DOI: 10.1098/rsos.230489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023]
Abstract
Audio playbacks are a common experimental tool in vocal communication research. However, low directionality of sound makes it hard to control the audience exposed to the stimuli. Parametric speakers offer a solution for transmitting directional audible signals by using ultrasonic carrier waves. The targeted transmission of vocal signals offers exciting opportunities for testing the diffusion of information in animal groups and mechanisms for resolving informational ambiguities. We have field tested the quality and directionality of a commercial parametric speaker, Soundlazer SL-01. Additionally, we assessed its usability for performing playback experiments by comparing behavioural responses of free-ranging meerkats (Suricata suricatta) with calls transmitted from conventional and parametric speakers. Our results show that the tested parametric speaker is highly directional. However, the acoustic structure of meerkat calls was strongly affected and low frequencies were not reliably reproduced by the parametric speaker. The playback trials elicited weakened behavioural responses probably due to the partial distortion of the signal but also indicating the potential importance of social facilitation for initiating mobbing events in meerkats. We conclude that parametric speakers can be useful tools for directed transmission of animals calls but after a careful assessment of signal fidelity.
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Affiliation(s)
- Lily Johnson-Ulrich
- Department of Evolutionary Biology and Environmental Studies, University of Zurich, Zurich 8057, Switzerland
- Kalahari Research Centre, Van Zylsrus, 8467 Northern Cape, South Africa
| | - Vlad Demartsev
- Kalahari Research Centre, Van Zylsrus, 8467 Northern Cape, South Africa
- Department of Biology, University of Konstanz, Konstanz 78464, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz 78464, Germany
- Department for the Ecology of Animal Societies, Max Planck Institute of Animal Behavior, Konstanz 78467, Germany
| | - Laurie Johnson
- Kalahari Research Centre, Van Zylsrus, 8467 Northern Cape, South Africa
| | - Emma Brown
- Kalahari Research Centre, Van Zylsrus, 8467 Northern Cape, South Africa
| | - Ariana Strandburg-Peshkin
- Kalahari Research Centre, Van Zylsrus, 8467 Northern Cape, South Africa
- Department of Biology, University of Konstanz, Konstanz 78464, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz 78464, Germany
- Department for the Ecology of Animal Societies, Max Planck Institute of Animal Behavior, Konstanz 78467, Germany
| | - Marta B. Manser
- Department of Evolutionary Biology and Environmental Studies, University of Zurich, Zurich 8057, Switzerland
- Interdisciplinary Center for the Evolution of Language, University of Zurich, Zurich 8057, Switzerland
- Kalahari Research Centre, Van Zylsrus, 8467 Northern Cape, South Africa
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14
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Wolf EJ, Hawn SE, Sullivan DR, Miller MW, Sanborn V, Brown E, Neale Z, Fein-Schaffer D, Zhao X, Logue MW, Fortier CB, McGlinchey RE, Milberg WP. Neurobiological and genetic correlates of the dissociative subtype of posttraumatic stress disorder. J Psychopathol Clin Sci 2023; 132:409-427. [PMID: 37023279 PMCID: PMC10286858 DOI: 10.1037/abn0000795] [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] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Approximately 10%-30% of individuals with posttraumatic stress disorder (PTSD) exhibit a dissociative subtype of the condition defined by symptoms of depersonalization and derealization. This study examined the psychometric evidence for the dissociative subtype of PTSD in a sample of young, primarily male post-9/11-era Veterans (n = 374 at baseline and n = 163 at follow-up) and evaluated its biological correlates with respect to resting state functional connectivity (default mode network [DMN]; n = 275), brain morphology (hippocampal subfield volume and cortical thickness; n = 280), neurocognitive functioning (n = 337), and genetic variation (n = 193). Multivariate analyses of PTSD and dissociation items suggested a class structure was superior to dimensional and hybrid ones, with 7.5% of the sample comprising the dissociative class; this group showed stability over 1.5 years. Covarying for age, sex, and PTSD severity, linear regression models revealed that derealization/depersonalization severity was associated with: decreased DMN connectivity between bilateral posterior cingulate cortex and right isthmus (p = .015; adjusted-p [padj] = .097); increased bilateral whole hippocampal, hippocampal head, and molecular layer head volume (p = .010-.034; padj = .032-.053); worse self-monitoring (p = .018; padj = .079); and a candidate genetic variant (rs263232) in the adenylyl cyclase 8 gene (p = .026), previously associated with dissociation. Results converged on biological structures and systems implicated in sensory integration, the neural representation of spatial awareness, and stress-related spatial learning and memory, suggesting possible mechanisms underlying the dissociative subtype of PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Erika J. Wolf
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Sage E. Hawn
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Danielle R. Sullivan
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Mark W. Miller
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Victoria Sanborn
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
| | - Emma Brown
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Educational and Clinical Center, VA Boston Healthcare System, Boston, MA
| | - Zoe Neale
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | | | - Xiang Zhao
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
| | - Mark W. Logue
- National Center for PTSD at VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA
- Department of Biostatistics, Boston University School of Public Health Boston, MA
- Biomedical Genetics, Boston University School of Medicine, Boston, MA
| | - Catherine B. Fortier
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Educational and Clinical Center, VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Regina E. McGlinchey
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Educational and Clinical Center, VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - William P. Milberg
- Translational Research Center for TBI and Stress Disorders and Geriatric Research Educational and Clinical Center, VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
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15
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Brown E, Whiteley W, Kale P. Incorporating Palliative Care Services in the Advanced Heart Failure Clinic. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.488] [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: 04/05/2023] Open
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16
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Brown E, Whiteley W, Kale P. Human Papilloma Virus Associated Malignancies in Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.468] [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: 04/05/2023] Open
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17
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Ellis J, Brown E, Colenutt C, Gubbins S. Assessing the effectiveness of environmental sampling for surveillance of foot-and-mouth disease virus in a cattle herd. Front Vet Sci 2023; 10:1074264. [PMID: 36992974 PMCID: PMC10040685 DOI: 10.3389/fvets.2023.1074264] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/22/2023] [Indexed: 03/15/2023] Open
Abstract
The survival of foot-and-mouth disease virus (FMDV) in the environment provides an opportunity for indirect transmission, both within and between farms. However it also presents the possibility of surveillance and detection via environmental sampling. This study assesses the effectiveness of environmental sampling strategies in the event of an outbreak, using a previous model for transmission of FMDV in a cattle herd that had been parameterized using data from transmission experiments and outbreaks. We show that environmental sampling can be an effective means of detecting FMDV in a herd, but it requires multiple samples to be taken on multiple occasions. In addition, environmental sampling can potentially detect FMDV in a herd more quickly than clinical inspection. For example, taking 10 samples every 3 days results in a mean time to detection of 6 days, which is lower than the mean time to detection estimated for the 2001 UK epidemic (8 days). We also show how environmental sampling could be used in a herd considered to be at risk as an alternative to pre-emptive culling. However, because of the time taken for virus to accumulate at the start of an outbreak, a reasonable level of confidence (> 99%) that an at-risk herd is indeed free from infection is unlikely to be achieved in less than 1 week.
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Emery J, McDaid L, Coleman T, Cooper S, Thomson R, Kinahan-Goodwin D, Dickinson A, Phillips L, Clark M, Bowker K, Brown E, Naughton F. Development and content validation of a questionnaire for measuring beliefs about using Nicotine Replacement Therapy for smoking cessation in pregnancy. Nicotine Tob Res 2023:7067302. [PMID: 36861351 DOI: 10.1093/ntr/ntad030] [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: 10/21/2022] [Indexed: 03/03/2023]
Abstract
INTRODUCTION Improving adherence to Nicotine Replacement Therapy (NRT) in pregnancy may result in higher smoking cessation rates. Informed by the Necessities and Concerns Framework, we developed an intervention targeting pregnancy NRT adherence. To evaluate this, we derived the NRT in Pregnancy Necessities and Concerns Questionnaire (NiP-NCQ), which measures perceived need for NRT and concerns about potential consequences. Here we describe the development and content validation of NiP-NCQ. METHODS From qualitative work, we identified potentially modifiable determinants of pregnancy NRT adherence and classed these as necessity beliefs or concerns. We translated these into draft self-report items and piloted items on 39 pregnant women offered NRT and a prototype NRT adherence intervention, assessing distributions and sensitivity to change. After removing poorly performing items, smoking cessation experts (N=16) completed an online discriminant content validation (DCV) task to determine whether retained items measure a necessity belief, concern, both or neither construct. RESULTS Draft NRT concern items encompassed safety for the baby, side effects, too much or insufficient nicotine, and addictiveness. Draft necessity belief items included perceived need for NRT for short-term and longer-term abstinence, and desire to minimise or cope without NRT. Of 22/29 items retained after piloting, four were removed following the DCV task: three judged to measure neither construct and one possibly both. The final NiP- NCQ comprised nine items per construct (18 total). CONCLUSIONS The NiP-NCQ measures potentially modifiable determinants of pregnancy NRT adherence within two distinct constructs and may have research and clinical utility for evaluating interventions targeting these. IMPLICATIONS Poor adherence to Nicotine Replacement Therapy (NRT) in pregnancy may result from low perceived need and/or concerns about consequences; interventions challenging these beliefs may yield higher smoking cessation rates. To evaluate an NRT adherence intervention informed by the Necessities and Concerns Framework, we developed the NRT in Pregnancy Necessities and Concerns Questionnaire (NiP-NCQ). Through the content development and refinement processes described in this paper, we derived an evidence-based, 18-item questionnaire measuring two distinct constructs within two nine-item subscales. Higher concerns and lower necessity beliefs indicate more negative NRT beliefs; NiP-NCQ may have research and clinical utility for interventions targeting these.
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Affiliation(s)
- Joanne Emery
- School of Health Sciences, University of East Anglia, Norwich, NR4 7UL, UK
| | - Lisa McDaid
- School of Health Sciences, University of East Anglia, Norwich, NR4 7UL, UK
| | - Tim Coleman
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Sue Cooper
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Ross Thomson
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK
| | | | - Anne Dickinson
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Lucy Phillips
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Miranda Clark
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Katharine Bowker
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Emma Brown
- School of Social Sciences, Leeds Beckett University, Leeds, LS1 3HE, UK
| | - Felix Naughton
- School of Health Sciences, University of East Anglia, Norwich, NR4 7UL, UK
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19
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Clarke NW, Armstrong AJ, Thiery-Vuillemin A, Oya M, Shore ND, Procopio G, Guedes JDC, Arslan C, Mehra N, Parnis F, Brown E, Schlürmann F, Joung JY, Sugimoto M, Sartor AO, Liu YZ, Poehlein CH, Barker L, del Rosario PM, Saad F. Final overall survival (OS) in PROpel: Abiraterone (abi) and olaparib (ola) versus abiraterone and placebo (pbo) as first-line (1L) therapy for metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.lba16] [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: 03/17/2023] Open
Abstract
LBA16 Background: PROpel (NCT03732820) met its primary endpoint showing significant investigator-assessed radiographic progression-free survival (rPFS) benefit for patients with mCRPC treated with abi + ola vs abi + pbo in the 1L setting (hazard ratio [HR] 0.66, 95% confidence interval [CI] 0.54–0.81, P< 0.001, data cut-off: 7/30/2021). Sensitivity analysis by blinded independent central review was consistent. A trend toward OS benefit with abi + ola was observed at the time of the primary rPFS analysis (28.6% maturity, HR 0.86, 95% CI 0.66–1.12) and a subsequent interim analysis (40.1% maturity, HR 0.83, 95% CI 0.66–1.03). We report OS and safety from the pre-planned final analysis (data cut-off: 10/12/2022). Methods: PROpel is a randomized, double-blind phase 3 trial of 1L therapy for patients with mCRPC eligible for abiraterone. Patients were prospectively assessed for homologous recombination repair mutation (HRRm) status using tumor tissue (FoundationOne CDx) and/or circulating tumor DNA (ctDNA; FoundationOne Liquid CDx) tests after randomization 1:1 to ola (300 mg twice daily [bid]) or pbo, and abi (1000 mg once daily) plus prednisone/prednisolone (5 mg bid). Treatment continued until radiographic disease progression, unacceptable toxicity or withdrawal of consent. OS was a key secondary endpoint (2-sided boundary for significance 0.0377). Aggregate results from tumor tissue and ctDNA tests were used to assign patients to HRRm/BRCAm subgroups. Results: Patient (n = 796) characteristics (including prior docetaxel, site of metastasis, symptom score and HRRm status) were generally balanced. There was a consistent trend toward OS benefit in the intention-to-treat (ITT) population with abi + ola vs abi + pbo (maturity 47.9%, HR 0.81, 95% CI 0.67–1.00, P= 0.0544), with median OS 42.1 months (m) vs 34.7 m, respectively. OS medians and HRs for HRRm, non-HRRm, BRCAm and non-BRCAm subgroups all favored abi + ola vs abi + pbo. In the abi + ola arm the most common Grade ≥3 adverse event was anemia (16.1%). Conclusions: At the prespecified final analysis in PROpel, abi + ola prolonged OS by > 7 m vs standard-of-care abiraterone (abi + pbo) in the ITT population. The median OS of > 42 m is the longest median reported to date in a phase 3 trial in 1L mCRPC. Consistent with rPFS results, a trend toward OS benefit was observed in HRRm, non-HRRm, BRCAm and non-BRCAm subgroups with greatest benefit in the BRCAm subgroup. No new long-term safety issues were identified. These results support the use of abi + ola in 1L mCRPC. Clinical trial information: NCT03732820 . [Table: see text]
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Affiliation(s)
- Noel W. Clarke
- The Christie and Salford Royal NHS Foundation Trusts, Manchester, United Kingdom
| | - Andrew J. Armstrong
- Duke Cancer Institute Center for Prostate and Urologic Cancer, Duke University, Durham, NC
| | | | | | | | | | | | - Cagatay Arslan
- İzmir Economy University Medical Park Hospital, Karsiyaka, Turkey
| | - Niven Mehra
- Radboud Universitair Medisch Centrum, Nijmegen, Netherlands
| | - Francis Parnis
- Ashford Cancer Centre Research, Kurralta Park, SA, Australia
| | - Emma Brown
- University Hospital Southampton, Southampton, United Kingdom
| | | | | | | | | | - Yu-Zhen Liu
- Precision Medicine, Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | | | - Laura Barker
- Global Medicines Development, Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | | | - Fred Saad
- Centre Hospitalier de l’Université de Montréal/CRCHUM, Université de Montreal, Montreal, QC, Canada
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Hayes JP, Pierce ME, Brown E, Salat D, Logue MW, Constantinescu J, Valerio K, Miller MW, Sherva R, Huber BR, Milberg W, McGlinchey R. Genetic Risk for Alzheimer Disease and Plasma Tau Are Associated With Accelerated Parietal Cortex Thickness Change in Middle-Aged Adults. Neurol Genet 2023; 9:e200053. [PMID: 36742995 PMCID: PMC9893442 DOI: 10.1212/nxg.0000000000200053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/21/2022] [Indexed: 02/04/2023]
Abstract
Background and Objectives Neuroimaging and biomarker studies in Alzheimer disease (AD) have shown well-characterized patterns of cortical thinning and altered biomarker concentrations of tau and β-amyloid (Aβ). However, earlier identification of AD has great potential to advance clinical care and determine candidates for drug trials. The extent to which AD risk markers relate to cortical thinning patterns in midlife is unknown. The first objective of this study was to examine cortical thickness change associated with genetic risk for AD among middle-aged military veterans. The second objective was to determine the relationship between plasma tau and Aβ and change in brain cortical thickness among veterans stratified by genetic risk for AD. Methods Participants consisted of post-9/11 veterans (N = 155) who were consecutively enrolled in the Translational Research Center for TBI and Stress Disorders prospective longitudinal cohort and were assessed for mild traumatic brain injury (TBI) and posttraumatic disorder (PTSD). Genome-wide polygenic risk scores (PRSs) for AD were calculated using summary results from the International Genomics of Alzheimer's Disease Project. T-tau and Aβ40 and Aβ42 plasma assays were run using Simoa technology. Whole-brain MRI cortical thickness change estimates were obtained using the longitudinal stream of FreeSurfer. Follow-up moderation analyses examined the AD PRS × plasma interaction on change in cortical thickness in AD-vulnerable regions. Results Higher AD PRS, signifying greater genetic risk for AD, was associated with accelerated cortical thickness change in a right hemisphere inferior parietal cortex cluster that included the supramarginal gyrus, angular gyrus, and intraparietal sulcus. Higher tau, but not Aβ42/40 ratio, was associated with greater cortical thickness change among those with higher AD PRS. Mild TBI and PTSD were not associated with cortical thickness change. Discussion Plasma tau, particularly when combined with genetic stratification for AD risk, can be a useful indicator of brain change in midlife. Accelerated inferior parietal cortex changes in midlife may be an important factor to consider as a marker of AD-related brain alterations.
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Affiliation(s)
- Jasmeet Pannu Hayes
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - Meghan E Pierce
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - Emma Brown
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - David Salat
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - Mark W Logue
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - Julie Constantinescu
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - Kate Valerio
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - Mark W Miller
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - Richard Sherva
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - Bertrand Russell Huber
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - William Milberg
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
| | - Regina McGlinchey
- Department of Psychology (J.P.H., K.V.), The Ohio State University, & Chronic Brain Injury Program, The Ohio State University, Columbus; Translational Research Center for TBI and Stress Disorders (TRACTS) (M.E.P., E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Department of Psychiatry (M.E.P., M.W.L., M.W.M., B.R.H.), Boston University School of Medicine, MA; Neuroimaging Research for Veterans (NeRVe) Center (E.B., D.S., J.C., W.M., R.M.), VA Boston Healthcare System, MA; Brain Aging and Dementia (BAnD) Laboratory (D.S.), A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown; National Center for PTSD (M.W.L., M.W.M., B.R.H.), Behavioral Sciences Division, VA Boston Healthcare System, MA; Boston University School of Medicine (M.W.L., R.S.), Biomedical Genetics, MA; Boston University School of Public Health (M.W.L.), Department of Biostatistics, MA; Department of Neurology (B.R.H.), Boston University School of Medicine, MA; Geriatric Research (W.M., R.M.), Education, and Clinical Center (GRECC), VA Boston Healthcare System, MA; and Department of Psychiatry (W.M., R.M.), Harvard Medical School, Boston, MA
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Atkinson T, Brown E, Jones G, Sage K, Wang X. "I Assumed It Would Be Somebody Who Had a Stroke That Was Doing This": Views of Stroke Survivors, Caregivers, and Health Professionals on Tailoring a Relaxation and Mindfulness Intervention. Healthcare (Basel) 2023; 11:healthcare11030399. [PMID: 36766974 PMCID: PMC9914663 DOI: 10.3390/healthcare11030399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/02/2023] Open
Abstract
Stroke survivors and informal caregivers experience high levels of stress and anxiety, linked to heightened risk of secondary stroke in survivors. Relaxation and mindfulness could reduce stress and anxiety; being most effective when tailored to the target populations. Aims of the PPI include to: (1) consult on possible alterations to an existing relaxation and mindfulness intervention, delivered via YouTube/DVD and (2) discuss relevance and preference of prompts and cues designed to facilitate the daily practice of the intervention. Eleven UK PPI contributors were consulted during 2020: four stroke survivors (F = 2, M = 2), three caregivers (F = 1, M = 2), and four HCPs (F = 4) (range = 23-63 years). Contributors watched the existing intervention and provided feedback via online discussions. Transcripts were analysed using thematic analysis. Five themes were identified, highlighting several necessary alterations to the intervention: "Who represents the stroke population?"; "The paradox of age"; "Specifically selected language"; "Visual presentation of the intervention"; and the "Audio qualities". Contributors ranked the prompts and cues in order of preference with setting alarms and email alerts as the most popular. The PPI consultations resulted in several alterations enabling a revised version of the intervention. Including a PPI consultation at an early stage of the research improves the relevance and appropriateness of the research. The revised intervention is more representative of the stroke population thus more likely to be practised by survivors and caregivers, which will enhance the extent of effectiveness, reducing the risk of a secondary stroke.
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Affiliation(s)
- Thomas Atkinson
- Psychology, Leeds School of Social Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
- Correspondence:
| | - Emma Brown
- Psychology, Leeds School of Social Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
| | - Georgina Jones
- Psychology, Leeds School of Social Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
| | - Karen Sage
- Applied Clinical Research, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Xu Wang
- Psychology, Leeds School of Social Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
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Hespe CM, Brown E, Rychetnik L. Learning from the implementation of a quality improvement intervention in Australian general practice: a qualitative analysis of participants views of a CVD preventive care project. BMC Prim Care 2022; 23:79. [PMID: 35421935 PMCID: PMC9011978 DOI: 10.1186/s12875-022-01692-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/04/2022] [Indexed: 11/23/2022]
Abstract
Background Quality improvement collaborative projects aim to reduce gaps in clinical care provided in the healthcare system. This study evaluated the experience of key participants from a Quality Improvement Program (QPulse) that focussed on cardiovascular disease assessment and management. The study goal was to identify critical barriers and factors enabling the implementation of a quality improvement framework in Australian general practice. Methods This qualitative study examined in-depth semi-structured interviews with nineteen purposively-selected participants of the QPulse project. Interviewees were from General Practices and the local supporting organisation, a Primary Health Network. Interviews were analysed thematically using the Complex Systems Improvement framework, focusing on five domains: strategy, culture, structure, workforce and technology. Results Despite reported engagement with QPulse objectives to improve cardiovascular preventive care, implementation barriers associated with this program were considerable for all interviewees. Adoption of the quality improvement process was reliant on designated leadership, aligned practice culture, organised systems for clear communication, tailored education and utilisation of clinical audit and review processes. Rather than practice size and location, practice culture and governance alignment to quality improvement predicted successful implementation. Financial incentives for both general practice and the Primary Health Network were also identified as prerequisites for systematised quality improvement projects in the future, along with individualised support and education for each general practice. Technology was both an enabler and a barrier, and the Primary Health Network was seen as key to assisting the successful utilisation of the available tools. Conclusions Implementation of Quality Improvement programs remains a potential tool for achieving better health outcomes in General Practice. However, enablers such as financial incentives, individualised education and support provided via a supporting organisation, and IT tools and support are crucial if the full potential of Quality Improvement programs are to be realised in the Australian healthcare setting. Trial registration ACTRN12615000108516, UTN U1111-1163–7995. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01692-0.
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Kumthekar P, Benatti H, Taghian T, Gormley WB, Nagpal S, Baker WC, Patel R, Brown E, Glicksman M, Gray-Edwards H. DDEL-01. ANIMAL STUDIES WITH A NEW CNS DRUG DELIVERY DEVICE TO EFFECTIVELY TREAT LEPTOMENINGEAL CARCINOMATOSIS PATIENTS. Neuro Oncol 2022. [PMCID: PMC9660871 DOI: 10.1093/neuonc/noac209.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Appropriate drug distribution is needed for effective treatment of brain metastases and leptomeningeal carcinomatosis. Lack of proper drug bioavailability in the CNS contributes to the poor outcome in these patients. EnClear Therapies has developed a device delivering intrathecal therapeutics utilizing the active control of CSF flow through an external pump. Herein, we look at intrathecal drug delivery of methotrexate with EnClear’s system and its impact of drug concentration in sheep and non-human primates.
METHODS
The EnClear device utilizes two implantable catheters (intracranial in the ventricular system and lumbar thecal sac) and an extracorporeal pump that controls the speed and direction of CSF flow. Software monitors the output from sensor arrays for pressure, respiration, and heart rate. Gadolinium and MRI were used to determine the CSF flow characteristics. Administration of Methotrexate via the EnClear system was compared to current two standards of delivery, intracerebroventricular or lumbar intrathecal administration. Methotrexate levels were measured with Liquid Chromatography/Mass Spectrometry in CSF, blood, and multiple CNS and peripheral tissues.
RESULTS
There was a two-fold increase in methotrexate levels in multiple regions of the brain including deeper brain structures including the striatum using the EnClear's system, compared to traditional lumbar intrathecal and intracerebroventricular delivery. Higher peak levels of methotrexate were reached in the CSF with the use of EnClear’s system, with simultaneous reduction in the peripheral nerves and systemic tissues – a potential source of toxicity.
Conclusions
In large animal studies, the EnClear device has for the first time, demonstrated increased brain parenchymal drug levels via intrathecal delivery. In addition to the drug parenchyma, drug delivery with this novel device has shown improved distribution throughout CNS and leptomeninges as compared to traditional intrathecal drug delivery and decreased peripheral distribution.
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Affiliation(s)
| | - Hector Benatti
- University of Massachusetts Medical School , Worcester, MA , USA
| | - Toloo Taghian
- University of Massachusetts Medical School , Worcester, MA , USA
| | | | | | - William C Baker
- University of Massachusetts Medical School , Worcester, MA , USA
| | | | - Emma Brown
- EnClear Therapies , Newburyport, MA , USA
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Oya M, Armstrong A, Thiery-Vuillemin A, Shore N, Procopio G, Arslan Ç, Mehra N, Parnis F, Brown E, Constans Schlurmann F, Joung J, Sugimoto M, Sartor O, Liu YZ, Poehlein C, Desai C, Del Rosario P, Clarke N, Saad F. 157O Biomarker analysis and updated results from the phase III PROpel trial of abiraterone (abi) and olaparib (ola) vs abi and placebo (pbo) as first-line (1L) therapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Yost J, Brown E, Winders T, Jaffee H, Klein S, Martinez E, Silvera T, Malawer E. EPINEPHRINE AUTOINJECTOR UTILIZATION AND ACCESS IN A NATIONALLY REPRESENTATIVE FOOD-ALLERGIC ADULT SAMPLE. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.527] [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: 11/11/2022]
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Escudero Sanchez L, Brown E, Rundo L, Ursprung S, Sala E, Bohndiek SE, Partarrieu IX. Photoacoustic imaging radiomics in patient-derived xenografts: a study on feature sensitivity and model discrimination. Sci Rep 2022; 12:15142. [PMID: 36071117 PMCID: PMC9452574 DOI: 10.1038/s41598-022-19084-w] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022] Open
Abstract
Photoacoustic imaging is an increasingly popular method of exploring the tumour microenvironment, which can provide insight into tumour oxygenation status and potentially treatment response assessment. Currently, the measurements most commonly performed on such images are the mean and median of the pixel values of the tumour volumes of interest. We investigated expanding the set of measurements that can be extracted from these images by adding radiomic features. In particular, we found that Skewness was sensitive to differences between basal and luminal patient derived xenograft cancer models with an [Formula: see text] of 0.86, and that it was robust to variations in confounding factors such as reconstruction type and wavelength. We also built discriminant models with radiomic features that were correlated with the underlying tumour model and were independent from each other. We then ranked features by their importance in the model. Skewness was again found to be an important feature, as were 10th Percentile, Root Mean Squared, and several other texture-based features. In summary, this paper proposes a methodology to select radiomic features extracted from photoacoustic images that are robust to changes in acquisition and reconstruction parameters, and discusses features found to have discriminating power between the underlying tumour models in a pre-clinical dataset.
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Affiliation(s)
- Lorena Escudero Sanchez
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK.
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK.
| | - Emma Brown
- Department of Physics, University of Cambridge, Cambridge, CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
- Washington University School of Medicine in St Louis, St. Louis, MO, 63110, USA
| | - Leonardo Rundo
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
- Department of Information and Electrical Engineering and Applied Mathematics (DIEM), University of Salerno, Fisciano, SA, 84084, Italy
| | - Stephan Ursprung
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Sarah E Bohndiek
- Department of Physics, University of Cambridge, Cambridge, CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
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Saad F, Armstrong A, Thiery-Vuillemin A, Oya M, Shore N, Procopio G, Arslan C, Mehra N, Parnis F, Brown E, Constans Schlurmann F, Joung J, Sugimoto M, Sartor O, Liu YZ, Poehlein C, Desai C, Del Rosario P, Clarke N. 1357O Biomarker analysis and updated results from the Phase III PROpel trial of abiraterone (abi) and olaparib (ola) vs abi and placebo (pbo) as first-line (1L) therapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Clarke NW, Armstrong AJ, Thiery-Vuillemin A, Oya M, Shore N, Loredo E, Procopio G, de Menezes J, Girotto G, Arslan C, Mehra N, Parnis F, Brown E, Schlürmann F, Joung JY, Sugimoto M, Virizuela JA, Emmenegger U, Navratil J, Buchschacher GL, Poehlein C, Harrington EA, Desai C, Kang J, Saad F. Abiraterone and Olaparib for Metastatic Castration-Resistant Prostate Cancer. NEJM Evid 2022; 1:EVIDoa2200043. [PMID: 38319800 DOI: 10.1056/evidoa2200043] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Abiraterone and Olaparib for Metastatic Prostate CancerPatients with metastatic castration-resistant prostate cancer, regardless of homologous recombination repair gene mutation status, received either abiraterone and olaparib or abiraterone and placebo in the first-line setting. Imaging-based progression-free survival was 24.8 months for patients treated with abiraterone and olaparib versus 16.6 months for those receiving abiraterone alone.
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Affiliation(s)
- Noel W Clarke
- The Christie and Salford Royal Hospital NHS Foundation Trusts, University of Manchester, Manchester, United Kingdom
| | - Andrew J Armstrong
- Duke Cancer Institute Center for Prostate and Urologic Cancer, Duke University, Durham, NC
| | | | | | - Neal Shore
- Carolina Urologic Research Center, Myrtle Beach, SC
| | - Eugenia Loredo
- Centro de Investigaciones Clinicas Viña del Mar, Valparaíso, Chile
| | | | | | - Gustavo Girotto
- Hospital de Base São José do Rio Preto, São José do Rio Preto, Brazil
| | - Cagatay Arslan
- Izmir Economy University Medical Park Hospital, Karsiyaka, Turkey
| | - Niven Mehra
- Radboud Universitair Medisch Centrum, Nijmegen, Netherlands
| | - Francis Parnis
- Ashford Cancer Centre Research, Adelaide, South Australia
| | - Emma Brown
- University Hospital Southampton, Southampton, United Kingdom
| | | | | | | | | | | | - Jiri Navratil
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | | | | | | | - Chintu Desai
- Global Medicines Development, Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | - Jinyu Kang
- Global Medicines Development, Oncology R&D, AstraZeneca, Gaithersburg, MD
| | - Fred Saad
- Centre Hospitalier de l'Universite de Montreal, Montreal
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29
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Goebel CA, Brown E, Fahlbusch FB, Wagner AL, Buehler A, Raupach T, Hohmann M, Späth M, Burton N, Woelfle J, Schmidt M, Hartner A, Regensburger AP, Knieling F. High-resolution label-free mapping of murine kidney vasculature by raster-scanning optoacoustic mesoscopy: an ex vivo study. Mol Cell Pediatr 2022; 9:13. [PMID: 35788444 PMCID: PMC9253231 DOI: 10.1186/s40348-022-00144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a global burden affecting both children and adults. Novel imaging modalities hold great promise to visualize and quantify structural, functional, and molecular organ damage. The aim of the study was to visualize and quantify murine renal vasculature using label-free raster scanning optoacoustic mesoscopy (RSOM) in explanted organs from mice with renal injury. MATERIAL AND METHODS For the experiments, freshly bisected kidneys of alpha 8 integrin knock-out (KO) and wildtype mice (WT) were used. A total of n=7 female (n=4 KO, n=3 WT) and n=6 male animals (n=2 KO, n=4 WT) aged 6 weeks were examined with RSOM optoacoustic imaging systems (RSOM Explorer P50 at SWL 532nm and/or ms-P50 imaging system at 532 nm, 555 nm, 579 nm, and 606 nm). Images were reconstructed using a dedicated software, analyzed for size and vascular area and compared to standard histologic sections. RESULTS RSOM enabled mapping of murine kidney size and vascular area, revealing differences between kidney sizes of male (m) and female (f) mice (merged frequencies (MF) f vs. m: 52.42±6.24 mm2 vs. 69.18±15.96 mm2, p=0.0156) and absolute vascular area (MF f vs. m: 35.67±4.22 mm2 vs. 49.07±13.48 mm2, p=0.0036). Without respect to sex, the absolute kidney area was found to be smaller in knock-out (KO) than in wildtype (WT) mice (WT vs. KO: MF: p=0.0255) and showed a similar trend for the relative vessel area (WT vs. KO: MF p=0.0031). Also the absolute vessel areas of KO compared to WT were found significantly different (MF p=0.0089). A significant decrease in absolute vessel area was found in KO compared to WT male mice (MF WT vs. KO: 54.37±9.35 mm2 vs. 34.93±13.82 mm2, p=0.0232). In addition, multispectral RSOM allowed visualization of oxygenated and deoxygenated parenchymal regions by spectral unmixing. CONCLUSION This study demonstrates the capability of RSOM for label-free visualization of differences in vascular morphology in ex vivo murine renal tissue at high resolution. Due to its scalability optoacoustic imaging provides an emerging modality with potential for further preclinical and clinical imaging applications.
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Affiliation(s)
- Colin A Goebel
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Emma Brown
- Department of Physics, University of Cambridge, Cambridge, UK.,Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK.,Washington University School of Medicine, St. Louis, USA
| | - Fabian B Fahlbusch
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Alexandra L Wagner
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Adrian Buehler
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Raupach
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Martin Hohmann
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Erlangen Graduate School in Advanced Optical Technologies, 91052, Erlangen, Germany
| | - Moritz Späth
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Erlangen Graduate School in Advanced Optical Technologies, 91052, Erlangen, Germany
| | | | - Joachim Woelfle
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Schmidt
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Erlangen Graduate School in Advanced Optical Technologies, 91052, Erlangen, Germany
| | - Andrea Hartner
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Adrian P Regensburger
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Ferdinand Knieling
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany.
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith E, Anderton J, Barabas M, Goyal S, Howard D, Joshi A, Mitchell D, Weatherby T, Badminton R, Bird R, Burtle D, Choi NY, Devalia K, Farr E, Fischer F, Fish J, Gunn F, Jacobs D, Johnston P, Kalakoutas A, Lau E, Loo YNAF, Louden H, Makariou N, Mohammadi K, Nayab Y, Ruhomaun S, Ryliskyte R, Saeed M, Shinde P, Sudul M, Theodoropoulou K, Valadao-Spoorenberg J, Vlachou F, Arshad SR, Janmohamed AM, Noor M, Oyerinde O, Saha A, Syed Y, Watkinson W, Ahmadi H, Akintunde A, Alsaady A, Bradley J, Brothwood D, Burton M, Higgs M, Hoyle C, Katsura C, Lathan R, Louani A, Mandalia R, Prihartadi AS, Qaddoura B, Sandland-Taylor L, Thadani S, Thompson A, Walshaw J, Teo S, Ali S, Bawa JH, Fox S, Gargan K, Haider SA, Hanna N, Hatoum A, Khan Z, Krzak AM, Li T, Pitt J, Tan GJS, Ullah Z, Wilson E, Cleaver J, Colman J, Copeland L, Coulson A, Davis P, Faisal H, Hassan F, Hughes JT, Jabr Y, Mahmoud Ali F, Nahaboo Solim ZN, Sangheli A, Shaya S, Thompson R, Cornwall H, De Andres Crespo M, Fay E, Findlay J, Groves E, Jones O, Killen A, Millo J, Thomas S, Ward J, Wilkins M, Zaki F, Zilber E, Bhavra K, Bilolikar A, Charalambous M, Elawad A, Eleni A, Fawdon R, Gibbins A, Livingstone D, Mala D, Oke SE, Padmakumar D, Patsalides MA, Payne D, Ralphs C, Roney A, Sardar N, Stefanova K, Surti F, Timms R, Tosney G, Bannister J, Clement NS, Cullimore V, Kamal F, Lendor J, McKay J, Mcswiggan J, Minhas N, Seneviratne K, Simeen S, Valverde J, Watson N, Bloom I, Dinh TH, Hirniak J, Joseph R, Kansagra M, Lai CKN, Melamed N, Patel J, Randev J, Sedighi T, Shurovi B, Sodhi J, Vadgama N, Abdulla S, Adabavazeh B, Champion A, Chennupati R, Chu K, Devi S, Haji A, Schulz J, Testa F, Davies P, Gurung B, Howell S, Modi P, Pervaiz A, Zahid M, Abdolrazaghi S, Abi Aoun R, Anjum Z, Bawa G, Bhardwaj R, Brown S, Enver M, Gill D, Gopikrishna D, Gurung D, Kanwal A, Kaushal P, Khanna A, Lovell E, McEvoy C, Mirza M, Nabeel S, Naseem S, Pandya K, Perkins R, Pulakal R, Ray M, Reay C, Reilly S, Round A, Seehra J, Shakeel NM, Singh B, Vijay Sukhnani M, Brown L, Desai B, Elzanati H, Godhaniya J, Kavanagh E, Kent J, Kishor A, Liu A, Norwood M, Shaari N, Wood C, Wood M, Brown A, Chellapuri A, Ferriman A, Ghosh I, Kulkarni N, Noton T, Pinto A, Rajesh S, Varghese B, Wenban C, Aly R, Barciela C, Brookes T, Corrin E, Goldsworthy M, Mohamed Azhar MS, Moore J, Nakhuda S, Ng D, Pillay S, Port S, Abdullah M, Akinyemi J, Islam S, Kale A, Lewis A, Manjunath T, McCabe H, Misra S, Stubley T, Tam JP, Waraich N, Chaora T, Ford C, Osinkolu I, Pong G, Rai J, Risquet R, Ainsworth J, Ayandokun P, Barham E, Barrett G, Barry J, Bisson E, Bridges I, Burke D, Cann J, Cloney M, Coates S, Cripps P, Davies C, Francis N, Green S, Handley G, Hathaway D, Hurt L, Jenkins S, Johnston C, Khadka A, McGee U, Morris D, Murray R, Norbury C, Pierrepont Z, Richards C, Ross O, Ruddy A, Salmon C, Shield M, Soanes K, Spencer N, Taverner S, Williams C, Wills-Wood W, Woodward S, Chow J, Fan J, Guest O, Hunter I, Moon WY, Arthur-Quarm S, Edwards P, Hamlyn V, McEneaney L, N D G, Pranoy S, Ting M, Abada S, Alawattegama LH, Ashok A, Carey C, Gogna A, Haglund C, Hurley P, Leelo N, Liu B, Mannan F, Paramjothy K, Ramlogan K, Raymond-Hayling O, Shanmugarajah A, Solichan D, Wilkinson B, Ahmad NA, Allan D, Amin A, Bakina C, Burns F, Cameron F, Campbell A, Cavanagh S, Chan SMZ, Chapman S, Chong V, Edelsten E, Ekpete O, El Sheikh M, Ghose R, Hassane A, Henderson C, Hilton-Christie S, Husain M, Hussain H, Javid Z, Johnson-Ogbuneke J, Johnston A, Khalil M, Leung TCC, Makin I, Muralidharan V, Naeem M, Patil P, Ravichandran S, Saraeva D, Shankey-Smith W, Sharma N, Swan R, Waudby-West R, Wilkinson A, Wright K, Balasubramanian A, Bhatti S, Chalkley M, Chou WK, Dixon M, Evans L, Fisher K, Gandhi P, Ho S, Lau YB, Lowe S, Meechan C, Murali N, Musonda C, Njoku P, Ochieng L, Pervez MU, Seebah K, Shaikh I, Sikder MA, Vanker R, Alom J, Bajaj V, Coleman O, Finch G, Goss J, Jenkins C, Kontothanassis A, Liew MS, Ng K, Outram M, Shakeel MM, Tawn J, Zuhairy S, Chapple K, Cinnamond A, Coleman S, George HA, Goulder L, Hare N, Hawksley J, Kret A, Luesley A, Mecia L, Porter H, Puddy E, Richardson G, Sohail B, Srikaran V, Tadross D, Tobin J, Tokidis E, Young L, Ashdown T, Bratsos S, Koomson A, Kufuor A, Lim MQ, Shah S, Thorne EPC, Warusavitarne J, Xu S, Abigail S, Ahmed A, Ahmed J, Akmal A, Al-Khafaji M, Amini B, Arshad M, Bogie E, Brazkiewicz M, Carroll M, Chandegra A, Cirelli C, Deng A, Fairclough S, Fung YJ, Gornell C, Green RL, Green SV, Gulamhussein AHM, Isaac AG, Jan R, Jegatheeswaran L, Knee M, Kotecha J, Kotecha S, Maxwell-Armstrong C, McIntyre C, Mendis N, Naing TKP, Oberman J, Ong ZX, Ramalingam A, Saeed Adam A, Tan LL, Towell S, Yadav J, Anandampillai R, Chung S, Hounat A, Ibrahim B, Jeyakumar G, Khalil A, Khan UA, Nair G, Owusu-Ayim M, Wilson M, Kanani A, Kilkelly B, Ogunmwonyi I, Ong L, Samra B, Schomerus L, Shea J, Turner O, Yang Y, Amin M, Blott N, Clark A, Feather A, Forrest M, Hague S, Hamilton K, Higginbotham G, Hope E, Karimian S, Loveday K, Malik H, McKenna O, Noor A, Onsiong C, Patel B, Radcliffe N, Shah P, Tye L, Verma K, Walford R, Yusufi U, Zachariah M, Casey A, Doré C, Fludder V, Fortescue L, Kalapu SS, Karel E, Khera G, Smith C, Appleton B, Ashaye A, Boggon E, Evans A, Faris Mahmood H, Hinchcliffe Z, Marei O, Silva I, Spooner C, Thomas G, Timlin M, Wellington J, Yao SL, Abdelrazek M, Abdelrazik Y, Bee F, Joseph A, Mounce A, Parry G, Vignarajah N, Biddles D, Creissen A, Kolhe S, K T, Lea A, Ledda V, O'Loughlin P, Scanlon J, Shetty N, Weller C, Abdalla M, Adeoye A, Bhatti M, Chadda KR, Chu J, Elhakim H, Foster-Davies H, Rabie M, Tailor B, Webb S, Abdelrahim ASA, Choo SY, Jiwa A, Mangam S, Murray S, Shandramohan A, Aghanenu O, Budd W, Hayre J, Khanom S, Liew ZY, McKinney R, Moody N, Muhammad-Kamal H, Odogwu J, Patel D, Roy C, Sattar Z, Shahrokhi N, Sinha I, Thomson E, Wonga L, Bain J, Khan J, Ricardo D, Bevis R, Cherry C, Darkwa S, Drew W, Griffiths E, Konda N, Madani D, Mak JKC, Meda B, Odunukwe U, Preest G, Raheel F, Rajaseharan A, Ramgopal A, Risbrooke C, Selvaratnam K, Sethunath G, Tabassum R, Taylor J, Thakker A, Wijesingha N, Wybrew R, Yasin T, Ahmed Osman A, Alfadhel S, Carberry E, Chen JY, Drake I, Glen P, Jayasuriya N, Kawar L, Myatt R, Sinan LOH, Siu SSY, Tjen V, Adeboyejo O, Bacon H, Barnes R, Birnie C, D'Cunha Kamath A, Hughes E, Middleton S, Owen R, Schofield E, Short C, Smith R, Wang H, Willett M, Zimmerman M, Balfour J, Chadwick T, Coombe-Jones M, Do Le HP, Faulkner G, Hobson K, Shehata Z, Beattie M, Chmielewski G, Chong C, Donnelly B, Drusch B, Ellis J, Farrelly C, Feyi-Waboso J, Hibell I, Hoade L, Ho C, Jones H, Kodiatt B, Lidder P, Ni Cheallaigh L, Norman R, Patabendi I, Penfold H, Playfair M, Pomeroy S, Ralph C, Rottenburg H, Sebastian J, Sheehan M, Stanley V, Welchman J, Ajdarpasic D, Antypas A, Azouaghe O, Basi S, Bettoli G, Bhattarai S, Bommireddy L, Bourne K, Budding J, Cookey-Bresi R, Cummins T, Davies G, Fabelurin C, Gwilliam R, Hanley J, Hird A, Kruczynska A, Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Becker C, As-Sanie S, Abrao M, Brown E, Arjona Ferreira J, Wagman R, Wang F, Perry J, Johnson N, Giuduce L. O-305 SPIRIT long-term extension study: two-year efficacy and safety of relugolix combination therapy in women with endometriosis-associated pain. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.102] [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: 11/15/2022] Open
Abstract
Abstract
Study question
To assess the long-term efficacy and safety of once-daily Relugolix combination therapy (Relugolix-CT) in the treatment of endometriosis-associated pain over two years.
Summary answer
Relugolix-CT previously demonstrated sustained improvement of endometriosis-associated pain and was generally well tolerated over 52 weeks. Research is ongoing: two-year results will be reported.
What is known already
SPIRIT 1&2 were international, Phase 3, replicate, randomized, double-blind, placebo-controlled studies of Relugolix-CT (relugolix 40mg, estradiol 1mg, norethisterone acetate 0.5mg) in premenopausal women with moderate-to-severe endometriosis-associated pain, which were followed by the open-label, 80-week, long-term extension. 52-week results showed sustained improvement in dysmenorrhea and non-menstrual pelvic pain (NMPP) with 84.8% and 73.3% of responders, respectively. Efficacy was evidenced by reductions in dysmenorrhea (82.8%,) NMPP (62.9%,) proportion of women using opioids, and improvements in function. Relugolix-CT was generally well tolerated. Bone mineral density (BMD) assessment showed minimal initial decline (<1%) from baseline followed by stabilization from Week 24 to 52.
Study design, size, duration
Women who completed the 24-week pivotal studies (SPIRIT 1&2) were eligible to enroll in an 80-week open-label, single-arm, long-term extension study of safety and efficacy, representing up to 104 weeks of treatment in total. All women enrolled in the long-term extension study received once-daily oral Relugolix-CT. Analyses were performed based on the initial randomized treatment groups in pivotal studies: Relugolix-CT, delayed Relugolix-CT (relugolix 40mg alone for 12 weeks, then Relugolix-CT for 12 weeks), or placebo.
Participants/materials, setting, methods
Primary endpoints are proportion of dysmenorrhea and NMPP responders at Weeks 52 and 104 based on daily Numerical Rating Scale (NRS) scores (0=no pain, 10=worst pain imaginable) and analgesic use. Responders are women who achieved a predefined, clinically meaningful reduction from baseline in NRS score and no increase in analgesic use. Secondary efficacy endpoints include change in Endometriosis Health Profile-30 pain domain scores, use of opioids/analgesics. Safety endpoints include adverse events and BMD (percent change).
Main results and the role of chance
Of 1251 randomized patients in SPIRIT 1&2, 1044 (83.4%) completed the pivotal studies; 802 (76.8%) enrolled in the long-term extension, and 681 (84.9%) completed 52 weeks of treatment. Baseline demographics and clinical characteristics of the long-term extension population were consistent with those of the pivotal study population. The study remains ongoing at the time of writing. Efficacy and safety data with Relugolix-CT for up to Week 104, will be presented at the scientific session of the 2022 congress.
Limitations, reasons for caution
The study was conducted as an open-label study without a control group over the 80 weeks of the extension period.
Wider implications of the findings
Through 52 weeks of treatment, Relugolix-CT demonstrated sustained improvement of dysmenorrhea, NMPP, function, and reduced need for opiates in women with endometriosis-associated pain. No new safety concerns were identified, and treatment was associated with BMD loss <1%. Data from 104 weeks of treatment will be presented at the 2022 congress.
Trial registration number
NCT03654274
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Affiliation(s)
- C Becker
- University of Oxford, Nuffield Department of Women's and Reproductive Health, Headington- Oxford , United Kingdom
| | - S As-Sanie
- University of Michigan Medical Center, Obstetrics and Gynecology , Michigan, U.S.A
| | - M.S Abrao
- São Paulo University , Ob/Gyn, São Paulo, Brazil
| | - E Brown
- Medi-Sense- Inc.-, Medi-Sense- Inc .-, Atlanta- Georgia, U.S.A
| | | | - R.B Wagman
- Myovant Sciences Inc., Myovant Sciences Inc ., Brisbane- California, U.S.A
| | - F Wang
- Myovant Sciences Inc., Myovant Sciences Inc ., Brisbane- California, U.S.A
| | - J.S Perry
- Myovant Sciences Inc., Myovant Sciences Inc ., Brisbane- California, U.S.A
| | - N Johnson
- University of Adelaide, Robinson Research Institute , Adelaide, Australia
| | - L.C Giuduce
- University of California San Francisco, Department of Obstetrics- Gynecology and Reproductive Sciences , San Francisco- California, U.S.A
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Quiros-Gonzalez I, Tomaszewski MR, Golinska MA, Brown E, Ansel-Bollepalli L, Hacker L, Couturier DL, Sainz RM, Bohndiek SE. Abstract LB057: Bevacizumab leaves a photoacoustic fingerprint in breast cancer mouse models. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-lb057] [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
Background: Photoacoustic tomography (PAT) provides a direct readout of tumor haemoglobin (Hb) concentration and oxygenation. This readout could be used to provide an early indication of response to anti-angiogenic drugs, thus optimizing the management of these therapies.
Experimental Procedures: Two cohorts of nude Balb/c were inoculated with either estrogen-dependent MCF-7 (n=7) or estrogen-independent MDA-MB-231 (n=19) cells. Mice were randomly split into Control (Ctrl) and Bevacizumab (Bev,10 mg/Kg, IP, weekly) groups. PAT was performed weekly, starting just before enrolment. Oxy- and deoxy-Hb were quantified in the tumour and reference areas. Total Hb (THb) and O2 saturation (SO2) were calculated. Blood samples and tissues were collected after imaging. Hypoxia (Hypoxyprobe and CA-IX) and vascular density/maturity (CD31 and ASMA) were analyzed by immunohistochemistry. Circulating levels of human and mouse vascular endothelial growth factor (hVEGF and mVEGF) and Hb were measured.
Summary of New Data: Reflecting clinical observations, the MCF-7 Bev group and most of the mice from the MDA-MB-231 Bev group (8/11) showed no improvement in survival with Bev treatment. All resistant tumours (Bev MCF-7 and Bev MDA-MB-231 non-responders (Bev-NR)) showed an increase in hVEGF production (Ctrl vs Bev; 73.0513.06 vs. 497103.9 for MCF-7; 247.984.81 vs. 330.4 85.97 for Bev NR). MDA-MB-231 responders (Bev-R) showed a significant decrease in hVEGF (247.984.81 vs. 80.53 26.13). These results indicate that VEGF was only successfully sequestered in a small subset of animals (3/11) and that VEGF overload might be a resistance mechanism. At the final time point, PAT showed no difference between Ctrl and Bev-NR in THb for either group (THbMDA-MB-231 7.2±1.3 vs. 5.5±1.2). THb was found significantly increased in the Bev-R group by PAT (13.9±3.3 p-valuevs.Crtl=0.0339; p-valuevs.Bev=0.0072) and biochemical measurements. SO2 showed a slight but significant decrease between Ctrl and Bev-NR (0.58±0.03 vs. 0.48±0.01). A dramatic decrease was seen in the Bev-R group (0.31±0.07) and significantly different from Ctrl and Bev-NR. SO2 was sensitive to early changes, SO2 values increased in Ctrl and Bev-NR 48h after enrolment (p-values paired t-test pCtrl= 0.0134; pNR=0.0268) while Bev-R shows a trend (p=0.0649). Analysis of SO2MSOT over time shows a significant (p<0.0001) change in slope at 3 weeks after enrolment in the Bev-R group compared to either of the Ctrl or Bev-NR groups. Our results indicate that PAT SO2 can differentiate responders at very early stages of the treatment. Histologically, we observed fewer blood vessels but better structured in Bev-NR than in Bev-R, which showed higher vascular density and also higher levels of hypoxia makers.
Statement of the Conclusions: Our results postulates PAT as a low-cost, label-free and non-invasive candidate to monitor response to Bevacizumab over time. Our results also indicate that tumours with functional vasculature may be resistant to Bevacizumab treatment.
Citation Format: Isabel Quiros-Gonzalez, Michal R. Tomaszewski, Monika A. Golinska, Emma Brown, Laura Ansel-Bollepalli, Lina Hacker, Dominique-Laurent Couturier, Rosa M. Sainz, Sarah E. Bohndiek. Bevacizumab leaves a photoacoustic fingerprint in breast cancer mouse models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB057.
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Affiliation(s)
| | | | | | - Emma Brown
- 2University of Cambridge, Cambridge, United Kingdom
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Pathmanathan K, Mubin M, Sevilla C, Zaman M, Chan R, Hussain M, Brown E, McDevitt G, Khan R, Nandi A, Mukherjee B, Obiechina N. 970 FRAILTY IS INVERSELY CORRELATED WITH SERUM ALBUMIN IN ACUTE HIP FRACTURE. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.027] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
Frailty and sarcopenia have been shown to significantly increase the risk of falls, traumatic hip fractures and all-cause mortality in the elderly. The assessment of frailty using a validated clinical frailty scale such as that proposed by Rockwood et al., therefore, continues to remain an important step in determining post-operative prognosis in patients undergoing hip fracture surgery. The purpose of this study was to examine the relationship between frailty and serum albumin—an independent biochemical predictor of survival in hip fracture patients (1).
Method
This retrospective cross-sectional study analysed 190 patients, aged above 60 years, admitted to Queen’s Hospital Burton (QHB) between the 1st January and 28th December 2019 with a newly diagnosed hip fracture. Pre-operative serum albumin levels (g/L) and Rockwood clinical frailty scores (rCFS) were recorded from electronic medical records (EMR). Using the SPSS 27 statistical package, Pearson’s correlation co-efficient and linear regression analysis were carried out using these variables.
Results
A total of 190 patients were included in the study (57 male, 133 female). Mean patient age was 82.2 ± 8.47 years. More than 50% of patients had a Rockwood CFS ≥5. Mean serum albumin (g/L) was 37.3 ± 6.56. A statistically significant inverse correlation was demonstrated between pre-operative serum albumin levels and Rockwood CFS (r = −0.243, p < 0.001).
Conclusion
This study showed how serum albumin, a negative acute phase reactant and marker of chronic malnutrition, is inversely associated with frailty in hip fracture patients and the important role of Rockwood CFS and pre-operative serum albumin levels in the prognostication of hip fractures in the elderly. References 1) Bohl D, Shen M, Hannon C, Fillingham Y, Darrith B, Della Valle C. Serum Albumin Predicts Survival and Postoperative Course Following Surgery for Geriatric Hip Fracture. Journal of Bone and Joint Surgery. 2017;99(24):2110–2,118.
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Affiliation(s)
- K Pathmanathan
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - M Mubin
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - C Sevilla
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - M Zaman
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - R Chan
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - M Hussain
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - E Brown
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - G McDevitt
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - R Khan
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - A Nandi
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - B Mukherjee
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
| | - N Obiechina
- Department of Elderly Medicine; University Hospitals Derby and Burton NHS Foundation Trust
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Quiros-Gonzalez I, Tomaszewski MR, Golinska MA, Brown E, Ansel-Bollepalli L, Hacker L, Couturier DL, Sainz RM, Bohndiek SE. Photoacoustic Tomography Detects Response and Resistance to Bevacizumab in Breast Cancer Mouse Models. Cancer Res 2022; 82:1658-1668. [PMID: 35404400 PMCID: PMC9359720 DOI: 10.1158/0008-5472.can-21-0626] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 08/27/2021] [Accepted: 02/18/2022] [Indexed: 01/07/2023]
Abstract
Angiogenesis is an established prognostic factor in advanced breast cancer, yet response to antiangiogenic therapies in this disease remains highly variable. Noninvasive imaging biomarkers could help identify patients that will benefit from antiangiogenic therapy and provide an ideal tool for longitudinal monitoring, enabling dosing regimens to be altered with real-time feedback. Photoacoustic tomography (PAT) is an emerging imaging modality that provides a direct readout of tumor hemoglobin concentration and oxygenation. We hypothesized that PAT could be used in the longitudinal setting to provide an early indication of response or resistance to antiangiogenic therapy. To test this hypothesis, PAT was performed over time in estrogen receptor-positive and estrogen receptor-negative breast cancer xenograft mouse models undergoing treatment with the antiangiogenic bevacizumab as a single agent. The cohort of treated tumors, which were mostly resistant to the treatment, contained a subset that demonstrated a clear survival benefit. At endpoint, the PAT data from the responding subset showed significantly lower oxygenation and higher hemoglobin content compared with both resistant and control tumors. Longitudinal analysis revealed that tumor oxygenation diverged significantly in the responding subset, identifying early treatment response and the evolution of different vascular phenotypes between the subsets. Responding tumors were characterized by a more angiogenic phenotype when analyzed with IHC, displaying higher vessel density, yet poorer vascular maturity and elevated hypoxia. Taken together, our findings indicate that PAT shows promise in providing an early indication of response or resistance to antiangiogenic therapy. SIGNIFICANCE Photoacoustic assessment of tumor oxygenation is a noninvasive early indicator of response to bevacizumab therapy, clearly distinguishing between control, responding, and resistant tumors within just a few weeks of treatment.
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Affiliation(s)
- Isabel Quiros-Gonzalez
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
| | - Michal R. Tomaszewski
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
| | - Monika A. Golinska
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
| | - Emma Brown
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
| | - Laura Ansel-Bollepalli
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
| | - Lina Hacker
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
| | - Dominique-Laurent Couturier
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
| | - Rosa M. Sainz
- Cell Morphology and Biology Department, IUOPA and ISPA, Universidad de Oviedo, Oviedo, Spain
| | - Sarah E. Bohndiek
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
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Ali A, Brown E, Tsang W, Spector A, Aguirre E, Hoare S, Hassiotis A. Individual cognitive stimulation therapy (iCST) for people with intellectual disability and dementia: a feasibility randomised controlled trial. Aging Ment Health 2022; 26:698-708. [PMID: 33393364 DOI: 10.1080/13607863.2020.1869180] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To examine the feasibility, acceptability and fidelity of individual Cognitive Stimulation Therapy (iCST) in people with intellectual disability (ID) and dementia. METHOD We aimed to recruit forty dyads (carer and individual with dementia and ID) who were randomised to iCST or a waiting list control group. Both groups received treatment as usual. Family and paid carers delivered the manualised intervention (40 sessions over 20 weeks). Recruitment and retention of participants, intervention adherence, fidelity and acceptability were assessed. Outcome measures of cognition, adaptive functioning, quality of life (QoL) and carer outcomes were collected at baseline, midpoint (11 weeks) and at 21 weeks. Qualitative interviews were conducted with six carers about their experience of iCST. RESULTS Forty dyads were recruited over 10 months from 12 National Health Service trusts. One dyad dropped out and 87.5% and 97.5% completed the midpoint and end-point assessments respectively. Assessment of fidelity indicated that the correct session structure was not followed; 70% completed at least 20 sessions and there was a high level of satisfaction with iCST. QoL was significantly higher in the iCST arm at 21 weeks (adjusted mean difference: 3.11; 95% CI: 0.64 to 5.58). There were no differences in the other outcome measures. CONCLUSION The intervention was feasible and acceptable. A full-scale trial is warranted but some modifications are needed, including improved training and supervision for carers to improve fidelity.
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Affiliation(s)
- Afia Ali
- Division of Psychiatry, University College London, London, UK
| | - Emma Brown
- Division of Psychiatry, University College London, London, UK
| | - Winnie Tsang
- Division of Psychiatry, University College London, London, UK
| | - Aimee Spector
- Clinical, Education and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Elisa Aguirre
- Talking Therapies, Barking & Dagenham IAPT, North East London NHS Foundation Trust, London, UK
| | - Sarah Hoare
- Community Learning Disabilities Team, North East London NHS Foundation Trust, London, UK
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Lefebvre TL, Brown E, Hacker L, Else T, Oraiopoulou ME, Tomaszewski MR, Jena R, Bohndiek SE. The Potential of Photoacoustic Imaging in Radiation Oncology. Front Oncol 2022; 12:803777. [PMID: 35311156 PMCID: PMC8928467 DOI: 10.3389/fonc.2022.803777] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/07/2022] [Indexed: 12/16/2022] Open
Abstract
Radiotherapy is recognized globally as a mainstay of treatment in most solid tumors and is essential in both curative and palliative settings. Ionizing radiation is frequently combined with surgery, either preoperatively or postoperatively, and with systemic chemotherapy. Recent advances in imaging have enabled precise targeting of solid lesions yet substantial intratumoral heterogeneity means that treatment planning and monitoring remains a clinical challenge as therapy response can take weeks to manifest on conventional imaging and early indications of progression can be misleading. Photoacoustic imaging (PAI) is an emerging modality for molecular imaging of cancer, enabling non-invasive assessment of endogenous tissue chromophores with optical contrast at unprecedented spatio-temporal resolution. Preclinical studies in mouse models have shown that PAI could be used to assess response to radiotherapy and chemoradiotherapy based on changes in the tumor vascular architecture and blood oxygen saturation, which are closely linked to tumor hypoxia. Given the strong relationship between hypoxia and radio-resistance, PAI assessment of the tumor microenvironment has the potential to be applied longitudinally during radiotherapy to detect resistance at much earlier time-points than currently achieved by size measurements and tailor treatments based on tumor oxygen availability and vascular heterogeneity. Here, we review the current state-of-the-art in PAI in the context of radiotherapy research. Based on these studies, we identify promising applications of PAI in radiation oncology and discuss the future potential and outstanding challenges in the development of translational PAI biomarkers of early response to radiotherapy.
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Affiliation(s)
- Thierry L. Lefebvre
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Emma Brown
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Lina Hacker
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Thomas Else
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Mariam-Eleni Oraiopoulou
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Michal R. Tomaszewski
- Department of Cancer Physiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States
| | - Rajesh Jena
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Sarah E. Bohndiek
- Department of Physics, University of Cambridge, Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
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Saad F, Armstrong AJ, Thiery-Vuillemin A, Oya M, Loredo E, Procopio G, Janoski de Menezes J, Girotto GC, Arslan C, Mehra N, Parnis F, Brown E, Schlürmann F, Joung JY, Sugimoto M, Poehlein CH, Harrington E, Desai C, Kang J, Clarke N. PROpel: Phase III trial of olaparib (ola) and abiraterone (abi) versus placebo (pbo) and abi as first-line (1L) therapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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
11 Background: Preclinical studies have shown combined anti-tumor effect through interactions between poly(adenosine diphosphate–ribose) polymerase and androgen receptor signaling pathways. A Phase II trial (NCT01972217) in pts with mCRPC unselected by homologous recombination repair (HRR) status who previously received docetaxel demonstrated improved radiographic progression-free survival (rPFS) for pts treated with ola + abi vs pbo + abi (Clarke N, 2018). The Phase III PROpel study (NCT03732820) evaluates the efficacy and safety of ola + abi in the 1L mCRPC setting. Methods: PROpel is a randomized, double-blind, placebo-controlled Phase III trial in pts with mCRPC undergoing 1L treatment after failure of primary androgen deprivation therapy, enrolled independent of HRR status. Pts were randomized 1:1 to receive ola (300 mg twice daily [bid]) or pbo, and abi (1000 mg once daily) + prednisone or prednisolone (5 mg bid). The primary endpoint was investigator-assessed rPFS with multiple secondary endpoints, including overall survival (OS). Results:796 pts were randomized to ola + abi (n=399) or pbo + abi (n=397).In this planned interim analysis, 1L treatment with ola + abi significantly prolonged rPFS vs pbo + abi in pts with mCRPC irrespective of HRR status (24.8 vs 16.6 months; hazard ratio [HR] 0.66, 95% confidence interval [CI] 0.54–0.81; P <0.0001). Predefined subgroup analyses showed rPFS improvement across all subgroups, including pts with (HR 0.54, 95% CI 0.36–0.79) and without (HR 0.76, 95% CI 0.59–0.97) HRR mutations detected by circulating tumor DNA testing. A sensitivity analysis of rPFS by blinded independent central review was consistent with the primary analysis (HR 0.61, 95% CI 0.49–0.74; P=0.004). OS is currently immature with 228 deaths (28.6%). A trend in OS favoring ola + abi was observed (HR 0.86, 95% CI 0.66–1.12). Secondary endpoints of time to first subsequent treatment (HR 0.74, 95% CI 0.61–0.90) and time to second progression-free survival or death (HR 0.69, 95% CI 0.51–0.94) were supportive of long-term benefits. The most common grade ≥3 adverse event (AE) reported was anemia (15.1 vs 3.3%) for ola + abi vs pbo + abi; 13.8 vs 7.8% pts, respectively, discontinued ola/pbo because of an AE. The rate of AEs leading to abi discontinuation were similar in both arms (8.5 vs 8.8%). Conclusions: At interim analysis, PROpel met its primary objective, demonstrating significant improvement in rPFS for ola + abi vs pbo + abi in pts with newly detected mCRPC who had not received prior 1L therapy, irrespective of HRR status. The safety and tolerability profile of ola + abi was consistent with the known safety profiles of the individual drugs. These results demonstrate the benefit of ola + abi without the need for HRR stratification in 1L treatment of mCRPC. Pt follow-up is ongoing for the planned OS analysis. Clinical trial information: NCT03732820.
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Affiliation(s)
- Fred Saad
- Centre Hospitalier de l’Université de Montréal/CRCHUM, Montreal, QC, Canada
| | | | | | | | - Eugenia Loredo
- Centro De Investigaciones Clinicas Vina Del Mar Li, Valparaíso, Chile
| | | | | | | | - Cagatay Arslan
- Izmir Economy University Medical Park Hospital, Karsiyaka, Turkey
| | - Niven Mehra
- Radboud Universitair Medisch Centrum, Nijmegen, Netherlands
| | - Francis Parnis
- Ashford Cancer Centre Research, Kurralta Park, SA, Australia
| | - Emma Brown
- University Hospital Southampton, Southampton, United Kingdom
| | | | | | | | | | - Elizabeth Harrington
- Oncology Translational Science, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom
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Etchin AG, Corbo V, Brown E, Fortier CB, Fonda JR, Milberg WP, Currao A, McGlinchey RE. Associations Among Clinical Variables and Anger Differ by Early Life Adversity Among Post‐9/11 Veterans. Clin Psychol Psychother 2022; 29:1403-1415. [DOI: 10.1002/cpp.2722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Anna G. Etchin
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
| | - Vincent Corbo
- Department of Psychology Southern New Hampshire University Manchester NH USA
| | - Emma Brown
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
| | - Catherine B. Fortier
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
- Department of Psychiatry Harvard Medical School Boston MA USA
| | - Jennifer R. Fonda
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
- Department of Psychiatry Boston University Medical Campus Boston MA USA
| | - William P. Milberg
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
- Department of Psychiatry Harvard Medical School Boston MA USA
- Geriatric Research Education and Clinical Center, VA Boston Healthcare System Boston MA USA
| | - Alyssa Currao
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
| | - Regina E. McGlinchey
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
- Department of Psychiatry Harvard Medical School Boston MA USA
- Geriatric Research Education and Clinical Center, VA Boston Healthcare System Boston MA USA
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Ramírez-Suárez AC, Paneque-Guerrero T, Casillas-Casanova D, Cosme K, Bacardí D, Duarte CA, Ancízar J, Brown E, Castro J, Suárez-Alba J, Garay H, Pereira K, Fernández-Ortega C. Preliminary safety assessment of CIGB-210, an investigational peptide for HIV infection. Hum Exp Toxicol 2022; 41:9603271211073708. [PMID: 35112887 DOI: 10.1177/09603271211073708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Current human immunodeficiency virus treatments need to be periodically administered lifelong. In this study we assess the effect of repeated doses of an anti-HIV peptide drug candidate in C57BL6 strain. Two schemes of up to 15 administrations and one of 30, daily dosing for 5 days per week, all by the subcutaneous route were evaluated. Different dose concentrations of the peptide were assayed. CIGB-210 treated animals showed no symptoms or abnormal behavior as compared with placebo. All the animals gained weight during the study. Macroscopic evaluation showed no alterations in any of the organs studied. Microscopic analysis of the tissues did not show morphological changes in thymus, stomach, small and large intestines, kidney, brain, or cerebellum. The proliferative response of splenocytes and their capacity to secrete gamma interferon were not compromised by the repeated administration of CIGB-210. There were not statistically significant differences for any of the parameters evaluated during the study among treated and non-treated groups. We can conclude that CIGB-210 is well tolerated in C57BL6 mice in the dose concentration range explored and merits subsequent toxicological studies.
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Affiliation(s)
- Anna C Ramírez-Suárez
- Pharmaceutical Department, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | - Taimi Paneque-Guerrero
- Pharmaceutical Department, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | | | - Karelia Cosme
- Preclinical Research Direction, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | - Dania Bacardí
- Preclinical Research Direction, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | - Carlos A Duarte
- Pharmaceutical Department, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | - Julio Ancízar
- Preclinical Research Direction, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | - Emma Brown
- Preclinical Research Direction, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | - Jorge Castro
- Preclinical Research Direction, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | - José Suárez-Alba
- Preclinical Research Direction, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | - Hilda Garay
- Chemical and Physical Department, 113016Center for Genetic Engineering and Biotechnology (CIGB), Havana, Cuba
| | - Karla Pereira
- Pharmaceutical Department, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
| | - Celia Fernández-Ortega
- Pharmaceutical Department, 113016Center for Genetic Engineering and Biotechnology, Habana, Cuba
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Jain A, Brown E, Htay H, Pawlak M, Chirumarry S, Gadi V, Singh S, Lim J, Gow S, Chen B, Jamaluddin S, Wang Y, Gori M, Venkataraya S, Foo M. POS-689 APPLICATION OF AN ADVANCED ULTRAFILTRATION MANAGEMENT SYSTEM USING AWAK SORBENT-BASED PERITIONEAL DIALYSIS IN A PORCINE MODEL. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Bent T, Holt RF, Van Engen KJ, Jamsek IA, Arzbecker LJ, Liang L, Brown E. How pronunciation distance impacts word recognition in children and adults. J Acoust Soc Am 2021; 150:4103. [PMID: 34972309 DOI: 10.1121/10.0008930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/12/2021] [Indexed: 06/14/2023]
Abstract
Although unfamiliar accents can pose word identification challenges for children and adults, few studies have directly compared perception of multiple nonnative and regional accents or quantified how the extent of deviation from the ambient accent impacts word identification accuracy across development. To address these gaps, 5- to 7-year-old children's and adults' word identification accuracy with native (Midland American, British, Scottish), nonnative (German-, Mandarin-, Japanese-accented English) and bilingual (Hindi-English) varieties (one talker per accent) was tested in quiet and noise. Talkers' pronunciation distance from the ambient dialect was quantified at the phoneme level using a Levenshtein algorithm adaptation. Whereas performance was worse on all non-ambient dialects than the ambient one, there were only interactions between talker and age (child vs adult or across age for the children) for a subset of talkers, which did not fall along the native/nonnative divide. Levenshtein distances significantly predicted word recognition accuracy for adults and children in both listening environments with similar impacts in quiet. In noise, children had more difficulty overcoming pronunciations that substantially deviated from ambient dialect norms than adults. Future work should continue investigating how pronunciation distance impacts word recognition accuracy by incorporating distance metrics at other levels of analysis (e.g., phonetic, suprasegmental).
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Affiliation(s)
- Tessa Bent
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana 47408, USA
| | - Rachael F Holt
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio 43210, USA
| | - Kristin J Van Engen
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri 63130, USA
| | - Izabela A Jamsek
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio 43210, USA
| | - Lian J Arzbecker
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio 43210, USA
| | - Laura Liang
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio 43210, USA
| | - Emma Brown
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana 47408, USA
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Walsh CL, Tafforeau P, Wagner WL, Jafree DJ, Bellier A, Werlein C, Kühnel MP, Boller E, Walker-Samuel S, Robertus JL, Long DA, Jacob J, Marussi S, Brown E, Holroyd N, Jonigk DD, Ackermann M, Lee PD. Imaging intact human organs with local resolution of cellular structures using hierarchical phase-contrast tomography. Nat Methods 2021; 18:1532-1541. [PMID: 34737453 PMCID: PMC8648561 DOI: 10.1038/s41592-021-01317-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022]
Abstract
Imaging intact human organs from the organ to the cellular scale in three dimensions is a goal of biomedical imaging. To meet this challenge, we developed hierarchical phase-contrast tomography (HiP-CT), an X-ray phase propagation technique using the European Synchrotron Radiation Facility (ESRF)'s Extremely Brilliant Source (EBS). The spatial coherence of the ESRF-EBS combined with our beamline equipment, sample preparation and scanning developments enabled us to perform non-destructive, three-dimensional (3D) scans with hierarchically increasing resolution at any location in whole human organs. We applied HiP-CT to image five intact human organ types: brain, lung, heart, kidney and spleen. HiP-CT provided a structural overview of each whole organ followed by multiple higher-resolution volumes of interest, capturing organotypic functional units and certain individual specialized cells within intact human organs. We demonstrate the potential applications of HiP-CT through quantification and morphometry of glomeruli in an intact human kidney and identification of regional changes in the tissue architecture in a lung from a deceased donor with coronavirus disease 2019 (COVID-19).
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Affiliation(s)
- C L Walsh
- Department of Mechanical Engineering, University College London, London, UK.
- Centre for Advanced Biomedical Imaging, University College London, London, UK.
| | - P Tafforeau
- European Synchrotron Radiation Facility, Grenoble, France.
| | - W L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- German Lung Research Centre (DZL), Translational Lung Research Centre Heidelberg (TLRC), Heidelberg, Germany
| | - D J Jafree
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
- UCL MB/PhD Programme, Faculty of Medical Sciences, University College London, London, UK
| | - A Bellier
- French Alps Laboratory of Anatomy (LADAF), Grenoble Alpes University, Grenoble, France
| | - C Werlein
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - M P Kühnel
- Institute of Pathology, Hannover Medical School, Hannover, Germany
- German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - E Boller
- European Synchrotron Radiation Facility, Grenoble, France
| | - S Walker-Samuel
- Centre for Advanced Biomedical Imaging, University College London, London, UK
| | - J L Robertus
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - D A Long
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - J Jacob
- Centre for Medical Image Computing, University College London, London, UK
- UCL Respiratory, University College London, London, UK
| | - S Marussi
- Department of Mechanical Engineering, University College London, London, UK
| | - E Brown
- Centre for Advanced Biomedical Imaging, University College London, London, UK
| | - N Holroyd
- Centre for Advanced Biomedical Imaging, University College London, London, UK
| | - D D Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany.
- German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.
| | - M Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
- Institute of Pathology and Department of Molecular Pathology, Helios University Clinic Wuppertal, University of Witten-Herdecke, Wuppertal, Germany.
| | - P D Lee
- Department of Mechanical Engineering, University College London, London, UK.
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Gensheimer M, Gee H, Von Eyben R, Shirato H, Taguchi H, Wong S, Brown E, Nguyen N, Liang R, Maxim P, Wakelee H, Neal J, Das M, Loo B, Diehn M. A Phase II Trial of Individualized Stereotactic Ablative Radiotherapy for Lung Tumors (iSABR). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Seligmann J, Fisher D, Brown L, Adams R, Graham J, Quirke P, Richman S, Butler R, Domingo E, Blake A, Braun M, Collinson F, Jones R, Brown E, De Winton E, Humphies T, Kaplan R, Wilson R, Seymour M, Maughan T. 382O Inhibition of WEE1 is effective in TP53 and RAS mutant metastatic colorectal cancer (mCRC): A randomised phase II trial (FOCUS4-C) comparing adavosertib (AZD1775) with active monitoring. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Mulcahy M, Salem R, Mahvash A, Pracht M, Montazeri A, Bandula S, Hermann K, Brown E, Zuckerman D, Wilson G, Kim TY, Weaver A, Ross P, Harris W, Johnson M, Sofocleous C, Padia S, Lewandowski R, Garin E, Sinclair P. LBA21 Radioembolization with chemotherapy for colorectal liver metastases: A randomized, open-label, international, multicenter, phase III trial (EPOCH study). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Brown E. Practical guide on dog behaviour. Vet Rec 2021; 189:160. [PMID: 34415591 DOI: 10.1002/vetr.866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Reviewed by Emma Brown, who runs a veterinary behaviour referral service at Kernow Vets in south-west England.
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Hydes T, Brown E, Hamid A, Bateman AC, Cuthbertson DJ. Current and Emerging Biomarkers and Imaging Modalities for Nonalcoholic Fatty Liver Disease: Clinical and Research Applications. Clin Ther 2021; 43:1505-1522. [PMID: 34400007 DOI: 10.1016/j.clinthera.2021.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Nonalcoholic fatty liver disease (NAFLD) is a metabolic disorder that frequently coexists with obesity, metabolic syndrome, and type 2 diabetes. The NAFLD spectrum, ranging from hepatic steatosis to nonalcoholic steatohepatitis, fibrosis, and cirrhosis, can be associated with long-term hepatic (hepatic decompensation and hepatocellular carcinoma) and extrahepatic complications. Diagnosis of NAFLD requires detection of liver steatosis with exclusion of other causes of chronic liver disease. Screening for NAFLD and identification of individuals at risk of end-stage liver disease represent substantial challenges that have yet to be met. NAFLD affects up to 25% of adults, yet only a small proportion will progress beyond steatosis to develop advanced disease (steatohepatitis and fibrosis) associated with increased morbidity and mortality. Identification of this cohort has required the gold standard liver biopsy, which is both invasive and expensive. The use of serum biomarkers and noninvasive imaging techniques is an area of significant clinical relevance. This narrative review outlines current and emerging technologies for the diagnosis of NAFLD, nonalcoholic steatohepatitis, and hepatic fibrosis. METHODS We reviewed the literature using PubMed and reviewed national and international guidelines and conference proceedings to provide a comprehensive overview of the evidence. FINDINGS Significant advances have been made during the past 2 decades that have enhanced noninvasive assessment of NAFLD without the need for liver biopsy. For the detection of steatosis, abdominal ultrasonography remains the first-line investigation, although a controlled attenuation parameter using transient elastography is more sensitive. For detecting fibrosis, noninvasive serum markers of fibrosis and algorithms based on routine biochemistry are available, in addition to transient elastography. These techniques are well validated and have been incorporated into national and international screening guidelines. These approaches have facilitated more judicious use of liver biopsy but are yet to entirely replace it. Although serum biomarkers present a pragmatic and widely available screening approach for NAFLD in large population-based studies, magnetic resonance imaging techniques offer the benefit of achieving high degrees of accuracy in disease grading, tumor staging, and assessing therapeutic response. IMPLICATIONS This diagnostic clinical and research field is rapidly evolving; increasingly combined applications of biomarkers and transient elastography or imaging of selective (intermediate or high risk) cases are being used for clinical and research purposes. Liver biopsy remains the gold standard investigation, particularly in the context of clinical trials, but noninvasive options are emerging, using multimodality assessment, that are quicker, more tolerable, more widely available and have greater patient acceptability.
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Affiliation(s)
- T Hydes
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals National Health Service Foundation Trust, Liverpool, United Kingdom.
| | - E Brown
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals National Health Service Foundation Trust, Liverpool, United Kingdom
| | - A Hamid
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals National Health Service Foundation Trust, Liverpool, United Kingdom
| | - A C Bateman
- Department of Cellular Pathology, Southampton General Hospital, Southampton, United Kingdom
| | - D J Cuthbertson
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals National Health Service Foundation Trust, Liverpool, United Kingdom
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Colenutt C, Brown E, Paton DJ, Mahapatra M, Parida S, Nelson N, Maud J, Motta P, Sumption K, Adhikari B, Kafle SC, Upadhyaya M, Pandey SK, Gubbins S. Environmental sampling for the detection of foot-and-mouth disease virus and peste des petits ruminants virus in a live goat market, Nepal. Transbound Emerg Dis 2021; 69:3041-3046. [PMID: 34331827 DOI: 10.1111/tbed.14257] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/20/2021] [Indexed: 01/15/2023]
Abstract
Livestock markets are considered vital parts of the agricultural economy, particularly in developing countries where livestock keeping contributes to both food security and economic stability. Animals from diverse sources are moved to markets, they mix while they are there and are subsequently redistributed over wide geographic areas. Consequently, markets provide an opportunity for targeted surveillance for circulating pathogens. This study investigated the use of environmental sampling at a live goat market in Nepal for the detection of foot-and-mouth disease virus (FMDV) and peste des petits ruminants virus (PPRV), both of which are endemic. Five visits to the market were carried out between November 2016 and April 2018, with FMDV RNA detected on four visits and PPRV RNA detected on all five visits. Overall, 4.1% of samples (nine out of 217) were positive for FMDV RNA and 60.8% (132 out of 217) were positive for PPRV RNA, though the proportion of positive samples varied amongst visits. These results demonstrate that non-invasive, environmental sampling methods have the potential to be used to detect circulation of high priority livestock diseases at a live animal market and, hence, to contribute to their surveillance and control.
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Affiliation(s)
| | - Emma Brown
- The Pirbright Institute, Pirbright, Surrey, UK
| | | | | | | | | | - Jenny Maud
- European Commission for the Control of Foot-and-Mouth Disease (EuFMD), Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Paolo Motta
- European Commission for the Control of Foot-and-Mouth Disease (EuFMD), Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Keith Sumption
- European Commission for the Control of Foot-and-Mouth Disease (EuFMD), Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Bishnu Adhikari
- European Commission for the Control of Foot-and-Mouth Disease (EuFMD), Food and Agriculture Organization of the United Nations (FAO), Rome, Italy.,Food and Agriculture Organization of the United Nations, Nepal Country Office, Kathmandu, Nepal
| | - Sharmila Chapagain Kafle
- FMD and TADs Laboratory, Department of Livestock Services, Ministry of Livestock Development, Kathmandu, Nepal
| | - Mukul Upadhyaya
- Department of Livestock Services, Veterinary Epidemiology Centre, Ministry of Livestock Development, Kathmandu, Nepal
| | - Samjana Kafle Pandey
- Directorate of Animal Health, Department of Livestock Services, Ministry of Livestock Development, Kathmandu, Nepal
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Wooten T, Brown E, Sullivan DR, Logue MW, Fortier CB, Fonda JR, DeGutis J, Salat DH, McGlinchey R, Milberg W, Esterman M. Apolipoprotein E (APOE) ε4 moderates the relationship between c-reactive protein, cognitive functioning, and white matter integrity. Brain Behav Immun 2021; 95:84-95. [PMID: 33631288 DOI: 10.1016/j.bbi.2021.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/26/2021] [Accepted: 02/18/2021] [Indexed: 01/21/2023] Open
Abstract
Elevated serum C-reactive protein (CRP) and possessing an APOE ε4 allele are two of the most prominent risk factors for cognitive and neurological dysfunction in older adults, but little is known about the unique or cumulative effects of these risk factors in young-to-middle-aged adults. To further characterize these potential relationships, measures of cognition and microstructural white matter integrity were examined using data from a sample of 329 post-9/11 war veterans that was collected as part of a comprehensive evaluation that included assessment of neuropsychological functioning, MRI scanning, psychiatric diagnoses, health screening, markers of inflammation, and APOE genotypes. Hierarchical linear regression analyses revealed the CRP and APOE ε4 interaction was associated with global cognition (β = -0.633), executive functioning (β = -0.566), and global fractional anisotropy (β = -0.470), such that elevated CRP was associated with worse cognition and white matter integrity in APOE ε4 carriers. Diffusion tensor imaging (DTI) was used to determine if CRP × APOE ε4 presence was associated with regionally specific fractional anisotropy in white matter tracts. Tract-based spatial statistics revealed CRP × APOE ε4 presence was associated with fractional anisotropy in the corpus callosum, right superior longitudinal fasciculus, right posterior corona radiata, as well as the bilateral anterior and superior corona radiatas. This suggests that APOE ε4 carriers may be uniquely vulnerable to the potentially negative impact of elevated systematic inflammation to cognition and microstructural white matter integrity.
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Affiliation(s)
- Thomas Wooten
- Tufts University, Boston, MA, USA; Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Boston Attention and Learning Laboratory, VA Healthcare System, Boston, MA, USA.
| | - Emma Brown
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
| | - Danielle R Sullivan
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Mark W Logue
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA; Biomedical Genetics, Boston University School of Medicine, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Catherine B Fortier
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA; Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer R Fonda
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA; Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Joseph DeGutis
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Boston Attention and Learning Laboratory, VA Healthcare System, Boston, MA, USA
| | - David H Salat
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Regina McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Michael Esterman
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA; Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA; Boston Attention and Learning Laboratory, VA Healthcare System, Boston, MA, USA
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Galetti I, Brown E, Kennedy A, Riggs RJ, Roennow A, Sauvé M, Welling J, Finnern H, Gilbert A, Gahlemann M, Sauter W. POS1497-PARE POST-TRIAL SURVEY OF PARTICIPANTS OF A PHASE 3 CLINICAL TRIAL IN SSC-ILD. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The SENSCIS® trial (2015–18) was a large clinical trial (n=576) investigating the efficacy and safety of nintedanib in patients with systemic sclerosis-associated interstitial lung disease.1 The clinical research sponsors (CRS) collaborated with the scleroderma patient community advisory board (CAB) regarding the design, implementation and conduct of the trial.2 As part of this collaboration, the CRS and CAB developed a post-trial survey for SENSCIS® participants. The use of the developed patient-centric materials was optional for the sites.Objectives:The objectives of the SENSCIS® post-trial survey were to gain experience in collecting real-world information and trial satisfaction data from patients to inform and improve future patient centric clinical research.Methods:SENSCIS® trial participants who were involved in the extension trial SENSCIS®-ON completed a post-trial survey covering nine multiple-choice questions about three main topics:[1]Recruitment – Where do patients usually search for clinical trials and how did they become aware of SENSCIS®?[2]Motivation & Retention – What motivated patients to start and continue participation in SENSCIS®?[3]Challenges & Wishes – What were the challenges during trial participation and how can future clinical trials be improved regarding patient centricity?Results:A total of 125 participants completed all survey questions. Participants could select more than one option. A total of 51 patients reported that they are usually not actively looking for trials. For those actively searching, the most common sources to learn about trials were specialists/general practitioners (GPs) (46 patients) and internet search engines (20 patients), followed by patient organisations (12 patients). Of note, 78 patients would pay attention to printed materials, such as a card/flyer/poster in a doctor’s office and get in touch with a trial/study site.Back in 2015–2017, during recruitment for the SENSCIS® trial, the majority of the patients who answered the survey were made aware via their specialist/GP (116 patients), whereas 5 were made aware via patient organisations and 4 via the internet.The most frequent motivations to join the trial were ‘hope to receive an improved therapy’ (98 patients), to help other patients (64 patients), and on the recommendation of their specialist/GP (81 patients). Similarly, the most liked aspects of the trial were the ‘opportunity to receive an improved therapy’ (92 patients) and ‘to support the development of an improved therapy for my illness’ (90 patients). More than half of patients reported ‘continuous observation of general health’ (72 patients) and ‘advice from GPs/specialists’ (71 patients) as motivation to stay in the trial (Figure 1).‘Concerns about side effects’ (72 patients) and ‘not knowing whether the trial medication will work for me’ (63 patients) were reported as the least liked aspects of the trial. Travel to the site was reported as a challenge by 21 patients.To improve clinical trials, patients requested more patient-friendly information (50 patients) and multiple formats of information material (46 patients). Finally, 48 patients expressed the desire to communicate with other trial participants.Conclusion:The SENSCIS® post-trial survey is a unique approach to receive real-world feedback from trial participants, and these pilot data will help improve future clinical trials and communication. The results highlight the importance of reaching patients who may not be actively looking for clinical trials.Figure 1.Motivation to stay in the SENSCIS® trial1,21More than one option could be selected.2Data collected on 9th January 2021References:[1]Distler O et al. N Engl J Med. 2019 Jun 27;380(26):2518-2528. doi: 10.1056/NEJMoa1903076.[2]Roennow A et al. BMJ Open. 2020 Dec 16;10(12):e039473. doi: 10.1136/bmjopen-2020-039473.Acknowledgements:Sue Farrington (Federation of European Scleroderma Associations [FESCA] Belgium), Luke Evnin (Scleroderma Research Foundation, United States), Beatriz Garcia (Asociacion Espanola de Esclerodermia, Spain), Catarina Leite (Associacao Portuguesa de Doentes com Esclerodermia, Portugal), Alison Zheng (Chinese Organisation for Scleroderma), Matea Perković Popović (Hrvatska udruga oboljelih od sklerodermije, Croatia), Tina Ampudia (Asociacion Mexicana de Orientacion Apoyo y Lucha Contra la Esclerodermia, AC, Mexico), Stephanie Munoz (Norsk Revmatikerforbund, Diagnosegruppen for Systemisk Sklerose, Norway), Monica Holmner (Reumatikerförbundet Riksföreningen för systemisk skleros, Sweden).Disclosure of Interests:Ilaria Galetti: None declared, EDITH BROWN: None declared, Ann Kennedy Consultant of: I have been a member of the CAB (Community Patient Advisory Board) described in the accompanying abstract under discussion. My patient organisation has been paid for its participation in the CAB., Grant/research support from: It is not myself personally, but FESCA (Federation of European Scleroderma Associations) aisbl., that has received project grants for awareness raising and education. I was President of this Federation., Robert J Riggs: None declared, Annelise Roennow: None declared, Maureen Sauvé: None declared, Joep Welling Speakers bureau: BI MIDI and BI International, Sanofi, Henrik Finnern Employee of: I am employee of Boehringer Ingelheim International GmbH, Annie Gilbert Consultant of: I am a paid consultant for Bohringer Ingelheim since 2016, Martina Gahlemann Employee of: I am employed by Boehringer Ingelheim (Schweiz) GmbH, Basel, Switzerland, Wiebke Sauter Employee of: I am employer of Boehringer-Ingelheim
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