1
|
Chen Y, Gong X, Bao H. Real-world clinical outcomes of oral anticoagulants among Japanese patients with atrial fibrillation and concomitant coronary artery disease. Int J Cardiol Heart Vasc 2023; 49:101285. [PMID: 38020057 PMCID: PMC10651495 DOI: 10.1016/j.ijcha.2023.101285] [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: 09/12/2023] [Revised: 10/11/2023] [Accepted: 10/15/2023] [Indexed: 12/01/2023]
Abstract
Background Stroke prevention is complicated in patients with atrial fibrillation (AF) and coronary artery disease (CAD). We compared the risk of major bleeding among Japanese patients with AF and CAD commencing warfarin, dabigatran, or rivaroxaban. Methods This study included adults with AF and CAD who were newly prescribed the non-vitamin K antagonist oral anticoagulants (NOACs) dabigatran or rivaroxaban, or warfarin, and registered between 18 April 2011 through 31 December 2020 in the Medical Data Vision hospital-based clinical database. The primary outcome was major bleeding, and the secondary outcome was a composite of stroke, systemic embolism, myocardial infarction, all-cause inpatient mortality, major bleeding, major gastrointestinal bleeding, and intracerebral hemorrhage. Cox proportional hazard models with stabilized inverse probability treatment weighting were used to estimate hazard ratios (HRs) with 95 % CIs via a two-step approach; first between warfarin and each NOAC, then between NOACs if sample size conditions were met. Results Dabigatran, rivaroxaban, and warfarin groups included 6712, 20,329, and 12,316 patients, respectively. Major bleeding risk was lower in NOACs versus warfarin (dabigatran: HR 0.50, 95 % CI: 0.40-0.62; rivaroxaban: HR 0.78, 95 % CI: 0.69-0.90); this risk was lower with dabigatran compared with rivaroxaban (HR 0.64, 95 % CI: 0.51─0.79). Net clinical benefit was superior to warfarin in both NOACs (dabigatran: HR 0.78, 95 % CI: 0.71-0.85; rivaroxaban: HR 0.83, 95 % CI: 0.78-0.88). Conclusions Among real-world Japanese patients with AF and CAD, NOACs were associated with better clinical outcomes than warfarin. Treatment with dabigatran had a lower risk of major bleeding than rivaroxaban.Clinical trial registration: NCT05051904 (ClinicalTrials.gov).
Collapse
Affiliation(s)
| | | | - Haikun Bao
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA
| |
Collapse
|
2
|
Xu H, Chen HC, Yang L, Yang G, Liang L, Yang Y, Tang H, Bao H, Wu X, Shao Y, An G, Wang Y. Mutational landscape of SWI/SNF complex genes reveal correlation to predictive biomarkers for immunotherapy sensitivity in lung adenocarcinoma patients. ESMO Open 2023; 8:101585. [PMID: 37327699 DOI: 10.1016/j.esmoop.2023.101585] [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: 01/18/2023] [Revised: 04/13/2023] [Accepted: 05/15/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND The search for prognostic biomarkers indicating sensitivity to immunotherapy in lung adenocarcinoma patients has zeroed in on genes in the switch/sucrose non-fermentable (SWI/SNF) pathway. The mutational profiles of key genes are not clearly defined, however, and no comparisons have been conducted on whether mutations in the genes involved provide the same predictive value. METHODS In this study, analysis of clinical factors, tumor mutation burden (TMB), chromosomal instability, and co-alterations was conducted for 4344 lung adenocarcinoma samples. Independent online cohorts (N = 1661 and 576) were used to supplement the analysis with survival and RNA-seq data. RESULTS Mutational burden and chromosomal instability analysis showed that ARID family mutations (including ARID1A, ARID1B, or ARID2 mutations) and SMARC family mutations (including SMARCA4 or SMARCB1 mutations) display different profiles from wild-type (WT) samples (TMB: ARID versus WT: P < 2.2 × 10-16, SMARC versus WT: P < 2.2 × 10-16; CIN: ARID versus WT: P = 1.8 × 10-5, SMARC versus WT: P = 0.027). Both mutant groups have a higher proportion of transversions than transitions, whereas the ratio is more equal for wild-type samples. Survival analysis shows that patients with ARID mutations were more sensitive to immunotherapy treatment than wild-type and SMARC-mutated patients (P < 0.001 and P = 0.013, respectively), and multivariate Cox analysis reveals that the presence of ARID mutations is likely the main cause. CONCLUSIONS The research presented in this study shows that mutations in the ARID gene family, including ARID1A, ARID1B, and ARID2, are primarily responsible for the sensitive response to immunotherapy treatment in patients with lung adenocarcinoma.
Collapse
Affiliation(s)
- H Xu
- Departments of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - H-C Chen
- Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - L Yang
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing
| | - G Yang
- Department of Respiratory Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong
| | - L Liang
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing
| | - Y Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - H Tang
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu
| | - H Bao
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu
| | - X Wu
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu
| | - Y Shao
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu
| | - G An
- Department of Oncology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Y Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing.
| |
Collapse
|
3
|
Bao H, Zhang J, Wang N, Kuznetsov NV, Bao BC. Adaptive synapse-based neuron model with heterogeneous multistability and riddled basins. Chaos 2022; 32:123101. [PMID: 36587361 DOI: 10.1063/5.0125611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
Biological neurons can exhibit complex coexisting multiple firing patterns dependent on initial conditions. To this end, this paper presents a novel adaptive synapse-based neuron (ASN) model with sine activation function. The ASN model has time-varying equilibria with the variation of externally applied current and its equilibrium stability involves transitions between stable and unstable points through fold and Hopf bifurcations, resulting in complex distributions of attractive regions with heterogeneous multi-stability. Globally coexisting heterogeneous behaviors are studied by bifurcation diagram, phase portrait, dynamical distribution, and basin of attraction. The results show that the number of coexisting heterogeneous attractors can be up to 12, but for a simple neuron model, such a large number of coexisting heterogeneous attractors has not been reported in the relevant literature. Most interestingly, the ASN model also has riddled-like complex basins of attraction and four illustrative examples are depicted by the phase portraits with small changes of the initial conditions. Besides, the ASN model is implemented using a simple microcontroller platform, and various heterogeneous coexisting attractors are acquired experimentally to validate the numerical results.
Collapse
Affiliation(s)
- H Bao
- School of Microelectronics and Control Engineering, Changzhou University, Changzhou 213164, China
| | - J Zhang
- School of Microelectronics and Control Engineering, Changzhou University, Changzhou 213164, China
| | - N Wang
- School of Microelectronics and Control Engineering, Changzhou University, Changzhou 213164, China
| | - N V Kuznetsov
- Faculty of Mathematics and Mechanics, St. Petersburg State University, Peterhof, St. Petersburg 198504, Russia
| | - B C Bao
- School of Microelectronics and Control Engineering, Changzhou University, Changzhou 213164, China
| |
Collapse
|
4
|
Meyer E, Kruglov D, Krivic M, Tanveer M, Argaez-Ramirez R, Zhang Y, Briseno Ojeda A, Smirnova K, Alekseev K, Safari Mugisho M, Cimbili B, Farid N, Dang Y, Shahid M, Ensan M, Banar J, Bao H, Matters-Kammerer M, Gustavsson U, Demuynck F, Zwick T, Acar M, Fager C, van der Heijden M, Ivashina M, Caratelli D, Hasselblad M, Ulusoy C, Smolders A, Eriksson K, Johannson M, Maaskant R, Quay R, Floriot D, Bao M, Bronckers L, Fridén J, van Beurden M, de Hon B, Kolitsidas C, Blanco D, Willems F, Eriksson T, Filippi A, Ponzini F, Johannsen U. The state of the art in beyond 5G distributed massive multiple-input multiple-output communication system solutions. Open Res Eur 2022; 2:106. [PMID: 37982077 PMCID: PMC10654493 DOI: 10.12688/openreseurope.14501.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/21/2023]
Abstract
Beyond fifth generation (5G) communication systems aim towards data rates in the tera bits per second range, with improved and flexible coverage options, introducing many new technological challenges in the fields of network architecture, signal pro- cessing, and radio frequency front-ends. One option is to move towards cell-free, or distributed massive Multiple-Input Multiple-Output (MIMO) network architectures and highly integrated front-end solutions. This paper presents an outlook on be- yond 5G distributed massive MIMO communication systems, the signal processing, characterisation and simulation challenges, and an overview of the state of the art in millimetre wave antennas and electronics.
Collapse
Affiliation(s)
- E. Meyer
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - D. Kruglov
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - M. Krivic
- Keysight Technologies, Kortrijksesteenweg 1093B, 9051 Gent, Belgium
| | - M. Tanveer
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - R. Argaez-Ramirez
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - Y. Zhang
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | | | - K. Smirnova
- Karlsruhe Institute of Technology, 6131 Karlsruhe, Germany
| | - K. Alekseev
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - M. Safari Mugisho
- Fraunhofer Institute for Applied Solid State Physics, IAF, Tullastraße 72, 79108 Freiburg, Germany
| | - B. Cimbili
- Fraunhofer Institute for Applied Solid State Physics, IAF, Tullastraße 72, 79108 Freiburg, Germany
| | - N. Farid
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - Y. Dang
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - M. Shahid
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - M. Ensan
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - J. Banar
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - H. Bao
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - M. Matters-Kammerer
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - U. Gustavsson
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - F. Demuynck
- Keysight Technologies, Kortrijksesteenweg 1093B, 9051 Gent, Belgium
| | - T. Zwick
- Karlsruhe Institute of Technology, 6131 Karlsruhe, Germany
| | - M. Acar
- NXP Semiconductors, High Tech Campus 60, 5656 AG Eindhoven, The Netherlands
| | - C. Fager
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - M. van der Heijden
- NXP Semiconductors, High Tech Campus 60, 5656 AG Eindhoven, The Netherlands
| | - M. Ivashina
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - D. Caratelli
- The Antenna Company, High Tech Campus 29, 5656 AE Eindhoven, The Netherlands
| | - M. Hasselblad
- Gapwaves, Nellickevagen 22, 412 63 Gothenburg, Sweden
| | - C. Ulusoy
- Karlsruhe Institute of Technology, 6131 Karlsruhe, Germany
| | - A.B. Smolders
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - K. Eriksson
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - M. Johannson
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - R. Maaskant
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - R. Quay
- Fraunhofer Institute for Applied Solid State Physics, IAF, Tullastraße 72, 79108 Freiburg, Germany
| | - D. Floriot
- United Monolithic Semiconductors SAS, Bâtiment Charmille, Mosaic parc de Courtaboeuf, 10 avenue du Québec, 91140, Villebon-sur-Yvette, France
| | - M. Bao
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - L.A. Bronckers
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - J. Fridén
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - M.C. van Beurden
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - B.P. de Hon
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - C. Kolitsidas
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - D. Blanco
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - F.M.J. Willems
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - T. Eriksson
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - A. Filippi
- NXP Semiconductors, High Tech Campus 60, 5656 AG Eindhoven, The Netherlands
| | - F. Ponzini
- Ericsson Telecomunicazioni SpA, Via Anagnina 203, 00118 Rome, Italy
| | - U. Johannsen
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| |
Collapse
|
5
|
Hu J, Ding N, Chen Y, Liu J, Zhou J, Xu X, Bao H, Song Y, Zhang D, Shao Y, Zhang Y. 1011P MET and NF2 alterations confer early resistance to first-line alectinib treatment in ALK-rearranged non-small cell lung cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
6
|
Fu R, Tang WF, Yang LL, Wu M, Bao H, Shao Y, Zhang C, Hong HZ, Wu YL, Zhong WZ. EP16.02-024 Plasma ctDNA Organ-Specific Genomic Patterns and Origination Analysis in Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1055] [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: 10/14/2022]
|
7
|
Su S, Xuan Y, Fan X, Bao H, Tang H, Lv X, Ren W, Chen F, Wu X, Shao Y, Wang T, Wang L. 1681P Testing the generalizability of cfDNA fragmentomic features across different studies for cancer early detection. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1760] [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: 11/28/2022] Open
|
8
|
Han Y, Lu S, Zhao R, Xu Y, Chen Y, Xiang C, Wu Q, Chen S, Pang J, Shang Z, Zhao J, Bao H, Shao Y. EP16.03-044 Genomic Evidence Depicting Clonal Evolution of Lung Adenosquamous Carcinoma. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1105] [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: 10/14/2022]
|
9
|
Chen S, Holyoak M, Liu H, Bao H, Ma Y, Dou H, Li G, Roberts NJ, Jiang G. Global warming responses of gut microbiota in moose (
Alces alces
) populations with different dispersal patterns. J Zool (1987) 2022. [DOI: 10.1111/jzo.12998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Chen
- Feline Research Center of National Forestry and Grassland Administration, College of Wildlife and Protected Area Northeast Forestry University Harbin China
- Northeast Asia Biodiversity Research Center Northeast Forestry University Harbin China
| | - M. Holyoak
- Department of Environmental Science and Policy University of California Davis California USA
| | - H. Liu
- Feline Research Center of National Forestry and Grassland Administration, College of Wildlife and Protected Area Northeast Forestry University Harbin China
- Northeast Asia Biodiversity Research Center Northeast Forestry University Harbin China
- College of Forestry Hainan University Haikou China
| | - H. Bao
- Feline Research Center of National Forestry and Grassland Administration, College of Wildlife and Protected Area Northeast Forestry University Harbin China
- Northeast Asia Biodiversity Research Center Northeast Forestry University Harbin China
| | - Y. Ma
- Feline Research Center of National Forestry and Grassland Administration, College of Wildlife and Protected Area Northeast Forestry University Harbin China
- Northeast Asia Biodiversity Research Center Northeast Forestry University Harbin China
- Key Lab of Animal Ecology and Conservation Biology, Institute of Zoology Chinese Academy of Sciences Beijing China
| | - H. Dou
- Feline Research Center of National Forestry and Grassland Administration, College of Wildlife and Protected Area Northeast Forestry University Harbin China
- Northeast Asia Biodiversity Research Center Northeast Forestry University Harbin China
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization Guangdong Academy of Forestry Guangzhou China
| | - G. Li
- State Key Laboratory of Integrated Pest Management, Institute of Zoology Chinese Academy of Sciences Beijing China
| | - N. J. Roberts
- Feline Research Center of National Forestry and Grassland Administration, College of Wildlife and Protected Area Northeast Forestry University Harbin China
- Northeast Asia Biodiversity Research Center Northeast Forestry University Harbin China
| | - G. Jiang
- Feline Research Center of National Forestry and Grassland Administration, College of Wildlife and Protected Area Northeast Forestry University Harbin China
- Northeast Asia Biodiversity Research Center Northeast Forestry University Harbin China
| |
Collapse
|
10
|
Hua G, Zhang X, Zhang M, Wang Q, Chen X, Yu R, Bao H, Liu J, Wu X, Shao Y, Liang B, Lu K. Real-world circulating tumor DNA analysis depicts resistance mechanism and clonal evolution in ALK inhibitor-treated lung adenocarcinoma patients. ESMO Open 2022; 7:100337. [PMID: 35123209 PMCID: PMC8818928 DOI: 10.1016/j.esmoop.2021.100337] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/01/2021] [Accepted: 11/15/2021] [Indexed: 12/11/2022] Open
Abstract
Background Sequential treatment with different generations of anaplastic lymphoma kinase (ALK) inhibitors have been widely applied to ALK-positive lung cancer; however, resistance mutations inevitably developed. Further characterization of ALK resistance mutations may provide key guidance to subsequent therapies. Here we explored the emergence of secondary ALK mutations during sequential ALK tyrosine kinase inhibitor (TKI) treatment in a real-world study of Chinese lung adenocarcinoma (ADC) patients. Methods A clinical-genomic database was queried for lung ADC patients with at least one ALK inhibitor treatment and at least one plasma sample collected following ALK inhibitor treatment. Targeted genome profiling was performed with a 139-gene panel in baseline tumor tissue and serial plasma samples of patients. Results A total of 116 patients met inclusion criteria. ALK G1202R was more common in patients with echinoderm microtubule-associated protein-like 4 (EML4)-ALK v3 fusion, whereas ALK L1196M was more common in v1. TP53 mutant patients were significantly associated with harboring multiple ALK resistance mutations (P = 0.03) and v3+/TP53 mutant patients had the highest rate of multiple ALK resistance mutations. The sequential use of ALK TKI led to an increased incidence of concurrent ALK mutations along the lines of therapies. Alectinib had a lower rate (9%) harboring ALK resistance mutation as first-line ALK TKI compared with crizotinib (36%). ALK compound mutations identified included ALK D1203N/L1196M, ALK G1202R/L1196M, and ALK G1202R/F1174C, which may be lorlatinib resistant. Using paired pretreatment and post-treatment samples, we identified several ALK-independent resistance-related genetic alterations, including PTPRD and CNKN2A/B loss, MYC, MYCN and KRAS amplification, and EGFR19del. Conclusions Sequential postprogression plasma profiling revealed that increased lines of ALK inhibitors can accelerate the accumulation of ALK resistance mutations and may lead to treatment-refractory compound ALK mutations. The selection for optimal first-line TKI is very important to achieve a more efficacious long-term strategy and prevent the emergence of on-target resistance, which may provide guidance for clinical decision making. ALK resistance mutations were differentially enriched in the setting of EML4-ALK v1/v3 and TP53 status. Serial liquid biopsies NGS depicted accumulation of multiple ALK secondary mutations during sequential ALK treatments. Several lorlatinib-resistant ALK compound mutations and ALK-independent resistance genetic alterations were identified.
Collapse
Affiliation(s)
- G Hua
- Department of Cardiothoracic Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China; Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - X Zhang
- Respiratory and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - M Zhang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Q Wang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - X Chen
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, China
| | - R Yu
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, China
| | - H Bao
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, China
| | - J Liu
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, China
| | - X Wu
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, China
| | - Y Shao
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, China; School of Public Health, Nanjing Medical University, Nanjing, China
| | - B Liang
- Department of Respiratory Medicine, Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Foshan, China.
| | - K Lu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| |
Collapse
|
11
|
Guo W, Liang N, Ma Q, Chen X, Liu R, Wu S, Bao H, Wu X, Shao Y, Qiu B, Wang D, Tan F, Gao Y, Xue Q, Gao S. MA07.07 Detecting Stage I Lung Cancer with High Sensitivity Using Genome-wide Multi-dimensional Fragmentomic Profiles of Cell Free DNA. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.145] [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: 11/29/2022]
|
12
|
Zhang X, Wang Z, Wang X, Tang W, Liu R, Bao H, Chen X, Wu S, Wu X, Shao Y, Fan J, Zhou J. 950P Ultra-sensitive and cost-effective method for early stage hepatocellular carcinoma and intrahepatic cholangiocarcinoma detection using plasma cfDNA fragmentomic profiles. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.170] [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
|
13
|
Wang Y, Fan X, Xu Y, Bao H, Xia F, Wan J, Shen L, Wu X, Shao Y, Li X, Xu Y, Cai S, Zhang Z. 451P Utility of circulating free DNA 5’-end motif profile in the prediction of pathological response after neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
14
|
Wen H, Feng Z, Ma Y, Liu R, Ou Q, Bao H, Wu X, Wu X. 67P Homologous recombination deficiency in diverse cancer types and its correlation with platinum chemotherapy efficiency in ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.347] [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] Open
|
15
|
Zhu M, Ji X, Zhou Y, Li S, Bao H, Xu J, Gao E, Zhu X. A NEW La(III) COMPLEX CONSTRUCTED BY A LONG FLEXIBLE LIGAND: CRYSTAL STRUCTURE, DNA BINDING, AND MOLECULAR DOCKING STUDIES. J STRUCT CHEM+ 2021. [DOI: 10.1134/s0022476621070192] [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: 11/22/2022]
|
16
|
Qiu L, Jin J, Cen H, Zhou K, Xu X, Li F, Wu T, Yang H, Wang Z, Li Z, Bao H, Xu Z, Shu Y. A PHASE I
B
STUDY OF AN ORAL PI3Kδ INHIBITOR LINPERLISIB IN PATIENTS WITH RELAPSED OR REFRACTORY PERIPHERAL T CELL LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.128_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- L. Qiu
- Blood Institute of the Chinese Academy of Medical Sciences lymphoma treatment center Tianjin China
| | - J. Jin
- First Hospital Affiliated Zhe Jiang Medical University Department of Hematology Hangzhou China
| | - H. Cen
- Guangxi Medical University Affiliated Tumor Hospital Department of Medical Oncology Nanning China
| | - K. Zhou
- Henan Cancer Hospital Department of Hematology Zhengzhou China
| | - X. Xu
- Cancer Hospital affiliated to Nantong University Department of Hematology and Lymphoma Nantong China
| | - F. Li
- The First Affiliated Hospital of Nanchang University Department of Hematology Nanchang China
| | - T. Wu
- Guizhou Cancer Hospital Department of Lymphoma Guiyang China
| | - H. Yang
- Cancer Hospital of The University of Chinese Academy of Sciences Department of Lymphoma Hangzhou China
| | - Z. Wang
- Linyi Cancer Hospital Department of Medical Oncology Linyi China
| | - Z. Li
- Sun Yat‐Sen University Cancer Center Department of Medical Oncology Guangzhou China
| | - H. Bao
- Shanghai Yingli Pharmaceutical Co., Ltd Clinical Management Department Shanghai China
| | - Z. Xu
- Shanghai Yingli Pharmaceutical Co., Ltd Clinical Management Department Shanghai China
| | - Y. Shu
- Shanghai Yingli Pharmaceutical Co., Ltd Clinical Management Department Shanghai China
| |
Collapse
|
17
|
Liu J, Zhou J, Li J, Bao H. Identification of candidate genes associated with slaughter traits in F2 chicken population using genome-wide association study. Anim Genet 2021; 52:532-535. [PMID: 34028062 DOI: 10.1111/age.13079] [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] [Accepted: 04/29/2021] [Indexed: 12/23/2022]
Abstract
Slaughter traits are crucial economic traits of chickens. We performed a GWAS to discover critical loci and candidate genes for 21 slaughter traits in an F2 chicken population resulting from crossing Luxi gamecocks and recessive white feather broilers. We found some SNPs and genes which were significantly associated with keel length, head length, body slope length, bilateral leg weight without shin, bilateral foot weight, subcutaneous fat thickness, heart weight, muscular stomach weight and glandular stomach weight. This study provides references for further investigation of slaughter traits and molecular breeding in chicken.
Collapse
Affiliation(s)
- J Liu
- National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory of Animal Genetic Improvement, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - J Zhou
- National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory of Animal Genetic Improvement, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - J Li
- National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory of Animal Genetic Improvement, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - H Bao
- National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory of Animal Genetic Improvement, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| |
Collapse
|
18
|
Wang Y, Li Y, Li C, Jiang Y, Han X, Liu S, Xu X, Tang W, Ou Q, Bao H, Wu X, Shao Y, Xing M, Zhang Y. MA08.06 Stratifying PD-L1 Expression Level Based on Multimodal Genomic Features for the Prediction of Immunotherapy Benefit in NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.193] [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: 10/21/2022]
|
19
|
Cai L, Chen Y, Tong X, Wu X, Bao H, Shao Y, Luo Z, Wang X, Cao Y. P35.29 The Genomic Landscape of Lung Cancer Patients Highlights Age-Dependent Mutation Frequencies and Clinical Actionability in Young Patients. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Tang W, Wu M, Bao H, Zhang Y, Zhang J, Su J, Lin J, Xu F, Chen J, Fu R, Chen Y, Wu T, Wu X, Shao Y, Dong S, Nie Q, Yang X, Wu Y, Zhong W. MA13.09 Heterogeneous Genomic Evolution and Immune Microenvironments in Metastatic Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.270] [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: 10/21/2022]
|
21
|
Zhang S, Xu Y, Zhao P, Bao H, Wang X, Liu R, Xu R, Xiang J, Jiang H, Yan J, Wu X, Shao Y, Liang J, Wu Q, Zhang Z, Lu S, Ma S. P35.23 Integrated Analysis of Genomic and Immunological Features in Lung Adenocarcinoma with Micropapillary Component. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.724] [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: 10/21/2022]
|
22
|
Mori M, Nasir K, Bao H, Jimenez A, Legore SS, Wang Y, Grady J, Lama SD, Brandi N, Lin Z, Kurlansky P, Geirsson A, Bernheim SM, Krumholz HM, Suter LG. Administrative Claims Measure for Profiling Hospital Performance Based on 90-Day All-Cause Mortality Following Coronary Artery Bypass Graft Surgery. Circ Cardiovasc Qual Outcomes 2021; 14:e006644. [PMID: 33535776 DOI: 10.1161/circoutcomes.120.006644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Coronary artery bypass graft (CABG) surgery is a focus of bundled and alternate payment models that capture outcomes up to 90 days postsurgery. While clinical registry risk models perform well, measures encompassing mortality beyond 30 days do not currently exist. We aimed to develop a risk-adjusted hospital-level 90-day all-cause mortality measure intended for assessing hospital performance in payment models of CABG surgery using administrative data. METHODS Building upon Centers for Medicare and Medicaid Services hospital-level 30-day all-cause CABG mortality measure specifications, we extended the mortality timeframe to 90 days after surgery and developed a new hierarchical logistic regression model to calculate hospital risk-standardized 90-day all-cause mortality rates for patients hospitalized for isolated CABG. The model was derived from Medicare claims data for a 3-year cohort between July 2014 to June 2017. The data set was randomly split into 50:50 development and validation samples. The model performance was evaluated with C statistics, overfitting indices, and calibration plot. The empirical validity of the measure result at the hospital level was evaluated against the Society of Thoracic Surgeons composite star rating. RESULTS Among 137 819 CABG procedures performed in 1183 hospitals, the unadjusted mortality rate within 30 and 90 days were 3.1% and 4.7%, respectively. The final model included 27 variables. Hospital-level 90-day risk-standardized mortality rates ranged between 2.04% and 11.26%, with a median of 4.67%. C statistics in the development and validation samples were 0.766 and 0.772, respectively. We identified a strong positive correlation between 30- and 90-day risk-standardized mortality rates, with a regression slope of 1.09. Risk-standardized mortality rates also showed a stepwise trend of lower 90-day mortality with higher Society of Thoracic Surgeons composite star ratings. CONCLUSIONS We present a measure of hospital-level 90-day risk-standardized mortality rates following isolated CABG. This measure complements Centers for Medicare and Medicaid Services' existing 30-day CABG mortality measure by providing greater insight into the postacute recovery period. It offers a balancing measure to ensure efforts to reduce costs associated with CABG recovery and rehabilitation do not result in unintended consequences.
Collapse
Affiliation(s)
- Makoto Mori
- Section of Cardiac Surgery, Department of Surgery, (M.M., A.G.), Yale School of Medicine, New Haven, CT.,Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Khurram Nasir
- Section of Cardiovascular Medicine (K.N., H.M.K), Yale School of Medicine, New Haven, CT.,Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Haikun Bao
- Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Andreina Jimenez
- Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Shani S Legore
- Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Yongfei Wang
- Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Jacqueline Grady
- Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Sonam D Lama
- Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Nina Brandi
- Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Zhenqiu Lin
- Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Paul Kurlansky
- Division of Cardiac Surgery, Columbia University Medical Center, New York, NY (P.K.)
| | - Arnar Geirsson
- Section of Cardiac Surgery, Department of Surgery, (M.M., A.G.), Yale School of Medicine, New Haven, CT
| | - Susannah M Bernheim
- Section of General Internal Medicine (S.M.B.), Yale School of Medicine, New Haven, CT.,Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.)
| | - Harlan M Krumholz
- Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.).,Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Lisa G Suter
- Section of Rheumatology, Department of Internal Medicine (L.G.S.) Yale School of Medicine, New Haven, CT.,Center for Outcomes Research & Evaluation, Yale New Haven Health System, New Haven, CT (M.M., K.N., H.B., A.J., S.L., Y.W., J.G., S.L., N.B., Z.L, S.M.B., H.M.K., L.G.S.).,West Haven Veterans Administration Medical Center, West Haven, CT (L.G.S.)
| |
Collapse
|
23
|
Yu Y, Hu L, Huang X, Zhou W, Bao H, Cheng X. BMI modifies the association between serum HDL cholesterol and stroke in a hypertensive population without atrial fibrillation. J Endocrinol Invest 2021; 44:173-181. [PMID: 32406023 DOI: 10.1007/s40618-020-01288-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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] [Received: 02/28/2020] [Accepted: 04/30/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Both high-density lipoprotein cholesterol (HDL-C) and body mass index (BMI) have an impact on the prevalence of stroke. However, it is unclear whether BMI can modify the relationship between HDL-C and stroke. Therefore, we aimed to assess the effect of the BMI on the association between HDL-C and stroke in a hypertensive population without atrial fibrillation (AF). METHODS We analyzed data of 10,925 hypertensive patients without AF from the Chinese Hypertension Registry Study. BMI was categorized as < 24 and ≥ 24 kg/m2. Multivariate logistic regression and smooth curve fitting (penalized spline method) were used to analyze the association between HDL-C and stroke in different BMI groups. Subgroup analysis and interaction tests were used to explore the effect of other variables on this relationship. RESULTS The results showed a negative association between HDL-C and stroke in the BMI < 24 kg/m2 group, but HDL-C was not associated with stroke in the BMI ≥ 24 kg/m2 group. In the BMI < 24 kg/m2 group, each 1 mmol/L increase in HDL-C was associated with a 50% decreased risk of stroke [odds ratio (OR) 0.50, 95% confidence interval (CI) 0.38-0.66]. No significant relationship between HDL-C and stroke was observed in the BMI ≥ 24 kg/m2 group (OR 0.73, 95% CI 0.49-1.10). There was a significant interaction between BMI and HDL-C in regard to the prevalence of stroke in the hypertensive population without AF (PInteraction = 0.027). CONCLUSIONS We found an inverse association between HDL-C and stroke only in the BMI < 24 kg/m2 group. The finding suggested that BMI could modify the association between HDL-C and stroke in hypertensive populations without AF.
Collapse
Affiliation(s)
- Y Yu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China
| | - L Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China
| | - X Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China
| | - W Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - H Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China.
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - X Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China.
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| |
Collapse
|
24
|
Shahin K, Zhang L, Bao H, Hedayatkhah A, Soleimani-Delfan A, Komijani M, He T, Barazandeh M, Mansoorianfar M, Bouzari M, Wang R. An in-vitro study on a novel six-phage cocktail against multi-drug resistant-ESBL Shigella in aquatic environment. Lett Appl Microbiol 2020; 72:231-237. [PMID: 33070360 DOI: 10.1111/lam.13418] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/06/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022]
Abstract
Shigella spp. are water-borne pathogens responsible for mild to severe cases bacilli dysentery all around the world known as Shigellosis. The progressively increasing of antibiotic resistance among Shigella calls for developing and establishing novel alternative therapeutic methods. The present study aimed to evaluate a novel phage cocktail of lytic phages against extended spectrum beta lactamase isolates of Shigella species in an aquatic environment. The phage cocktail containing six novel Shigella specific phages showed a broad host spectrum. The cocktail was very stable in aquatic environment. The cocktail resulted in about 99% decrease in the bacterial counts in the contaminated water by several species and strains of Shigella such as Shigella sonnei, Shigella flexneri and Shigella dysenteriae. Achieving such a high efficiency in this in-vitro study demonstrates a high potential for in-vivo and in-situ application of this phage cocktail as a bio-controlling agent against Shigella spp. contamination and infections.
Collapse
Affiliation(s)
- K Shahin
- Institute of Food Safety and Nutrition, Key Lab of Food Quality and Safety of Jiangsu Province-State Key Laboratory Breeding Base, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - L Zhang
- Institute of Food Safety and Nutrition, Key Lab of Food Quality and Safety of Jiangsu Province-State Key Laboratory Breeding Base, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - H Bao
- Institute of Food Safety and Nutrition, Key Lab of Food Quality and Safety of Jiangsu Province-State Key Laboratory Breeding Base, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - A Hedayatkhah
- School of Pharmacy and Biomedical Sciences, Curtin University, Perth, WA, Australia
| | - A Soleimani-Delfan
- Institute of Food Safety and Nutrition, Key Lab of Food Quality and Safety of Jiangsu Province-State Key Laboratory Breeding Base, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - M Komijani
- Department of Biology, Faculty of Science, Arak University, Arak, Iran
| | - T He
- Institute of Food Safety and Nutrition, Key Lab of Food Quality and Safety of Jiangsu Province-State Key Laboratory Breeding Base, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - M Barazandeh
- Institute of Food Safety and Nutrition, Key Lab of Food Quality and Safety of Jiangsu Province-State Key Laboratory Breeding Base, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - M Mansoorianfar
- Chinese Academy of Science, Suzhou Institute of Nano-Tech and Nano-Bionics, Suzhou, China
| | - M Bouzari
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - R Wang
- Institute of Food Safety and Nutrition, Key Lab of Food Quality and Safety of Jiangsu Province-State Key Laboratory Breeding Base, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| |
Collapse
|
25
|
Li L, Tang S, Yin J, Pang J, Bao H, Ge H, Liu Y, Wang J, Dong L, Mu D, Yuan S, Wu X, Wang X, Shao Y, Yu J, Yuan S. Molecular Biomarkers for Chemoradiotherapy Response in Unresectable Limited Stage Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
26
|
Weerahandi H, Li L, Bao H, Herrin J, Dharmarajan K, Ross JS, Kim KL, Jones S, Horwitz LI. Risk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study. J Am Med Dir Assoc 2020; 20:432-437. [PMID: 30954133 DOI: 10.1016/j.jamda.2019.01.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 09/21/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Discharge to skilled nursing facilities (SNFs) is common in patients with heart failure (HF). It is unknown whether the transition from SNF to home is risky for these patients. Our objective was to study outcomes for the 30 days after discharge from SNF to home among Medicare patients hospitalized with HF who had subsequent SNF stays of 30 days or less. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS All Medicare fee-for-service beneficiaries 65 and older admitted during 2012-2015 with a HF diagnosis discharged to SNF then subsequently discharged home. MEASURES Patients were followed for 30 days following SNF discharge. We categorized patients by SNF length of stay: 1 to 6 days, 7 to 13 days, and 14 to 30 days. For each group, we modeled time to a composite outcome of unplanned readmission or death after SNF discharge. Our model examined 0-2 days and 3-30 days post-SNF discharge. RESULTS Our study included 67,585 HF hospitalizations discharged to SNF and subsequently discharged home. Overall, 16,333 (24.2%) SNF discharges to home were readmitted within 30 days of SNF discharge. The hazard rate of the composite outcome for each group was significantly increased on days 0 to 2 after SNF discharge compared to days 3 to 30, as reflected in their hazard rate ratios: for patients with SNF length of stay 1 to 6 days, 4.60 (4.23-5.00); SNF length of stay 7 to 13 days, 2.61 (2.45-2.78); SNF length of stay 14 to 30 days, 1.70 (1.62-1.78). CONCLUSIONS/IMPLICATIONS The hazard rate of readmission after SNF discharge following HF hospitalization is highest during the first 2 days home. This risk attenuated with longer SNF length of stay. Interventions to improve postdischarge outcomes have primarily focused on hospital discharge. This evidence suggests that interventions to reduce readmissions may be more effective if they also incorporate the SNF-to-home transition.
Collapse
Affiliation(s)
- Himali Weerahandi
- Division of General Internal Medicine and Clinical Innovation, Department of Medicine, NYU School of Medicine, New York, NY.
| | - Li Li
- Center for Outcomes Research & Evaluation, Yale University, New Haven, CT
| | - Haikun Bao
- Center for Outcomes Research & Evaluation, Yale University, New Haven, CT
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT
| | | | - Joseph S Ross
- Center for Outcomes Research & Evaluation, Yale University, New Haven, CT; Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT
| | - Kunhee Lucy Kim
- Division of Healthcare Delivery Science, Department of Population Health, NYU School of Medicine, New York, NY
| | - Simon Jones
- Division of Healthcare Delivery Science, Department of Population Health, NYU School of Medicine, New York, NY
| | - Leora I Horwitz
- Division of Healthcare Delivery Science, Department of Population Health, NYU School of Medicine, New York, NY
| |
Collapse
|
27
|
Wu Y, Xu M, Bao H, Zhang JH. Sitagliptin inhibits EndMT in vitro and improves cardiac function of diabetic rats through the SDF-1α/PKA pathway. Eur Rev Med Pharmacol Sci 2020; 23:841-848. [PMID: 30720193 DOI: 10.26355/eurrev_201901_16899] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this paper was to study sitagliptin in improving the endothelial-mesenchymal transition (EndMT) of human aortic endothelial cells (HAECs) and cardiac function of rats with diabetes mellitus (DM) and its possible pathway. MATERIALS AND METHODS Sprague Dawley (SD) rats were divided into control group, DM group and sitagliptin group. The myocardial contraction and relaxation functions of rats in each group were observed via echocardiography. The changes in cardiac structure and fiber were observed via hematoxylin-eosin (HE) staining, Masson staining and Sirius red staining. The immunohistochemical assay was performed to observe the expressions of α-smooth muscle actin (α-SMA) and VE-cadherin in HAECs; the expression of reactive oxygen species (ROS) in HAECs was detected using the fluorescence probe. Moreover, the expressions of transforming growth factor-β1 (TGF-β1), phosphorylated-protein kinase A (p-PKA), PKA and extracellular signal-regulated kinase (ERK) were observed via Western blotting. RESULTS Sitagliptin could improve the myocardial contraction and relaxation functions in diabetic rats and EndMT and ROS production in HAECs. In the DM group, the expression of Glucagon-like peptide-1 (GLP-1) was decreased, while the expression of stromal-derived factor-1α (SDF-1α) was decreased and the expressions of downstream PKA/ERK pathway and TGF-β1 were increased. The above changes could be reversed by sitagliptin. CONCLUSIONS Sitagliptin can reverse the EndMT in HAECs as well as the cardiac function in diabetic rats through the SDF-1α/PKA pathway.
Collapse
Affiliation(s)
- Y Wu
- Department of Endocrine, Shanxian Central Hospital, Heze, Shandong, China.
| | | | | | | |
Collapse
|
28
|
Spatz ES, Suter LG, George E, Perez M, Curry L, Desai V, Bao H, Geary LL, Herrin J, Lin Z, Bernheim SM, Krumholz HM. An instrument for assessing the quality of informed consent documents for elective procedures: development and testing. BMJ Open 2020; 10:e033297. [PMID: 32434933 PMCID: PMC7247404 DOI: 10.1136/bmjopen-2019-033297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To develop a nationally applicable tool for assessing the quality of informed consent documents for elective procedures. DESIGN Mixed qualitative-quantitative approach. SETTING Convened seven meetings with stakeholders to obtain input and feedback on the tool. PARTICIPANTS Team of physician investigators, measure development experts, and a working group of nine patients and patient advocates (caregivers, advocates for vulnerable populations and patient safety experts) from different regions of the country. INTERVENTIONS With stakeholder input, we identified elements of high-quality informed consent documents, aggregated into three domains: content, presentation and timing. Based on this comprehensive taxonomy of key elements, we convened the working group to offer input on the development of an abstraction tool to assess the quality of informed consent documents in three phases: (1) selecting the highest-priority elements to be operationalised as items in the tool; (2) iteratively refining and testing the tool using a sample of qualifying informed consent documents from eight hospitals; and (3) developing a scoring approach for the tool. Finally, we tested the reliability of the tool in a subsample of 250 informed consent documents from 25 additional hospitals. OUTCOMES Abstraction tool to evaluate the quality of informed consent documents. RESULTS We identified 53 elements of informed consent quality; of these, 15 were selected as highest priority for inclusion in the abstraction tool and 8 were feasible to measure. After seven cycles of iterative development and testing of survey items, and development and refinement of a training manual, two trained raters achieved high item-level agreement, ranging from 92% to 100%. CONCLUSIONS We identified key quality elements of an informed consent document and operationalised the highest-priority elements to define a minimum standard for informed consent documents. This tool is a starting point that can enable hospitals and other providers to evaluate and improve the quality of informed consent.
Collapse
Affiliation(s)
- Erica S Spatz
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Yale-New Haven Health Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lisa G Suter
- Yale-New Haven Health Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut, USA
- Section of Rheumatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Elizabeth George
- School of Medicine, Quinnipiac University, Hamden, Connecticut, USA
| | - Mallory Perez
- Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Leslie Curry
- Robert Wood Johnson Foundation Clinical Scholars Program, Yale School of Medicine, New Haven, Connecticut, USA
- Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut, USA
| | - Vrunda Desai
- Obstetrics and Gynecology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Haikun Bao
- Yale-New Haven Health Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lori L Geary
- Yale-New Haven Health Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Zhenqiu Lin
- Yale-New Haven Health Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Susannah M Bernheim
- Yale-New Haven Health Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut, USA
- Robert Wood Johnson Foundation Clinical Scholars Program, Yale School of Medicine, New Haven, Connecticut, USA
- Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Harlan M Krumholz
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Yale-New Haven Health Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
29
|
Spatz ES, Bao H, Herrin J, Desai V, Ramanan S, Lines L, Dendy R, Bernheim SM, Krumholz HM, Lin Z, Suter LG. Quality of informed consent documents among US. hospitals: a cross-sectional study. BMJ Open 2020; 10:e033299. [PMID: 32434934 PMCID: PMC7247389 DOI: 10.1136/bmjopen-2019-033299] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/16/2019] [Accepted: 01/15/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To determine whether informed consent for surgical procedures performed in US hospitals meet a minimum standard of quality, we developed and tested a quality measure of informed consent documents. DESIGN Retrospective observational study of informed consent documents. SETTING 25 US hospitals, diverse in size and geographical region. COHORT Among Medicare fee-for-service patients undergoing elective procedures in participating hospitals, we assessed the informed consent documents associated with these procedures. We aimed to review 100 qualifying procedures per hospital; the selected sample was representative of the procedure types performed at each hospital. PRIMARY OUTCOME The outcome was hospital quality of informed consent documents, assessed by two independent raters using an eight-item instrument previously developed for this measure and scored on a scale of 0-20, with 20 representing the highest quality. The outcome was reported as the mean hospital document score and the proportion of documents meeting a quality threshold of 10. Reliability of the hospital score was determined based on subsets of randomly selected documents; face validity was assessed using stakeholder feedback. RESULTS Among 2480 informed consent documents from 25 hospitals, mean hospital scores ranged from 0.6 (95% CI 0.3 to 0.9) to 10.8 (95% CI 10.0 to 11.6). Most hospitals had at least one document score at least 10 out of 20 points, but only two hospitals had >50% of their documents score above a 10-point threshold. The Spearman correlation of the measures score was 0.92. Stakeholders reported that the measure was important, though some felt it did not go far enough to assess informed consent quality. CONCLUSION All hospitals performed poorly on a measure of informed consent document quality, though there was some variation across hospitals. Measuring the quality of hospital's informed consent documents can serve as a first step in driving attention to gaps in quality.
Collapse
Affiliation(s)
- Erica S Spatz
- Section of Cardiovascular Medicine, Yale University, New Haven, Connecticut, USA
- Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut, USA
| | - Haikun Bao
- Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut, USA
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Yale University, New Haven, Connecticut, USA
| | - Vrunda Desai
- Obstetrics and Gynecology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sriram Ramanan
- Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut, USA
| | - Lynette Lines
- Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut, USA
| | - Rebecca Dendy
- Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut, USA
| | - Susannah M Bernheim
- Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut, USA
- Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Harlan M Krumholz
- Section of Cardiovascular Medicine, Yale University, New Haven, Connecticut, USA
- Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut, USA
| | - Zhenqiu Lin
- Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut, USA
| | - Lisa G Suter
- Center for Outcomes Research and Evaluation, Yale New Haven Health System, New Haven, Connecticut, USA
- Section of Rheumatology, Yale School of Medicine, New Haven, CT, United States
| |
Collapse
|
30
|
Secemsky EA, Khera R, Maddox TM, Bhatt D, Armstrong EJ, Curtis JP, Bao H, Yeh RW. TEMPORAL TRENDS AND CONTEMPORARY USE OF MULTIVESSEL PERCUTANEOUS CORONARY REVASCULARIZATION FOR ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE US: AN NCDR RESEARCH TO PRACTICE (R2P) PROJECT. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31755-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Feldman DA, Shroff AR, Bao H, Curtis JP, Minges KE, Ardati AK. Stent selection among patients with chronic kidney disease: Results from the NCDR CathPCI Registry. Catheter Cardiovasc Interv 2020; 96:1213-1221. [PMID: 31909543 DOI: 10.1002/ccd.28698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/20/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This study sought to define contemporary rates of drug eluting stent (DES) usage in patients with chronic kidney disease (CKD). BACKGROUND Among patients with CKD undergoing percutaneous coronary interventions (PCIs), outcomes are superior for those who receive DES compared to those who receive bare metal stents (BMSs). However, perceived barriers may limit the use of DES in this population. METHODS All adult PCI cases from the NCDR CathPCI Registry involving coronary stent placement between July 1, 2009 and December 31, 2015 were analyzed. The rate of DES usage was then compared among four groups, stratified by CKD stage (I/II, III, IV, and V). Subgroup analysis was conducted based on PCI status and indication. Cases were linked to Medicare claims data to assess 1-year mortality. RESULTS A total of 3,650,333 PCI cases met criteria for analysis. DES usage significantly declined as renal function worsened (83.0%, 79.9%, 75.6%, and 75.6%, respectively, in the four CKD stages; p < .001). DES usage was universally lower across the four groups in the setting of ST-Elevation Myocardial Infarction (STEMI) (70.6%, 66.5%, 58.7%, 58.0%; p < .001) and higher in the setting of elective PCI (87.6%, 84.9%, 82.3%, 77.9%; p < .0001). DES was associated with improved 1-year survival, and usage increased over time across each group. CONCLUSIONS DESs are underutilized in patients with advanced renal dysfunction. Although DES usage has increased over time, variation still exists between patients with normal renal function and those with CKD.
Collapse
Affiliation(s)
- Daniel A Feldman
- Section of Cardiology, Adventist Health Portland, Portland, Oregon
| | - Adhir R Shroff
- Division of Cardiology, Department of Medicine, University of Illinois Chicago, Chicago, Illinois
| | - Haikun Bao
- Center for Outcomes Research and Evaluation, Yale-New Haven Health Services Corporation, New Haven, Connecticut
| | - Jeptha P Curtis
- Center for Outcomes Research and Evaluation, Yale-New Haven Health Services Corporation, New Haven, Connecticut.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Karl E Minges
- Center for Outcomes Research and Evaluation, Yale-New Haven Health Services Corporation, New Haven, Connecticut.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Amer K Ardati
- Division of Cardiology, Department of Medicine, University of Illinois Chicago, Chicago, Illinois
| |
Collapse
|
32
|
Wang X, Bao H, Bau T. Nutritional value and volatiles of the edible mushroom Leucocalocybe mongolica. Quality Assurance and Safety of Crops & Foods 2019. [DOI: 10.3920/qas2019.1585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- X. Wang
- Key Laboratory of Medicinal Fungal Resources and Development and Utilization, Jilin Agricultural University, Changchun 130118, China P.R
- Changchun Science-Technology University, Changchun 130600, China P.R
| | - H. Bao
- Key Laboratory of Medicinal Fungal Resources and Development and Utilization, Jilin Agricultural University, Changchun 130118, China P.R
| | - T. Bau
- Key Laboratory of Medicinal Fungal Resources and Development and Utilization, Jilin Agricultural University, Changchun 130118, China P.R
| |
Collapse
|
33
|
Weerahandi H, Bao H, Herrin J, Dharmarajan K, Ross JS, Jones S, Horwitz LI. Home Health Care After Skilled Nursing Facility Discharge Following Heart Failure Hospitalization. J Am Geriatr Soc 2019; 68:96-102. [PMID: 31603248 DOI: 10.1111/jgs.16179] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/14/2019] [Accepted: 08/16/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND/OBJECTIVE Heart failure (HF) readmission rates have plateaued despite scrutiny of hospital discharge practices. Many HF patients are discharged to skilled nursing facility (SNF) after hospitalization before returning home. Home healthcare (HHC) services received during the additional transition from SNF to home may affect readmission risk. Here, we examined whether receipt of HHC affects readmission risk during the transition from SNF to home following HF hospitalization. DESIGN Retrospective cohort study. SETTING Fee-for-service Medicare data, 2012 to 2015. PARTICIPANTS Beneficiaries, aged 65 years and older, hospitalized with HF who were subsequently discharged to SNF and then discharged home. MEASUREMENTS The primary outcome was unplanned readmission within 30 days of discharge to home from SNF. We compared time to readmission between those with and without HHC services using a Cox model. RESULTS Of 67 585 HF hospitalizations discharged to SNFs and subsequently discharged home, 13 257 (19.6%) were discharged with HHC, and 54 328 (80.4%) were discharged without HHC. Patients discharged home from SNFs with HHC had lower 30-day readmission rates than patients discharged without HHC (22.8% vs 24.5%; P < .0001) and a longer time to readmission. In an adjusted model, the hazard for readmission was 0.91 (0.86-0.95) with receipt of HHC. CONCLUSIONS Recipients of HHC were less likely to be readmitted within 30 days vs those discharged home without HHC. This is unexpected, as patients discharged with HHC likely have more functional impairments. Since patients requiring a SNF stay after hospital discharge may have additional needs, they may particularly benefit from restorative therapy through HHC; however, only approximately 20% received such services. J Am Geriatr Soc 68:96-102, 2019.
Collapse
Affiliation(s)
- Himali Weerahandi
- Division of General Internal Medicine and Clinical Innovation, Department of Medicine, NYU School of Medicine, New York, New York.,Division of Healthcare Delivery Science, Department of Population Health, NYU School of Medicine, New York, New York.,Center for Healthcare Innovation and Delivery Science, NYU Langone Health, New York, New York
| | - Haikun Bao
- Center for Outcomes Research and Evaluation, Yale University, New Haven, Connecticut
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | | | - Joseph S Ross
- Center for Outcomes Research and Evaluation, Yale University, New Haven, Connecticut.,Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Simon Jones
- Division of Healthcare Delivery Science, Department of Population Health, NYU School of Medicine, New York, New York.,Center for Healthcare Innovation and Delivery Science, NYU Langone Health, New York, New York
| | - Leora I Horwitz
- Division of General Internal Medicine and Clinical Innovation, Department of Medicine, NYU School of Medicine, New York, New York.,Division of Healthcare Delivery Science, Department of Population Health, NYU School of Medicine, New York, New York.,Center for Healthcare Innovation and Delivery Science, NYU Langone Health, New York, New York
| |
Collapse
|
34
|
Araujo D, Wang A, Torti D, Huang J, Leon A, Marsh K, McCarthy A, Berman H, Spreafico A, Hansen A, Razak A, Bedard P, Wang L, Plackmann E, Chow H, Bao H, Wu X, Pugh T, Siu L. Blood-based TMB (bTMB) correlates with tissue-based TMB (tTMB) in a multi-cancer phase I IO cohort. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
35
|
Wu YL, Liu SY, Wang Q, Mao W, Wu L, Shen Y, Cheng Y, Chen C, Xu L, Wang J, Liu HX, Bao H, Chen YD, Zhang X, Chen ZH, Yan HH, Yang JJ, Shao Y, Zhou Q, Zhong WZ. A comprehensive model of genetic-features predicts outcome of personalized adjuvant treatment in resected EGFR-mutant stage II-IIIA NSCLC: Results from a phase III trial (CTONG 1104-ADJUVANT). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz258.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
36
|
Stewart E, Martins-Filho S, Cabanero M, Wang A, Huang J, Bao H, Wu X, Patel D, Chen Z, Law J, Bradbury P, Shepherd F, Leighl N, Tsao M, Pugh T, Bratman S, Liu G, Sacher A. P2.14-62 Early, Subclinical SCLC Transformation in Patients with EGFR Mutant Lung Cancer Receiving Osimertinib, Detected Through Cell-Free DNA. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
37
|
Jin Y, Bao H, Le X, Fan X, Tang M, Fan Y, Zhang Y, Shi X, Zhao J, Lou G, Shao L, He Q, Lin C, Zhang J, Futreal P, Wistuba I, Heymach J, Wu X, Shao Y, Yan J, Chen Y, Chen M, Zhang J, Yu X, Xu Y. P1.14-17 Genomic Evolution During TKI Treatment in Non-Small Cell Lung Cancer Patients With or Without Acquired T790M Mutation. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1168] [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]
|
38
|
Baskar S, Bao H, Minges KE, Spar DS, Czosek RJ. Characteristics and Outcomes of Pediatric Patients Who Undergo Placement of Implantable Cardioverter Defibrillators: Insights From the National Cardiovascular Data Registry. Circ Arrhythm Electrophysiol 2019; 11:e006542. [PMID: 30354291 DOI: 10.1161/circep.118.006542] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Implantable cardioverter defibrillators (ICDs) are an important part of therapy for many patients, yet there is little data on population characteristics, complications, or system survival in pediatric patients. Methods A retrospective review of ICD recipients in the National Cardiovascular Data Registry ICD Registry was performed from 2010 to 2016. Patient characteristics and complications between pediatric (≤21 years) and adult populations (>21 years) were compared. Variables associated with complications and early device interventions within the pediatric cohort were evaluated using multivariate modeling. Results There were 562 209 total ICD implants, of which 3461 occurred in the pediatric cohort. Among the pediatric patients, 60% of implants were for primary prevention, and nonischemic cardiomyopathy was the most common underlying disease (60%). Over time, there was an increasing trend of both primary and secondary prevention ICD implantations ( P<0.05). Compared with adults, pediatric patients were more likely to have structural heart disease, hypertrophic cardiomyopathy, and channelopathy, and to receive a single-chamber device (all P<0.001). There was no difference in inhospital complications between the adult and pediatric cohorts (2.4% versus 2.6%, P=0.3). However, among the pediatric patients, lower weight, Ebstein anomaly, worse New York Heart Association class, dual chamber, and cardiac resynchronization therapy-defibrillator were associated with greater risk of complications. Although reintervention for generator replacement or upgrade was more common in adults, the time to reintervention was shorter in the pediatric cohort. Conclusions We observed an increasing trend in ICD device implantation among pediatric patients. The pediatric cohort had similar inhospital complication rates compared with adults but had a shorter time to reintervention.
Collapse
Affiliation(s)
- Shankar Baskar
- The Heart Institute, Cincinnati Children's Hospital Medical Center, OH (S.B., D.S.S., R.J.C.)
| | - Haikun Bao
- Center for Outcomes Research and Evaluation, Yale-New Haven Health Services Corporation, CT (H.B., K.E.M.)
| | - Karl E Minges
- Center for Outcomes Research and Evaluation, Yale-New Haven Health Services Corporation, CT (H.B., K.E.M.).,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (K.E.M.)
| | - David S Spar
- The Heart Institute, Cincinnati Children's Hospital Medical Center, OH (S.B., D.S.S., R.J.C.)
| | - Richard J Czosek
- The Heart Institute, Cincinnati Children's Hospital Medical Center, OH (S.B., D.S.S., R.J.C.)
| |
Collapse
|
39
|
Yang L, Wang Y, Bao H, Wan J, Fan X, Bao H, Shen L, Guan Y, Wu X, Shao Y, Zhu J, Zhang Z. ctDNA As a Potential Prognostic Marker for Locally Advanced Rectal Cancer Patients Receiving Neoadjuvant Chemo-Radiation Therapy on Disease-Free Survival (DFS). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
40
|
Sandhu A, Bao H, Minges KE, Varosy PD, Borne RT, Zipse MM, Marzec L, Peterson P, Masoudi F, Bradley SM. Use of Cardiac Resynchronization Therapy Defibrillator in US Hospitals. JAMA Cardiol 2019; 4:804-809. [PMID: 31215970 DOI: 10.1001/jamacardio.2019.1755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Cardiac resynchronization therapy (CRT) provides significant reduction in morbidity and mortality in select patients with left ventricular systolic dysfunction and specific parameters of electrocardiographic evidence of dyssynchrony. Relative to the 2012 American College of Cardiology/American Heart Association/Heart Rhythm Society guideline update for patient selection, little is known about the contemporary use of CRT in the United States. Objective To describe the use of CRT defibrillator (CRT-D) in the period around guideline revision. Design, Setting, and Participants All patients undergoing new CRT-D implantations in the National Cardiovascular Data Registry for implantable cardioverter-defibrillators from January 1, 2012, to December 31, 2015, at 1710 participating hospitals were identified for this population-based study. Rates of CRT-D implantation that were concordant and discordant with the 2012 American College of Cardiology/American Heart Association/Heart Rhythm Society update of the 2008 guidelines for device-based therapy were determined. Analysis began in January 2012. Main Outcomes and Measures Increase in guideline-concordant CRT-D implantation. Results Among 135 253 patients undergoing initial CRT-D implantation, 88 923 were included in the study cohort, of which 73 859 implants (83.1%) were guideline concordant. The proportion of guideline-concordant devices increased from 81.2% (16 710 of 20 481) in 2012 to 84.2% (20 515 of 24 356) in 2015 (P for trend < .001). Significant clustering was noted with 33% (565 of 1710) of hospitals accounting for greater than 70% (10 545 of 15 065) of guideline-discordant CRT-D implants. Conduction abnormalities, in particular, underlying right bundle branch block (3597 [23.9%] vs 7425 [10.1%]; P < .001) and nonspecific intraventricular conduction delay (3341 [22.2%] vs 4769 [6.5%]; P < .001) were more common in those who received guideline-discordant devices. Conclusions and Relevance Rates of guideline-concordant CRT-D implantation increased during the study. The major fraction of guideline-discordant implants were clustered at a minority of hospitals. Conduction abnormalities, particularly non-left bundle branch block and nonspecific intraventricular conduction delay, correlated with guideline-discordant implants indicating continued opportunity for dissemination and understanding of guideline updates.
Collapse
Affiliation(s)
- Amneet Sandhu
- Division of Cardiology, University of Colorado School of Medicine, Aurora.,Eastern Colorado VA Medical Center, Aurora
| | - Haikun Bao
- Yale University School of Medicine, New Haven, Connecticut
| | - Karl E Minges
- Yale University School of Medicine, New Haven, Connecticut
| | - Paul D Varosy
- Division of Cardiology, University of Colorado School of Medicine, Aurora.,Eastern Colorado VA Medical Center, Aurora
| | - Ryan T Borne
- Division of Cardiology, University of Colorado School of Medicine, Aurora
| | - Mathew M Zipse
- Division of Cardiology, University of Colorado School of Medicine, Aurora
| | | | - Pamela Peterson
- Division of Cardiology, University of Colorado School of Medicine, Aurora.,Division of Cardiology, Denver Health Medical Center, Denver, Colorado
| | - Frederick Masoudi
- Division of Cardiology, University of Colorado School of Medicine, Aurora
| | - Steven M Bradley
- Minneapolis Heart Institute, Minneapolis, Minnesota.,Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
| |
Collapse
|
41
|
Echouffo-Tcheugui JB, Masoudi FA, Bao H, Curtis JP, Heidenreich PA, Fonarow GC. Body mass index and outcomes of cardiac resynchronization with implantable cardioverter-defibrillator therapy in older patients with heart failure. Eur J Heart Fail 2019; 21:1093-1102. [PMID: 31359595 DOI: 10.1002/ejhf.1552] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/26/2018] [Revised: 11/02/2018] [Accepted: 12/04/2018] [Indexed: 11/06/2022] Open
Abstract
AIMS To assess the association of body mass index (BMI) with heart failure (HF) outcomes after cardiac resynchronization therapy with defibrillator (CRT-D) implantation. METHODS AND RESULTS Medicare beneficiaries with HF aged ≥ 65 years (n = 18 922) undergoing first-time CRT-D from the National Cardiovascular Data Registry (NCDR) Implantable Cardioverter-Defibrillator Registry between 2010 and 2013, were followed for 3 years post-implantation. Survival curves and covariate adjusted hazard ratio (aHR) or odds ratio were used to assess the risks for death, readmission, and device-related complications by BMI status. Of 18 922 HF patients receiving CRT-D, 5265 (27.8%) were normal weight, 6896 (37%) were overweight, 6318 (33.4%) were obese, and 353 (1.8%) were underweight. Compared to those of normal weight (BMI 18.5-24.9 kg/m2 ), underweight patients had a higher 3-year post-device implantation risk of death [aHR: 1.34 (95% confidence interval 1.09-1.65); P < 0.001] and of readmission [sub-aHR: 1.25 (1.09-1.42); P < 0.001]. The corresponding 3-year aHRs for death were 0.83 (0.77-0.89) for overweight, 0.74 (0.67-0.82) for obesity class I (BMI 30-34.9 kg/m2 ), 0.78 (0.68-0.90) for obesity class II (BMI 35-39.9 kg/m2 ), and 0.75 (0.60-0.93) for obesity class III (BMI ≥ 40 kg/m2 , P for all categories < 0.001). Individuals with class III obesity had a higher risk of readmission [sub-aHR: 1.17 (1.06-1.30)]. There were no differences in rates of device-related complications within 90 days across BMI categories. CONCLUSION Most elderly patients with HF receiving CRT-D were overweight or obese. While being underweight was associated with greater risks of death and hospitalization, overweight and obese patients were at lower risk of death after CRT-D.
Collapse
Affiliation(s)
| | - Frederick A Masoudi
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Haikun Bao
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA
| | - Jeptha P Curtis
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA.,Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Paul A Heidenreich
- Division of Cardiology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Gregg C Fonarow
- Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, Los Angeles, CA, USA
| |
Collapse
|
42
|
Day S, Bao H, Day S, Li L, Mathews A, Tucker J. Barriers and facilitators of open contests to promote community engagement in HIV cure research: a qualitative evaluation among trial participants and community members. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)31069-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
43
|
Marzec LN, Peterson PN, Bao H, Curtis JP, Masoudi FA, Varosy PD, Bradley SM. Use of Cardiac Resynchronization Therapy Among Eligible Patients Receiving an Implantable Cardioverter Defibrillator: Insights From the National Cardiovascular Data Registry Implantable Cardioverter Defibrillator Registry. JAMA Cardiol 2019; 2:561-565. [PMID: 28122073 DOI: 10.1001/jamacardio.2016.5388] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Cardiac resynchronization therapy (CRT) reduces the risk for mortality and heart failure-related events in select patients. Little is known about the use of CRT in combination with an implantable cardioverter defibrillator (ICD) in patients who are eligible for this therapy in clinical practice. Objective To (1) identify patient, clinician, and hospital characteristics associated with CRT defibrillator (CRT-D) use and (2) determine the extent of hospital-level variation in the use of CRT-D among guideline-eligible patients undergoing ICD placement. Design, Setting, and Participants Multicenter retrospective cohort from 1428 hospitals participating in the National Cardiovascular Data Registry ICD Registry between April 1, 2010, and June 30, 2014. Adult patients meeting class I or IIa guideline recommendations for CRT at the time of device implantation were included in this study. Main Outcomes and Measures Implantation of an ICD with or without CRT. Results A total of 63 506 eligible patients (88.6%) received CRT-D at the time of device implantation. The mean (SD) ages of those in the ICD and CRT-D groups were 67.9 (12.2) years and 68.4 (11.5) years, respectively. In hierarchical multivariable models, black race was independently associated with lower use of CRT-D (odds ratio [OR], 0.77; 95% CI, 0.71-0.83) as was nonprivate insurance (OR, 0.90; 95% CI, 0.85-0.95 for Medicare and OR, 0.73; 95% CI, 0.65-0.82 for Medicaid). Clinician factors associated with greater CRT-D use included clinician implantation volume (OR, 1.01 per 10 additional devices implanted; 95% CI, 1.01-1.01) and electrophysiology training (OR, 3.13 as compared with surgery-boarded clinicians; 95% CI, 2.50-3.85). At the hospital level, the overall median risk-standardized rate of CRT-D use was 79.9% (range, 26.7%-100%; median OR, 2.08; 95% CI, 1.99-2.18). Conclusions and Relevance In a national cohort of patients eligible for CRT-D at the time of device implantation, nearly 90% received a CRT-D device. However, use of CRT-D differed by race and implanting operator characteristics. After accounting for these factors, the use of CRT-D continued to vary widely by hospital. Addressing disparities and variation in CRT-D use among guideline-eligible patients may improve patient outcomes.
Collapse
Affiliation(s)
| | - Pamela N Peterson
- University of Colorado School of Medicine, Aurora2Denver Health Medical Center, Denver, Colorado
| | - Haikun Bao
- Yale University School of Medicine, New Haven, Connecticut
| | | | | | - Paul D Varosy
- University of Colorado School of Medicine, Aurora4Veterans Affairs Eastern Colorado Health Care System, Denver
| | - Steven M Bradley
- University of Colorado School of Medicine, Aurora4Veterans Affairs Eastern Colorado Health Care System, Denver
| |
Collapse
|
44
|
Hummel JP, Leipold RJ, Amorosi SL, Bao H, Deger KA, Jones PW, Kansal AR, Ott LS, Stern S, Stein K, Curtis JP, Akar JG. Outcomes and costs of remote patient monitoring among patients with implanted cardiac defibrillators: An economic model based on the PREDICT RM database. J Cardiovasc Electrophysiol 2019; 30:1066-1077. [PMID: 30938894 PMCID: PMC6850124 DOI: 10.1111/jce.13934] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 01/08/2023]
Abstract
Background Remote monitoring of implantable cardioverter‐defibrillators has been associated with reduced rates of all‐cause rehospitalizations and mortality among device recipients, but long‐term economic benefits have not been studied. Methods and Results An economic model was developed using the PREDICT RM database comparing outcomes with and without remote monitoring. The database included patients ages 65 to 89 who received a Boston Scientific device from 2006 to 2010. Parametric survival equations were derived for rehospitalization and mortality to predict outcomes over a maximum time horizon of 25 years. The analysis assessed rehospitalization, mortality, and the cost‐effectiveness (expressed as the incremental cost per quality‐adjusted life year) of remote monitoring versus no remote monitoring. Remote monitoring was associated with reduced mortality; average life expectancy and average quality‐adjusted life years increased by 0.77 years and 0.64, respectively (6.85 life years and 5.65 quality‐adjusted life years). When expressed per patient‐year, remote monitoring patients had fewer subsequent rehospitalizations (by 0.08 per patient‐year) and lower hospitalization costs (by $554 per patient year). With longer life expectancies, remote monitoring patients experienced an average of 0.64 additional subsequent rehospitalizations with increased average lifetime hospitalization costs of $2784. Total costs of outpatient and physician claims were higher with remote monitoring ($47 515 vs $42 792), but average per patient‐year costs were lower ($6232 vs $6244). The base‐case incremental cost‐effectiveness ratio was $10 752 per quality‐adjusted life year, making remote monitoring high‐value care. Conclusion Remote monitoring is a cost‐effective approach for the lifetime management of patients with implantable cardioverter‐defibrillators.
Collapse
Affiliation(s)
- James P Hummel
- Division of Cardiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | | | - Haikun Bao
- Yale University School of Medicine and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; and on behalf of the NCDR
| | | | - Paul W Jones
- Boston Scientific Corporation, Marlborough, Massachusetts
| | | | - Lesli S Ott
- Yale University School of Medicine and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; and on behalf of the NCDR
| | | | - Kenneth Stein
- Boston Scientific Corporation, Marlborough, Massachusetts
| | - Jeptha P Curtis
- Yale University School of Medicine and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; and on behalf of the NCDR
| | - Joseph G Akar
- Yale University School of Medicine and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut; and on behalf of the NCDR
| |
Collapse
|
45
|
Nishimura M, Marcus GM, Varosy PD, Bao H, Wang Y, Curtis JP, Hsu JC. Association of body mass index with cardiac resynchronization therapy intention and left ventricular lead implantation failure: insights from the NCDR implantable cardioverter-defibrillator registry. J Interv Card Electrophysiol 2019; 57:279-288. [PMID: 31004224 DOI: 10.1007/s10840-019-00550-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/03/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cardiac resynchronization therapy with defibrillator (CRT-D) implantation involves left ventricular (LV) lead placement for biventricular pacing and is more complex than implantable cardioverter-defibrillator (ICD)-only implantation. Differences in the prescription of CRT-D versus ICD may result from clinician biases based on patient body habitus, and body habitus may be associated with LV lead implantation failure. OBJECTIVE We sought to evaluate whether patient body mass index (BMI) was associated with planned use and implantation failure of CRT-D therapy. METHODS We studied all patients enrolled in the National Cardiovascular Data Registry ICD Registry who met standard CRT-D criteria and received either an ICD or CRT-D between 2010 and 2012. BMI was categorized based on World Health Organization classification. Using hierarchical logistic regression, two multivariate models adjusted for patient demographic and clinical characteristics were fit based on the following outcome variables: (1) planned implantation with CRT-D versus ICD and (2) failed versus successful LV lead placement. RESULTS Of 337,547 patients, 41,872 met inclusion criteria for the first analysis and 35,186 met criteria for the second analysis. After multivariable adjustment, patients with extreme (BMI > 40 kg/m2) obesity were less likely to receive guideline-concordant CRT-D compared with patients with normal weight (adjusted odds ratio (AOR), 0.86; 95% confidence interval (CI), 0.75-0.99; p = 0.04). Extreme (BMI > 40 kg/m2) obesity was associated with higher odds of failed LV lead placement (AOR, 1.35; 95% CI, 1.07-1.72, p = 0.01). CONCLUSIONS Compared with normal weight patients, extremely obese (BMI > 40 kg/m2) CRT-D eligible patients were less likely to be prescribed CRT-D and were at higher odds for failed LV lead placement.
Collapse
Affiliation(s)
- Marin Nishimura
- Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Gregory M Marcus
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Paul D Varosy
- Division of Cardiology, Department of Electrophysiology, VA Eastern Colorado Health Care System, University of Colorado, Denver, CO, USA
| | - Haikun Bao
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Yongfei Wang
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Jeptha P Curtis
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Jonathan C Hsu
- Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Diego, San Diego, CA, USA.
| |
Collapse
|
46
|
Lichtman JH, Leifheit EC, Safdar B, Bao H, Krumholz HM, Lorenze NP, Daneshvar M, Spertus JA, D'Onofrio G. Sex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction: Evidence from the VIRGO Study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients). Circulation 2019; 137:781-790. [PMID: 29459463 DOI: 10.1161/circulationaha.117.031650] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/11/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Some studies report that women are less likely to present with chest pain for acute myocardial infarction (AMI). Information on symptom presentation, perception of symptoms, and care-seeking behaviors is limited for young patients with AMI. METHODS We interviewed 2009 women and 976 men aged 18 to 55 years hospitalized for AMI at 103 US hospitals participating in the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients). Structured patient interviews during the index AMI hospitalization were used to collect information on symptom presentation, perception of symptoms, and care-seeking behaviors. We compared patient characteristics and presentation information by sex. Multivariable hierarchical logistic regression was used to evaluate the association between sex and symptom presentation. RESULTS The majority of women (87.0%) and men (89.5%) presented with chest pain (defined as pain, pressure, tightness, or discomfort). Women were more likely to present with ≥3 associated symptoms than men (eg, epigastric symptoms, palpitations, and pain or discomfort in the jaw, neck, arms, or between the shoulder blades; 61.9% for women versus 54.8% for men, P<0.001). In adjusted analyses, women with an ST-segment-elevation AMI were more likely than men to present without chest pain (odds ratio, 1.51; 95% confidence interval, 1.03-2.22). In comparison with men, women were more likely to perceive symptoms as stress/anxiety (20.9% versus 11.8%, P<0.001) but less likely to attribute symptoms to muscle pain (15.4% versus 21.2%, P=0.029). Approximately 29.5% of women and 22.1% of men sought medical care for similar symptoms before their hospitalization (P<0.001); however, 53% of women reported that their provider did not think these symptoms were heart-related in comparison with 37% of men (P<0.001). CONCLUSIONS The presentation of AMI symptoms was similar for young women and men, with chest pain as the predominant symptom for both sexes. Women presented with a greater number of additional non-chest pain symptoms regardless of the presence of chest pain, and both women and their healthcare providers were less likely to attribute their prodromal symptoms to heart disease in comparison with men.
Collapse
Affiliation(s)
- Judith H Lichtman
- Department of Chronic Disease Epidemiology (J.H.L., E.C.L.) .,Yale School of Public Health, New Haven, CT. Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (J.H.L., H.B., H.M.K., N.P.L.)
| | | | | | - Haikun Bao
- Yale School of Public Health, New Haven, CT. Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (J.H.L., H.B., H.M.K., N.P.L.)
| | - Harlan M Krumholz
- Department of Health Policy and Management (H.M.K.).,Yale School of Public Health, New Haven, CT. Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (J.H.L., H.B., H.M.K., N.P.L.).,Section of Cardiovascular Medicine, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT
| | - Nancy P Lorenze
- Yale School of Public Health, New Haven, CT. Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (J.H.L., H.B., H.M.K., N.P.L.)
| | - Mitra Daneshvar
- Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania, Philadelphia (M.D.)
| | - John A Spertus
- St. Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).,University of Missouri-Kansas City (J.A.S.)
| | | |
Collapse
|
47
|
Li Z, Furlong MJ, Yonow T, Kriticos DJ, Bao H, Yin F, Lin Q, Feng X, Zalucki MP. Management and population dynamics of diamondback moth (Plutella xylostella): planting regimes, crop hygiene, biological control and timing of interventions. Bull Entomol Res 2019; 109:257-265. [PMID: 29929570 DOI: 10.1017/s0007485318000500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Using an age-structured process-based simulation model for diamondback moth (DBM), we model the population dynamics of this major Brassica pest using the cropping practices and climate of Guangdong, China. The model simulates two interacting sub-populations (demes), each representing a short season crop. The simulated DBM abundance, and hence pest problems, depend on planting regime, crop hygiene and biological control. A continuous supply of hosts, a low proportion of crop harvested and long residue times between harvest and replanting each exacerbate pest levels. Biological control provided by a larval parasitoid can reduce pest problems, but not eliminate them when climate is suitable for DBM and under certain planting practices. The classic Integrated Pest Management (IPM) method of insecticide application, when pest threshold is reached, proved effective and halved the number of insecticide sprays when compared with the typical practice of weekly insecticide application.
Collapse
Affiliation(s)
- Z Li
- Institute of Plant Protection, Guangdong Academy of Agricultural Sciences,Guangzhou 510640,China
| | - M J Furlong
- School of Biological Sciences, The University of Queensland,Brisbane 4072,Australia
| | - T Yonow
- CSIRO,GPO Box 1700, Canberra 2601,Australia
| | | | - H Bao
- Institute of Plant Protection, Guangdong Academy of Agricultural Sciences,Guangzhou 510640,China
| | - F Yin
- Institute of Plant Protection, Guangdong Academy of Agricultural Sciences,Guangzhou 510640,China
| | - Q Lin
- Institute of Plant Protection, Guangdong Academy of Agricultural Sciences,Guangzhou 510640,China
| | - X Feng
- Institute of Plant Protection, Guangdong Academy of Agricultural Sciences,Guangzhou 510640,China
| | - M P Zalucki
- School of Biological Sciences, The University of Queensland,Brisbane 4072,Australia
| |
Collapse
|
48
|
Borne RT, Bao H, Curtis J, Masoudi F, Zipse M, Sandhu A, Hsu J, Peterson P. USE AND OUTCOMES OF DUAL CHAMBER AND CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATORS AMONG OLDER PATIENTS UNDERGOING ICD IMPLANTATION WITH A VENTRICULAR PACING INDICATION: AN ANALYSIS OF THE NATIONAL CARDIOVASCULAR DATA ICD REGISTRY. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)30997-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
49
|
Benchetrit L, Zimmerman C, Bao H, Dharmarajan K, Altaf F, Herrin J, Lin Z, Krumholz HM, Drye EE, Lipska KJ, Spatz ES. Admission diagnoses among patients with heart failure: Variation by ACO performance on a measure of risk-standardized acute admission rates. Am Heart J 2019; 207:19-26. [PMID: 30404047 DOI: 10.1016/j.ahj.2018.09.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 09/15/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND A key quality metric for Accountable Care Organizations (ACOs) is the rate of hospitalization among patients with heart failure (HF). Among this patient population, non-HF-related hospitalizations account for a substantial proportion of admissions. Understanding the types of admissions and the distribution of admission types across ACOs of varying performance may provide important insights for lowering admission rates. METHODS We examined admission diagnoses among 220 Medicare Shared Savings Program ACOs in 2013. ACOs were stratified into quartiles by their performance on a measure of unplanned risk-standardized acute admission rates (RSAARs) among patients with HF. Using a previously validated algorithm, we categorized admissions by principal discharge diagnosis into: HF, cardiovascular/non-HF, and noncardiovascular. We compared the mean admission rates by admission type as well as the proportion of admission types across RSAAR quartiles (Q1-Q4). RESULTS Among 220 ACOs caring for 227,356 patients with HF, the median (IQR) RSAARs per 100 person-years ranged from 64.5 (61.7-67.7) in Q1 (best performers) to 94.0 (90.1-99.9) in Q4 (worst performers). The mean admission rates by admission types for ACOs in Q1 compared with Q4 were as follows: HF admissions: 9.8 (2.2) vs 14.6 (2.8) per 100 person years (P < .0001); cardiovascular/non-HF admissions: 11.1 (1.6) vs 15.9 (2.6) per 100 person-years (P < .0001); and noncardiovascular admissions: 42.7 (5.4) vs 69.6 (11.3) per 100 person-years (P < .0001). The proportion of admission due to HF, cardiovascular/non-HF, and noncardiovascular conditions was 15.4%, 17.5%, and 67.1% in Q1 compared with 14.6%, 15.9%, and 69.4% in Q4 (P < .007). CONCLUSIONS Although ACOs with the best performance on a measure of all-cause admission rates among people with HF tended to have fewer admissions for HF, cardiovascular/non-HF, and noncardiovascular conditions compared with ACOs with the worst performance (highest admission rates), the largest difference in admission rates were for noncardiovascular admission types. Across all ACOs, two-thirds of admissions of patients with HF were for noncardiovascular causes. These findings suggest that comprehensive approaches are needed to reduce the diverse admission types for which HF patients are at risk.
Collapse
|
50
|
Si Y, Bao H, Han L, Chen L, Zeng L, Jing L, Xing Y, Geng Y. Dexmedetomidine attenuation of renal ischaemia-reperfusion injury requires sirtuin 3 activation. Br J Anaesth 2018; 121:1260-1271. [PMID: 30442253 DOI: 10.1016/j.bja.2018.07.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 06/20/2018] [Accepted: 07/12/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Dexmedetomidine attenuates renal ischaemia and reperfusion (I/R) injury, but its mechanism of action is unclear. As sirtuin 3 (SIRT3) activation can alleviate acute kidney injury, we investigated whether dexmedetomidine acts through SIRT3 to reduce renal I/R injury. METHODS The potential involvement of SIRT3 in dexmedetomidine attenuation of renal I/R injury was tested in HK2 cells subjected to hypoxia/reoxygenation and C57BL/6J mice subjected to renal I/R. A short interfering RNA targeting SIRT3 was used in some experiments to examine the potential role of SIRT3. Cell death and mitochondrial membrane potential (Δψm) were analysed in cultured cells. Mitochondrial damage in mice was assessed using electron microscopy and markers for renal function. Expression of cyclophilin D, cytochrome c, and SIRT3, and the level of cyclophilin D acetylation were determined. RESULTS Hypoxia/reoxygenation of HK2 cells increased cell death, cytochrome C expression, and cyclophilin D acetylation, and decreased Δψm and SIRT3 expression (P<0.05). Dexmedetomidine attenuated these changes. The dexmedetomidine effects were enhanced by SIRT3 overexpression and eliminated by SIRT3 knockdown. I/R in mice damaged renal function, and increased histological lesions, mitochondrial damage, cytochrome c expression, and cyclophilin D acetylation, while SIRT3 activity was decreased by 51% (P<0.05). Dexmedetomidine inhibited these changes in mice expressing normal levels of SIRT3, but not in SIRT3-knockdown mice. CONCLUSIONS Dexmedetomidine appears to act, at least in part, by up-regulating SIRT3 to inhibit mitochondrial damage and cell apoptosis and thereby protect against renal I/R injury.
Collapse
Affiliation(s)
- Y Si
- Department of Anaesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - H Bao
- Department of Anaesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.
| | - L Han
- Department of Anaesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - L Chen
- Department of Anaesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - L Zeng
- Department of Anaesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - L Jing
- Department of Anaesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Y Xing
- Mechanical Engineering, Southeast University, Nanjing, People's Republic of China
| | - Y Geng
- Department of Anaesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| |
Collapse
|