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Ma EM, Lu K, Wei YB. [Constructing an early-warning model for mortality risk in heat stroke patients based on Fisher discriminant analysis]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2024; 42:282-285. [PMID: 38677992 DOI: 10.3760/cma.j.cn121094-20230223-00050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Objective: To establish an early warning model to assess the mortality risk of patients with heat stroke disease. Methods: The case data of patients diagnosed with heat stroke disease admitted to the comprehensive ICU of Shanshan County from January 2016 to December 2020 were selected. According to the short-term outcome (28 days) of patients, they were divided into death group (20 cases) and survival group (53 cases) . The relevant indicators with statistically significant differences between groups within 24 hours after admission were selected. By drawing the subject work curve (ROC) and calculating the area under the curve, the relevant indicators with the area under the curve greater than 0.7 were selected, Fisher discriminant analysis was used to establish an assessment model for the death risk of heat stroke disease. The data of heat stroke patients from January 1, 2021 to December 2022 in the comprehensive ICU of Shanshan County were collected for external verification. Results There were significant differences in age, cystatin C, procalcitonin, platelet count, CKMB, CK, CREA, PT, TT, APTT, heart rate, respiratory rate and GLS score among the groups. Cystatin C, CKMB, CREA, PT, TT, heart rate AUC area at admission was greater than 0.7. Fisher analysis method is used to build a functional model. Results: The diagnostic sensitivity, specificity and AUC area of the functional model were 95%, 83% and 0.937 respectively. The external validation results showed that the accuracy of predicting survival group was 85.71%, the accuracy of predicting death group was 88.89%. Conclusion: The early warning model of heat stroke death constructed by ROC curve analysis and Fisher discriminant analysis can provide objective reference for early intervention of heat stroke.
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Affiliation(s)
- E M Ma
- Department of Respiratory and Critical Care Medicine, Shanshan Country People's Hospital, Shanshan 838200, China
| | - K Lu
- Department of Respiratory and Critical Care Medicine, Shanshan Country People's Hospital, Shanshan 838200, China
| | - Y B Wei
- Department of Respiratory and Critical Care Medicine, Shanshan Country People's Hospital, Shanshan 838200, China
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Xu W, Zhong Y, Li X, Lu K. Stabilizing Supersaturation with Extreme Grain Refinement in Spinodal Aluminum Alloys. Adv Mater 2024; 36:e2303650. [PMID: 37276137 DOI: 10.1002/adma.202303650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/01/2023] [Indexed: 06/07/2023]
Abstract
Supersaturated solid solutions can be formed in alloys from various non-equilibrium processes, but stabilizing the metastable phases against decomposition is challenging, particularly the spinodal decomposition that occurs via chemical fluctuations without energy barriers to nucleation. In this work, it is found that spinodal decomposition in supersaturated Al(Zn) solid solutions can be inhibited with straining-induced extreme grain refinement. For the refined supersaturated grains at the nanoscale, their spinodal decomposition is obviously resisted by the relaxed grain boundaries and reduced lattice defects. As grains are refined below 10 nm the decomposition is completely inhibited, in which atomic diffusion is blocked by the stable Schwarz crystal structure with vacancy-free grains. Extreme grain refinement offers a general approach to stabilize supersaturated phases with broadened compositional windows for property modulation of alloys.
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Affiliation(s)
- Wei Xu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang, 110016, China
| | - Yiming Zhong
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang, 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Shenyang, 110016, China
| | - Xiuyan Li
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang, 110016, China
| | - K Lu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang, 110016, China
- Liaoning Academy of Materials, Shenyang, 110004, China
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Wei P, Lamont B, He T, Xue W, Wang PC, Song W, Zhang R, Keyhani AB, Zhao S, Lu W, Dong F, Gao R, Yu J, Huang Y, Tang L, Lu K, Ma J, Xiong Z, Chen L, Wan N, Wang B, He W, Teng M, Dian Y, Wang Y, Zeng L, Lin C, Dai M, Zhou Z, Xiao W, Yan Z. Vegetation-fire feedbacks increase subtropical wildfire risk in scrubland and reduce it in forests. J Environ Manage 2024; 351:119726. [PMID: 38052142 DOI: 10.1016/j.jenvman.2023.119726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/07/2023]
Abstract
Climate dictates wildfire activity around the world. But East and Southeast Asia are an apparent exception as fire-activity variation there is unrelated to climatic variables. In subtropical China, fire activity decreased by 80% between 2003 and 2020 amid increased fire risks globally. Here, we assessed the fire regime, vegetation structure, fuel flammability and their interactions across subtropical Hubei, China. We show that tree basal area (TBA) and fuel flammability explained 60% of fire-frequency variance. Fire frequency and fuel flammability, in turn, explained 90% of TBA variance. These results reveal a novel system of scrubland-forest stabilized by vegetation-fire feedbacks. Frequent fires promote the persistence of derelict scrubland through positive vegetation-fire feedbacks; in forest, vegetation-fire feedbacks are negative and suppress fire. Thus, we attribute the decrease in wildfire activity to reforestation programs that concurrently increase forest coverage and foster negative vegetation-fire feedbacks that suppress wildfire.
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Affiliation(s)
- P Wei
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - B Lamont
- Ecology Section, School of Molecular and Life Sciences, Curtin University, Perth, WA 6845, Australia.
| | - T He
- College of Science Engineering & Education, Murdoch University, Murdoch, WA 6150, Australia.
| | - W Xue
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - P C Wang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W Song
- College of Agronomy, Northwest Agriculture & Forestry University, Xianyang, 712100, China.
| | - R Zhang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - A B Keyhani
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - S Zhao
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W Lu
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - F Dong
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - R Gao
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - J Yu
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - Y Huang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - L Tang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - K Lu
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - J Ma
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - Z Xiong
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - L Chen
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - N Wan
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - B Wang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W He
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - M Teng
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - Y Dian
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - Y Wang
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - L Zeng
- Key Laboratory of Forest Ecology and Environment, Chinese Academy of Forestry, Beijing, 100091, China.
| | - C Lin
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - M Dai
- Hubei Forestry Survey and Design Institute, East Lake Science and Technology, District, Wuhan, 430074, Hubei, China.
| | - Z Zhou
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
| | - W Xiao
- Key Laboratory of Forest Ecology and Environment, Chinese Academy of Forestry, Beijing, 100091, China.
| | - Z Yan
- Department of Forestry, College of Horticulture and Forestry, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
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Xu W, Liu G, Varghese C, Wells C, Smith N, Windsor J, Gaborit L, Goh S, Basam A, Elhadi M, Soh RT, Saeed U, Abdulwahed E, Farrell M, Wright D, Martin J, Pockney P, Xu W, Basam A, Goh S, Li J, Shah J, Waraich A, Gaborit L, Pathak U, Hilder A, Elhadi M, Jabur A, Kalyanasundaram K, Ohis C, Ong CF, Park M, Siribaddana V, Raubenheimer K, Vu J, Wells C, Liu G, Ferguson L, Xu W, Varghese C, Pockney P, Atherton K, Dawson A, Martin J, Banerjee A, Dudi-Venkata N, Lightfoot N, Ludbrook I, Peters L, Sara R, Watson D, Wright D, Adeyeye A, Alvarez-Lozada LA, Atici SD, Buhavac M, Calini G, Elhadi M, Ioannidis O, Tepe MD, Nath U, Uzair A, Yang W, Zaidi F, Singh S, Abdullah B, Palacios DSG, Ragab A, Ahmed A, Raubenheimer K, Daudu D, Goh S, Benyani SV, Karthikeyan N, Mansour LT, Seow W, Tasi Z, Jabur A, Pathak U, Park M, Abdelmelek DE, Boussahel IFZ, Kaabache O, Lemdaoui N, Nebbar O, Rais M, Abdoun M, Kouicem AT, Bouaoud S, Bouchenak K, Saada H, Ouyahia A, Messai W, Choong ZS, Ting C, Larkin M, Fong PJ, Soh I, Grandi AD, Iftikhar H, Sinha A, Kapoor D, Chlebicka T, Singer D, Goddard K, Matthews L, Lin R, Chambers J, Chan J, Macnab B, Barker J, Mckenzie M, Ferguson N, Juwaheer G, Muralidharan V, Gill S, Sung N, Patel R, Walters C, Nguyen K, Liu D, Cabalag C, Lee J, Leow SHA, Ng SL, Ashraf H, Mulder F, Loo J, Proud D, Wong S, Zhou Y, Soh QR, Chye D, Stevens S, Tang P, Kritharides S, Dong J, Morice O, Huang D, Hardidge A, Amarasekara M, Kink A, Bolton D, Rawal A, Singh J, Heard M, Hassan Y, Naqeeb A, Cobden A, Prinsloo D, Quadros D, Gunn E, Kim HJ, Ekwebelam J, Shanahan J, Alkazali M, Hoosenally M, Nara N, Nguyen P, Barker S, Hilder A, Hui A, Karmakar A, Wang B, Goonawardena J, Cheung KT, Chan N, Natarajan R, Cade R, Jin R, Sengupta S, Snider R, Morisetty H, Weeda L, Sun P, Chilaka L, Cover J, Gunasekara ADSA, Senthilrajan R, Alwahaib A, Limmer A, Zamanbandhon B, Jaffry K, Shen Y, Chua A, Syed S, Saha S, Glynatsis J, Aitchison L, Lagana B, Crossman M, Watson D, Dawson A, Fong B, Harrison E, Horsburgh E, Glynatsis J, Khoo M, Mishra K, Hewton L, Mesecke A, Tu H, Tun T, Wong J, Ong E, Law TN, Landy A, Leano A, Li A, Soni A, Dowdle B, Pilgrim C, Abeysirigunawardana D, Jeyarajan DR, Patel D, Mckinnon K, Gould M, Gilmore P, Geng R, Loughnan R, Norton-Smith S, Nyame S, Tan S, Yoon SW, Wang Y, Zhang Y, Wang Z, Mare H, Withanage I, Khattar M, Toft A, Sivasuthan G, Zhao H, Addley J, O'brien L, Raza M, Bindra R, Sharma S, Cornwell C, Patil A, Cheung A, Lown A, Dawson A, Blassey A, Ochigbo B, Cheng F, Fatima A, Zhang E, Kocatekin H, Roth C, Brewster D, Kwok K, Chen P, Laura S, Tynan D, Latif E, Lun E, Honore E, Ziergiebel F, Blake J, Chandiok K, Bird K, Ngothanh L, Lee M, El-Masry M, Hamer P, Palaniappan RR, Mcgee R, Huang S, Zhang S, Hariharan S, Silva YD, Lee C, Fotheringham P, Incoll I, Cordingley T, Cheng F, Brown M, Kang L, Wijayaratne R, Moore P, Qian G, Elgindy Y, Carnuccio E, Rae H, Shehata M, Liu M, Lockwood B, Bockxmeer JV, Alsoudani A, Swan D, Hsieh J, Orchard-Hall F, Tay KYJ, Mehra R, Gebeh A, Bailey A, Brown G, Colaco A, Gopal H, Boyley J, Changati V, Fletcher J, Khandelwal T, House C, O'neil C, Jaarsma E, Ly V, Balogh Z, Shui A, Sathasivam V, Legge-Wilkinson H, Wong KH, Chen A, Tran A, Rehfisch P, Wang G, Nguyen J, Peker J, Gallert K, Komesaroff M, Namburi M, Goldfinch E, Muchabaiwa R, Jangam A, Taylor I, Nusem I, Park JH(D, Gundara J, Heigan R, Tran T, Mackay T, Butterworth Y, Sadauskas T, Tung M, Ellepola H, Gan C, Fong H, Das A, Naicker L, Hauptman S, Kamath A, Yew A, Parange A, Kim K, Kharwadkar S, Gamage T, Vance L, Seldon A, Ghaly M, Phan V, Chauhan K, Bassam A, Vollenhoven B, Jaffry K, Mandhan K, Sritharan M, Sakthivel M, Evans N, Robinson S, Sivakumar S, Marrison L, Jollow D, Joshi K, Tao S, Shrestha P, Nukala SK, Hodgson R, Crotty A, Esho A, Harris A, Surkitt A, Bland L, Mcleod B, Yin C, Keng C, Greenwood E, Yuan G, Haege E, Wu H, Xiao H, Pozzi I, Fu J, Ross JS, Gentle J, Gan K, Chang K, Sun K, Singh M, Xie M, Mccabe N, Slavec M, Clarnette N, Niknami B, Zou P, Flintoft S, Jayatilleke S, Sok R, Tan S, Wadhwa S, Swansson W, Abulafia D, Blundell J, Sweetapple A, Solar CD, Martin C, Bell D, Fernando I, Chang J, Vanzuylekom K, Zuylekom KV, Zuylekom KV, Hobbs K, Liang R, Jabur A, Tarmidi J, Ugool M, Beatson N, Bowman S, Moin S, Tan WPJ, Chidambaram S, Gan SW, Wang P, Naicker L, Kim K, Wang NQ, Kwan YX, Patil C, Joshi D, Kamath A, Hanan A, Sheriff A, Duffield J, Naiker L, Smitham P, Neo EL, Chua M, Prasad S, Nagaratnam A, Sammour T, Lin Y, Lee C, Hopping E, Jangra M, Das A, Lin K, Bunjo Z, Raubenheimer K, Yunos MHM, Yeung KL, Phu R, Betts A, Just B, Gera S, Leeson H, Jamieson J, Wang K, Luu E, Innes M, Vu J, Hong J, Dzator S, Flame A, Jiang V, Kwok J, Lawrence A, Meads K, Pearce L, Sarangadasa P, Shaw H, Yu V, Crostella ;E, Wong J, Bobba S, Muller M, Hau YCH, Wilson T, Markovic A, Green J, Forbes C, Burrows E, Hou L, O'sullivan C, Foo J, Greig H, Collins AJ, Chandler C, Heaney E, Gross H, Morgan M, Loder R, Rajesh K, Ananthapadmanabhan S, Razmi A, Vong C, Pothukuchi P, Theophilus M, Sriranjan R, Kaur S, Kanczuk M, Groot JD, Corrigan A, Li D, Badri D, Ciranni D, Needi ET, Clanfield M, Copertino N, Rumble W, Vanguardia MK, Lew C, Dennaoui R, Shah J, Kong J, Koh I, Zeng R, Baziotis-Kalfas K, Denby H, Li A, Tran W, Singh A, Lin O, Chau M, Donaldson O, Min C(S, Ballah S, Tsui SCT, Yong N, Standish L, Tan S, Fujihara A, Davies L, Odisho R, Ravi A, Collins J, Chandra P, Abdelmeguid R, Singh G, Feierdaiweisi X, Seneviratne D, Srivastava S, Yao M, Teng C, Chowdhury N, Vidanagama S, Lin C, Sampatha-Waduge T, Wang E, Yodkitydomying C, Koh I, Silverii J, Lam A, Zeng R, Solanki K, Franks A, Edwards L, Atilhan R, Nandurkar R, Wells O, Vanguardia K, King D, Edwards E, Edwards L, Tran Q, Chau M, Min S, Rauf A, Fu Y, Haximolla H, Shang M, Segaran S, Wang S, Sivakumar G, Sandhu JK, Mishra N, Hauptman S, Chua A, Chene D, Maddern G, Shaw H, Wang Q, Pang S, Lu C, Fung J, Cyr K, Lu K, How MZ, Hu N, Anderson P, Jakanovski P, Youssef A, Tang H, Keenan R, Chan A, Canny M, Tahir F, Egerton J, Yeung J, Chan J, Tiffany L, Bei M, Raj M, Williams P, Nagpal S, Outhred T, Krawitz R, Choi CCM, Younus K, Giurgius M, Kirk R, Pegorer AG, Tang-Ieam P, Ward J, Wijetunga A, Zhang C, Nahm C, Wang C, Golja D, Jenkins G, Qian H, Luong J, Nguyen K, Suttor S, Lai S, Ma V, Chen Y, Yu HH, Lee A, Barbaro A, Mcguinness C, Maddern G, Young S, Lim YF, Trotta G, Chao P, Ding G, Fang C, Lu A, Wagaarachchi P, Cornwell C, Gojnich A, Stewart P, Dong I, Wong K, Burruso L, Hogan L, Mcorist N, Singh R, Jeyamohan R, Hou Z, Lai W, Taylor E, Palacios DSG, Pantoja MAN, Nanez DMB, Hernandez GOP, Jimenez Ramirez LJ, Mohamed M, El-Taher AK, Elewa A, Soliman MA, Diab M, Ali R, Ahmed A, Galal A, Elkhodary A, Alaa A, Faisal A, Badawy A, Eldomiaty D, Sayed MA, Rasslan E, Ramadan M, Fares GE, Altabbaa H, Emad H, Alboridy M, Mongy M, Albarhomy O, Selim O, Rafaei R, Atta R, Altaweel A, Sherif Y, Elghoul Y, Tarek Y, Sabry AA, Moustafa A, AbouHiekal O, Shaqran OA, Haggag Z, Abbas AM, Temerik AR, Atef D, Mahmoud A, Saad MM, Ragab M, Mahmoud AO, Hussien A, Abdelbaky M, Muhammad I, Morad A, Ali A, Hussien A, Shipa A, Aboulfotouh A, Abdelaal AM, Hashem AM, Youssef AA, Morsi A, Ebrahim A, Sayed AM, Kamel AM, Elmaghrabey A, Elgharib AM, Abdelrahman A, Ali A, Abdelnaeam S, Emam A, el-mola AG, Shaban A, Shaltout AS, Nabil B, Barsoum F, Mostafa E, Abdelbaset D, Salah D, Othman D, Othman S, Khairallah NS, Hassan SA, Morsi S, Azer A, Abdelsamed EA, Ahmed R, Ibrahim I, AbdElbaset E, Hamoda E, Monib F, Harb F, Maher H, Ahmed H, Mohammed H, Hana K, Ayoub K, Henes K, Shamshoon K, Soliman K, Hassanein M, Abdelhamid MM, Mahdy M, Khalil M, Ali M, Khalifa M, Amary M, Suliman ME, Abdallah MM, Nasr MSA, Elia M, Adly M, Roshdy M, Ramadan MF, Shahat MA, Abdelnasser MK, Zaed M, Al-Quossi M, Zarzour MA, Hares MM, Abdelfatah MA, Abughanima M, Abdeljaber M, Saber M, Amin MK, Abbas M, Haroon O, Khalil O, Talaat O, Elnagar R, Soliman R, Aboelela R, Salah S, Abdelgawad S, Mohammed T, Hussien TA, Sobhy G, Sayed Y, Silem YOR, Dawood A, Hemaida T, Ahmed R, Kamaleldin A, Zakaria A, Salah M, Salem E, Rashed OFAA, Halawa M, Elfeki H, Mosaad A, Shaaban A, Abdelsalam H, Sakr A, Sanad A, Elsawy A, Maged BM, Hegazy D, Abdelmaksoud M, Laymon M, Taman M, Moawad ER, AboElfarh HE, Elkenawi K, Osama M, Sadek M, Elghazy MA, Attia M, Nader M, Shalaby M, Attiya O, Gaarour OS, Zaghloul A, Mikhail P, Badr K, Soltan H, Donia M, Gaafar M, Abdelwahab K, Sallam A, Eid A, Yousri M, Hamdy O, Al-Touny A, Alshawadfy A, Hamdy A, Ellilly A, Mahdy A, El-Sakka A, Hendawy H, Salah A, Raslan B, Teema E, Albayadi E, Nasser E, Mohamed H, Mahmoud M, Elsaied M, Taha O, Dahshan S, Al-Touny S, Karrar A, Khairy A, Farag A, Deafallah A, Ads AM, Alomar R, AbuShawareb I, Saeed A, Mashaal A, Ads AM, Ghanem S, Elghamry A, Nada EA, Noureldin YA, Fouda MF, Shaheen N, Allam S, Mazrou I, Shehab AF, Kussaili W, Korkolis D, Fradelos E, Sarafi A, Machairas N, Giannakopoulos KS, Stavratis F, Korovesis G, Tsourouflis G, Keramida MD, Kydonakis N, Kykalos S, Syllaios A, Dorovinis P, Schizas D, Ioannidis O, Malliora A, Anestiadou E, Zapsalis K, Kontidis F, Loutzidou L, Ouzounidis N, Bitsianis S, Symeonidis S, Skalidou S, Ioannidis O, Valaroutsou OM, Dagklis T, Arvanitaki A, Mamopoulos A, Athanasiadis A, Kopatsaris S, Kalogiannidis I, Tsakiridis I, Kapetanios G, Papanikolaou E, Tsakiridis N, Zachomitros F, Larentzakis A, Gyftopoulos A, Albanopoulos K, Champipis A, Yiannakopoulos C, Vrakopoulou GZ, Saliaris K, Lathouras K, Skoufias S, Doulami G, Bareka M, Arnaoutoglou E, Angelis F, Angeslis F, Hantes M, Ntalouka M, Al-Juaifari MA, Alwash M, Maala R, Zwain YA, Saleh SA, Khorsheed M, Pesce A, Feo CV, Bernabei M, Petrarulo F, Fabbri N, Labriola R, Barbara SJ, Bosi S, Romano A, Canavese A, Catalioto C, Isopi C, Larotonda C, Dajti G, Rottoli M, Russo IS, Cardelli S, Castagnini F, Traina F, Guizzardi G, Giuzzardi G, Gorgone M, Maestri M, Cianci P, Conversano I, Restini E, Gattulli D, Grillea G, Varesano M, Calini G, Andriani A, Gattesco D, Terrosu G, Zambon M, Cerinic PM, Moretti L, Muschitiello D, Polo S, Bresadola V, Wardeh SA, Al-Baw M, Alhaleeq S, Al-Issawi S, Alsaify E, Banihani F, Massadeh N, Massadeh N, Al-issawi D, Elyan B, Al-Shami Q, Alomari Y, Khamees A, Al-Tahayneh SA, Alsheik A, Sawaftah K, Sarhan O, Alkhatib AA, Alzghoul B, Saleh A, Yaghmour J, Shahin M, Maali M, Alatefi D, Al-Smirat H, Hezam A, Alathameen N, Kaddah AA, Al Hammoud A, Ayasrah S, Abuuqteish H, Al-Mwajeh T, Makableh R, Bataineh S, Shabaneh A, Alnatsheh W, Aldeges M, Hamad H, Shehahda S, Khassawneh D, Alzyoud O, Alrosan R, Awad H, Khaldoon T, Shannaq R, hamoud MA, fadalah BA, Al-Hazaimeh M, Khraise W, Alnajjar L, Alnajjar M, Al-Omary S, Ababneh A, Albashaireh A, Khadrawi M, Aljamal M, Athamneh T, Muqbel RA, Al-jammal M, Masarrat A, Al-zawaydeh A, Taha I, Qattawi T, Smadi R, Alhaleem A, Alboon M, Hazaymeh O, Karasneh L, Al-Haek S, Almahroush M, Alfrijat T, Elporgay A, Shanag H, Agilla H, Alameen H, Bensalem M, Altair M, Ghemmied M, Alarabi R, Alhudhairy S, Gweder R, Alzarroug A, Alabed E, Elreaid F, Elkharaz OA, Elreaid FF, Albatni SS, Elmehdawi H, Gahwagi M, Mohamed A, Alfrjani T, Khafifi K, Rasheed A, Akwaisah A, Bushaala H, Elfadli M, Moftah M, Algabbasi S, Esaiti S, Elfallah S, Alharam A, Alariby F, Isweesi M, Eldarat TA, Dabas AA, Alkaseek A, Abodina AM, Alqaarh A, Bakeer HB, Alhaddad HS, Aboudlal H, Alsaih S, Abubaker N, Abdelrahim N, Alzarga A, Omar B, Faris F, Alhadad Q, Abufanas A, Badi H, Benismai I, Obeid H, Abdalei A, Abdulrahman A, Swalem A, Alzarouq E, Safar A, Shagroun E, Hashem B, Elrishi F, Abdulali F, Ahmed H, Eltaib I, Elzoubia J, Albarki A, Mugassabi HE, Abushaala F, Abuzaho A, Juha N, Egzait R, Shetwan S, Lemhaishi A, Matoug F, Abdulwahed E, Askar A, Ashur AB, Bezweek A, Altughar B, Emhimmed D, Elferis D, Elgherwi L, Soula E, Gidiem D, Grada M, Derwish K, Alameen M, Algatanesh N, Elkheshebi A, Ghmagh R, Barka S, Ahmeed S, Aljamal S, Alragig Z, Addalla M, Atia A, Kharim A, Mahmoud F, Binnawara M, Alshareea E, Alsori M, Alshawesh A, Alrifae GMH, Ashour A, Abozid A, Alflite AOS, Mohamed A, Arebi J, Alagelli F, Gineeb HY, Ghmagh R, Omar RMB, Alaqoubi R, Mohammed S, Bensalem SH, Elgadi T, Sami W, Bariun Y, Alhashimi AMA, Abdulla DA, Rhuma H, Enaami H, Alboueishi AA, Alkchr HBHMAA, Albakosh BA, Hasan NB, Alsari N, Aldreawi M, Abushanab K, Yahya R, Samalavicius N, Eismontas V, Jurgaitis J, Aliosin O, Nutautiene V, Zakaria AD, Pillai AKSK, Vadioaloo DK, Daud MAM, Soh JY, Zakaria MZ, Rusli SM, Ashar NAK, Ahmad ZA, Ramlee AA, Alsagoff SNASAL, Sofian AA, Jamil MBHM, Abdullah B, Noorman MF, Abidin MFZ, Isahak MI, Adnan SNN, Noor ZHM, Alvarez-Lozada LA, Garza AQ, Leal AA, Reyes BAF, Guerra EVO, Garza FJA, Mey HEA, Isais JAR, Zertuche JTG, García PLG, Sánchez LAH, Mercado MPF, Sierra OAV, Morales PER, Fuentes SO, Martínez VMP, Guerra-Juárez YA, Flores-González AK, Singh S, Hadi A, Woodbridge C, Thornton-Hume D, Forsythe J, Dharmaratne I, Pai V, Windsor J, Zargar K, Waldin L, Winthrop L, Alvarez M, Huang M, Kumove M, Simonetti M, Chand N, Goldsmith O, Guo O, Monk P, Zhou K, Penneru SH, Prasad S, Ren S, Hill T, Mistry V, Sun S, Pereira A, Mclaughlin S, Stokes A, Sathiyaseelan A, Rossaak J, Lim J, Brooke K, Quinlan L, Pottier M, Podder N, Jinu P, Ramphal S, Vermeulen W, Jeffery F, Busaidi ISA, Divinagracia J, Ju W, Liu Y, Glyn T, Thompson N, Graziadei V, Canton J, Furey J, Choi H, Coomber G, Divekar T, English T, Gernhoefer E, Healy T, Chou J, Parajuli D, Reed C, Studd R, Lin A, Wells C, Xu C, Hadi A, Maccormick A, Park H, Rathnayake A, Williams B, Chan A, Smith C, Casciola F, Bhikha J, Luo J, Yi K, Singhal M, George R, Luo R, Frost T, Hakak F, George A, Carlos A, Ho A, Mcrae C, Lescheid J, Soek J, Pham A, Clair SS, Yee SA, Lim J, Wu CY, Kim T, Chua AQ, Harmston C, Boyes H, Cook H, Struthers J, Radovanovich J, Quek N, Fearnley-Fitzgerald C, Wright D, Ghandi K, Matheson N, McGuinness MJ, Chen B, Douglas RI, Richter K, Soliman NB, Bolam SM, Vimalan V, Currie W, Cuthbert M, Ross P, Nicholson A, Garton B, Agnew E, Conlon N, Waaka N, Kejriwal R, Nguyen S, Leung E, Ratnayake M, Smith Q, Joseph N, Yue B, Fraser C, Lam C, Figgitt E, Liu G, Tan K, You HS, Zheng H, Luo J, Sharp J, Khanna K, Simiona L, Luo M, Ratnayake M, Wong P, Luu R, Paul R, Nair S, Asadyari-Lupo S, Hung W, Ying G, Ho J, Wu A, Walsh E, Lee J, Liu J, Yao S, Nosseir O, Dang J, Young S, Zyul'korneeva S, Boyd T, Ho J, Wu A, Yao S, Kirfi AM, Ningi AB, Garba MA, Salihu MB, Ukwuoma OE, Ibrahim A, Sajo IM, Aminu MB, Usman LH, Lanre ON, Shuaibu IS, Yusuf S, Ismail T, Umar GI, Adeyeye A, Afeikhena E, Nnaji FC, Agu JO, Maxwell TP, Motajo OO, Ifoto O, Okon SAI, Makama JG, Mohammed-Durosinlorun AA, Aminu B, Onwuhafua PI, Mohammed C, Abdulrasheed L, Adze JA, Suleiman KR, Airede LR, Taingson MC, Bature SB, Kache SA, Ogbonna UO, Fufore MB, Iya A, Ajulo AA, Mahmud A, Yahya BS, Onimisi-Yusuf F, Isaac H, Jawa T, Joseph F, Kala B, Bakari MA, Ngwan DW, umar A, Filikus AL, Wycliff D, Okunlola A, Abiola O, Adeniyi A, Adeyemo O, Awoyinka B, Babalola O, Bakare A, Buari T, Okunlola C, Adeleye G, Salawu A, Abiyere H, Ogidi A, Orewole T, Abdullahi HI, Akaba G, Achem A, Bassey AO, Ayogu E, Sulaiman B, Isah DA, Akpamgbo CN, Asudo F, Adewole N, Oguche O, Ejembi P, Sani SA, Andrew PC, Isah A, Eniola B, Songden Z, Agida T, Atim T, Mohammed TO, Raji HO, Ibiyemi F, Salawu H, Fasiku O, Solagbade RS, Shiru MM, Ibraheem GH, Oruade J, Ezeoke G, Chawla T, Aziz AB, Marium A, Waheed AA, Aamir FB, Qureshi F, Ather MH, Ali IFM, Tahir I, Akbar MG, Ukrani RD, Raja S, Virani SS, Noordin S, Rehman SU, Golani S, Aamir SR, Mufarrih SM, Waqar U, Taufiq M, Ammar AS, Ejaz A, Sarwar A, Khalid AU, Khattak S, Imran A, Khalid OB, Kaleem U, Muneer U, Kashaf Y, Zafar F, Zaheer A, Ali M, Shafaat A, Qazi A, Tariq AI, Aslam MN, Ali S, Atiq T, Wasim T, Babar D, Zain A, Ibtisam M, Ahmed U, Aqeel STB, Muhib M, Abbal MA, Khan NA, Javed I, Alkaraja L, Amro D, Manasrah G, Hammouri I, Hilail IA, Zalloum J, Alamlih L, Nasereddin M, Rajabi M, Shalalfeh S, Natsheh Z, Elessi K, Jayyab MA, Astal M, Al-Dahdouh M, Salameh AE, Ayyad A, Dawod N, Alsaid H, Matar I, Hassan M, Bakeer M, Malasah M, Abuhashem S, Salem M, Lunca S, Dimofte MG, Morarasu S, Musina AM, Roata CE, Velenciuc N, Butyrskii A, Bozhko M, Ametov A, Chowdhury S, Bagazi D, Domenech J, Rosello-Añon A, Monis A, Chiappe C, Cuneo B, Clemente-Navarro P, Febre J, Sanz-Romera J, Lopez-Vega M, Miranda I, Valverde-Vazquez R, Garcia S, Sanguesa MJ, Balciscueta Z, Ruiz E, Marco E, Talavera E, Farre J, Bacariza L, Duart M, Ureña V, Carre X, Hamid HKS, Abd-Albain MA, Galal-Eldin S, Sarih M, Adam E, Ismail S, Azhari M, Hassan T, Salaheldein M, Abdalla Z, Ahmed W, Alhassan M, Mohamed A, Suliman HMA, Eltayeb MOM, Ahmed RAA, Babekir EMA, Khairy MAT, Mukhtar MMA, Ali RAH, Al-Shambaty YBA, Yousif FI, Mohammed HMH, Osher L, Osher L, Abdelbast M, Yassin M, Moawia N, Abdalsadeg R, Husein A, Elhassan B, Abdelbagi AY, Adam MA, Ali EM, Mohammed IAB, Mohamed M, Abdulaziz M, Akasha M, Hassan M, Hilal N, Mohamed NAA, Abubaker N, Mohammed O, Mohamed S, Osman W, Mustafa F, Salih AA, Ali D, Almakki DMA, Mohamed HE, Elmubark A, Hassan M, Alnour A, Elaagib A, Abdelrahman A, Abdelkhalig M, Eldaim KN, Babiker A, Ahmed E, Ali M, Hussain E, Wedatalla M, Ahmed A, Hamza AA, Mohammed M, Osman O, Ibrahim R, Ahmed R, Ahmed R, Yasir R, Awadallah S, Mohmmed S, Hassan S, Shaban W, Hussein A, Rafea R, Abdalla A, Ahmed A, Mohamed K, Mohammed M, Altahir M, Adam M, Mohamed O, Abdullah W, Fadlalmola H, Abdalla AY, Omer AA, Mustafa AA, Elhadi REH, Banaga EEA, Osman F, Abdalla MGA, Taha HAM, Abdalmahmoud NE, Nafie RH, Jamal S, Ahmed S, Ali RA, Aladna A, Aljoumaa A, Nawfal H, Jamali S, Khouja F, Niazi A, Al Rawashdeh T, Kechiche N, Gara M, Nasr M, Baccar M, Benamor O, Chakroun S, Sanli AN, Yildiz A, Demirkiran MA, Atadag YB, Tandogan YI, Ozkan E, Ozer Y, Ozkan E, Oncel MM, Kalkan S, Gover T, Manoglu B, Oksak I, Kurt I, Rifaioglu K, Sokmen S, Bisgin T, Yildirim Y, Keskin AY, Dogan T, Sahin Bİ, Aydin C, Benek DE, Tiras HN, Arslangilay M, Aslangilay M, Yaytokgil M, Capar MA, Yazgan Y, Bektas S, Alagoz AC, Dagsali AE, Izgis A, Uzel K, Soytas M, Cakir N, Askin AE, Azboy I, Sabuncu K, Aslan M, Sahin M, Oncel M, Okkabaz N, Sivrikaya RK, Saylar A, Saylar A, Yasar M, Erginoz E, Bozkir HO, Zengin K, Ozcelik MF, Uludag SS, Ozdemir Z, Sibic O, Telci H, Bozkurt MA, Kara Y, Tepe MD, Gündoğdu A, Akın B, Pehlivan D, Guner A, Baysallar D, Yıldız B, Cepe H, Reis ME, Yuzgec AN, Kıralı N, Kodalak TA, Ulusahin M, Selim K, Kale A, Gecici ME, Ozbilen M, Düzyol Z, Gemici A, Korkmaz E, Şen E, Taşcı ME, Camkıran E, Elieyioğlu G, Kayabaş İ, Uprak TK, Aral C, Saraçoğlu A, Uğurlu MÜ, Baltacı ZH, Akkaya EN, Fergar C, Tabak EZ, Kocyigit GZ, Kayilioglu I, Polat S, Çolak E, Kara ME, Candan M, Uyanık MS, Sarı AC, Ulkucu A, Certel AT, Dindar A, Durdu B, Bayram C, Kaya E, Akdere H, Cakcak IE, Yavuz I, Omur M, Ajredini M, Aydoğdu EO, Şenödeyici E, Koksoy UC, Kazbek BK, Korkmaz DS, Yavuz D, Yilmaz H, Cetınkaya ZS, Durmus E, Tuzuner F, Hokelekli F, Mutlu M, Akbuz SO, Kus ZC, Kus ZC, Farrell M, Craig-Lucas A, Painter M, Titan A, Narayan A, Fariyike B, Knowlton L, Yue T, Benham E, Nimeri A, Werenski H, Kaiser N, Reinke C. Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries. Br J Surg 2024; 111:znad421. [PMID: 38207169 PMCID: PMC10783642 DOI: 10.1093/bjs/znad421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures. METHODS This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge. RESULTS The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (β coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not. CONCLUSION Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely.
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Lu K, Wu YM, Shi Q, Gong YQ, Zhang T, Li C. The impact of acute-phase reaction on mortality and re-fracture after zoledronic acid in hospitalized elderly osteoporotic fracture patients. Osteoporos Int 2023; 34:1613-1623. [PMID: 37247006 DOI: 10.1007/s00198-023-06803-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Abstract
This study involving 674 elderly osteoporotic fracture (OPF) patients undergoing orthopedic surgery investigated the long-term outcomes of acute phase reaction (APR) after initial zoledronic acid (ZOL). Those who had an APR had a 97% higher risk of mortality and a 73% lower rate of re-fracture than patients who did not. INTRODUCTION Annual infusion of ZOL efficiently decreases the risk of fracture. A temporary APR, consisting of flu-like symptoms, myalgia, and fever, is frequently observed within 3 days after the first dose. This work aimed to identify whether the occurrence of APR after initial ZOL infusion is a reliable indicator of drug efficacy for mortality and re-fracture in elderly OPF patients undergoing orthopedic surgery. METHODS This retrospectively observed work was constructed on a database prospectively collected from the Osteoporotic Fracture Registry System of a tertiary level A hospital in China. Six hundred seventy-four patients 50 years old or older with newly identified hip/morphological vertebral OPF who received ZOL for the first time after orthopedic surgery were included in the final analysis. APR was identified as a maximum axillary body temperature greater than 37.3 °C for the first 3 days after ZOL infusion. We utilized models of multivariate Cox proportional hazards to compare the risk of all-cause mortality in OPF patients with APR (APR+) and without APR (APR-). Competing risks regression analysis was used to examine the association between the occurrence of APR and re-fracture when mortality was taken into account. RESULTS In a fully adjusted Cox proportional hazards model, APR+ patients had a significantly higher risk of death than APR- patients with a hazard ratio [HR] 1.97 (95% CI, 1.09-3.56; P-value = 0.02). Furthermore, in an adjusted competing risk regression analysis, APR+ patients had a significantly reduced risk of re-fracture compared with APR- patients with a sub-distribution HR, 0.27 (95% CI, 0.11-0.70; P-value = 0.007). CONCLUSIONS Our findings suggested a potential association between the occurrence of APR and increased mortality risk. An initial dose of ZOL following orthopedic surgery was found to be protective against re-fracture in older patients with OPFs.
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Affiliation(s)
- K Lu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Y-M Wu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Q Shi
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute of Soochow University, Suzhou, Jiangsu, China
| | - Y-Q Gong
- Information Department, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - T Zhang
- Chronic Disease Department, Kunshan Center For Disease Control and Prevention, Suzhou, Jiangsu, China
| | - C Li
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China.
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Wang H, He Q, Liu D, Deng XZ, Ma J, Xie LN, Sun ZL, Liu C, Zhao RR, Lu K, Chu XX, Gao N, Wei HC, Sun YH, Zhong YP, Xing LJ, Zhang HY, Zhang H, Xu WW, Li ZJ. [Efficacy and safety of bendamustine-rituximab combination therapy for newly diagnosed indolent B-cell non-Hodgkin's lymphoma and elderly mantle cell lymphoma: a multi-center prospective phase II clinical trial in China]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:550-554. [PMID: 37749033 PMCID: PMC10509620 DOI: 10.3760/cma.j.issn.0253-2727.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Indexed: 09/27/2023]
Abstract
Objectives: This study aimed to assess the efficacy and safety of bendamustine in combination with rituximab (BR regimen) for the treatment of newly diagnosed indolent B-cell non-Hodgkin's lymphoma (B-iNHL) and elderly mantle cell lymphoma (eMCL) . Methods: From December 1, 2020 to September 10, 2022, a multi-center prospective study was conducted across ten Grade A tertiary hospitals in Shandong Province, China. The BR regimen was administered to evaluate its efficacy and safety in newly diagnosed B-iNHL and eMCL patients, and all completed at least four cycles of induction therapy. Results: The 72 enrolled patients with B-iNHL or MCL were aged 24-74 years, with a median age of 55 years. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-1 were observed in 76.4% of patients, while 23.6% had scores of 2. Disease distribution included follicular lymphoma (FL) (51.4% ), marginal zone lymphoma (MZL) (33.3% ), eMCL (11.1% ), and the unknown subtype (4.2% ). According to the Ann Arbor staging system, 16.7% and 65.3% of patients were diagnosed with stage Ⅲ and stage Ⅳ lymphomas, respectively. Following four cycles of BR induction therapy, the overall response rate was 98.6%, with a complete response (CR) rate of 83.3% and a partial response (PR) rate of 15.3%. Only one eMCL patient experienced disease progression during treatment, and only one FL patient experienced a relapse. Even when evaluated using CT alone, the CR rate was 63.9%, considering the differences between PET/CT and CT assessments. The median follow-up duration was 11 months (range: 4-22), with a PFS rate of 96.8% and an OS rate of 100.0%. The main hematologic adverse reactions included grade 3-4 leukopenia (27.8%, with febrile neutropenia observed in 8.3% of patients), grade 3-4 lymphopenia (23.6% ), grade 3-4 anemia (5.6% ), and grade 3-4 thrombocytopenia (4.2% ). The main non-hematologic adverse reactions such as fatigue, nausea/vomiting, rash, and infections occurred in less than 20.0% of patients. Conclusion: Within the scope of this clinical trial conducted in China, the BR regimen demonstrated efficacy and safety in treating newly diagnosed B-iNHL and eMCL patients.
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Affiliation(s)
- H Wang
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Q He
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - D Liu
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - X Z Deng
- Department of Hematology, Weihai Municipal Hospital, Weihai 264200, China
| | - J Ma
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - L N Xie
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Z L Sun
- Department of Hematology, Jining First People's Hospital, Jining 272000, China
| | - C Liu
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - R R Zhao
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - K Lu
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - X X Chu
- Department of Hematology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, China
| | - N Gao
- Department of Hematology, Binzhou Medical University Hospital, Binzhou 256600, China
| | - H C Wei
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Y H Sun
- Department of Hematology, Weifang People's Hospital, Weifang 261000, China
| | - Y P Zhong
- Department of Hematology, Qingdao Municipal Hospital, Qingdao 266000, China
| | - L J Xing
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
| | - H Y Zhang
- Department of Hematology, Linyi People's Hospital, Linyi 276000, China
| | - H Zhang
- Department of Hematology, Affiliated Hospital of Jining Medical University, Jining 272000, China
| | - W W Xu
- Department of Hematology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250000, China
| | - Z J Li
- Department of Hematology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250000, China
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Yeh PG, Toumazis I, Sun C, Lu K, Meyer LA. Abstract 5769: Disparities in uptake of levonorgestrel-releasing intrauterine system (LNG-IUS): implications for uterine cancer primary prevention. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-5769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Introduction: Levonorgestrel-releasing intrauterine system (LNG-IUS) is associated with ~50% risk reduction for uterine cancer incidence and can be an effective primary prevention strategy. We aimed to understand current patterns of LNG-IUS use and identify disparities that could inform implementation strategies for more effective and equitable uterine cancer primary prevention.
Methods: We analyzed LNG-IUS use among U.S. women aged 18-50 with the 2017-2019 National Survey of Family Growth. Statistical analysis was stratified by race, sociodemographic, and health factors. Predictors of LNG-IUS use were assessed through weighted multivariable logistic regression using the Wald chi-square test.
Results: Current LNG-IUS use was significantly lower in Hispanic women compared to White women (AOR 0.65, P=0.049). Compared to women with up to a high school education, LNG-IUS use was higher for women with a college degree or higher in the overall sample (AOR 1.86, P=0.009), White women (AOR 1.91, P=0.04), and Black women (AOR 4.54, P=0.007), but not for Hispanic women (AOR 0.79, P=0.64). All racial/ethnic subgroups had lower odds of LNG-IUS for non-parous women than parous women (all P<0.002). Although a known uterine cancer risk factor, obesity was not associated with LNG-IUS use.
Conclusions: Hispanic women, women with lower educational levels, and nulliparous women have disproportionately low LNG-IUS use despite being at increased uterine cancer risk. Community-based educational interventions for high-risk women and their providers on the benefits of LNG-IUS on uterine cancer prevention are needed to mitigate uterine cancer disparities.
Table 1. Logistic Regression on Predictors for LNG-IUS Use in U.S. Women Aged 18-50 OVERALL (N=4107) WHITE (n=1948) HISPANIC (n=1052) BLACK (n=861) AOR (95% CI) AOR (95% CI) AOR (95% CI) AOR (95% CI) Race Ref 0.65* (0.42-0.98) 0.77 (0.46-1.27) Age 18-24 1.16 (0.55-2.46) 1.15 (0.45-2.94) 13.13* (1.42-121.3) 0.55 (0.11-2.83) 25-34 1.65 (0.88-3.10) 1.46 (0.69-3.13) 31.75** (4.04-249.5) 0.63 (0.18-2.14) 35-44 1.07 (0.55-2.10) 1.10 (0.49-2.47) 13.28* (1.51-116.6) 0.54 (0.14-2.02) 45-50 Ref Ref Ref Ref Education ≤High School Ref Ref Ref Ref Some College 1.56* (1.02-2.51) 1.56 (0.83-2.94) 1.05 (0.47-2.32) 3.90* (1.39-10.96) ≥Bachelor’s 1.86** (1.17-2.97) 1.91* (1.03-3.54) 0.79 (0.30-2.12) 4.54** (1.51-13.65) BMI Normal Ref Ref Ref Ref Overweight 1.44 (0.93-3.22) 1.40 (0.81-2.41) 0.96 (0.35-2.62) 1.54 (0.56-4.22) Obese 0.87 (0.57-1.31) 0.86 (0.52-1.43) 0.68 (0.28-1.63) 1.01 (0.35-2.89) Parity Parous 2.85*** (1.89-4.30) 2.21** (1.33-3.67) 7.30*** (2.61-20.38) 5.38*** (2.27-12.76) Nulliparous Ref Ref Ref Ref Abbreviations: AOR, adjusted odds ratio; BMI, body mass index; CI, confidence interval; Ref, reference group. *P<0.05; ** P<0.01; *** P<0.001 aEarly Menarche <12yo; Normal Menarche 12-14yo; Late Menarche >14yo.
Citation Format: Paul G. Yeh, Iakovos Toumazis, Charlotte Sun, Karen Lu, Larissa A. Meyer. Disparities in uptake of levonorgestrel-releasing intrauterine system (LNG-IUS): implications for uterine cancer primary prevention. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5769.
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Affiliation(s)
- Paul G. Yeh
- 1University of Texas Health Science Center At Houston, Houston, TX
| | | | - Charlotte Sun
- 2University of Texas MD Anderson Cancer Center, Houston, TX
| | - Karen Lu
- 2University of Texas MD Anderson Cancer Center, Houston, TX
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Li W, Yang N, Li K, Fan H, Yu Q, Wu H, Wang Y, Meng X, Wu J, Wang Z, Liu Y, Wang X, Qin X, Lu K, Zhuang W, He S, Janne P, Seto T, Ou SH, Zhou C. 14MO Updated efficacy and safety of taletrectinib in patients (pts) with ROS1+ non-small cell lung cancer (NSCLC). J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00268-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Fu S, Yao S, Yuan Y, Previs RA, Elias AD, Carvajal RD, George TJ, Yuan Y, Yu L, Westin SN, Xing Y, Dumbrava EE, Karp DD, Piha-Paul SA, Tsimberidou AM, Ahnert JR, Takebe N, Lu K, Keyomarsi K, Meric-Bernstam F. Multicenter Phase II Trial of the WEE1 Inhibitor Adavosertib in Refractory Solid Tumors Harboring CCNE1 Amplification. J Clin Oncol 2023; 41:1725-1734. [PMID: 36469840 PMCID: PMC10489509 DOI: 10.1200/jco.22.00830] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/02/2022] [Accepted: 10/20/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Preclinical cancer models harboring CCNE1 amplification were more sensitive to adavosertib treatment, a WEE1 kinase inhibitor, than models without amplification. Thus, we conducted this phase II study to assess the antitumor activity of adavosertib in patients with CCNE1-amplified, advanced refractory solid tumors. PATIENTS AND METHODS Patients aged ≥ 18 years with measurable disease and refractory solid tumors harboring CCNE1 amplification, an Eastern Cooperative Oncology Group performance status of 0-1, and adequate organ function were studied. Patients received 300 mg of adavosertib once daily on days 1 through 5 and 8 through 12 of a 21-day cycle. The trial followed Bayesian optimal phase II design. The primary end point was objective response rate (ORR). RESULTS Thirty patients were enrolled. The median follow-up duration was 9.9 months. Eight patients had partial responses (PRs), and three had stable disease (SD) ≥ 6 months, with an ORR of 27% (95% CI, 12 to 46), a SD ≥ 6 months/PR rate of 37% (95% CI, 20 to 56), a median progression-free survival duration of 4.1 months (95% CI, 1.8 to 6.4), and a median overall survival duration of 9.9 months (95% CI, 4.8 to 15). Fourteen patients with epithelial ovarian cancer showed an ORR of 36% (95% CI, 13 to 65) and SD ≥ 6 months/PR of 57% (95% CI, 29 to 82), a median progression-free survival duration of 6.3 months (95% CI, 2.4 to 10.2), and a median overall survival duration of 14.9 months (95% CI, 8.9 to 20.9). Common treatment-related toxicities were GI, hematologic toxicities, and fatigue. CONCLUSION Adavosertib monotherapy demonstrates a manageable toxicity profile and promising clinical activity in refractory solid tumors harboring CCNE1 amplification, especially in epithelial ovarian cancer. Further study of adavosertib, alone or in combination with other therapeutic agents, in CCNE1-amplified epithelial ovarian cancer is warranted.
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Affiliation(s)
- Siqing Fu
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Shuyang Yao
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Yuan Yuan
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | | | | | | | - Ying Yuan
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lihou Yu
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Yan Xing
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | - Daniel D. Karp
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Naoko Takebe
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
| | - Karen Lu
- The University of Texas MD Anderson Cancer Center, Houston, TX
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10
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Zhukovsky DS, Soliman P, Liu D, Meyer M, Haider A, Heung Y, Gaeta S, Lu K, Stepan K, Stanton P, Rodriguez A, Bruera E. Patient Engagement With Early Stage Advance Care Planning at a Comprehensive Cancer Center. Oncologist 2023:7059093. [PMID: 36848260 DOI: 10.1093/oncolo/oyad015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/30/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Establishing care preferences and selecting a prepared medical decision-maker (MDM) are basic components of advance care planning (ACP) and integral to treatment planning. Systematic ACP in the cancer setting is uncommon. We evaluated a systematic social work (SW)-driven process for patient selection of a prepared MDM. METHODS We used a pre/post design, centered on SW counseling incorporated into standard-of-care practice. New patients with gynecologic malignancies were eligible if they had an available family caregiver or an established Medical Power of Attorney (MPOA). Questionnaires were completed at baseline and 3 months to ascertain MPOA document (MPOAD) completion status (primary objective) and evaluate factors associated with MPOAD completion (secondary objectives). RESULTS Three hundred and sixty patient/caregiver dyads consented to participate. One hundred and sixteen (32%) had MPOADs at baseline. Twenty (8%) of the remaining 244 dyads completed MPOADs by 3 months. Two hundred and thirty-six patients completed the values and goals survey at both baseline and follow-up: at follow-up, care preferences were stable in 127 patients (54%), changed toward more aggressive care in 60 (25%), and toward the focus on the quality of life in 49 (21%). Correlation between the patient's values and goals and their caregiver's/MPOA's perception was very weak at baseline, improving to moderate at follow-up. Patients with MPOADs by study completion had statistically significant higher ACP Engagement scores than those without. CONCLUSION A systematic SW-driven intervention did not engage new patients with gynecologic cancers to select and prepare MDMs. Change in care preferences was common, with caregivers' knowledge of patients' treatment preferences moderate at best.
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Affiliation(s)
- Donna S Zhukovsky
- Department of Palliative Care Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pamela Soliman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Diane Liu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Margaret Meyer
- Department of Social Work, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ali Haider
- Department of Palliative Care Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yvonne Heung
- Department of Palliative Care Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Susan Gaeta
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Karen Lu
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Karen Stepan
- Department of Medical Affairs, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Penny Stanton
- Department of Palliative Care Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alma Rodriguez
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eduardo Bruera
- Department of Palliative Care Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Li C, Lu K. Comments on "Relatively low and moderate pre-fracture serum 25-hydroxyvitamin D levels associated with the highest survival in elderly hip fracture patients in Finland: a minimum 3-year follow-up". Osteoporos Int 2023; 34:413-414. [PMID: 36409360 DOI: 10.1007/s00198-022-06417-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/01/2022] [Indexed: 11/22/2022]
Affiliation(s)
- C Li
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 91 West of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - K Lu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 91 West of Qianjin Road, Suzhou, 215300, Jiangsu, China.
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Wamsley C, Kislevitz M, Vingan NR, Oesch S, Lu K, Barillas J, Hoopman J, Akgul Y, Basci D, Kho K, Zimmern PE, Kenkel JM. A Randomized, Placebo-Controlled Trial Evaluating the Single and Combined Efficacy of Radiofrequency and Hybrid Fractional Laser for Nonsurgical Aesthetic Genital Procedures in Post-Menopausal Women. Aesthet Surg J 2022; 42:1445-1459. [PMID: 35882474 DOI: 10.1093/asj/sjac202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The efficacy of interventions that provide long-term relief of genitourinary symptoms of menopause has not been determined. OBJECTIVES The authors sought to evaluate radiofrequency and hybrid fractional laser (HFL) treatments for menopausal vulvovaginal symptoms. METHODS Thirty-one postmenopausal women completed all treatments and at least 1 follow-up. Outcomes included the Vulvovaginal Symptom Questionnaire (VSQ), Vaginal Laxity Questionnaire (VLQ), Urogenital Distress Short Form, Incontinence Impact Questionnaire (IIQ), Female Sexual Function Index (FSFI), laxity measurements via a vaginal biometric analyzer probe, and gene expression studies. RESULTS Mean VSQ score decreased 2.93 (P = 0.0162), 4.07 (P = 0.0035), and 4.78 (P = 0.0089) among placebo, dual, and HFL groups 3 months posttreatment and decreased to 3.3 (P = 0.0215) for dual patients at 6 months. FSFI scores increased in the desire domain for placebo and dual groups and in arousal, lubrication, orgasm, satisfaction, and pain domains for the HFL group 3 and 6 months posttreatment. An increase of 1.14 in VLQ score (P = 0.0294) was noted 3 months and 2.2 (P = 0.002) 6 months following dual treatment. There was also a mean decrease of 15.3 (P = 0.0069) in IIQ score for HFL patients at 3 months. Dual, HFL, and RF treatments resulted in statistically significant decreases in collagen I, elastin, and lysyl oxidase expression. CONCLUSIONS Several self-reported improvements were noted, particularly among HFL, dual, and placebo groups 3 and 6 months posttreatment. Objective biopsy analysis illustrated decreased gene expression, suggesting that treatments did not stimulate new extracellular matrix production. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Christine Wamsley
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Mikaela Kislevitz
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nicole R Vingan
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sydney Oesch
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Karen Lu
- Department of Plastic Surgery, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Jennifer Barillas
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John Hoopman
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yucel Akgul
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Deniz Basci
- plastic surgeon in private practice in Dallas, TX, USA
| | - Kimberly Kho
- Department of Obstetrics and Gynecology, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Phillipe E Zimmern
- Department of Urology, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey M Kenkel
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
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13
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Sidey-Gibbons CJ, Sun C, Schneider A, Lu SC, Lu K, Wright A, Meyer L. Predicting 180-day mortality for women with ovarian cancer using machine learning and patient-reported outcome data. Sci Rep 2022; 12:21269. [PMID: 36481644 PMCID: PMC9732183 DOI: 10.1038/s41598-022-22614-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 10/17/2022] [Indexed: 12/13/2022] Open
Abstract
Contrary to national guidelines, women with ovarian cancer often receive treatment at the end of life, potentially due to the difficulty in accurately estimating prognosis. We trained machine learning algorithms to guide prognosis by predicting 180-day mortality for women with ovarian cancer using patient-reported outcomes (PRO) data. We collected data from a single academic cancer institution in the United States. Women completed biopsychosocial PRO measures every 90 days. We randomly partitioned our dataset into training and testing samples. We used synthetic minority oversampling to reduce class imbalance in the training dataset. We fitted training data to six machine learning algorithms and combined their classifications on the testing dataset into an unweighted voting ensemble. We assessed each algorithm's accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) using testing data. We recruited 245 patients who completed 1319 PRO assessments. The final voting ensemble produced state-of-the-art results on the task of predicting 180-day mortality for ovarian cancer paitents (Accuracy = 0.79, Sensitivity = 0.71, Specificity = 0.80, AUROC = 0.76). The algorithm correctly identified 25 of the 35 women in the testing dataset who died within 180 days of assessment. Machine learning algorithms trained using PRO data offer encouraging performance in predicting whether a woman with ovarian cancer will die within 180 days. This model could be used to drive data-driven end-of-life care and address current shortcomings in care delivery. Our model demonstrates the potential of biopsychosocial PROM information to make substantial contributions to oncology prediction modeling. This model could inform clinical decision-making Future research is needed to validate these findings in a larger, more diverse sample.
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Affiliation(s)
- Chris J. Sidey-Gibbons
- grid.240145.60000 0001 2291 4776Section of Patient-Centered Analytics, Department of Symptom Research, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Charlotte Sun
- grid.240145.60000 0001 2291 4776Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Amy Schneider
- grid.240145.60000 0001 2291 4776Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Sheng-Chieh Lu
- grid.240145.60000 0001 2291 4776Section of Patient-Centered Analytics, Department of Symptom Research, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Karen Lu
- grid.240145.60000 0001 2291 4776Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Alexi Wright
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA ,grid.38142.3c000000041936754XDepartment of Medicine, Harvard Medical School, Boston, USA
| | - Larissa Meyer
- grid.240145.60000 0001 2291 4776Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, USA
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Zhang BB, Tang YG, Mei QS, Li XY, Lu K. Inhibiting creep in nanograined alloys with stable grain boundary networks. Science 2022; 378:659-663. [DOI: 10.1126/science.abq7739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Creep, the time-dependent deformation of materials stressed below the yield strength, is responsible for a great number of component failures at high temperatures. Because grain boundaries (GBs) in materials usually facilitate diffusional processes in creep, eliminating GBs is a primary approach to resisting high-temperature creep in metals, such as in single-crystal superalloy turbo blades. We report a different strategy to inhibiting creep by use of stable GB networks. Plastic deformation triggered structural relaxation of high-density GBs in nanograined single-phased nickel-cobalt-chromium alloys, forming networks of stable GBs interlocked with abundant twin boundaries. The stable GB networks effectively inhibit diffusional creep processes at high temperatures. We obtained an unprecedented creep resistance, with creep rates of ~10
–7
per second under gigapascal stress at 700°C (~61% melting point), outperforming that of conventional superalloys.
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Affiliation(s)
- B. B. Zhang
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Y. G. Tang
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Shenyang 110016, China
| | - Q. S. Mei
- School of Power and Mechanical Engineering, Wuhan University, Wuhan 430072, China
| | - X. Y. Li
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - K. Lu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
- Liaoning Academy of Materials, Shenyang 110004, China
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Gisbert E, Moreira DC, Mozanzadeh MT, Lu K. Editorial: Rising stars in aquatic physiology: 2022. Front Physiol 2022; 13:1081961. [DOI: 10.3389/fphys.2022.1081961] [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] [Received: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
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16
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Irajizad E, Han CY, Celestino J, Wu R, Murage E, Spencer R, Dennison JB, Vykoukal J, Long JP, Do KA, Drescher C, Lu K, Lu Z, Bast RC, Hanash S, Fahrmann JF. A Blood-Based Metabolite Panel for Distinguishing Ovarian Cancer from Benign Pelvic Masses. Clin Cancer Res 2022; 28:4669-4676. [PMID: 36037307 PMCID: PMC9633421 DOI: 10.1158/1078-0432.ccr-22-1113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/06/2022] [Accepted: 08/24/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE To assess the contributions of circulating metabolites for improving upon the performance of the risk of ovarian malignancy algorithm (ROMA) for risk prediction of ovarian cancer among women with ovarian cysts. EXPERIMENTAL DESIGN Metabolomic profiling was performed on an initial set of sera from 101 serous and nonserous ovarian cancer cases and 134 individuals with benign pelvic masses (BPM). Using a deep learning model, a panel consisting of seven cancer-related metabolites [diacetylspermine, diacetylspermidine, N-(3-acetamidopropyl)pyrrolidin-2-one, N-acetylneuraminate, N-acetyl-mannosamine, N-acetyl-lactosamine, and hydroxyisobutyric acid] was developed for distinguishing early-stage ovarian cancer from BPM. The performance of the metabolite panel was evaluated in an independent set of sera from 118 ovarian cancer cases and 56 subjects with BPM. The contributions of the panel for improving upon the performance of ROMA were further assessed. RESULTS A 7-marker metabolite panel (7MetP) developed in the training set yielded an AUC of 0.86 [95% confidence interval (CI): 0.76-0.95] for early-stage ovarian cancer in the independent test set. The 7MetP+ROMA model had an AUC of 0.93 (95% CI: 0.84-0.98) for early-stage ovarian cancer in the test set, which was improved compared with ROMA alone [0.91 (95% CI: 0.84-0.98); likelihood ratio test P: 0.03]. In the entire specimen set, the combined 7MetP+ROMA model yielded a higher positive predictive value (0.68 vs. 0.52; one-sided P < 0.001) with improved specificity (0.89 vs. 0.78; one-sided P < 0.001) for early-stage ovarian cancer compared with ROMA alone. CONCLUSIONS A blood-based metabolite panel was developed that demonstrates independent predictive ability and complements ROMA for distinguishing early-stage ovarian cancer from benign disease to better inform clinical decision making.
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Affiliation(s)
- Ehsan Irajizad
- Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Chae Y. Han
- Department of Experimental Therapeutics, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Joseph Celestino
- Department of Experimental Therapeutics, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Ranran Wu
- Department of Clinical Cancer Prevention; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Eunice Murage
- Department of Clinical Cancer Prevention; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Rachelle Spencer
- Department of Clinical Cancer Prevention; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer B. Dennison
- Department of Clinical Cancer Prevention; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Jody Vykoukal
- Department of Clinical Cancer Prevention; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - James P Long
- Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Kim Anh Do
- Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Charles Drescher
- Translational Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Division of Gynecologic Oncology, Swedish Cancer Institute, Seattle, Washington, USA
| | - Karen Lu
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Zhen Lu
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Robert C. Bast
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Sam Hanash
- Department of Clinical Cancer Prevention; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA,Corresponding Authors: Johannes F. Fahrmann, PhD, The University of Texas MD Anderson Cancer Center, 6767 Bertner Street, Houston, TX 77030, USA, Phone: 713-792-8239, Fax: 713-792-1474, , Samir M. Hanash, M.D., Ph.D., The University of Texas M. D. Anderson Cancer Center, 6767 Bertner Ave, Houston, Texas 77030, Phone: 713-745-5242, Fax: 713-563-5746,
| | - Johannes F. Fahrmann
- Department of Clinical Cancer Prevention; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA,Corresponding Authors: Johannes F. Fahrmann, PhD, The University of Texas MD Anderson Cancer Center, 6767 Bertner Street, Houston, TX 77030, USA, Phone: 713-792-8239, Fax: 713-792-1474, , Samir M. Hanash, M.D., Ph.D., The University of Texas M. D. Anderson Cancer Center, 6767 Bertner Ave, Houston, Texas 77030, Phone: 713-745-5242, Fax: 713-563-5746,
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Zhu H, Liu Q, Xu H, Mo M, Wang Z, Lu K, Zhou J, Chen J, Zheng X, Ye J, Ge X, Luo H, Song S, Chen Y, Zhao K. 132TiP Dose escalation of chemoradiotherapy in locally advanced esophageal squamous cell carcinoma based on positron emission tomography response: A phase III, open-label, randomized, controlled trial (ESO-Shanghai 12). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Lu K, Rothe M, Floegel U, Kotzka J, Oehler D, Roden M, Kelm M, Szendroedi J, Westenfeld R. Chronic insulin resistance deteriorates cardiac mitochondrial quality control in a mouse model of SEC-NAFLD-IR. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Insulin resistance and nonalcoholic fatty liver disease (NAFLD) both relate to cardiovascular mortality. Using a mouse model of chronic lipid overload and secondary-NAFLD-induced insulin resistance (SEC-NAFLD-IR), we recently deciphered that SEC-NAFLD-IR already at young age provoked myocardial lipotoxicity with reduced mitochondrial efficiency and increased vulnerability to cardiac ischemia. However, long-term consequences of SEC-NAFLD-IR remain elusive.
Purpose
Here we aimed to elucidate the impact of long-term SEC-NAFLD-IR on multiple mitochondrial quality control (mQC) mechanisms in the heart and its consequences for cardiac function.
Methods
We studied 36 SEC-NAFLD-IR mice (72-week-old). For mechanistic experiments, we applied palmitate-induced insulin resistant murine HL-1 cells. Cardiac mitochondrial dynamics were measured via quantification of mitochondrial morphology and expression of mitochondrial fusion and fission factors (Opa1, Drp1, Fis1, Mfn 1 & 2). Mitophagy level was evaluated via immunofluorescence and protein expression of key mitophagy-related genes (Parkin, NIX, LC3). Mitochondrial biogenesis and mass were examined via quantitation of PGC-1α expression, mtDNA and citrate synthase activity.
Results
72-week-old SEC-NAFLD-IR mice exhibited 21% (p=0.001) and 32% (p<0.001) higher body weight and heart weight compared with controls. Along with elevated oxidative stress, hepatic lipid accumulation and inflammation, 6h-fasted SEC-NAFLD-IR mice were characterized by increased plasma glucose, insulin and cholesterol. SEC-NAFLD-IR mice displayed a cardiac phenotype with 21% higher left ventricular mass (normalized to body weight, p<0.001) and 6% lower ejection fraction compared to controls (73.5% SEM 0.90 vs 69.4% SEM 1.65, p=0.04). We found several advantageous mQC mechanisms suppressed in aged SEC-NAFLD-IR mice including long form OPA1-mediated mitochondrial fusion, Parkin- and NIX-mediated mitophagy. Likewise, mitochondrial biogenesis was suppressed in the aged insulin-resistant heart, which was connected to a 65% downregulation of PGC-1α1 expression (p=0.01). Interestingly, downregulation of cardiac PGC-1α1 in aged SEC-NAFLD-IR mice coincided with upregulation of PARIS, indicating the crucial participation of the Parkin/PARIS pathway in mQC of the insulin-resistant heart. In addition, induction of insulin resistance in murine HL-1 cardiomyocytes also led to increased mitochondrial fragmentation and decreased PGC-1α1 expression.
Conclusion
This study demonstrated that regulation of mitochondrial network and turnover is hampered by SEC-NAFLD-IR in the hearts of aged mice, which may contribute to hypertrophy and cardiac dysfunction in insulin resistance.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Collaborative Research Centre 1116 (German Research Foundation)
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Affiliation(s)
- K Lu
- University Hospital Duesseldorf, Division of Cardiology, Pulmonology and Vascular Medicine , Duesseldorf , Germany
| | - M Rothe
- Heinrich Heine University, Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research , Duesseldorf , Germany
| | - U Floegel
- Heinrich Heine University, Department of Molecular Cardiology, Medical Faculty , Duesseldorf , Germany
| | - J Kotzka
- Heinrich Heine University, Institute for Biochemistry and Pathobiochemistry, German Diabetes Center , Duesseldorf , Germany
| | - D Oehler
- University Hospital Duesseldorf, Division of Cardiology, Pulmonology and Vascular Medicine , Duesseldorf , Germany
| | - M Roden
- Heinrich Heine University, Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research , Duesseldorf , Germany
| | - M Kelm
- University Hospital Duesseldorf, Division of Cardiology, Pulmonology and Vascular Medicine , Duesseldorf , Germany
| | - J Szendroedi
- University Hospital of Heidelberg, Internal Medicine I and Clinical Chemistry , Heidelberg , Germany
| | - R Westenfeld
- University Hospital Duesseldorf, Division of Cardiology, Pulmonology and Vascular Medicine , Duesseldorf , Germany
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Lu K, Pedersen B, Rosa RL, Krogh-Johansen H, Conlon B, Muhlebach M. 503 Bacterial characteristics and metabolism of persistent methicillin-resistant Staphylococcus aureus infection. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01193-6] [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: 11/06/2022]
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Hu X, Garcia E, Goossens A, Gozo M, Lee T, Liu X, Le B, Taylor Meadows K, Eto D, Yusuf I, Lu K, Michels T, Kasem M, Marby K, Rowbottom M, Osterhout R, Carter L. An orally bioavailable ENPP1-selective inhibitor demonstrates superior immune preservation effects over STING agonists and confers antitumor efficacy in combination with other therapies in syngeneic tumor models. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01133-9] [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: 11/27/2022]
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Hinchcliff E, Mosely A, Hull S, Westin S, Sood A, Schmeler K, Taylor J, Huang S, Sheth R, Lu K, Jazaeri A. 567P Phase Ib study of Intraperitoneal (IP) administration of nivolumab plus ipilimumab in patients with recurrent gynaecologic malignancies with peritoneal involvement. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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22
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Dirr M, Christensen R, Anvery N, Merkel E, Worley B, Harikumar V, Lu K, Evans S, Poon E, Alam M. LB984 Intralesional sodium thiosulfate as a reversal agent for calcium hydroxylapatite soft tissue filler: An in vitro and ex vivo comparison. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.1008] [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: 10/17/2022]
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Waters M, Melendez B, Chan WK, Zhang Q, Lu K, Yates M. Not-so-mighty mitochondria: Mitochondrial dysfunction in mismatch repair deficient endometrial cancer development (234). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01458-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Techner J, Hooper M, Evans S, LeWitt T, Paller A, Lu K, Guitart J, Zhou X. 859 Skin tape strip proteomics in mycosis fungoides identifies tumor associated biomarkers. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Dee SG, Nabizadeh E, Nittrouer CL, Baldwin JW, Li C, Gaviria L, Guo S, Lu K, Saunders‐Shultz BM, Gurwitz E, Samarth G, Weinberger KR. Increasing Health Risks During Outdoor Sports Due To Climate Change in Texas: Projections Versus Attitudes. Geohealth 2022; 6:e2022GH000595. [PMID: 36254118 PMCID: PMC9363732 DOI: 10.1029/2022gh000595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 06/16/2023]
Abstract
Extreme heat is a recognized threat to human health. This study examines projected future trends of multiple measures of extreme heat across Texas throughout the next century, and evaluates the expected climate changes alongside Texas athletic staff (coach and athletic trainer) attitudes toward heat and climate change. Numerical climate simulations from the recently published Community Earth System Model version 2 and the Climate Model Intercomparison Project were used to predict changes in summer temperatures, heat indices, and wet bulb temperatures across Texas and also within specific metropolitan areas. A survey examining attitudes toward the effects of climate change on athletic programs and student athlete health was also distributed to high-school and university athletic staff. Heat indices are projected to increase beyond what is considered healthy/safe limits for outdoor sports activity by the mid-to-late 21st century. Survey results reveal a general understanding and acceptance of climate change and a need for adjustments in accordance with more dangerous heat-related events. However, a portion of athletic staff still do not acknowledge the changing climate and its implications for student athlete health and their athletic programs. Enhancing climate change and health communication across the state may initiate important changes to athletic programs (e.g., timing, duration, intensity, and location of practices), which should be made in accordance with increasingly dangerous temperatures and weather conditions. This work employs a novel interdisciplinary approach to evaluate future heat projections alongside attitudes from athletic communities toward climate change.
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Affiliation(s)
- Sylvia G. Dee
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | | | | | - Jane W. Baldwin
- Department of Earth System ScienceUniversity of California IrvineIrvineCAUSA
- Lamont‐Doherty Earth ObservatoryColumbia UniversityPalisadesNYUSA
| | - Chelsea Li
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | - Lizzy Gaviria
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | - Selena Guo
- Department of EconomicsRice UniversityHoustonTXUSA
| | - Karen Lu
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | | | - Emily Gurwitz
- Stanford University School of Humanities and SciencesPalo AltoCAUSA
| | - Gargi Samarth
- Department of Earth, Environmental, and Planetary SciencesRice UniversityHoustonTXUSA
| | - Kate R. Weinberger
- School of Population and Public HealthThe University of British ColumbiaVancouverBCCanada
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Vergote I, Gonzalez-Martin A, Lorusso D, Gourley C, Mirza MR, Kurtz JE, Okamoto A, Moore K, Kridelka F, McNeish I, Reuss A, Votan B, du Bois A, Mahner S, Ray-Coquard I, Kohn EC, Berek JS, Tan DSP, Colombo N, Zang R, Concin N, O'Donnell D, Rauh-Hain A, Herrington CS, Marth C, Poveda A, Fujiwara K, Stuart GCE, Oza AM, Bookman MA, Mahner S, Reuss A, du Bois A, Grimm C, Marth C, Berger R, Concin N, Chang TC, Ochiai K, Gebski V, Davis A, Beale P, Vergote I, Kridelka F, Denys H, Vandecaveye V, Cancido dos Reis FJ, Del Pilar Estevez Diz M, Stuart G, MacKay H, Carey M, Cibula D, Dundr (path) P, Dorigo O, Berek J, O'Donnell D, Saadeh A, Boere I, Lok C, Coronado P, Ottevanger N, Tan DSP, Ng J, Gonzalez Martin A, Oaknin A, Poveda A, Perez Fidalgo A, Rauh-Hain A, Lu K, López-Zavala C, Gómez-García EM, Ray-Coquard I, Paoletti X, Kurtz JE, Joly F, Votan B, Bookman M, Moore K, Arend R, Fujiwara K, Fujiwara H, Hasegawa K, Bruchim I, Tsoref D, Oda K, Okamoto A, Enomoto T, Michel D, Kim HS, Lee JY, Mukhopadhyay A, Katsaros D, Colombo N, Pignata S, Lorusso D, Scambia G, Kohn E, Lee JM, McNeish I, Nicum S, Farrelly L, Sehouli J, Keller M, Braicu E, Bjørge L, Mirza MR, Auranen A, Welch S, Oza AM, Heinzelmann V, Gourley C, Roxburgh P, Herrington CS, Glasspool R, Zang R, Zhu J. Clinical research in ovarian cancer: consensus recommendations from the Gynecologic Cancer InterGroup. Lancet Oncol 2022; 23:e374-e384. [PMID: 35901833 PMCID: PMC9465953 DOI: 10.1016/s1470-2045(22)00139-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 12/13/2022]
Abstract
The Gynecologic Cancer InterGroup (GCIG) sixth Ovarian Cancer Conference on Clinical Research was held virtually in October, 2021, following published consensus guidelines. The goal of the consensus meeting was to achieve harmonisation on the design elements of upcoming trials in ovarian cancer, to select important questions for future study, and to identify unmet needs. All 33 GCIG member groups participated in the development, refinement, and adoption of 20 statements within four topic groups on clinical research in ovarian cancer including first line treatment, recurrent disease, disease subgroups, and future trials. Unanimous consensus was obtained for 14 of 20 statements, with greater than 90% concordance in the remaining six statements. The high acceptance rate following active deliberation among the GCIG groups confirmed that a consensus process could be applied in a virtual setting. Together with detailed categorisation of unmet needs, these consensus statements will promote the harmonisation of international clinical research in ovarian cancer.
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Biyashev D, Siwicka Z, Demczuk M, Onay U, Evans S, Collins-McCallum N, Gianneschi N, Lu K. 577 Synthetic melanin nanoparticles improve wound healing. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.586] [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: 11/27/2022]
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Hinchcliff E, Patel A, Fellman B, Yuan Y, Chelvanambi M, Wargo J, LIU YAN, Liu J, Lee S, Roszik J, Hillman R, Westin S, Sood A, Soliman P, Frumovitz M, Shafer A, Meyer L, Fleming N, Gershenson D, Vining D, Ganeshan D, Hwu P, Lu K, Jazaeri A. Loss-of-function mutations in PPP2R1A Correlate with Exceptional Survival in Ovarian Clear Cell Carcinomas Treated with Immune Checkpoint Inhibitors (099). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01325-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fleming N, Nick A, Coleman R, Westin S, Ramirez P, Soliman P, Fellman B, Hilton T, Rangel K, Meyer L, Schmeler K, Lu K, Sood A. Impact of laparoscopic surgical algorithm to triage timing of tumor reductive surgery on overall survival in newly diagnosed advanced ovarian cancer (548). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01769-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ernst M, Evans S, Techner J, Rothbaum R, Christensen L, Onay U, Biyashev D, Demczuk M, Cooper K, Lu K. 839 Early biomarker identification for immune sensitization and prevention with oral vitamin D3. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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31
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Onay U, Xu D, Biyashev D, Demczuk M, Evans S, Podojil J, Miller S, Lu K. 793 The ”T” in cutaneous wound healing. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.806] [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]
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How JA, Dang M, Ferri-Borgogno S, Euscher E, Yates MS, Peng W, Patel SD, Burks JJ, Vletic I, Gomez J, Lu K, Mok SC, Wang L, Jazaeri AA. Abstract 1248: Predictors of innate resistance to pembrolizumab in patients with microsatellite instability-high endometrial cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Despite FDA approval of pembrolizumab in microsatellite instability-high (MSI-H)/mismatch repair deficient solid tumors, approximately half of patients with MSI-H endometrial cancer are treatment-refractory. We sought to evaluate pre-treatment MSI-H endometrial tumor samples to examine cell subpopulation differences in the tumor microenvironment (TME) associated with resistance to pembrolizumab.
Methods: Archival tumor samples from MSI-H endometrial cancer patients treated with pembrolizumab at MD Anderson Cancer Center were obtained under an IRB-approved protocol. Twenty-one patients were identified, and pre-treatment archival tumor samples were collected and submitted for RNA-seq and imaging mass cytometry (IMC) with an optimized 38-antibody panel to identify predictive immuno-genomic signatures and cell subpopulations associated with treatment response.
Results: Among the 21 patients treated with pembrolizumab, there were 14 responders and 7 non-responders. Based on transcriptomic signatures, TME heterogeneity was observed. The 14 responders consisted of samples with immunologically “hot” (5/5; 100%), “cold” (6/8; 75%), and “warm” TMEs (3/8; 37.5%) while the 7 non-responders consisted of only “cold” (2/8; 25%) and “warm” (5/8; 62.5%) TME samples. There was an enrichment of fibroblasts and endothelial cell transcriptomic signatures in the samples of the non-responders compared to responders (p=0.018) with a trend of increasing enrichment in those signatures as response strength decreased. IMC performed on archival tissue from 20 patients demonstrated similar trend of higher population of activated fibroblasts (SMA+, MFAP5+) and endothelial cells (CD31+) in non-responders. Furthermore, non-responders had significantly higher total regulatory T cells (CD4+FOXP3+) in the tumor (p=0.027) and stroma (p=0.0282) compared to responders. Additionally, significantly higher activated regulatory T cells (CD4+FOXP3+CD25+) were observed in the tumor (p=0.016) and stroma (p=0.008) of non-responders compared to responders. Similar abundance of total and subpopulations of CD8+ T cells were observed between responders and non-responders.
Conclusion: The MSI-H endometrial TME is heterogeneous. Increased presence of fibroblasts, endothelial cells, and regulatory T-cells in the TME correlate with innate resistance to pembrolizumab. Treatment aimed toward the reduction of these cellular subpopulations may improve sensitivity to PD-1 inhibitors. Future studies are needed to validate these findings.
Citation Format: Jeffrey A. How, Minghao Dang, Sammy Ferri-Borgogno, Elizabeth Euscher, Melinda S. Yates, Weiyi Peng, Shrina D. Patel, Jared J. Burks, Ivo Vletic, Javier Gomez, Karen Lu, Samuel C. Mok, Linghua Wang, Amir A. Jazaeri. Predictors of innate resistance to pembrolizumab in patients with microsatellite instability-high endometrial cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1248.
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Affiliation(s)
- Jeffrey A. How
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Minghao Dang
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - Shrina D. Patel
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jared J. Burks
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ivo Vletic
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Javier Gomez
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Karen Lu
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Samuel C. Mok
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Linghua Wang
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Amir A. Jazaeri
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
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33
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Li E, Zou XL, Xu LQ, Chu YQ, Feng X, Lian H, Liu HQ, Liu AD, Han MK, Dong JQ, Wang HH, Liu JW, Zang Q, Wang SX, Zhou TF, Huang YH, Hu LQ, Zhou C, Qu HX, Chen Y, Lin SY, Zhang B, Qian JP, Hu JS, Xu GS, Chen JL, Lu K, Liu FK, Song YT, Li JG, Gong XZ. Experimental Evidence of Intrinsic Current Generation by Turbulence in Stationary Tokamak Plasmas. Phys Rev Lett 2022; 128:085003. [PMID: 35275672 DOI: 10.1103/physrevlett.128.085003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 09/16/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
High-β_{θe} (a ratio of the electron thermal pressure to the poloidal magnetic pressure) steady-state long-pulse plasmas with steep central electron temperature gradient are achieved in the Experimental Advanced Superconducting Tokamak. An intrinsic current is observed to be modulated by turbulence driven by the electron temperature gradient. This turbulent current is generated in the countercurrent direction and can reach a maximum ratio of 25% of the bootstrap current. Gyrokinetic simulations and experimental observations indicate that the turbulence is the electron temperature gradient mode (ETG). The dominant mechanism for the turbulent current generation is due to the divergence of ETG-driven residual flux of current. Good agreement has been found between experiments and theory for the critical value of the electron temperature gradient triggering ETG and for the level of the turbulent current. The maximum values of turbulent current and electron temperature gradient lead to the destabilization of an m/n=1/1 kink mode, which by counteraction reduces the turbulence level (m and n are the poloidal and toroidal mode number, respectively). These observations suggest that the self-regulation system including turbulence, turbulent current, and kink mode is a contributing mechanism for sustaining the steady-state long-pulse high-β_{θe} regime.
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Affiliation(s)
- Erzhong Li
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - X L Zou
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - L Q Xu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - Y Q Chu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
- University of Science and Technology of China, Hefei 230022, People's Republic of China
| | - X Feng
- University of Science and Technology of China, Hefei 230022, People's Republic of China
| | - H Lian
- University of California Los Angeles, Los Angeles, California 90095, USA
| | - H Q Liu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - A D Liu
- University of Science and Technology of China, Hefei 230022, People's Republic of China
| | - M K Han
- Southwestern Institute of Physics, P.O. Box 432, Chengdu 610041, People's Republic of China
| | - J Q Dong
- Southwestern Institute of Physics, P.O. Box 432, Chengdu 610041, People's Republic of China
| | - H H Wang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - J W Liu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
- University of Science and Technology of China, Hefei 230022, People's Republic of China
| | - Q Zang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - S X Wang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - T F Zhou
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - Y H Huang
- Advanced Energy Research Center, Shenzhen University, Shenzhen 518060, People's Republic of China
| | - L Q Hu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - C Zhou
- University of Science and Technology of China, Hefei 230022, People's Republic of China
| | - H X Qu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
- University of Science and Technology of China, Hefei 230022, People's Republic of China
| | - Y Chen
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
- University of Science and Technology of China, Hefei 230022, People's Republic of China
| | - S Y Lin
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - B Zhang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - J P Qian
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - J S Hu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - G S Xu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - J L Chen
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - K Lu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - F K Liu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - Y T Song
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - J G Li
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
| | - X Z Gong
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, People's Republic of China
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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.
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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.
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Doumtsis N, Patel S, Ramchand J, Lu K, Srivastava P, Patel S, Burrell L. Circulating Angiotensin Converting Enzyme 2 Activity in Hospitalised Patients With Acute Heart Failure. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.075] [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: 11/27/2022]
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Basen-Engquist K, Raber M, Strong LL, Schembre S, Li L, Arun B, Lu K, You N, Vilar E, Lynch P, Fares S, Peterson SK. Optimization of an mHealth lifestyle intervention for families with hereditary cancer syndromes: Study protocol for a multiphase optimization strategy feasibility study. Contemp Clin Trials 2021; 113:106662. [PMID: 34971795 DOI: 10.1016/j.cct.2021.106662] [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: 07/23/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Individuals at increased hereditary risk of cancer are an important target for health promotion and cancer prevention interventions. Health-4-Families uses the Multiphase Optimization STrategy (MOST) framework and is designed to pilot digital delivery strategies for a distance-based, 16-week intervention to promote weight management, healthy diet, and increased physical activity among individuals with BRCA1/BRCA2 or DNA mismatch repair (MMR) pathogenic germline variants. This communication describes participant recruitment and the design of the Health-4-Families pilot study. METHODS Health-4-Families is a full-factorial (16 condition) randomized pilot study of four lifestyle intervention components: social networking, telephone or email coaching, text messaging, and self-monitoring. The primary outcome was feasibility and satisfaction with these study components. Participants with pathogenic germline variants were identified via clinic surveillance lists and advocacy organizations and were invited to participate with family members. All participants had to report meeting at least one of the following criteria: (1) having a BMI ≥ 25 kg/m2, (2) consuming <5 servings of fruit and vegetables per day, or (3) getting <150 min of moderate-to-vigorous intensity activity per week. RESULTS The majority of screened potential participants with pathogenic variants (83%) were eligible; 86% of those eligible provided informed consent and 79% (n = 104) completed baseline. A total of 206 family members were nominated by study participants and 49% (n = 102) completed baseline. DISCUSSION Recruitment data suggest that individuals with pathogenic germline variants, who are at increased risk for hereditary cancers, are motivated to participate in digital lifestyle interventions. This recruitment success highlights the importance of identifying and prioritizing effective and efficient intervention components for hereditary cancer families. We intend to use the outcomes of our pilot study to inform a fully-powered factorial study for this community.
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Affiliation(s)
- Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
| | - Margaret Raber
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Larkin L Strong
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, TX, United States of America
| | - Susan Schembre
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America; Department of Family and Community Medicine, University of Arizona College of Medicine-Tucson, Tucson, AZ, United States of America
| | - Liang Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Banu Arun
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Karen Lu
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Nancy You
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Eduardo Vilar
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Patrick Lynch
- Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Sara Fares
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
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Coffin T, Bowen D, Lu K, Swisher EM, Rayes N, Norquist B, Blank SV, Levine DA, Bakkum-Gamez JN, Fleming GF, I Olopade O, Romero I, D'Andrea A, Nebgen DR, Peterson C, Munsell MF, Gavin K, Crase J, Polinsky D, Lechner R. #GeneticTesting: Using Social Media to Facilitate Communication about testing to Women (Preprint). JMIR Form Res 2021; 6:e35035. [PMID: 36155347 PMCID: PMC9555323 DOI: 10.2196/35035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 12/02/2022] Open
Abstract
Background Strong participant recruitment practices are critical to public health research but are difficult to achieve. Traditional recruitment practices are often time consuming, costly, and fail to adequately target difficult-to-reach populations. Social media platforms such as Facebook are well-positioned to address this area of need, enabling researchers to leverage existing social networks and deliver targeted information. The MAGENTA (Making Genetic Testing Accessible) study aimed to improve the availability of genetic testing for hereditary cancer susceptibility in at-risk individuals through the use of a web-based communication system along with social media advertisements to improve reach. Objective This paper is aimed to evaluate the effectiveness of Facebook as an outreach tool for targeting women aged ≥30 years for recruitment in the MAGENTA study. Methods We designed and implemented paid and unpaid social media posts with ongoing assessment as a primary means of research participant recruitment in collaboration with patient advocates. Facebook analytics were used to assess the effectiveness of paid and unpaid outreach efforts. Results Over the course of the reported recruitment period, Facebook materials had a reach of 407,769 people and 57,248 (14.04%) instances of engagement, indicating that approximately 14.04% of people who saw information about the study on Facebook engaged with the content. Paid advertisements had a total reach of 373,682. Among those reached, just <15% (54,117/373,682, 14.48%) engaged with the page content. Unpaid posts published on the MAGENTA Facebook page resulted in a total of 34,087 reach and 3131 instances of engagement, indicating that around 9.19% (3131/34,087) of people who saw unpaid posts engaged. Women aged ≥65 years reported the best response rate, with approximately 43.95% (15,124/34,410) of reaches translating to engagement. Among the participants who completed the eligibility questionnaire, 27.44% (3837/13,983) had heard about the study through social media or another webpage. Conclusions Facebook is a useful way of enhancing clinical trial recruitment of women aged ≥30 years who have a potentially increased risk for ovarian cancer by promoting news stories over social media, collaborating with patient advocacy groups, and running paid and unpaid campaigns. Trial Registration ClinicalTrials.gov NCT02993068; https://clinicaltrials.gov/ct2/show/NCT02993068
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Affiliation(s)
- Tara Coffin
- University of Washington, Seattle, WA, United States
| | - Deborah Bowen
- University of Washington, Seattle, WA, United States
| | - Karen Lu
- MD Anderson Cancer Center, Houston, TX, United States
| | | | - Nadine Rayes
- MD Anderson Cancer Center, Houston, TX, United States
| | | | | | | | | | | | | | - Iris Romero
- University of Chicago, Chicago, IL, United States
| | - Alan D'Andrea
- Dana-Farber Cancer Institute, Boston, MA, United States
| | | | | | | | - Kathleen Gavin
- Minnesota Ovarian Cancer Alliance, Minneapolis, MN, United States
| | - Jamie Crase
- University of Washington, Seattle, WA, United States
| | | | - Rebecca Lechner
- Minnesota Ovarian Cancer Alliance, Minneapolis, MN, United States
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Coffin T, Bowen D, Swisher E, Lu K, Lu K, Lu K, Rayes N, Norquist B, Norquist B, Norquist B, Blank S, Levine D, Levine D, Levine D, Bakkum-Gamez J, Bakkum-Gamez J, Bakkum-Gamez J, Bakkum-Gamez J, Fleming G, Fleming G, Olopade O, Olopade O, Olopade O, D’Andrea A, D’Andrea A, Nebgen D, Nebgen D, Nebgen D, Nebgen D, Peterson C, Peterson C, Peterson C, Munsell M, Gavin K, Gavin K, Lechner R, Lechner R, Crase J, Crase J, Polinsky D, Romero I. Development and assessment of an accessible communication system for population based genetic testing (Preprint). JMIR Form Res 2021; 6:e34055. [DOI: 10.2196/34055] [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] [Received: 10/05/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
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Jin Z, Li X, Lu K. Formation of Stable Schwarz Crystals in Polycrystalline Copper at the Grain Size Limit. Phys Rev Lett 2021; 127:136101. [PMID: 34623842 DOI: 10.1103/physrevlett.127.136101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
A prototype Schwarz crystal (SC) structure of dividing-space minimal grain boundaries (GBs) constrained by coherent twin boundaries (CTBs) was recently discovered in extremely fine-grained polycrystalline Cu. In this Letter, constraining effects of 3D CTB network on the formation and thermostability of SC are addressed via atomistic simulations. GB migration and evolution of CTB network trigger formation of SC diamond. CTB constraints are critical to generate GBs of zero mean curvature underlying vanishing capillary pressure, and to counterbalance the elastic driving forces of lattice. GB motion can be suppressed at temperatures close to the melting point with GB aperture down to 3 nm.
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Affiliation(s)
- Zhaohui Jin
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Xiuyan Li
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - K Lu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
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Da J, Ali K, Lu K, Lou H, Qiu Y, Shan J, Wu L. Off-label use of dupilumab for the treatment of moderate to severe atopic dermatitis in children aged below 6 years of age: a case series. Clin Exp Dermatol 2021; 47:423-425. [PMID: 34482550 DOI: 10.1111/ced.14925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/28/2021] [Accepted: 09/01/2021] [Indexed: 11/27/2022]
Affiliation(s)
- J Da
- Department of, Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - K Ali
- Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - K Lu
- Department of, Oncological Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - H Lou
- Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Y Qiu
- Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - J Shan
- Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - L Wu
- Department of, Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Xu W, Zhang B, Li XY, Lu K. Suppressing atomic diffusion with the Schwarz crystal structure in supersaturated Al-Mg alloys. Science 2021; 373:683-687. [PMID: 34353952 DOI: 10.1126/science.abh0700] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 07/01/2021] [Indexed: 12/24/2022]
Abstract
High atomic diffusivity in metals enables substantial tuneability of their structure and properties by tailoring the diffusional processes, but this causes their customized properties to be unstable at elevated temperatures. Eliminating diffusive interfaces by fabricating single crystals or heavily alloying helps to address this issue but does not inhibit atomic diffusion at high homologous temperatures. We discovered that the Schwarz crystal structure was effective at suppressing atomic diffusion in a supersaturated aluminum-magnesium alloy with extremely fine grains. By forming these stable structures, diffusion-controlled intermetallic precipitation from the nanosized grains and their coarsening were inhibited up to the equilibrium melting temperature, around which the apparent across-boundary diffusivity was reduced by about seven orders of magnitude. Developing advanced engineering alloys using the Schwarz crystal structure may lead to useful properties for high-temperature applications.
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Affiliation(s)
- W Xu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - B Zhang
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - X Y Li
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China.
| | - K Lu
- Shenyang National Laboratory for Materials Science, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China.
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How J, Dang M, Euscher E, Yates M, Peng W, Patel S, Lu K, Hwu P, Naing A, Wang L, Jazaeri A. The tumor immune microenvironment shapes response to pembrolizumab in microsatellite instability-high endometrial cancer. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)01235-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cun H, Zhu Y, Borgogno SF, Sheng J, Cheng R, Kim JH, Han GH, Wong S, Lu K, Mok S. Clear cell ovarian tumors display a unique tumor immune microenvironment. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)00852-0] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fu S, Yao S, Yuan Y, Previs RA, Elias AD, Carvajal R, George TJ, Yuan Y, Yamamura Y, Westin S, Xing Y, Dumbrava EEI, Karp DD, Piha-Paul SA, Tsimberidou AM, Rodon J, Takebe N, Kunos C, Lu K, Keyomarsi K, Meric-Bernstam F. Abstract 974: Phase II trial of the Wee1 inhibitor adavosertib in advanced refractory solid tumors with CCNE1 amplification. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Wee1 kinase, which prevents premature mitotic entry by inhibiting cyclin-dependent kinases (CDKs), may be essential when cyclin E1 is overexpressed in order to prevent DNA damage and cell death. In preclinical studies, cancer models harboring CCNE1 amplification are highly sensitive to treatment with adavosertib, a Wee1 kinase inhibitor. A multicenter phase 2 study was conducted to assess the antitumor activity of adavosertib in patients with CCNE1 amplified advanced refractory solid tumors.
Methods: Patients with advanced refractory solid tumors harboring CCNE1 amplification pre-identified in a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory were eligible. They had refractory disease, on standard options available, or they declined standard-of-care therapy. Eligible patients must be aged ≥ 18 years and had measurable disease per RECIST (Response Evaluation Criteria in Solid Tumors) 1.1, ECOG (Eastern Cooperative Oncology Group) performance status of 0-1, and adequate organ functions. After informed consent, patients received adavosertib 300 mg daily on days 1 to 5 and 8 to 12 of a 21-day cycle. The primary endpoint was objective response rate (ORR). The trial employed Simon's two-stage design.
Results: Between January 22, 2019 and May 20, 2020, 29 patients with 12 tumor types were enrolled on study: ovarian = 14, breast = 3, endometrial = 2; and carcinosarcoma, cholangiocarcinoma, esophageal, gallbladder, germ cell tumor, melanoma, prostate, sarcoma, sarcomatoid and urothelial = 10 (1 each tumor). Median follow-up was 11.7 months. The median line of prior systemic therapy was 4 (range 1-8). Twenty-seven patients were evaluable for response. In these patients, 7 confirmed partial responses (PR) were observed, for an ORR of 25.9% (95% CI 15.1-47.5%). The median progression-free survival was 4.0 months and one-year overall survival was 55%. In 13 patients with measurable high-grade serous ovarian cancer, 5 achieved PR (38.5%) and 8 had stable disease ≥6 months/PR (61.5%). Other PRs were seen in 1 urothelial carcinoma and 1 melanoma. Fifteen patients experienced grade 3 or higher treatment-related adverse events: neutropenia (24%), thrombocytopenia (17%), anemia (14%), nausea (17%), diarrhea (17%) and fatigue (17%). Sixteen patients required dose duction of adavosertib to 250 mg, and 7 further to 200 mg. Biomarker analysis is ongoing to investigate potential biomarkers of response.
Conclusions: Adavosertib monotherapy demonstrates promising clinical activity in patients with refractory solid tumors harboring CCNE1 amplification, especially in high-grade serous ovarian cancer. Further exploration of adavosertib in CCNE1 amplified high grade serous ovarian cancer is warranted.
Citation Format: Siqing Fu, Shuyang Yao, Yuan Yuan, Rebecca A. Previs, Anthony D. Elias, Richard Carvajal, Thomas J. George, Ying Yuan, Yuko Yamamura, Shannon Westin, Yan Xing, Ecaterina E. Ileana Dumbrava, Daniel D. Karp, Sarina A. Piha-Paul, Apostolia M. Tsimberidou, Jordi Rodon, Naoko Takebe, Charles Kunos, Karen Lu, Khanda Keyomarsi, Funda Meric-Bernstam. Phase II trial of the Wee1 inhibitor adavosertib in advanced refractory solid tumors with CCNE1 amplification [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 974.
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Affiliation(s)
- Siqing Fu
- 1UT-MD Anderson Cancer Center, Houston, TX
| | | | - Yuan Yuan
- 2City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | | | - Richard Carvajal
- 4New York-Presbyterian/Columbia University Medical Center, New York, NY
| | | | - Ying Yuan
- 1UT-MD Anderson Cancer Center, Houston, TX
| | | | | | - Yan Xing
- 6City of Home Comprehensive Cancer Center, Duarte, CA
| | | | | | | | | | | | | | | | - Karen Lu
- 1UT-MD Anderson Cancer Center, Houston, TX
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Lu K, Yin Y, Li C, Jin Y, Shan HQ. Efficacy of annual zoledronic acid in initial percutaneous kyphoplasty patients with osteoporotic vertebral compression fractures: a 3-year follow-up study. Osteoporos Int 2021; 32:1429-1439. [PMID: 33462653 DOI: 10.1007/s00198-020-05816-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/30/2020] [Indexed: 12/30/2022]
Abstract
UNLABELLED This study investigated the efficacy of annual zoledronic acid (ZOL) administration against previously treated recompression vertebral fractures (RVF) and new vertebral fractures (NVF) in initial percutaneous kyphoplasty (PKP) patients with osteoporotic vertebral compression fractures (OVCF) over a 3-year follow-up period. INTRODUCTION Although PKP achieves a satisfactory outcome, previously treated RVF and NVF can limit its effectiveness. The annual infusion of ZOL over 3 years can improve fracture protection, particularly in the vertebrae. We hypothesized that ZOL can reduce the incidence of RVFs and/or NVFs, and improve the clinical outcomes of PKP. METHODS This was a placebo-controlled, double-blind prospective trial of 154 PKP patients (mean age: 70 years) with OVCFs. Patients were randomly assigned to receive a single infusion of ZOL (5 mg) or placebo (78 ZOL vs. 76 placebo) at 1 week, 12 months, and 24 months after surgery. Patients were followed-up for 36 months. RESULTS ZOL treatment lowered the risk of RVF by ~ 65% over the 36-month period when compared to placebo controls (6.41% in ZOL vs. 18.42% in placebo groups; relative risk, 0.35; 95% CI, 0.13 to 0.92). ZOL also reduced the risk of NVF by ~ 73% (3.85% in ZOL vs. 14.47% in placebo groups; relative risk, 0.27; 95% CI, 0.08 to 0.92). ZOL also significantly reduced the vertebral height lost rate (HLR) at 12, 24, and 36 months. ZOL also improved the visual analog scale (VAS), Oswestry disability index (ODI) scores, and bone mineral density (BMD). CONCLUSION Annual ZOL administration significantly lowers the risk of RVFs and NVFs, improving the clinical outcome of initial PKP in patients with OVCFs over a 3-year follow-up period. TRIAL REGISTRATION ChiCTR2000029307.
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Affiliation(s)
- K Lu
- Department of Joint Surgery, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, 215300, Jiangsu, China
| | - Y Yin
- Department of Spinal Surgery, Affiliated Kunshan Hospital of Jiangsu University, No. 91 West of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - C Li
- Department of Orthopaedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, 215300, Jiangsu, China
| | - Y Jin
- Department of Spinal Surgery, Affiliated Kunshan Hospital of Jiangsu University, No. 91 West of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - H-Q Shan
- Department of Spinal Surgery, Affiliated Kunshan Hospital of Jiangsu University, No. 91 West of Qianjin Road, Suzhou, 215300, Jiangsu, China.
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Wang YQ, Wang R, Shi D, Lu K, Jin D, Xu L, Fan GH, Shen JK, Gong JP, Qian MH. [Primary malignant peripheral nerve sheath tumor in left orbit: a case report]. Zhonghua Zhong Liu Za Zhi 2021; 43:509-510. [PMID: 33902216 DOI: 10.3760/cma.j.cn112152-20200428-00386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Y Q Wang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - R Wang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - D Shi
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - K Lu
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - D Jin
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - L Xu
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - G H Fan
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J K Shen
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J P Gong
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - M H Qian
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Techner J, Rothbaum R, Christensen L, Evans S, Onay U, Biyashev D, Demczuk M, Cooper K, Lu K. 439 Oral 25-hydroxyvitamin D3 reduces chemical-induced skin inflammation in humans. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Onay U, Biyashev D, Xu D, Demczuk M, Evans S, Techner J, Miller S, Lu K. 629 PLGA-immune modifying particles as a potential therapy for treating injured skin. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.658] [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]
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Mitra A, Yoshida-Court K, Solley TN, Mikkelson M, Yeung CLA, Nick A, Lu K, Klopp AH. Extracellular vesicles derived from ascitic fluid enhance growth and migration of ovarian cancer cells. Sci Rep 2021; 11:9149. [PMID: 33911091 PMCID: PMC8080718 DOI: 10.1038/s41598-021-88163-1] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/01/2021] [Indexed: 12/22/2022] Open
Abstract
Ovarian cancer is associated with a high mortality rate due to diagnosis at advanced stages. Dissemination often occurs intraperitoneally within the ascites fluid. The microenvironment can support dissemination through several mechanisms. One potential ascites factor which may mediate dissemination are EVs or extracellular vesicles that can carry information in the form of miRNAs, proteins, lipids, and act as mediators of cellular communication. We present our observations on EVs isolated from ascitic supernatants from patients diagnosed with high grade serous ovarian carcinoma in augmenting motility, growth, and migration towards omental fat. MicroRNA profiling of EVs from malignant ascitic supernatant demonstrates high expression of miR 200c-3p, miR18a-5p, miR1246, and miR1290 and low expression of miR 100- 5p as compared to EVs isolated from benign ascitic supernatant. The migration of ovarian cancer spheroids towards omental fat is enhanced in the presence of malignant ascitic EVs. Gene expression of these cells showed increased expression of ZBED2, ZBTB20, ABCC3, UHMK1, and low expression of Transgelin and MARCKS. We present evidence that ovarian ascitic EVs increase the growth of ovarian cancer spheroids through miRNAs.
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Affiliation(s)
- Aparna Mitra
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Kyoko Yoshida-Court
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Travis N Solley
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Megan Mikkelson
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Chi Lam Au Yeung
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Alpa Nick
- Tennessee Oncology, Nashville, TN, 37203, USA
| | - Karen Lu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Ann H Klopp
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
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Wu YF, Lu K, Girgis C, Preda M, Preda V. Postpartum bilateral sacral stress fracture without osteoporosis-a case report and literature review. Osteoporos Int 2021; 32:623-631. [PMID: 33439310 DOI: 10.1007/s00198-020-05788-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Sacral stress fractures are rare complications which can arise during pregnancy or in the early postpartum period. We report a case and discuss the findings of a confirmed postpartum sacral stress fracture in a 39-year-old multiparous woman and review previous case reports in the literature of sacral stress fracture related to pregnancy. METHODS A review of the literature was conducted to examine the main characteristics of sacral stress fractures related to pregnancy. The Ovid/Medline, Embase and Google Scholar databases were searched with the inclusion criteria: human studies, English language, intrapartum, postpartum (within 6 months of parturition), sacrum and stress fracture. Our exclusion criteria included pubic fractures, vertebral fractures and non-English articles. The search terms included "stress fracture", "postpartum", "pregnancy", "atraumatic" and the wildcard "sacr*". Thirty-four cases were found and summarised in Table 2. RESULTS A total of 65% of patients had onset of symptoms postpartum. Most patients did not have risk factors for sacral stress fractures including macrosomia, excessive pregnancy weight gain, heparin exposure, rapid vaginal delivery or predisposition to accelerated osteoporosis. Lumbar radiculopathy can be a feature of sacral stress fracture and it is more common (17.6%) than reported in the literature (2%). MRI is the preferred imaging modality for its safety profile in pregnancy and high sensitivity. A total of 70% reported normal bone mineral density (BMD). The mainstay treatment for sacral stress fractures includes relative bed rest, analgesia and modified weight-bearing exercises. Most patients have favourable outcome with complete symptom resolution. CONCLUSION Sacral stress fractures in the absence of osteoporosis are rare complications of pregnancy that can present with lumbar radiculopathy. Conservative management often produces good clinical outcomes.
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Affiliation(s)
- Y F Wu
- Department of Endocrinology, Macquarie University Hospital, Sydney, NSW, Australia.
| | - K Lu
- Doctors-In-Training, Macquarie University Hospital, Sydney, NSW, Australia
| | - C Girgis
- Department of Endocrinology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - M Preda
- I-MED Radiology, Sydney, NSW, Australia
| | - V Preda
- Department of Endocrinology, Macquarie University Hospital, Sydney, NSW, Australia
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