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Narotam A, Archary M, Naidoo P, Naidoo Y, Naidu V. Atypical presentation of a posterior fossa tumour: A case report. World J Clin Cases 2024; 12:2281-2285. [DOI: 10.12998/wjcc.v12.i13.2281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/19/2024] [Accepted: 03/21/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND We described a case of a patient with a meningioma in the posterior fossa presenting atypically with an isolated unilateral vocal cord palsy causing severe respiratory distress. This is of interest as the patient had no other symptomatology, especially given the size of the mass, which would typically cause a pressure effect leading to neurological and auditory symptoms.
CASE SUMMARY This case report described a 48-year-old male who was married with two children and employed as a car guard. He had a medical history of asthma for the past 10 years controlled with an as-needed beta 2 agonist metered dose inhaler. He initially presented to our facility with severe respiratory distress. He reported a 1-wk history of shortness of breath and wheezing that was not relieved by his bronchodilator. He had no constitutional symptoms or impairment of hearing. On clinical examination, the patient’s chest was “silent.” Our initial assessment was status asthmaticus with type 2 respiratory failure, based on the history of asthma, a “silent chest,” and the arterial blood gas results.
CONCLUSION A posterior fossa meningioma of such a large size and with extensive infiltration rarely presents with an isolated unilateral vocal cord palsy. The patient’s chief presenting feature was severe respiratory distress, which combined with his background medical history of asthma, was misleading. Clinicians should thus consider meningioma as a differential diagnosis for a unilateral vocal cord palsy even without audiology involvement.
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Affiliation(s)
- Alisha Narotam
- Department of Internal Medicine, King Edward VIII Hospital - University of Kwazulu-Natal, Durban 4001, Kwa-Zulu Natal, South Africa
| | - Mikara Archary
- Department of Internal Medicine, King Edward VIII Hospital - University of Kwazulu-Natal, Durban 4001, Kwa-Zulu Natal, South Africa
| | - Poobalan Naidoo
- Department of Internal Medicine, Nelson R Mandela, School of Medicine, University of Kwa-Zulu Natal, Durban 4001, Kwa-Zulu Natal, South Africa
| | - Yeshkhir Naidoo
- Department of Radiology, King Edward VIII Hospital - University of Kwazulu-Natal, Durban 4001, Kwazulu-Natal, South Africa
| | - Vanesha Naidu
- Department of Radiology, King Edward VIII Hospital - University of Kwazulu-Natal, Durban 4001, Kwazulu-Natal, South Africa
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Unice T, Naidoo P, Hiralal P, Naidoo Y, Pillay S. Multiple fusiform and saccular aneurysms in a person living with Human Immunodeficiency Virus. SAGE Open Med Case Rep 2023; 11:2050313X231211048. [PMID: 38022860 PMCID: PMC10656792 DOI: 10.1177/2050313x231211048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Cerebral aneurysms secondary to human immunodeficiency virus vasculopathy are a diagnosis by exclusion and its mechanism is unknown. We report on a 21-year-old male with human immunodeficiency virus infection and suboptimal virological control, despite highly active antiretroviral therapy. An incidental discovery of multiple cerebral aneurysms occurred in this patient, who initially presented with signs of disorientation, acute psychosis, and a history of blunt cranial trauma. A non-contrasted computerized tomography scan of the encephalon showed no intracranial hemorrhage but multiple cerebral (saccular and fusiform) aneurysms. Subsequently, a non-urgent computerized tomography angiogram of the cerebral vasculature corroborated the existence of multiple cerebral aneurysms. Despite investigation, no secondary etiological factors for the aneurysmal condition were identified. The multitude of cerebral aneurysms was consequently ascribed to human immunodeficiency virus-associated vasculopathy. The patient was managed conservatively. At discharge, he was lucid and apsychotic. A unique aspect of the case is the presence of both fusiform and saccular cerebral aneurysms.
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Affiliation(s)
- Talia Unice
- King Edward VIII Hospital, Durban, Kzn, South Africa
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Naidoo P, Naidoo K, Karamchand S, Leisegang RF. Access to novel anti-diabetic agents in resource limited settings: A brief commentary. World J Diabetes 2023; 14:939-941. [PMID: 37547585 PMCID: PMC10401454 DOI: 10.4239/wjd.v14.i7.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/31/2022] [Accepted: 06/13/2023] [Indexed: 07/12/2023] Open
Abstract
The prevalence of diabetes mellitus is increasing in resource limited settings. Simultaneously, there has been an increase in the number of novel therapies for the management of diabetes mellitus. However, use of novel antidiabetic therapies is limited because of major market access challenges in resource limited settings. Niching products to those patients with the highest absolute risk for major adverse cardiovascular outcomes, and thus most likely to benefit from the therapy, are less likely to have negative budget impact for funders. To improve access, and reduce morbidity and mortality, requires alignment amongst key stakeholders including patient advocacy groups, health care professional councils, national departments of health, the pharmaceutical industry, treasury and finance departments.
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Affiliation(s)
- Poobalan Naidoo
- Department of Internal Medicine, Nelson R Mandela, School of Medicine, University of Kwa-Zulu Natal, Durban 4001, Kwa-Zulu Natal, South Africa
| | - Kiolan Naidoo
- Department of Law, University of South Africa, Pretoria 3, Gauteng, South Africa
| | - Sumanth Karamchand
- Department of Cardiology, University of Stellenbosch and Tygerberg Hospital, Stellenbosch 7600, Western Cape, South Africa
| | - Rory F Leisegang
- Department of Pharmacometrics, Upsala University, Uppsala 751 04, Sweden
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4
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Diehl S, Trotta N, Joo K, Achenbach P, Akbar Z, Armstrong WR, Atac H, Avakian H, Baashen L, Baltzell NA, Barion L, Bashkanov M, Battaglieri M, Bedlinskiy I, Benmokhtar F, Bianconi A, Biselli AS, Bossù F, Brinkmann KT, Briscoe WJ, Bulumulla D, Burkert V, Capobianco R, Carman DS, Carvajal JC, Celentano A, Charles G, Chatagnon P, Chesnokov V, Ciullo G, Cole PL, Contalbrigo M, Costantini G, Crede V, D'Angelo A, Dashyan N, De Vita R, Deur A, Djalali C, Dupre R, Ehrhart M, El Alaoui A, El Fassi L, Elouadrhiri L, Fegan S, Filippi A, Gavalian G, Glazier DI, Golubenko AA, Gosta G, Gothe RW, Gotra Y, Griffioen K, Hafidi K, Hakobyan H, Hattawy M, Hayward TB, Heddle D, Hobart A, Holtrop M, Illari I, Ireland DG, Isupov EL, Jo HS, Johnston R, Keller D, Khachatryan M, Khanal A, Kim A, Kim W, Klimenko V, Kripko A, Kubarovsky V, Kuhn SE, Lagerquist V, Lanza L, Leali M, Lee S, Lenisa P, Li X, MacGregor IJD, Marchand D, Mascagna V, Matousek G, McKinnon B, McLauchlin C, Meziani ZE, Migliorati S, Milner RG, Mineeva T, Mirazita M, Mokeev V, Moran P, Munoz Camacho C, Naidoo P, Neupane K, Niccolai S, Niculescu G, Osipenko M, Pandey P, Paolone M, Pappalardo LL, Paremuzyan R, Paul SJ, Phelps W, Pilleux N, Pokhrel M, Poudel J, Price JW, Prok Y, Radic A, Raue BA, Reed T, Richards J, Ripani M, Ritman J, Rossi P, Sabatié F, Salgado C, Schadmand S, Schmidt A, Sharabian YG, Shrestha U, Sokhan D, Sparveris N, Spreafico M, Stepanyan S, Strakovsky I, Strauch S, Turisini M, Tyson R, Ungaro M, Vallarino S, Venturelli L, Voskanyan H, Voutier E, Watts DP, Wei X, Williams R, Wishart R, Wood MH, Yurov M, Zachariou N, Zhao ZW, Zurek M. First Measurement of Hard Exclusive π^{-}Δ^{++} Electroproduction Beam-Spin Asymmetries off the Proton. Phys Rev Lett 2023; 131:021901. [PMID: 37505937 DOI: 10.1103/physrevlett.131.021901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/22/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023]
Abstract
The polarized cross-section ratio σ_{LT^{'}}/σ_{0} from hard exclusive π^{-}Δ^{++} electroproduction off an unpolarized hydrogen target has been extracted based on beam-spin asymmetry measurements using a 10.2 GeV/10.6 GeV incident electron beam and the CLAS12 spectrometer at Jefferson Lab. The study, which provides the first observation of this channel in the deep-inelastic regime, focuses on very forward-pion kinematics in the valence regime, and photon virtualities ranging from 1.5 GeV^{2} up to 7 GeV^{2}. The reaction provides a novel access to the d-quark content of the nucleon and to p→Δ^{++} transition generalized parton distributions. A comparison to existing results for hard exclusive π^{+}n and π^{0}p electroproduction is provided, which shows a clear impact of the excitation mechanism, encoded in transition generalized parton distributions, on the asymmetry.
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Affiliation(s)
- S Diehl
- University of Connecticut, Storrs, Connecticut 06269, USA
- II Physikalisches Institut der Universitaet Giessen, 35392 Giessen, Germany
| | - N Trotta
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - K Joo
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - P Achenbach
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Z Akbar
- Florida State University, Tallahassee, Florida 32306, USA
- University of Virginia, Charlottesville, Virginia 22901, USA
| | - W R Armstrong
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - H Atac
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - H Avakian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Baashen
- Florida International University, Miami, Florida 33199, USA
| | - N A Baltzell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Barion
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - M Bashkanov
- University of York, York YO10 5DD, United Kingdom
| | | | - I Bedlinskiy
- National Research Centre Kurchatov Institute-TEP, Moscow, 117259, Russia
| | - F Benmokhtar
- Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
| | - A Bianconi
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - A S Biselli
- Fairfield University, Fairfield Connecticut 06824, USA
| | - F Bossù
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - K-T Brinkmann
- II Physikalisches Institut der Universitaet Giessen, 35392 Giessen, Germany
| | - W J Briscoe
- The George Washington University, Washington, D.C. 20052, USA
| | - D Bulumulla
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - V Burkert
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Capobianco
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - D S Carman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J C Carvajal
- Florida International University, Miami, Florida 33199, USA
| | - A Celentano
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - G Charles
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - P Chatagnon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Chesnokov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - G Ciullo
- Università di Ferrara, 44121 Ferrara, Italy
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - P L Cole
- Lamar University, 4400 MLK Boulevard, P.O. Box 10046, Beaumont, Texas 77710, USA
| | | | - G Costantini
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - V Crede
- Florida State University, Tallahassee, Florida 32306, USA
| | - A D'Angelo
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Università di Roma Tor Vergata, 00133 Rome, Italy
| | - N Dashyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - R De Vita
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - A Deur
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Djalali
- Ohio University, Athens, Ohio 45701, USA
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - R Dupre
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Ehrhart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - A El Alaoui
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - L El Fassi
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - L Elouadrhiri
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Fegan
- University of York, York YO10 5DD, United Kingdom
| | - A Filippi
- INFN, Sezione di Torino, 10125 Torino, Italy
| | - G Gavalian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D I Glazier
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - A A Golubenko
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - G Gosta
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - R W Gothe
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - Y Gotra
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Griffioen
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - K Hafidi
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - H Hakobyan
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - M Hattawy
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - T B Hayward
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - D Heddle
- Christopher Newport University, Newport News, Virginia 23606, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Hobart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Holtrop
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
| | - I Illari
- The George Washington University, Washington, D.C. 20052, USA
| | - D G Ireland
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - E L Isupov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - H S Jo
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - R Johnston
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - D Keller
- University of Virginia, Charlottesville, Virginia 22901, USA
| | - M Khachatryan
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Khanal
- Florida International University, Miami, Florida 33199, USA
| | - A Kim
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - W Kim
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - V Klimenko
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - A Kripko
- II Physikalisches Institut der Universitaet Giessen, 35392 Giessen, Germany
| | - V Kubarovsky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S E Kuhn
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - V Lagerquist
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - L Lanza
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Università di Roma Tor Vergata, 00133 Rome, Italy
| | - M Leali
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - S Lee
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - P Lenisa
- Università di Ferrara, 44121 Ferrara, Italy
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - X Li
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | | | - D Marchand
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - V Mascagna
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi dell'Insubria, 22100 Como, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - G Matousek
- Duke University, Durham, North Carolina 27708-0305, USA
| | - B McKinnon
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - C McLauchlin
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - Z E Meziani
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - S Migliorati
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - R G Milner
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - T Mineeva
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - M Mirazita
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - V Mokeev
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Moran
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - C Munoz Camacho
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Naidoo
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - K Neupane
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - S Niccolai
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - G Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - M Osipenko
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - P Pandey
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - M Paolone
- New Mexico State University, P.O. Box 30001, Las Cruces, New Mexico 88003, USA
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - L L Pappalardo
- Università di Ferrara, 44121 Ferrara, Italy
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - R Paremuzyan
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S J Paul
- University of California Riverside, 900 University Avenue, Riverside, California 92521, USA
| | - W Phelps
- Christopher Newport University, Newport News, Virginia 23606, USA
- The George Washington University, Washington, D.C. 20052, USA
| | - N Pilleux
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Pokhrel
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - J Poudel
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - J W Price
- California State University, Dominguez Hills, Carson, California 90747, USA
| | - Y Prok
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Radic
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - B A Raue
- Florida International University, Miami, Florida 33199, USA
| | - T Reed
- Florida International University, Miami, Florida 33199, USA
| | - J Richards
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Ripani
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - J Ritman
- GSI Helmholtzzentrum fur Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
- Institute fur Kernphysik (Juelich), Juelich, Germany
| | - P Rossi
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Sabatié
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Salgado
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - S Schadmand
- GSI Helmholtzzentrum fur Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
| | - A Schmidt
- The George Washington University, Washington, D.C. 20052, USA
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - Y G Sharabian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - U Shrestha
- University of Connecticut, Storrs, Connecticut 06269, USA
- Ohio University, Athens, Ohio 45701, USA
| | - D Sokhan
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - N Sparveris
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - M Spreafico
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - S Stepanyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - I Strakovsky
- The George Washington University, Washington, D.C. 20052, USA
| | - S Strauch
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - M Turisini
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - R Tyson
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M Ungaro
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Vallarino
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - L Venturelli
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - H Voskanyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - E Voutier
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - D P Watts
- University of York, York YO10 5DD, United Kingdom
| | - X Wei
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Williams
- University of York, York YO10 5DD, United Kingdom
| | - R Wishart
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M H Wood
- Canisius College, Buffalo, New York 14208-1517, USA
| | - M Yurov
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - N Zachariou
- University of York, York YO10 5DD, United Kingdom
| | - Z W Zhao
- Duke University, Durham, North Carolina 27708-0305, USA
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - M Zurek
- Argonne National Laboratory, Argonne, Illinois 60439, USA
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Christiaens G, Defurne M, Sokhan D, Achenbach P, Akbar Z, Amaryan MJ, Atac H, Avakian H, Gayoso CA, Baashen L, Baltzell NA, Barion L, Bashkanov M, Battaglieri M, Bedlinskiy I, Benkel B, Benmokhtar F, Bianconi A, Biselli AS, Bondi M, Booth WA, Bossù F, Boiarinov S, Brinkmann KT, Briscoe WJ, Bueltmann S, Bulumulla D, Burkert VD, Cao T, Carman DS, Carvajal JC, Celentano A, Chatagnon P, Chesnokov V, Chetry T, Ciullo G, Clash G, Cole PL, Contalbrigo M, Costantini G, D'Angelo A, Dashyan N, De Vita R, Deur A, Diehl S, Dilks C, Djalali C, Dupre R, Egiyan H, Ehrhart M, Alaoui AE, Fassi LE, Elouadrhiri L, Fegan S, Filippi A, Gates K, Gavalian G, Ghandilyan Y, Gilfoyle GP, Girod FX, Glazier DI, Golubenko AA, Gosta G, Gothe RW, Gotra Y, Griffioen KA, Guidal M, Hafidi K, Hakobyan H, Hattawy M, Hauenstein F, Hayward TB, Heddle D, Hobart A, Holmberg DE, Holtrop M, Ilieva Y, Ireland DG, Isupov EL, Jo HS, Keller D, Khachatryan M, Khanal A, Kim W, Kripko A, Kubarovsky V, Kuhn SE, Lagerquist V, Lanza L, Kabir ML, Leali M, Lee S, Lenisa P, Li X, Livingston K, MacGregor IJD, Marchand D, Mascagna V, Matousek G, McKinnon B, McLauchlin C, Meziani ZE, Migliorati S, Milner RG, Mineeva T, Mirazita M, Mokeev V, Molina E, Camacho CM, Nadel-Turonski P, Naidoo P, Neupane K, Niccolai S, Nicol M, Niculescu G, Osipenko M, Ouillon M, Pandey P, Paolone M, Pappalardo LL, Paremuzyan R, Pasyuk E, Paul SJ, Phelps W, Pilleux N, Pokhrel M, Poudel J, Price JW, Prok Y, Radic A, Ramasubramanian N, Raue BA, Reed T, Richards J, Ripani M, Ritman J, Rossi P, Sabatié F, Salgado C, Schadmand S, Schmidt A, Scott MBC, Sharabian YG, Shirokov EV, Shrestha U, Simmerling P, Sparveris N, Spreafico M, Stepanyan S, Strakovsky II, Strauch S, Tan JA, Trotta N, Turisini M, Tyson R, Ungaro M, Vallarino S, Venturelli L, Voskanyan H, Voutier E, Watts DP, Wei X, Williams R, Wishart R, Wood MH, Zachariou N, Zhang J, Zhao ZW, Ziegler V, Zurek M. First CLAS12 Measurement of Deeply Virtual Compton Scattering Beam-Spin Asymmetries in the Extended Valence Region. Phys Rev Lett 2023; 130:211902. [PMID: 37295113 DOI: 10.1103/physrevlett.130.211902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/24/2023] [Accepted: 04/21/2023] [Indexed: 06/12/2023]
Abstract
Deeply virtual Compton scattering (DVCS) allows one to probe generalized parton distributions describing the 3D structure of the nucleon. We report the first measurement of the DVCS beam-spin asymmetry using the CLAS12 spectrometer with a 10.2 and 10.6 GeV electron beam scattering from unpolarized protons. The results greatly extend the Q^{2} and Bjorken-x phase space beyond the existing data in the valence region and provide 1600 new data points measured with unprecedented statistical uncertainty, setting new, tight constraints for future phenomenological studies.
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Affiliation(s)
- G Christiaens
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M Defurne
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Sokhan
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - P Achenbach
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Z Akbar
- University of Virginia, Charlottesville, Virginia 22901, USA
| | - M J Amaryan
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - H Atac
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - H Avakian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Ayerbe Gayoso
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - L Baashen
- Florida International University, Miami, Florida 33199, USA
| | - N A Baltzell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Barion
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - M Bashkanov
- University of York, York YO10 5DD, United Kingdom
| | | | - I Bedlinskiy
- National Research Centre Kurchatov Institute-ITEP, Moscow, 117259, Russia
| | - B Benkel
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - F Benmokhtar
- Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
| | - A Bianconi
- Universit'a degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - A S Biselli
- Fairfield University, Fairfield, Connecticut 06824, USA
| | - M Bondi
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
| | - W A Booth
- University of York, York YO10 5DD, United Kingdom
| | - F Bossù
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Boiarinov
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K-Th Brinkmann
- II Physikalisches Institut der Universitaet Giessen, 35392 Giessen, Germany
| | - W J Briscoe
- The George Washington University, Washington, D.C. 20052, USA
| | - S Bueltmann
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - D Bulumulla
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - V D Burkert
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Cao
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D S Carman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J C Carvajal
- Florida International University, Miami, Florida 33199, USA
| | - A Celentano
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - P Chatagnon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - V Chesnokov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - T Chetry
- Florida International University, Miami, Florida 33199, USA
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
- Ohio University, Athens, Ohio 45701, USA
| | - G Ciullo
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
- Universita' di Ferrara, 44121 Ferrara, Italy
| | - G Clash
- University of York, York YO10 5DD, United Kingdom
| | - P L Cole
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Lamar University, 4400 MLK Boulevard, P.O. Box 10046, Beaumont, Texas 77710, USA
- Catholic University of America, Washington, D.C. 20064, USA
| | | | - G Costantini
- Universit'a degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - A D'Angelo
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Universita' di Roma Tor Vergata, 00133 Rome, Italy
| | - N Dashyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - R De Vita
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - A Deur
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Diehl
- II Physikalisches Institut der Universitaet Giessen, 35392 Giessen, Germany
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - C Dilks
- Duke University, Durham, North Carolina 27708-0305, USA
| | - C Djalali
- Ohio University, Athens, Ohio 45701, USA
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - R Dupre
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - H Egiyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Ehrhart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - A El Alaoui
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - L El Fassi
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - L Elouadrhiri
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Fegan
- University of York, York YO10 5DD, United Kingdom
| | - A Filippi
- INFN, Sezione di Torino, 10125 Torino, Italy
| | - K Gates
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - G Gavalian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Y Ghandilyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - G P Gilfoyle
- University of Richmond, Richmond, Virginia 23173, USA
| | - F X Girod
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D I Glazier
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - A A Golubenko
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - G Gosta
- Universit'a degli Studi di Brescia, 25123 Brescia, Italy
| | - R W Gothe
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - Y Gotra
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K A Griffioen
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - M Guidal
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - K Hafidi
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - H Hakobyan
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - M Hattawy
- Old Dominion University, Norfolk, Virginia 23529, USA
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - F Hauenstein
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - T B Hayward
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - D Heddle
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - A Hobart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - D E Holmberg
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - M Holtrop
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
| | - Y Ilieva
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - D G Ireland
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - E L Isupov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - H S Jo
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - D Keller
- University of Virginia, Charlottesville, Virginia 22901, USA
| | - M Khachatryan
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Khanal
- Florida International University, Miami, Florida 33199, USA
| | - W Kim
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - A Kripko
- II Physikalisches Institut der Universitaet Giessen, 35392 Giessen, Germany
| | - V Kubarovsky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S E Kuhn
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - V Lagerquist
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - L Lanza
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
| | - M L Kabir
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - M Leali
- Universit'a degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - S Lee
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - P Lenisa
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
- Universita' di Ferrara, 44121 Ferrara, Italy
| | - X Li
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - K Livingston
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | | | - D Marchand
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - V Mascagna
- Universit'a degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi dell'Insubria, 22100 Como, Italy
| | - G Matousek
- Duke University, Durham, North Carolina 27708-0305, USA
| | - B McKinnon
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - C McLauchlin
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - Z E Meziani
- Temple University, Philadelphia, Pennsylvania 19122, USA
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - S Migliorati
- Universit'a degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - R G Milner
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - T Mineeva
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - M Mirazita
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - V Mokeev
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E Molina
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - C Munoz Camacho
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Nadel-Turonski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Naidoo
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - K Neupane
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - S Niccolai
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Nicol
- University of York, York YO10 5DD, United Kingdom
| | - G Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - M Osipenko
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - M Ouillon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Pandey
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - M Paolone
- Temple University, Philadelphia, Pennsylvania 19122, USA
- New Mexico State University, P.O. Box 30001, Las Cruces, New Mexico 88003, USA
| | - L L Pappalardo
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
- Universita' di Ferrara, 44121 Ferrara, Italy
| | - R Paremuzyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
| | - E Pasyuk
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S J Paul
- University of California Riverside, 900 University Avenue, Riverside, California 92521, USA
| | - W Phelps
- The George Washington University, Washington, D.C. 20052, USA
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - N Pilleux
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Pokhrel
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - J Poudel
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - J W Price
- California State University, Dominguez Hills, Carson, California 90747, USA
| | - Y Prok
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Radic
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | | | - B A Raue
- Florida International University, Miami, Florida 33199, USA
| | - Trevor Reed
- Florida International University, Miami, Florida 33199, USA
| | - J Richards
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Ripani
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - J Ritman
- GSI Helmholtzzentrum fur Schwerionenforschung GmbH, D 64291 Darmstadt, Germany
- Institute fur Kernphysik (Juelich), 52428 Juelich, Germany
| | - P Rossi
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - F Sabatié
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Salgado
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - S Schadmand
- GSI Helmholtzzentrum fur Schwerionenforschung GmbH, D 64291 Darmstadt, Germany
- Institute fur Kernphysik (Juelich), 52428 Juelich, Germany
| | - A Schmidt
- The George Washington University, Washington, D.C. 20052, USA
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - M B C Scott
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - Y G Sharabian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E V Shirokov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - U Shrestha
- Ohio University, Athens, Ohio 45701, USA
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - P Simmerling
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - N Sparveris
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - M Spreafico
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - S Stepanyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - I I Strakovsky
- The George Washington University, Washington, D.C. 20052, USA
| | - S Strauch
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - J A Tan
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - N Trotta
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Turisini
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - R Tyson
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M Ungaro
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Vallarino
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - L Venturelli
- Universit'a degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - H Voskanyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - E Voutier
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - D P Watts
- University of York, York YO10 5DD, United Kingdom
| | - X Wei
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Williams
- University of York, York YO10 5DD, United Kingdom
| | - R Wishart
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M H Wood
- Canisius College, Buffalo, New York 14208, USA
| | - N Zachariou
- University of York, York YO10 5DD, United Kingdom
| | - J Zhang
- University of Virginia, Charlottesville, Virginia 22901, USA
| | - Z W Zhao
- Old Dominion University, Norfolk, Virginia 23529, USA
- Duke University, Durham, North Carolina 27708-0305, USA
| | - V Ziegler
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Zurek
- Argonne National Laboratory, Argonne, Illinois 60439, USA
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Pillay E, Naidoo P. Hodgkin lymphoma in the bone marrow aspirate of a young patient with human immunodeficiency virus. EJHaem 2023; 4:510-512. [PMID: 37206272 PMCID: PMC10188499 DOI: 10.1002/jha2.670] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 02/25/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Evashin Pillay
- University of KwaZulu‐Natal & National Health Laboratory Service, Inkosi Albert Luthuli Central & King Edward VIII HospitalsDurbanSouth Africa
| | - Poobalan Naidoo
- University of KwaZulu‐Natal & KwaZulu Natal Provincial Department of HealthInkosi Albert Luthuli Central & King Edward VIII HospitalsDurbanSouth Africa
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Bhana S, Variava E, Mhazo TV, de Beer JC, Naidoo P, Pillay S, Carrihill M, Naidoo K, van Wyk L, Pauly B. Healthcare Resource Utilization in Controlled Versus Uncontrolled Adults Living With Type 1 Diabetes in the South African Public Healthcare Sector. Value Health Reg Issues 2023; 36:66-75. [PMID: 37037071 DOI: 10.1016/j.vhri.2023.03.002] [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: 11/02/2022] [Revised: 02/17/2023] [Accepted: 03/04/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVES This study aimed to understand the cost implications of managing people living with type 1 diabetes mellitus in the South African public healthcare system. METHODS A multicenter, noninterventional retrospective chart review study was performed. Data on healthcare resource consumption, demographics, risk factors, clinical history, and acute events were collected. Direct medical costs were collected over a 1-year period, stratified by controlled versus uncontrolled patients. In addition, the costs in people with controlled (glycated hemoglobin < 7%) versus uncontrolled glycated hemoglobin (≥ 7%) at time horizons of 1, 5, 10, and 25 years were modeled using the IQVIA Core Diabetes Model. RESULTS The costs based on the retrospective chart review were $630 versus $1012 (controlled versus uncontrolled population). The modeled costs at various time horizons were as follows: at 1 year, $900 versus $1331; at 5 years, $4163 versus $6423; at 10 years, $7759 versus $16 481; and at 25 years, $16 969 versus $66 268. The largest cost in the controlled population was severe hypoglycemia requiring nonmedical assistance, severe hypoglycemia requiring medical assistance, and treatment costs. In the uncontrolled population, the largest cost was the cost of diabetic ketoacidosis, severe hypoglycemia requiring nonmedical assistance, severe hypoglycemia requiring medical assistance, and foot complications. CONCLUSIONS Strict glycemic control reduces healthcare resource use overall. Patients in the controlled group still experienced high resource use related to hypoglycemic events. The introduction of a structured patient education program and analog insulins may result in less episodes of hypoglycemia and potential cost savings.
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Affiliation(s)
- Sindeep Bhana
- Chris Hani Baragwanath Hospital Complex, Johannesburg, South Africa; University of Witwatersrand, Johannesburg, South Africa
| | - Ebrahim Variava
- University of Witwatersrand, Johannesburg, South Africa; Klerksdorp Tshepong Hospital Complex, Klerksdorp, South Africa
| | | | | | - Poobalan Naidoo
- King Edward VIII Hospital, Durban, South Africa; University of KwaZulu-Natal, Durban, South Africa
| | - Somasundram Pillay
- King Edward VIII Hospital, Durban, South Africa; University of KwaZulu-Natal, Durban, South Africa
| | - Michelle Carrihill
- Red Cross War Memorial Hospital/ Groote Schuur Hospital, Cape Town, South Africa; University of Cape Town, Cape Town, South Africa
| | | | | | - Bruno Pauly
- Chris Hani Baragwanath Hospital Complex, Johannesburg, South Africa
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8
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Mim SR, Hussein H, Vidadi S, Leisegang R, Karamchand S, Rambiritch V, Cotton MF, Naidoo P, Kjellsson MC. Optimal dosing of gliclazide - a model-based approach. Basic Clin Pharmacol Toxicol 2023. [PMID: 36999176 DOI: 10.1111/bcpt.13868] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/01/2023]
Abstract
Gliclazide was approved as a treatment for type 2 diabetes in an era before model-based drug development and consequently the recommended doses were not optimized with modern methods. To investigate various dosing regimens of gliclazide, we used publicly available data to characterise the dose-response relationship using pharmacometric models. A literature search identified 21 published gliclazide pharmacokinetic (PK) studies with full profiles. These were digitized and a PK model was developed for immediate- (IR) and modified-release (MR) formulations. Data from a gliclazide dose-ranging study of postprandial glucose were used to characterise the concentration-response relationship, using the integrated glucose-insulin model. Simulations from the full model showed that the maximum effect was 44% of the patients achieving HbA1c<7 % with 11% experiencing glucose<3 mmol/L and the most sensitive patients (i.e., 5% most extreme) experiencing 35 min of hypoglycaemia. Simulations revealed that the recommended IR dose (320 mg) was appropriate with no efficacy gain with increased dose. However, the recommended dose for the MR formulation may be increased to 270 mg, with more patients achieving HbA1c goals (i.e., HbA1c<7%) without a hypoglycaemic risk higher than the resulting risk from the recommended IR dose.
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Affiliation(s)
- Sabiha R Mim
- Pharmacometric Research Group, Department of Pharmacy, Uppsala University, Sweden
| | - Haneen Hussein
- Pharmacometric Research Group, Department of Pharmacy, Uppsala University, Sweden
| | - Samira Vidadi
- Pharmacometric Research Group, Department of Pharmacy, Uppsala University, Sweden
| | - Rory Leisegang
- Pharmacometric Research Group, Department of Pharmacy, Uppsala University, Sweden
- Family Center for Research with Ubuntu, Department of Paediatrics and Child Health, Stellenbosch University, South Africa
| | | | - Virendra Rambiritch
- Discipline of Pharmaceutical Science, University of KwaZulu-Natal, South Africa
| | - Mark F Cotton
- Family Center for Research with Ubuntu, Department of Paediatrics and Child Health, Stellenbosch University, South Africa
| | - Poobalan Naidoo
- Department of Nephrology, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa; Nelson R Mandela School of Medicine, University of Kwa-Zulu Natal, South Africa
| | - Maria C Kjellsson
- Pharmacometric Research Group, Department of Pharmacy, Uppsala University, Sweden
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9
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Mavragani A, Naidoo P, Pillay S, Variava E, Naidoo K, Rohitlall N, Sekhuthe L, Pauly B. Health Care Resource Utilization in Adults Living With Type 1 Diabetes Mellitus in the South African Public Health Sector: Protocol for a 1-Year Retrospective Analysis With a 5-, 10-, and 25-Year Projection. JMIR Res Protoc 2023; 12:e44308. [PMID: 36780227 PMCID: PMC9983812 DOI: 10.2196/44308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is less common than type 2 diabetes mellitus but is increasing in frequency in South Africa. It tends to affect younger individuals, and upon diagnosis, exogenous insulin is essential for survival. In South Africa, the health care system is divided into private and public health care systems. The private system is well resourced, whereas the public sector, which treats more than 80% of the population, has minimal resources. There are currently no studies in South Africa, and Africa at large, that have evaluated the immediate and long-term costs of managing people living with T1DM in the public sector. OBJECTIVE The primary objective was to quantify the cost of health care resource utilization over a 12-month period in patients with controlled and uncontrolled T1DM in the public health care sector. In addition, we will project costs for 5, 10, and 25 years and determine if there are cost differences in managing subsets of patients who achieve glycemic control (hemoglobin A1c [HbA1c] <7%) and those who do not. METHODS The study was performed in accordance with Good Epidemiological Practice. Ethical clearance and institutional permissions were acquired. Clinical data were collected from 2 tertiary hospitals in South Africa. Patients with T1DM, who provided written informed consent, and who satisfied the inclusion criteria were enrolled in the study. Data collection included demographic and clinical characteristics, acute and chronic complications, hospital admissions, and so on. We plan to perform a cost-effectiveness analysis to quantify the costs of health care utilization in the preceding 12 months. In addition, we will estimate projected costs over the next 10 years, assuming that study participants maintain their current HbA1c level. The cost-effectiveness analysis will be modeled using the IQVIA CORE Diabetes Model. The primary outcome measures are incremental quality-adjusted life years, incremental costs, incremental cost-effectiveness ratios, and incremental life years. RESULTS Ethical clearance and institutional approval were obtained (reference number 200407). Enrollment began on February 9, 2021, and was completed on August 24, 2021, with 224 participants. A database lock was performed on October 29, 2021. The statistical analysis and clinical study report were completed in January 2022. CONCLUSIONS At present, there are no data assessing the short- and long-term costs of managing patients with T1DM in the South African public sector. It is hoped that the findings of this study will help policy makers optimally use limited resources to reduce morbidity and mortality in people living with T1DM. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/44308.
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Affiliation(s)
| | | | | | - Ebrahim Variava
- Klerksdorp Tshepong Hospital Complex, Klerksdorp, South Africa
| | | | | | | | - Bruno Pauly
- Chris Hani Baragwanath Hospital Complex, Johannesburg, South Africa
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10
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Avakian H, Hayward TB, Kotzinian A, Armstrong WR, Atac H, Ayerbe Gayoso C, Baashen L, Baltzell NA, Barion L, Bashkanov M, Battaglieri M, Bedlinskiy I, Benkel B, Benmokhtar F, Bianconi A, Biondo L, Biselli AS, Bondi M, Boiarinov S, Bossù F, Brinkman KT, Briscoe WJ, Brooks WK, Bueltmann S, Bulumulla D, Burkert VD, Capobianco R, Carman DS, Carvajal JC, Celentano A, Chatagnon P, Chesnokov V, Chetry T, Ciullo G, Cole PL, Contalbrigo M, Costantini G, D'Angelo A, Dashyan N, De Vita R, Defurne M, Deur A, Diehl S, Dilks C, Djalali C, Dupre R, Egiyan H, El Alaoui A, El Fassi L, Elouadrhiri L, Fegan S, Filippi A, Forest T, Gates K, Gavalian G, Ghandilyan Y, Glazier DI, Golubenko AA, Gosta G, Gothe RW, Gotra Y, Griffioen KA, Guidal M, Hakobyan H, Hattawy M, Hauenstein F, Heddle D, Hobart A, Holtrop M, Hyde CE, Ilieva Y, Ireland DG, Isupov EL, Jo HS, Johnston R, Joo K, Kabir ML, Keller D, Khachatryan M, Khanal A, Kim A, Kim W, Klimenko V, Kripko A, Kubarovsky V, Kuhn SE, Lagerquist V, Lanza L, Leali M, Lee S, Lenisa P, Li X, MacGregor IJD, Marchand D, Mascagna V, McKinnon B, Migliorati S, Mineeva T, Mirazita M, Mokeev V, Montgomery RA, Munoz Camacho C, Nadel-Turonski P, Naidoo P, Neupane K, Nguyen D, Niccolai S, Nicol M, Niculescu G, Osipenko M, Pandey P, Paolone M, Pappalardo LL, Paremuzyan R, Pasyuk E, Paul SJ, Phelps W, Pilleux N, Pogorelko O, Pokhrel M, Poudel J, Price JW, Prok Y, Raue BA, Reed T, Richards J, Ripani M, Ritman J, Rossi P, Sabatié F, Salgado C, Schmidt A, Sharabian YG, Shirokov EV, Shrestha U, Simmerling P, Sokhan D, Sparveris N, Stepanyan S, Strakovsky II, Strauch S, Tan JA, Trotta N, Tyson R, Ungaro M, Vallarino S, Venturelli L, Voskanyan H, Vossen A, Voutier E, Watts DP, Wei X, Wishart R, Wood MH, Zachariou N, Zhao ZW, Zurek M. Observation of Correlations between Spin and Transverse Momenta in Back-to-Back Dihadron Production at CLAS12. Phys Rev Lett 2023; 130:022501. [PMID: 36706384 DOI: 10.1103/physrevlett.130.022501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/07/2022] [Accepted: 12/07/2022] [Indexed: 06/18/2023]
Abstract
We report the first measurements of deep inelastic scattering spin-dependent azimuthal asymmetries in back-to-back dihadron electroproduction in the deep inelastic scattering process. In this reaction, two hadrons are produced in opposite hemispheres along the z axis in the virtual photon-target nucleon center-of-mass frame, with the first hadron produced in the current-fragmentation region and the second in the target-fragmentation region. The data were taken with longitudinally polarized electron beams of 10.2 and 10.6 GeV incident on an unpolarized liquid-hydrogen target using the CLAS12 spectrometer at Jefferson Lab. Observed nonzero sinΔϕ modulations in ep→e^{'}pπ^{+}X events, where Δϕ is the difference of the azimuthal angles of the proton and pion in the virtual photon and target nucleon center-of-mass frame, indicate that correlations between the spin and transverse momenta of hadrons produced in the target- and current-fragmentation regions may be significant. The measured beam-spin asymmetries provide a first access in dihadron production to a previously unexplored leading-twist spin- and transverse-momentum-dependent fracture function. The fracture functions describe the hadronization of the target remnant after the hard scattering of a virtual photon off a quark in the target particle and provide a new avenue for studying nucleonic structure and hadronization.
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Affiliation(s)
- H Avakian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T B Hayward
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - A Kotzinian
- Yerevan Physics Institute, 375036 Yerevan, Armenia
- INFN, Sezione di Torino, 10125 Torino, Italy
| | - W R Armstrong
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - H Atac
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - C Ayerbe Gayoso
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - L Baashen
- Florida International University, Miami, Florida 33199, USA
| | - N A Baltzell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Barion
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - M Bashkanov
- University of York, York YO10 5DD, United Kingdom
| | | | - I Bedlinskiy
- National Research Centre Kurchatov Institute-ITEP, Moscow 117259, Russia
| | - B Benkel
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - F Benmokhtar
- Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
| | - A Bianconi
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - L Biondo
- INFN, Sezione di Genova, 16146 Genova, Italy
- INFN, Sezione di Catania, 95123 Catania, Italy
- Università degli Studi di Messina, 98166 Messina, Italy
| | - A S Biselli
- Fairfield University, Fairfield, Connecticut 06824, USA
| | - M Bondi
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
| | - S Boiarinov
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Bossù
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - K T Brinkman
- II. Physikalisches Institut der Universität Gießen, 35392 Gießen, Germany
| | - W J Briscoe
- The George Washington University, Washington, D.C. 20052, USA
| | - W K Brooks
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - S Bueltmann
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - D Bulumulla
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - V D Burkert
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Capobianco
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - D S Carman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J C Carvajal
- Florida International University, Miami, Florida 33199, USA
| | - A Celentano
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - P Chatagnon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - V Chesnokov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - T Chetry
- Florida International University, Miami, Florida 33199, USA
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
- Ohio University, Athens, Ohio 45701, USA
| | - G Ciullo
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
- Università di Ferrara, 44121 Ferrara, Italy
| | - P L Cole
- Lamar University, 4400 MLK Boulevard, P.O. Box 10046, Beaumont, Texas 77710, USA
| | | | - G Costantini
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - A D'Angelo
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Università di Roma Tor Vergata, 00133 Rome, Italy
| | - N Dashyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - R De Vita
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - M Defurne
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Deur
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Diehl
- University of Connecticut, Storrs, Connecticut 06269, USA
- II. Physikalisches Institut der Universität Gießen, 35392 Gießen, Germany
| | - C Dilks
- Duke University, Durham, North Carolina 27708-0305, USA
| | - C Djalali
- Ohio University, Athens, Ohio 45701, USA
| | - R Dupre
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - H Egiyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A El Alaoui
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - L El Fassi
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - L Elouadrhiri
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Fegan
- University of York, York YO10 5DD, United Kingdom
| | - A Filippi
- INFN, Sezione di Torino, 10125 Torino, Italy
| | - T Forest
- Idaho State University, Pocatello, Idaho 83209, USA
| | - K Gates
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - G Gavalian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Y Ghandilyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - D I Glazier
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - A A Golubenko
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - G Gosta
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - R W Gothe
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - Y Gotra
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K A Griffioen
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - M Guidal
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - H Hakobyan
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - M Hattawy
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - F Hauenstein
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Heddle
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - A Hobart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Holtrop
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
| | - C E Hyde
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - Y Ilieva
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - D G Ireland
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - E L Isupov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - H S Jo
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - R Johnston
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - K Joo
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M L Kabir
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - D Keller
- University of Virginia, Charlottesville, Virginia 22901, USA
| | - M Khachatryan
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Khanal
- Florida International University, Miami, Florida 33199, USA
| | - A Kim
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - W Kim
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - V Klimenko
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - A Kripko
- II. Physikalisches Institut der Universität Gießen, 35392 Gießen, Germany
| | - V Kubarovsky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S E Kuhn
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - V Lagerquist
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - L Lanza
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
| | - M Leali
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - S Lee
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - P Lenisa
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
- Università di Ferrara, 44121 Ferrara, Italy
| | - X Li
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | | | - D Marchand
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - V Mascagna
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - B McKinnon
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - S Migliorati
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - T Mineeva
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - M Mirazita
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - V Mokeev
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - C Munoz Camacho
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Nadel-Turonski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Naidoo
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - K Neupane
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - D Nguyen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Niccolai
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Nicol
- University of York, York YO10 5DD, United Kingdom
| | - G Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - M Osipenko
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - P Pandey
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - M Paolone
- Temple University, Philadelphia, Pennsylvania 19122, USA
- New Mexico State University, P.O. Box 30001, Las Cruces, New Mexico 88003, USA
| | - L L Pappalardo
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
- Università di Ferrara, 44121 Ferrara, Italy
| | - R Paremuzyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
| | - E Pasyuk
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S J Paul
- University of California Riverside, 900 University Avenue, Riverside, California 92521, USA
| | - W Phelps
- The George Washington University, Washington, D.C. 20052, USA
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - N Pilleux
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - O Pogorelko
- National Research Centre Kurchatov Institute-ITEP, Moscow 117259, Russia
| | - M Pokhrel
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - J Poudel
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - J W Price
- California State University, Dominguez Hills, Carson, California 90747, USA
| | - Y Prok
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - B A Raue
- Florida International University, Miami, Florida 33199, USA
| | - T Reed
- Florida International University, Miami, Florida 33199, USA
| | - J Richards
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Ripani
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - J Ritman
- GSI Helmholtzzentrum fur Schwerionenforschung GmbH, D-64291 Darmstadt, Germany
- Institute fur Kernphysik (Juelich), 52428 Juelich, Germany
| | - P Rossi
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - F Sabatié
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Salgado
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - A Schmidt
- The George Washington University, Washington, D.C. 20052, USA
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - Y G Sharabian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E V Shirokov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - U Shrestha
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - P Simmerling
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - D Sokhan
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - N Sparveris
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - S Stepanyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - I I Strakovsky
- The George Washington University, Washington, D.C. 20052, USA
| | - S Strauch
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - J A Tan
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - N Trotta
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - R Tyson
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M Ungaro
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Vallarino
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - L Venturelli
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - H Voskanyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - A Vossen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Duke University, Durham, North Carolina 27708-0305, USA
| | - E Voutier
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - D P Watts
- University of York, York YO10 5DD, United Kingdom
| | - X Wei
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Wishart
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M H Wood
- Canisius College, Buffalo, New York 14208, USA
| | - N Zachariou
- University of York, York YO10 5DD, United Kingdom
| | - Z W Zhao
- Duke University, Durham, North Carolina 27708-0305, USA
| | - M Zurek
- Argonne National Laboratory, Argonne, Illinois 60439, USA
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11
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Diehl S, Kim A, Angelini G, Joo K, Adhikari S, Amaryan M, Arratia M, Atac H, Avakian H, Ayerbe Gayoso C, Baltzell NA, Barion L, Bastami S, Battaglieri M, Bedlinskiy I, Benmokhtar F, Bianconi A, Biselli AS, Bondi M, Bossù F, Boiarinov S, Brinkmann KT, Briscoe WJ, Brooks W, Bulumulla D, Burkert VD, Carman DS, Carvajal JC, Celentano A, Chatagnon P, Chetry T, Ciullo G, Clark L, Clary BA, Cole PL, Contalbrigo M, Costantini G, Crede V, D'Angelo A, Dashyan N, De Vita R, Defurne M, Deur A, Dilks C, Djalali C, Dugger M, Dupre R, Egiyan H, Ehrhart M, El Alaoui A, El Fassi L, Elouadrhiri L, Fegan S, Filippi A, Forest T, Gavalian G, Gilfoyle GP, Girod FX, Glazier DI, Golubenko AA, Gothe RW, Gotra Y, Griffioen KA, Guidal M, Hafidi K, Hakobyan H, Hattawy M, Hauenstein F, Hayward TB, Heddle D, Hicks K, Hobart A, Holtrop M, Hyde CE, Ireland DG, Isupov EL, Jo HS, Johnston R, Joosten S, Keller D, Khachatryan M, Khanal A, Kim W, Kripko A, Kubarovsky V, Kuhn SE, Lanza L, Leali M, Lee S, Lenisa P, Livingston K, Lu Z, MacGregor IJD, Marchand D, Markov N, Marsicano L, Mascagna V, McKinnon B, Meziani ZE, Milner RG, Mineeva T, Mirazita M, Mokeev V, Moran P, Movsisyan A, Munoz Camacho C, Nadel-Turonski P, Naidoo P, Nanda S, Neupane K, Niccolai S, Niculescu G, O'Connell TR, Osipenko M, Paolone M, Pappalardo LL, Paremuzyan R, Pasyuk E, Phelps W, Pogorelko O, Prok Y, Prokudin A, Raue BA, Ripani M, Ritman J, Rizzo A, Roberts CD, Rossi P, Rowley J, Sabatié F, Salgado C, Schmidt A, Segarra EP, Sharabian YG, Shrestha U, Simmerling P, Sokhan D, Soto O, Sparveris N, Stepanyan S, Stoler P, Strakovsky II, Strauch S, Tezgin K, Thornton A, Tyler N, Tyson R, Ungaro M, Venturelli L, Voskanyan H, Vossen A, Voutier E, Watts DP, Wei K, Wei X, Xu SS, Yale B, Zachariou N, Zhang J. Multidimensional, High Precision Measurements of Beam Single Spin Asymmetries in Semi-inclusive π^{+} Electroproduction off Protons in the Valence Region. Phys Rev Lett 2022; 128:062005. [PMID: 35213183 DOI: 10.1103/physrevlett.128.062005] [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: 01/10/2021] [Revised: 09/28/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
High precision measurements of the polarized electron beam-spin asymmetry in semi-inclusive deep inelastic scattering (SIDIS) from the proton have been performed using a 10.6 GeV incident electron beam and the CLAS12 spectrometer at Jefferson Lab. We report here a high precision multidimensional study of single π^{+} SIDIS data over a large kinematic range in Bjorken x, fractional energy, and transverse momentum of the hadron as well as photon virtualities Q^{2} ranging from 1-7 GeV^{2}. In particular, the structure function ratio F_{LU}^{sinϕ}/F_{UU} has been determined, where F_{LU}^{sinϕ} is a twist-3 quantity that can reveal novel aspects of emergent hadron mass and quark-gluon correlations within the nucleon. The data's impact on the evolving understanding of the underlying reaction mechanisms and their kinematic variation is explored using theoretical models for the different contributing transverse momentum dependent parton distribution functions.
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Affiliation(s)
- S Diehl
- University of Connecticut, Storrs, Connecticut 06269, USA
- II. Physikalisches Institut der Universität Gießen, 35392 Gießen, Germany
| | - A Kim
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - G Angelini
- The George Washington University, Washington, D.C. 20052, USA
| | - K Joo
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - S Adhikari
- Florida International University, Miami, Florida 33199, USA
| | - M Amaryan
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - M Arratia
- University of California, Riverside, California 92521, USA
| | - H Atac
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - H Avakian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Ayerbe Gayoso
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - N A Baltzell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Barion
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - S Bastami
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Battaglieri
- INFN, Sezione di Genova, 16146 Genova, Italy
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - I Bedlinskiy
- National Research Centre Kurchatov Institute-ITEP, Moscow, 117259, Russia
| | - F Benmokhtar
- Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
| | - A Bianconi
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - A S Biselli
- Fairfield University, Fairfield, Connecticut 06824, USA
| | - M Bondi
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - F Bossù
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Boiarinov
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K-T Brinkmann
- II. Physikalisches Institut der Universität Gießen, 35392 Gießen, Germany
| | - W J Briscoe
- The George Washington University, Washington, D.C. 20052, USA
| | - W Brooks
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - D Bulumulla
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - V D Burkert
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D S Carman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J C Carvajal
- Florida International University, Miami, Florida 33199, USA
| | - A Celentano
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - P Chatagnon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - T Chetry
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
- Ohio University, Athens, Ohio 45701, USA
| | - G Ciullo
- Universitá di Ferrara, 44121 Ferrara, Italy
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - L Clark
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - B A Clary
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - P L Cole
- Lamar University, 4400 MLK Blvd, P.O. Box 10046, Beaumont, Texas 77710, USA
| | | | - G Costantini
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - V Crede
- Florida State University, Tallahassee, Florida 32306, USA
| | - A D'Angelo
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Università di Roma Tor Vergata, 00133 Rome Italy
| | - N Dashyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - R De Vita
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - M Defurne
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Deur
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Dilks
- Duke University, Durham, North Carolina 27708-0305, USA
| | - C Djalali
- Ohio University, Athens, Ohio 45701, USA
| | - M Dugger
- Arizona State University, Tempe, Arizona 85281, USA
| | - R Dupre
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - H Egiyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Ehrhart
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - A El Alaoui
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - L El Fassi
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - L Elouadrhiri
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Fegan
- University of York, York YO10 5DD, United Kingdom
| | - A Filippi
- INFN, Sezione di Torino, 10125 Torino, Italy
| | - T Forest
- Idaho State University, Pocatello, Idaho 83209, USA
| | - G Gavalian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - G P Gilfoyle
- University of Richmond, Richmond, Virginia 23173, USA
| | - F X Girod
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D I Glazier
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - A A Golubenko
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - R W Gothe
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - Y Gotra
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K A Griffioen
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - M Guidal
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - K Hafidi
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - H Hakobyan
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - M Hattawy
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - F Hauenstein
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - T B Hayward
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - D Heddle
- Christopher Newport University, Newport News, Virginia 23606, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Hicks
- Ohio University, Athens, Ohio 45701, USA
| | - A Hobart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Holtrop
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
| | - C E Hyde
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - D G Ireland
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - E L Isupov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - H S Jo
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - R Johnston
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - S Joosten
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - D Keller
- University of Virginia, Charlottesville, Virginia 22901, USA
| | - M Khachatryan
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Khanal
- Florida International University, Miami, Florida 33199, USA
| | - W Kim
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - A Kripko
- II. Physikalisches Institut der Universität Gießen, 35392 Gießen, Germany
| | - V Kubarovsky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S E Kuhn
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - L Lanza
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
| | - M Leali
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - S Lee
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - P Lenisa
- Universitá di Ferrara, 44121 Ferrara, Italy
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - K Livingston
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - Z Lu
- School of Physics, Southeast University, Nanjing 211189, Jiangsu, China
| | | | - D Marchand
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - N Markov
- University of Connecticut, Storrs, Connecticut 06269, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Marsicano
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - V Mascagna
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi dell'Insubria, 22100 Como, Italy
| | - B McKinnon
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - Z E Meziani
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - R G Milner
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - T Mineeva
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - M Mirazita
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - V Mokeev
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Moran
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - A Movsisyan
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - C Munoz Camacho
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Nadel-Turonski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Naidoo
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - S Nanda
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - K Neupane
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - S Niccolai
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - G Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - T R O'Connell
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Osipenko
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - M Paolone
- New Mexico State University, P.O. Box 30001, Las Cruces, New Mexico 88003, USA
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - L L Pappalardo
- Universitá di Ferrara, 44121 Ferrara, Italy
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - R Paremuzyan
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E Pasyuk
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - W Phelps
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - O Pogorelko
- National Research Centre Kurchatov Institute-ITEP, Moscow, 117259, Russia
| | - Y Prok
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Prokudin
- Science Division, Penn State University Berks, Reading, Pennsylvania 19610, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - B A Raue
- Florida International University, Miami, Florida 33199, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Ripani
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - J Ritman
- Institute fur Kernphysik (Juelich), Juelich, Germany
| | - A Rizzo
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Università di Roma Tor Vergata, 00133 Rome Italy
| | - C D Roberts
- School of Physics and Institute for Nonperturbative Physics, Nanjing University, Nanjing 210093, Jiangsu, China
| | - P Rossi
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Rowley
- Ohio University, Athens, Ohio 45701, USA
| | - F Sabatié
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Salgado
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - A Schmidt
- The George Washington University, Washington, D.C. 20052, USA
| | - E P Segarra
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - Y G Sharabian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - U Shrestha
- Ohio University, Athens, Ohio 45701, USA
| | - P Simmerling
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - D Sokhan
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - O Soto
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - N Sparveris
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - S Stepanyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Stoler
- Rensselaer Polytechnic Institute, Troy, New York 12180-3590, USA
| | - I I Strakovsky
- The George Washington University, Washington, D.C. 20052, USA
| | - S Strauch
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Tezgin
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - A Thornton
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - N Tyler
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - R Tyson
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M Ungaro
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Venturelli
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - H Voskanyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - A Vossen
- Duke University, Durham, North Carolina 27708-0305, USA
| | - E Voutier
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - D P Watts
- University of York, York YO10 5DD, United Kingdom
| | - K Wei
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - X Wei
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S-S Xu
- School of Science, Nanjing University of Posts and Telecommunications, Nanjing 210023, Jiangsu, China
| | - B Yale
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - N Zachariou
- University of York, York YO10 5DD, United Kingdom
| | - J Zhang
- University of Virginia, Charlottesville, Virginia 22901, USA
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12
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Chatagnon P, Niccolai S, Stepanyan S, Amaryan MJ, Angelini G, Armstrong WR, Atac H, Ayerbe Gayoso C, Baltzell NA, Barion L, Bashkanov M, Battaglieri M, Bedlinskiy I, Benmokhtar F, Bianconi A, Biondo L, Biselli AS, Bondi M, Bossù F, Boiarinov S, Briscoe WJ, Brooks WK, Bulumulla D, Burkert VD, Carman DS, Carvajal JC, Caudron M, Celentano A, Chetry T, Ciullo G, Clark L, Cole PL, Contalbrigo M, Costantini G, Crede V, D'Angelo A, Dashyan N, Defurne M, De Vita R, Deur A, Diehl S, Djalali C, Dupré R, Egiyan H, Ehrhart M, El Alaoui A, El Fassi L, Elouadrhiri L, Fegan S, Fersch R, Filippi A, Gavalian G, Ghandilyan Y, Gilfoyle GP, Girod FX, Glazier DI, Golubenko AA, Gothe RW, Gotra Y, Griffioen KA, Guidal M, Guo L, Hakobyan H, Hattawy M, Hayward TB, Heddle D, Hobart A, Holtrop M, Hyde CE, Ilieva Y, Ireland DG, Isupov EL, Jo HS, Joo K, Kabir ML, Keller D, Khachatryan G, Khanal A, Kim A, Kim W, Kripko A, Kubarovsky V, Kuhn SE, Lanza L, Leali M, Lee S, Lenisa P, Livingston K, MacGregor IJD, Marchand D, Marsicano L, Mascagna V, McKinnon B, McLauchlin C, Migliorati S, Mirazita M, Mokeev V, Montgomery RA, Munoz Camacho C, Nadel-Turonski P, Naidoo P, Neupane K, O'Connell TR, Osipenko M, Ouillon M, Pandey P, Paolone M, Pappalardo LL, Paremuzyan R, Pasyuk E, Phelps W, Pogorelko O, Poudel J, Price JW, Prok Y, Raue BA, Reed T, Ripani M, Rizzo A, Rossi P, Rowley J, Sabatié F, Schmidt A, Segarra EP, Sharabian YG, Shirokov EV, Shrestha U, Sokhan D, Soto O, Sparveris N, Strakovsky II, Strauch S, Tyler N, Tyson R, Ungaro M, Vallarino S, Venturelli L, Voskanyan H, Vossen A, Voutier E, Watts DP, Wei K, Wei X, Wishart R, Yale B, Zachariou N, Zhang J, Zhao ZW. First Measurement of Timelike Compton Scattering. Phys Rev Lett 2021; 127:262501. [PMID: 35029502 DOI: 10.1103/physrevlett.127.262501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/21/2021] [Accepted: 11/11/2021] [Indexed: 06/14/2023]
Abstract
We present the first measurement of the timelike Compton scattering process, γp→p^{'}γ^{*}(γ^{*}→e^{+}e^{-}), obtained with the CLAS12 detector at Jefferson Lab. The photon beam polarization and the decay lepton angular asymmetries are reported in the range of timelike photon virtualities 2.25<Q^{'2}<9 GeV^{2}, squared momentum transferred 0.1<-t<0.8 GeV^{2}, and average total center-of-mass energy squared s=14.5 GeV^{2}. The photon beam polarization asymmetry, similar to the beam-spin asymmetry in deep virtual Compton scattering, is sensitive to the imaginary part of the Compton form factors and provides a way to test the universality of the generalized parton distributions. The angular asymmetry of the decay leptons accesses the real part of the Compton form factors and thus the D-term in the parametrization of the generalized parton distributions.
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Affiliation(s)
- P Chatagnon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - S Niccolai
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - S Stepanyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M J Amaryan
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - G Angelini
- The George Washington University, Washington, D.C. 20052, USA
| | - W R Armstrong
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - H Atac
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - C Ayerbe Gayoso
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - N A Baltzell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Barion
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - M Bashkanov
- University of York, York YO10 5DD, United Kingdom
| | - M Battaglieri
- INFN, Sezione di Genova, 16146 Genova, Italy
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - I Bedlinskiy
- National Research Centre Kurchatov Institute-ITEP, Moscow, 117259, Russia
| | - F Benmokhtar
- Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
| | - A Bianconi
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - L Biondo
- INFN, Sezione di Genova, 16146 Genova, Italy
- INFN, Sezione di Catania, 95123 Catania, Italy
- Universit'a degli Studi di Messina, 98166 Messina, Italy
| | - A S Biselli
- Fairfield University, Fairfield, Connecticut 06824, USA
| | - M Bondi
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - F Bossù
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Boiarinov
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - W J Briscoe
- The George Washington University, Washington, D.C. 20052, USA
| | - W K Brooks
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - D Bulumulla
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - V D Burkert
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D S Carman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J C Carvajal
- Florida International University, Miami, Florida 33199, USA
| | - M Caudron
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - A Celentano
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - T Chetry
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
- Ohio University, Athens, Ohio 45701, USA
| | - G Ciullo
- Universita' di Ferrara, 44121 Ferrara, Italy
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - L Clark
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - P L Cole
- Lamar University, 4400 M. L. King, Jr. Boulevard, P.O. Box 10046, Beaumont, Texas 77710, USA
| | | | - G Costantini
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - V Crede
- Florida State University, Tallahassee, Florida 32306, USA
| | - A D'Angelo
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Universita' di Roma Tor Vergata, 00133 Rome, Italy
| | - N Dashyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - M Defurne
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - R De Vita
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - A Deur
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Diehl
- University of Connecticut, Storrs, Connecticut 06269, USA
- II Physikalisches Institut der Universitaet Giessen, 35392 Giessen, Germany
| | - C Djalali
- Ohio University, Athens, Ohio 45701, USA
| | - R Dupré
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - H Egiyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Ehrhart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - A El Alaoui
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - L El Fassi
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - L Elouadrhiri
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Fegan
- University of York, York YO10 5DD, United Kingdom
| | - R Fersch
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - A Filippi
- INFN, Sezione di Torino, 10125 Torino, Italy
| | - G Gavalian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Y Ghandilyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - G P Gilfoyle
- University of Richmond, Richmond, Virginia 23173, USA
| | - F X Girod
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D I Glazier
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - A A Golubenko
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - R W Gothe
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - Y Gotra
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K A Griffioen
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - M Guidal
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - L Guo
- Florida International University, Miami, Florida 33199, USA
| | - H Hakobyan
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - M Hattawy
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - T B Hayward
- University of Connecticut, Storrs, Connecticut 06269, USA
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - D Heddle
- Christopher Newport University, Newport News, Virginia 23606, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Hobart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Holtrop
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
| | - C E Hyde
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - Y Ilieva
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - D G Ireland
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - E L Isupov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - H S Jo
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - K Joo
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M L Kabir
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - D Keller
- University of Virginia, Charlottesville, Virginia 22901, USA
| | | | - A Khanal
- Florida International University, Miami, Florida 33199, USA
| | - A Kim
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - W Kim
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - A Kripko
- II Physikalisches Institut der Universitaet Giessen, 35392 Giessen, Germany
| | - V Kubarovsky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S E Kuhn
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - L Lanza
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
| | - M Leali
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - S Lee
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - P Lenisa
- Universita' di Ferrara, 44121 Ferrara, Italy
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - K Livingston
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | | | - D Marchand
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - L Marsicano
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - V Mascagna
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi dell'Insubria, 22100 Como, Italy
| | - B McKinnon
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - C McLauchlin
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - S Migliorati
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - M Mirazita
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - V Mokeev
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - C Munoz Camacho
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Nadel-Turonski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Naidoo
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - K Neupane
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - T R O'Connell
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Osipenko
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - M Ouillon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Pandey
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - M Paolone
- New Mexico State University, P.O. Box 30001, Las Cruces, New Mexico 88003, USA
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - L L Pappalardo
- Universita' di Ferrara, 44121 Ferrara, Italy
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - R Paremuzyan
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E Pasyuk
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - W Phelps
- Christopher Newport University, Newport News, Virginia 23606, USA
- The George Washington University, Washington, D.C. 20052, USA
| | - O Pogorelko
- National Research Centre Kurchatov Institute-ITEP, Moscow, 117259, Russia
| | - J Poudel
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - J W Price
- California State University, Dominguez Hills, Carson, California 90747, USA
| | - Y Prok
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - B A Raue
- Florida International University, Miami, Florida 33199, USA
| | - T Reed
- Florida International University, Miami, Florida 33199, USA
| | - M Ripani
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - A Rizzo
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Universita' di Roma Tor Vergata, 00133 Rome, Italy
| | - P Rossi
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Rowley
- Ohio University, Athens, Ohio 45701, USA
| | - F Sabatié
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Schmidt
- The George Washington University, Washington, D.C. 20052, USA
| | - E P Segarra
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - Y G Sharabian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E V Shirokov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - U Shrestha
- University of Connecticut, Storrs, Connecticut 06269, USA
- Ohio University, Athens, Ohio 45701, USA
| | - D Sokhan
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - O Soto
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - N Sparveris
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - I I Strakovsky
- The George Washington University, Washington, D.C. 20052, USA
| | - S Strauch
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - N Tyler
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - R Tyson
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M Ungaro
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Vallarino
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - L Venturelli
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi di Brescia, 25123 Brescia, Italy
| | - H Voskanyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - A Vossen
- Duke University, Durham, North Carolina 27708-0305, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E Voutier
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - D P Watts
- University of York, York YO10 5DD, United Kingdom
| | - K Wei
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - X Wei
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Wishart
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - B Yale
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - N Zachariou
- University of York, York YO10 5DD, United Kingdom
| | - J Zhang
- University of Virginia, Charlottesville, Virginia 22901, USA
| | - Z W Zhao
- Duke University, Durham, North Carolina 27708-0305, USA
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13
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Naidoo P, Bouharati C, Rambiritch V, Karamchand S, Tafuto BA, Leisegang RF. Glycated haemoglobin reduction and fixed ratio combinations of analogue basal insulin and glucagon-like peptide-1 receptor agonists: A systematic review. World J Meta-Anal 2021; 9:297-308. [DOI: 10.13105/wjma.v9.i3.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 06/05/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fixed ratio combinations (FRCs) of analogue basal insulin and glucagon-like peptide-1 receptor agonists are a newer addition to the therapeutic armamentarium for the management of type 2 diabetes mellitus. They reduce treatment complexity by combining two injectables in a single daily injectable, thus potentially improving adherence and persistence. Clinicians wanting to use FRCs would need to choose between members of the class.
AIM To describe and contrast the glycated haemoglobin reduction of two FRCs of analogue basal insulin and glucagon like peptide-1 receptor agonist in adults with type 2 diabetes mellitus.
METHODS The following Population, Intervention, Comparison, Outcome question was used for the primary analysis: Among adult patients with type 2 diabetes mellitus [P], what is the effect of iGlarLixi [I] compared to IDegLira [C] for bringing about glycaemic control (as measured by reduction in glycosylated haemoglobin) [O]? The Prisma Statement was used as a guideline for framing this systematic review. We searched PubMed, EMBASE and Cochrane library databases and Clinicaltrials.gov using various keywords and medical search headings related to type 2 diabetes mellitus, iGlarlixi, IDegLira and glycated haemoglobin A1c.
RESULTS All 14 studies identified by the systematic search met the primary efficacy endpoint of reduction in glycated haemoglobin. There were no head-to-head studies between the FRCs of iGlarlixi and IDegLira, and we therefore did an indirect comparison based on a common comparator of insulin glargine U100. Both iGlarLixi and IDegLira effectively reduce glycated haemoglobin when compared to insulin glargine U100. However, using indirect comparisons, IDegLira had a greater haemoglobin A1c reducing ability (0.6% vs 0.3%). The indirect comparison is limited by the differences between the studies; the fasting blood glucose targets were slightly higher for iGlarLixi studies when compared to the IDegLira studies (4.0-5.0 mmol/L and 4.4-5.6 mmol/L), and the IDegLira study used a greater average dose of insulin glargine when compared to the iGlarLixi studies (66 U/d vs 40 U/d).
CONCLUSION Both iGlarLixi and IDegLira effectively reduce glycated haemoglobin. Indirect comparisons, using insulin glargine as the common comparator, suggest that IDegLira reduces glycated haemoglobin to a greater extent than iGlarLixi. However, given the limitations of indirect comparisons, robust head to head studies and real-world data would better inform clinician choice and clinical practice guidelines.
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Affiliation(s)
- Poobalan Naidoo
- Department of Nephrology, Inkosi Albert Luthuli Central Hospital, Durban 4092, KwaZulu-Natal, South Africa
| | - Celia Bouharati
- Department of Medical Research, Independent Researcher, Paris 75000, France
| | - Virendra Rambiritch
- Department of Pharmacology, University of KwaZulu-Natal, Durban 3629, KwaZulu-Natal, South Africa
| | - Sumanth Karamchand
- Department of Internal Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town 7600, South Africa
| | - Barbara A Tafuto
- Department of Health Informatics, Rutgers University, Piscataway, NJ 08854, United States
| | - Rory F Leisegang
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala 75236, Sweden
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14
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Hayward TB, Dilks C, Vossen A, Avakian H, Adhikari S, Angelini G, Arratia M, Atac H, Ayerbe Gayoso C, Baltzell NA, Barion L, Battaglieri M, Bedlinskiy I, Benmokhtar F, Bianconi A, Biselli AS, Bondì M, Bossù F, Boiarinov S, Briscoe WJ, Brooks WK, Bulumulla D, Burkert VD, Carman DS, Carvajal JC, Celentano A, Chatagnon P, Chetry T, Ciullo G, Clary BA, Cole PL, Contalbrigo M, Costantini G, Crede V, D'Angelo A, Dashyan N, De Vita R, Defurne M, Deur A, Diehl S, Djalali C, Dupre R, Dugger M, Egiyan H, Ehrhart M, El Alaoui A, El Fassi L, Elouadrhiri L, Fegan S, Filippi A, Forest TA, Gavalian G, Gilfoyle GP, Girod FX, Glazier DI, Golubenko AA, Gothe RW, Gotra Y, Griffioen KA, Guidal M, Hafidi K, Hakobyan H, Hattawy M, Hauenstein F, Hicks K, Hobart A, Holtrop M, Ireland DG, Isupov EL, Jo HS, Joo K, Joosten S, Keller D, Khachatryan M, Khanal A, Kim A, Kim W, Kripko A, Kubarovsky V, Kuhn SE, Lanza L, Leali M, Lee S, Lenisa P, Livingston K, MacGregor IJD, Marchand D, Markov N, Marsicano L, Mascagna V, McKinnon B, Meziani ZE, Mirazita M, Mokeev V, Movsisyan A, Munoz Camacho C, Nadel-Turonski P, Naidoo P, Nanda S, Neupane K, Niccolai S, Niculescu G, O'Connell TR, Osipenko M, Paolone M, Pappalardo LL, Paremuzyan R, Pasyuk E, Phelps W, Pogorelko O, Prok Y, Raue BA, Ripani M, Ritman J, Rizzo A, Rossi P, Rowley J, Sabatié F, Salgado C, Schmidt A, Segarra EP, Sharabian YG, Shrestha U, Sokhan D, Soto O, Sparveris N, Stepanyan S, Strakovsky II, Strauch S, Thornton A, Tyler N, Tyson R, Ungaro M, Venturelli L, Voskanyan H, Voutier E, Watts DP, Wei K, Wei X, Wood MH, Yale B, Zachariou N, Zhang J. Observation of Beam Spin Asymmetries in the Process ep→e^{'}π^{+}π^{-}X with CLAS12. Phys Rev Lett 2021; 126:152501. [PMID: 33929247 DOI: 10.1103/physrevlett.126.152501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/25/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
The observation of beam spin asymmetries in two-pion production in semi-inclusive deep inelastic scattering off an unpolarized proton target is reported. The data presented here were taken in the fall of 2018 with the CLAS12 spectrometer using a 10.6 GeV longitudinally spin-polarized electron beam delivered by CEBAF at JLab. The measured asymmetries provide the first opportunity to extract the parton distribution function e(x), which provides information about the interaction between gluons and quarks, in a collinear framework that offers cleaner access than previous measurements. The asymmetries also constitute the first ever signal sensitive to the helicity-dependent two-pion fragmentation function G_{1}^{⊥}. A clear sign change is observed around the ρ mass that appears in model calculations and is indicative of the dependence of the produced pions on the helicity of the fragmenting quark.
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Affiliation(s)
- T B Hayward
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - C Dilks
- Duke University, Durham, North Carolina 27708-0305, USA
| | - A Vossen
- Duke University, Durham, North Carolina 27708-0305, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - H Avakian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Adhikari
- Florida International University, Miami, Florida 33199, USA
| | - G Angelini
- The George Washington University, Washington, D.C. 20052, USA
| | - M Arratia
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- University of California, Riverside, Riverside, California 92521, USA
| | - H Atac
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - C Ayerbe Gayoso
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - N A Baltzell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Barion
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - M Battaglieri
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - I Bedlinskiy
- National Research Centre Kurchatov Institute-ITEP, Moscow 117259, Russia
| | - F Benmokhtar
- Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
| | - A Bianconi
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - A S Biselli
- Fairfield University, Fairfield, Connecticut 06824, USA
| | - M Bondì
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - F Bossù
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Boiarinov
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - W J Briscoe
- The George Washington University, Washington, D.C. 20052, USA
| | - W K Brooks
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - D Bulumulla
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - V D Burkert
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D S Carman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J C Carvajal
- Florida International University, Miami, Florida 33199, USA
| | - A Celentano
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - P Chatagnon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - T Chetry
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
- Ohio University, Athens, Ohio 45701, USA
| | - G Ciullo
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
- Università di Ferrara, 44121 Ferrara, Italy
| | - B A Clary
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - P L Cole
- Lamar University, 4400 MLK Boulevard, P.O. Box 10046, Beaumont, Texas 77710, USA
| | | | - G Costantini
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - V Crede
- Florida State University, Tallahassee, Florida 32306, USA
| | - A D'Angelo
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Università di Roma Tor Vergata, 00133 Rome, Italy
| | - N Dashyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - R De Vita
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - M Defurne
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Deur
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Diehl
- University of Connecticut, Storrs, Connecticut 06269, USA
- II. Physikalisches Institut der Universität Gießen, 35392 Gießen, Germany
| | - C Djalali
- Ohio University, Athens, Ohio 45701, USA
| | - R Dupre
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Dugger
- Arizona State University, Tempe, Arizona 85287, USA
| | - H Egiyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Ehrhart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - A El Alaoui
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
| | - L El Fassi
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - L Elouadrhiri
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Fegan
- University of York, York YO10 5DD, United Kingdom
| | - A Filippi
- INFN, Sezione di Torino, 10125 Torino, Italy
| | - T A Forest
- Idaho State University, Pocatello, Idaho 83209, USA
| | - G Gavalian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - G P Gilfoyle
- University of Richmond, Richmond, Virginia 23173, USA
| | - F X Girod
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D I Glazier
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - A A Golubenko
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - R W Gothe
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - Y Gotra
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K A Griffioen
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - M Guidal
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - K Hafidi
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - H Hakobyan
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - M Hattawy
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - F Hauenstein
- Old Dominion University, Norfolk, Virginia 23529, USA
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - K Hicks
- Ohio University, Athens, Ohio 45701, USA
| | - A Hobart
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Holtrop
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
| | - D G Ireland
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - E L Isupov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - H S Jo
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - K Joo
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - S Joosten
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - D Keller
- University of Virginia, Charlottesville, Virginia 22901, USA
| | - M Khachatryan
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Khanal
- Florida International University, Miami, Florida 33199, USA
| | - A Kim
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - W Kim
- Kyungpook National University, Daegu 41566, Republic of Korea
| | - A Kripko
- II. Physikalisches Institut der Universität Gießen, 35392 Gießen, Germany
| | - V Kubarovsky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S E Kuhn
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - L Lanza
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
| | - M Leali
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - S Lee
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - P Lenisa
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
- Università di Ferrara, 44121 Ferrara, Italy
| | - K Livingston
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | | | - D Marchand
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - N Markov
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - L Marsicano
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - V Mascagna
- INFN, Sezione di Pavia, 27100 Pavia, Italy
- Università degli Studi dell'Insubria, 22100 Como, Italy
| | - B McKinnon
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - Z E Meziani
- Temple University, Philadelphia, Pennsylvania 19122, USA
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M Mirazita
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - V Mokeev
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Movsisyan
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
| | - C Munoz Camacho
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Nadel-Turonski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Naidoo
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - S Nanda
- Mississippi State University, Mississippi State, Mississippi 39762-5167, USA
| | - K Neupane
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - S Niccolai
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - G Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - T R O'Connell
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Osipenko
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - M Paolone
- Temple University, Philadelphia, Pennsylvania 19122, USA
- New Mexico State University, P.O. Box 30001, Las Cruces, New Mexico 88003, USA
| | - L L Pappalardo
- INFN, Sezione di Ferrara, 44100 Ferrara, Italy
- Università di Ferrara, 44121 Ferrara, Italy
| | - R Paremuzyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- University of New Hampshire, Durham, New Hampshire 03824-3568, USA
| | - E Pasyuk
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - W Phelps
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - O Pogorelko
- National Research Centre Kurchatov Institute-ITEP, Moscow 117259, Russia
| | - Y Prok
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - B A Raue
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Florida International University, Miami, Florida 33199, USA
| | - M Ripani
- INFN, Sezione di Genova, 16146 Genova, Italy
| | - J Ritman
- Institute fur Kernphysik (Juelich), Juelich 52428, Germany
| | - A Rizzo
- INFN, Sezione di Roma Tor Vergata, 00133 Rome, Italy
- Università di Roma Tor Vergata, 00133 Rome, Italy
| | - P Rossi
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - J Rowley
- Ohio University, Athens, Ohio 45701, USA
| | - F Sabatié
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Salgado
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - A Schmidt
- The George Washington University, Washington, D.C. 20052, USA
| | - E P Segarra
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139-4307, USA
| | - Y G Sharabian
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - U Shrestha
- Ohio University, Athens, Ohio 45701, USA
| | - D Sokhan
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - O Soto
- Universidad Técnica Federico Santa María, Casilla 110-V Valparaíso, Chile
- INFN, Laboratori Nazionali di Frascati, 00044 Frascati, Italy
| | - N Sparveris
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - S Stepanyan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - I I Strakovsky
- The George Washington University, Washington, D.C. 20052, USA
| | - S Strauch
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - A Thornton
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - N Tyler
- University of South Carolina, Columbia, South Carolina 29208, USA
| | - R Tyson
- University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - M Ungaro
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Venturelli
- Università degli Studi di Brescia, 25123 Brescia, Italy
- INFN, Sezione di Pavia, 27100 Pavia, Italy
| | - H Voskanyan
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - E Voutier
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - D P Watts
- University of York, York YO10 5DD, United Kingdom
| | - K Wei
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - X Wei
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M H Wood
- Canisius College, Buffalo, New York 14208-1098, USA
| | - B Yale
- College of William and Mary, Williamsburg, Virginia 23187-8795, USA
| | - N Zachariou
- University of York, York YO10 5DD, United Kingdom
| | - J Zhang
- University of Virginia, Charlottesville, Virginia 22901, USA
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15
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Naidoo P, Bouharati C, Rambiritch V, Jose N, Karamchand S, Chilton R, Leisegang R. Real-world evidence and product development: Opportunities, challenges and risk mitigation. Wien Klin Wochenschr 2021; 133:840-846. [PMID: 33837463 PMCID: PMC8034870 DOI: 10.1007/s00508-021-01851-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/09/2021] [Indexed: 11/25/2022]
Abstract
Real-world evidence (RWE) is derived from real-world data (RWD) sources including electronic health records, claims data, registries (disease, product) and pragmatic clinical trials. The importance of RWE derived from RWD has been once again demonstrated during the coronavirus disease 2019 (COVID-19) pandemic, as it can improve patient care by complementing information obtained from traditional clinical trial programs. Additionally, RWE can generate insights into disease mechanisms, epidemiology, patient flows in and out of healthcare systems, and drivers and barriers to optimal clinical care in real-world settings. Identifying unmet medical needs is crucial as it often can inform which investigational new drugs enter clinical trial testing, and RWE studies from hospital settings have contributed substantial progress here. RWE can also optimize the design of clinical studies, inform benefit risk assessments and use networks of pragmatic studies to help with clinical trial feasibilities and eventual trial initiation. The challenges of RWD include data quality, reproducibility and accuracy which may affect validity. RWD and RWE must be fit for purpose and one must be cognizant of inherent biases.
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Affiliation(s)
- Poobalan Naidoo
- Department of Nephrology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Célia Bouharati
- Clinical Operations and Medical Affairs, Sanofi, Midrand, South Africa.
| | - Virendra Rambiritch
- Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Nadina Jose
- Department of Health Informatics, Rutgers School of Health Professions, The State University of New Jersey, Newark, New Jersey, United States
| | - Sumanth Karamchand
- Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robert Chilton
- Faculty of Medicine, Division of Cardiology and Interventional Cardiology, University of Texas Health Science Centre at San Antonio, San Antonio, Texas, United States
| | - Rory Leisegang
- Faculty of Pharmacy, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
- Department of Paediatrics and Child Health, Tygerberg Hospital, FAMCRU, Stellenbosch University, Cape Town, South Africa
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16
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Inderlall R, Naidoo P. Role of pharmacists in the provision of palliative care services and support in South Africa. Int J Pharm Pract 2021; 29:157-163. [PMID: 33729521 DOI: 10.1093/ijpp/riaa013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 10/13/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVES South Africa (SA) has high demand but inequitable access to palliative care (PC). Realising this need and the growing recognition of pharmacists' in PC globally, a study was undertaken regarding the role of pharmacists in the provision of PC services and support in SA. METHOD A descriptive cross-sectional quantitative study was conducted among 540 community and hospital pharmacists. A self-administered, closed-ended questionnaire covering knowledge, attitude, current role, future role and barriers to PC was used. Data was coded and analysed using SPSS® Version 24.0. P-values < 0.05 were considered statistically significant. KEY FINDINGS Response rate was 48.7% (n = 263). Pharmacists (72.2%) were already playing a role in PC, however, only 20.5% reported frequent involvement in PC. Services provided included medicine supply (88.2%), side-effect/symptom management (82.1%), information sharing (60.8%), bereavement counselling (60.8%), treatment/care needs (57.4%) and spiritual support (52.1%). More pharmacists (96.6%) wanted to play a role in PC, beyond medicine supply to include PC team member (91.6%), medicine reviews (91.3%), referrals (80.2%) and patient visits (50.6%). Pharmacists had a good knowledge (71.4%) and a positive attitude (61.5%) towards PC despite many health system barriers such as lack of training (91.3%), inadequate clinical experience (90.5%) and insufficient resources (77.2%). CONCLUSIONS Pharmacists with their high level of knowledge, positive attitude and broad scope of practice are well-placed to play a role in PC. Further strengthening and integration of their roles into the continuum of care, will encourage the involvement of more pharmacists, enhancing availability, access and resources for PC.
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Affiliation(s)
- R Inderlall
- Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - P Naidoo
- Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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17
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Karamchand S, Williams M, Naidoo P, Decloedt E, Allwood B. Post-tuberculous lung disease: should we be using Theophylline? J Thorac Dis 2021; 13:1230-1238. [PMID: 33717595 PMCID: PMC7947523 DOI: 10.21037/jtd-20-1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Tuberculosis affects 10 million people and over 320,000 South Africans every year. A significant proportion of patients treated for tuberculosis develop post-tuberculous lung disease (PTBLD), a disease of chronic respiratory impairment for which there is a lack of affordable treatment options. PTBLD a heterogenous disorder that shares phenotypical features with chronic obstructive lung disease, bronchiectasis, lung fibrosis and destruction as well as pulmonary hypertension. There remains a paucity of proven pharmacotherapy for the management of PTBLD. Theophylline, a widely available and affordable medicine that has largely fell out of favour in high-income settings due to its toxicity and narrow therapeutic index, may be repositioned for the treatment of PTBLD. In this review, we unpack the potential role of theophylline in the management of PTBLD by reviewing the evidence for its bronchodilatory, anti-inflammatory and potential pleotrophic effects.
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Affiliation(s)
- Sumanth Karamchand
- Division of Pulmonology, Western Cape Department of Health, Tygerberg Hospital, Bellville, South Africa
| | - Morne Williams
- Division of Pulmonology, Western Cape Department of Health, Tygerberg Hospital, Bellville, South Africa
| | - Poobalan Naidoo
- Department of Informatics, School of Health Professions, Rutgers University, New Jersey, USA
| | - Eric Decloedt
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Bellville, South Africa
| | - Brian Allwood
- Division of Pulmonology, Western Cape Department of Health, Tygerberg Hospital, Bellville, South Africa
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18
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Blom DJ, Ranjith N, Joshi P, Naidoo P, van Tonder A, Musa MG, Joshi S, Leisegang R, Trokis JS, Makan H, Raal FJ. The therapeutic management of South African dyslipidaemic patients at very high cardiovascular risk (CARDIO TRACK): a cross-sectional study. Cardiovasc J Afr 2021; 31:245-251. [PMID: 33151240 PMCID: PMC8762769 DOI: 10.5830/cvja-2020-010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 05/16/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Dyslipidaemia is a major modifiable risk factor for atherosclerotic cardiovascular disease. At the time the study was conducted, guidelines recommended a low-density lipoprotein cholesterol (LDL-C) target of less than 1.8 mmol/l and a reduction of at least 50% if the baseline LDL-C was between 1.8 and 3.5 mmol/l in patients with either very high cardiovascular risk or established atherosclerosis. In South Africa, there is a paucity of data on attainment of LDL-C goal in patients with very high cardiovascular risk who are on maximum tolerated statin with or without ezetimibe. OBJECTIVE The aim was to assess the percentage of very high cardiovascular risk South African patients with dyslipidaemia not reaching an LDL-C goal of less than 1.8 mmol/l, despite maximum tolerated statin with or without ezetimibe. METHODS This was a multi-centre, observational, cross-sectional study conducted at 15 private healthcare sector sites and one public sector site. Adults (> 18 years) with very high cardiovascular risk of familial hypercholesterolaemia receiving stable, maximum-tolerated statin therapy for at least four weeks prior to their latest lipid profile were enrolled into the study, and electronic case report forms were completed after written informed consent was provided. LDL-C goal attainment was modelled, first assuming an increase in the statin dose to the registered maximum, followed by the addition of ezetimibe or a PCSK9-inhibitor. RESULTS In total, 507 patients were screened, of whom 492 were eligible for study participation. One patient was excluded from the analysis because of a missing LDL-C value. Most participants were male (male 329, 67%; female 162, 33%). Most patients were either obese (223, 46.0%) or overweight (176, 36.3%). Hypertension and diabetes mellitus were frequent co-morbidities and were found in 381 (77.6%) and 316 (64.4%) patients, respectively. Eighty (16.3%) patients reported current smoking. Only 68 (13.8%) patients were taking ezetimibe in addition to a statin. Reasons for not using ezetimibe included no requirement for ezetimibe in the opinion of the treating physician (229, 48.7%), cost (149, 31.7%), Physician's choice (39, 8.3%), or other (53, 11.3%). Only 161 (32.8%) of the patients attained their goal LDL-C level. In our modelling analysis, increasing the statin dose to the registered maximum and adding ezetimibe brought an additional 34.5% of patients to goal, while adding a PCSK9-inhibitor, irrespective of any other changes to lipid-lowering therapy brought over 90% of not-at-goal patients to goal. CONCLUSIONS Most study participants were not at LDL-C goal despite maximum-tolerated statin, highlighting the need for treatment intensification in this high-risk population. Although intensifying treatment by adding a PCSK9-inhibitor brought more patients to goal, the initial addition of ezetimibe would be more reasonable, given the cost of PCSK9-inhibitors.
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Affiliation(s)
- Dirk Jacobus Blom
- Division of Lipidology and Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | | | - Pankaj Joshi
- Diabetes Care and Clinical Trials Centre, Pretoria, South Africa
| | - Poobalan Naidoo
- Medical Affairs, Sanofi, Midrand, South Africa; Department of Health Informatics, School of Health Professions, Rutgers, State University of New Jersey, NJ, USA
| | | | | | - Shaifali Joshi
- Diabetes Care and Clinical Trials Centre, Pretoria, South Africa
| | - Rory Leisegang
- Department of Pharmaceutical Biosciences, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden; Family Clinical Research Unit (FAM-CRU), University of Stellenbosch, Tygerberg Hospital, Tygerberg, South Africa
| | | | | | - Frederick Johan Raal
- Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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19
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Affiliation(s)
- Poobalan Naidoo
- Department of Nephrology, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, South Africa
| | - Yeshkhir Naidoo
- Department of Radiology, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, South Africa
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20
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Raal FJ, Chilton R, Ranjith N, Rambiritch V, Leisegang RF, Ebrahim IO, Tonder AV, Shunmoogam N, Bouharati C, Musa MG, Karamchand S, Naidoo P, Blom DJ. PCSK9 Inhibitors: From Nature’s Lessons to Clinical Utility. Endocr Metab Immune Disord Drug Targets 2020; 20:840-854. [DOI: 10.2174/1871530320666200213114138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Received: 09/14/2019] [Revised: 10/31/2019] [Accepted: 12/02/2019] [Indexed: 12/21/2022]
Abstract
Background:
Proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors are a novel
class of non-statin lipid lowering therapy that reduce LDL-cholesterol by 50 - 60%. PCSK9 inhibitors
decrease LDL-cholesterol by preventing intracellular degradation of LDL receptors; subsequently, a
greater number of LDL-receptors are available on the cell surface to extract circulating LDL.
Objective:
To describe the origins of PCSK9 inhibitors and their current use in clinical practice.
Methods:
We performed a narrative review of the PCSK9 inhibitor class of drugs.
Results:
Current data indicate that PCSK9 inhibitors effectively reduce LDL-cholesterol and are well
tolerated and safe. PCSK9 inhibitors have also been shown to reduce cardiovascular event rates in
patients with stable atherosclerotic cardiovascular disease and in patients with a recent (up to one year)
acute coronary syndrome. Given the costs, chronicity of the treatment and the potential budget impact,
PCSK9 inhibitors are often limited to patients with the highest absolute risk for major adverse cardiovascular
events despite optimal treatment with high-intensity statin and ezetimibe.
Conclusion:
PCSK9 inhibitors have a favorable safety, efficacy and tolerability profile. Postmarketing
safety surveillance and real-world studies are needed to further support the long-term safety
profile of this class of medicine.
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Affiliation(s)
- Frederick J. Raal
- Department of Medicine, Division of Endocrinology and Metabolism, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Robert Chilton
- Department of Medicine, Faculty of Medicine, Division of Cardiology and Interventional Cardiology, University of Texas Health Science Center at San Antonia, Texas, United States
| | - Naresh Ranjith
- Department of Cardiology, Cardiovascular Research Centre, Durban, South Africa
| | - Virendra Rambiritch
- Department of Pharmacology, Faculty of Health Sciences, Discipline of Pharmaceutical Sciences, University of Kwa-Zulu Natal, Durban, South Africa
| | - Rory F. Leisegang
- Department of Pharmaceutical Biosciences, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden
| | | | - Alet van Tonder
- Department of Diabetes and Cardiovascular Medicine, Medical Affairs, Sanofi, Midrand, South Africa
| | - Nelusha Shunmoogam
- Department of Diabetes and Cardiovascular Medicine, Medical Affairs, Sanofi, Midrand, South Africa
| | - Célia Bouharati
- Department of Clinical Trials, Clinical Study Unit, Sanofi, Midrand, South Africa
| | - Moji G. Musa
- Department of Diabetes and Cardiovascular Medicine, Medical Affairs, Sanofi, Midrand, South Africa
| | - Sumanth Karamchand
- Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Poobalan Naidoo
- Department of Diabetes and Cardiovascular Medicine, Medical Affairs, Sanofi, Midrand, South Africa
| | - Dirk J. Blom
- Department of Medicine, Division of Lipidology and Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa
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21
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Mbanya JC, Naidoo P, Kolawole BA, Tsymbal E, McMaster A, Karamchand S, Kaplan H, Rambiritch V, Cotton M, Malek R, Allen Distiller L, Leisegang RF. Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7). Medicine (Baltimore) 2020; 99:e20553. [PMID: 32569176 PMCID: PMC7310899 DOI: 10.1097/md.0000000000020553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
There is a paucity of information on real world management of African adult patients with type 1 diabetes mellitus (T1DM). We aimed to describe a cohort of African adults with T1DM.The International Diabetes Management Practices Study is an observational survey conducted from 2005 to 2017. Data were collected in seven individual waves from countries in Asia, Africa, East Europe, and Latin America. Wave 7 was conducted from 2016 to 2017 and the African cohort included 12 countries. Questionnaires were administered to clinicians and patients. Analyses were mainly descriptive. Logistic regressions were performed to identify predictive factors for glycaemic control.A total of 788 patients were enrolled in the study. HbA1c values were available for 712 patients; only 16.6% had HbA1c values <7%. A total of 196 (24.9%) reported being hospitalized in the preceding year, with the most common reasons being diabetic ketoacidosis (58.1%, 93/160) and hypoglycaemia (31.1%; 52/167). Over half of the patients (55.4%) stated that the cost of test strips limited regular glycemic monitoring; a minority of patients (15%, 120/788) received structured diabetes education. Predictors of HbA1c <7% included patients receiving diabetes education (odds ratio [OR] [95% confidence interval, CI] = 2.707 [1.157-6.335] P = .022), following a healthy diet and exercise plan (OR [95% CI] = 2.253 [1.206-4.209], P < .001) and self-managing (monitoring glucose levels and adjusting insulin accordingly) (OR [95% CI] 2.508 [1.500-4.191] P < .001).African adults with T1DM have suboptimal glycemic control with almost one-quarter reporting hospitalization within the preceding year. Most patients felt comfortable with self-adjustment of insulin dose but said that the cost of test strips was the main factor that limited regular monitoring. Reducing direct costs of testing strips and insulin, and improving education will address major challenges within these settings.
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Affiliation(s)
- Jean Claude Mbanya
- Medicine and Endocrinology, Faculty of Medicine and Biological Science, University of Yaoundé
- Biotechnology Center and Doctoral School of Life, Health and Environmental Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - Poobalan Naidoo
- Medical Affairs, Sanofi, Johannesburg, South Africa
- Department of Health Informatics, School of Health Professions, Rutgers, State University of New Jersey, NJ
| | | | | | | | - Sumanth Karamchand
- Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town
| | | | - Virendra Rambiritch
- University of KwaZulu-Natal, Biomedical Research Ethics Committee and Discipline of Pharmaceutical Sciences, KwaZulu-Natal
| | - Mark Cotton
- Family Clinical Research Unit (FAMCRU), Tygerberg Hospital, Department of Pediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - Rachid Malek
- Department of Internal Medicine, CHU Sétif, Algeria
| | | | - Rory Forseth Leisegang
- Clinical Pharmacology & Toxicology, University Hospital / Inselspital Bern, Bern, Switzerland
- Pharmacometrics, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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22
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D'Andrea I, Naidoo P, Schoeman E, Kotze C. Closed positive end-expiratory pressure system: Pre-oxygenation and ventilatory support in COVID-19. S Afr Med J 2020; 110:12916. [PMID: 32880538] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023] Open
Affiliation(s)
- I D'Andrea
- Drs Mabasa and D'Andrea Inc., Emergency Physicians, Century City, Cape Town, South Africa.
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23
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Marx FM, Cohen T, Lombard C, Hesseling AC, Dlamini SS, Beyers N, Naidoo P. Notification of relapse and other previously treated tuberculosis in the 52 health districts of South Africa. Int J Tuberc Lung Dis 2020; 23:891-899. [PMID: 31533878 DOI: 10.5588/ijtld.18.0609] [Citation(s) in RCA: 2] [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] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To investigate the extent to which relapse and other previously treated tuberculosis (TB) contribute to the notified TB burden in South Africa.DESIGN: We conducted an ecological analysis at the level of the 52 South African health districts using national electronic TB register data. We included all bacteriologically confirmed TB cases treated for presumed drug-susceptible TB in 2011. Treatment history information was based on recorded patient categories (new vs. retreatment).RESULTS: Relapse and other previously treated TB cases constituted between 7.6% and 40% (median 17%, interquartile range 12-22) of all bacteriologically confirmed TB cases in the 52 South African districts. Multivariable analysis suggested that districts with higher proportions of previously treated TB cases had higher TB case notification rates (P < 0.001), lower estimates of antenatal human immunodeficiency virus (HIV) prevalence in the district population (P < 0.001) as well as lower HIV co-infection rates (P < 0.001) among new TB cases.CONCLUSION: Relapse and other previously treated TB cases contributed substantially to the notified TB burden in several South African health districts, particularly those with high case notification rates and lower antenatal HIV prevalence. Additional efforts to prevent TB among previously treated people, such as strengthening treatment monitoring and/or secondary preventive therapy, should be considered.
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Affiliation(s)
- F M Marx
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - T Cohen
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - C Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town
| | - A C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - S S Dlamini
- Research, Information Monitoring, Evaluation & Surveillance (RIMES), National TB Programme (NTP), National Department of Health, Pretoria, South Africa
| | - N Beyers
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - P Naidoo
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
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24
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du Preez K, Schaaf HS, Dunbar R, Swartz A, Naidoo P, Hesseling AC. Closing the reporting gap for childhood tuberculosis in South Africa: improving hospital referrals and linkages. Public Health Action 2020; 10:38-46. [PMID: 32368523 DOI: 10.5588/pha.19.0053] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/08/2019] [Indexed: 12/29/2022] Open
Abstract
Setting A referral hospital in Cape Town, Western Cape Province, Republic of South Africa. Objective To measure the impact of a hospital-based referral service (intervention) to reduce initial loss to follow-up among children with tuberculosis (TB) and ensure the completeness of routine TB surveillance data. Design A dedicated TB referral service was established in the paediatric wards at Tygerberg Hospital, Cape Town, in 2012. Allocated personnel provided TB education and counselling, TB referral support and weekly telephonic follow-up after hospital discharge. All children identified with TB were matched to electronic TB treatment registers (ETR.Net/EDRWeb). Multivariable logistic regression was used to compare reporting of culture-confirmed and drug-susceptible TB cases before (2007-2009) and during (2012) the intervention. Results Successful referral with linkage to care was confirmed in 267/272 (98%) and successful reporting in 227/272 (84%) children. Children with drug-susceptible, culture-confirmed TB were significantly more likely to be reported during the intervention period than in the pre-intervention period (OR 2.52, 95%CI 1.33-4.77). The intervention effect remained consistent in multivariable analysis (adjusted OR 2.62; 95%CI 1.31-5.25) after adjusting for age, sex, human immunodeficiency virus status and the presence of TB meningitis. Conclusions A simple hospital-based TB referral service can reduce initial loss to follow-up and improve recording and reporting of childhood TB in settings with decentralised TB services.
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Affiliation(s)
- K du Preez
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - H S Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Paediatrics and Child Health, Tygerberg Hospital, Cape Town, South Africa
| | - R Dunbar
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - A Swartz
- Western Cape Department of Health, Cape Town, South Africa
| | - P Naidoo
- Public health management consultant, Cape Town, South Africa
| | - A C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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25
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Jacobson B, Rambiritch V, Paek D, Sayre T, Naidoo P, Shan J, Leisegang R. Safety and Efficacy of Enoxaparin in Pregnancy: A Systematic Review and Meta-Analysis. Adv Ther 2020; 37:27-40. [PMID: 31673991 PMCID: PMC6979442 DOI: 10.1007/s12325-019-01124-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Indexed: 12/19/2022]
Abstract
Introduction International guidelines support the use of low molecular weight heparins for the treatment of thromboembolism and thromboprophylaxis during pregnancy. However, evidence of the benefit and harm associated with specific low molecular weight heparins such as enoxaparin is dated. No current systematic review and meta-analysis describing the safety and efficacy of enoxaparin for thromboembolism and thromboprophylaxis during pregnancy exists. Methods PubMed, Embase, and Cochrane databases were searched on August 17, 2018 for clinical trials or observational studies in pregnant women receiving enoxaparin; patients with a prosthetic heart valve were excluded. Risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random effects model, and heterogeneity was measured using the I2 statistic. Results Of the 485 records identified in the search, 24 studies published clinical trials, and observational studies were found dating back to 2000. Only one observational cohort and one randomized control trial focused on the use of enoxaparin for thromboprophylaxis and therefore efficacy was not assessed; the other studies included women with recurrent pregnancy loss (15 studies), history of placental vascular complications (five studies), and recurrent in vitro fertilization failure (two studies) and were therefore analyzed in terms of safety only. Bleeding events were non-significantly more often reported for enoxaparin compared to untreated controls (RR 1.35 [0.88–2.07]) but less often reported for enoxaparin versus aspirin (RR 0.93 [0.62–1.39]); thromboembolic events, thrombocytopenia, and teratogenicity were rarely reported events; in patients with a history of recurrent pregnancy loss, encouragingly the rates of pregnancy loss were significantly lower for enoxaparin compared to untreated controls (RR 0.58 [0.34–0.96]) and enoxaparin + aspirin versus aspirin alone (RR 0.42 [0.32–0.56]) as well as observably lower for enoxaparin versus aspirin alone (RR 0.39 [0.15–1.01]), though significant heterogeneity was observed (I2 > 60). Conclusion Literature on the efficacy and safety of enoxaparin for thromboembolism and thromboprophylaxis remains scanty, and therefore efficacy was not assessed; in terms of safety, when including other indications for enoxaparin in pregnancy, we found that enoxaparin was associated with significantly lower complications than aspirin. Given differences in study design and study heterogeneity, pregnancy loss results should be interpreted with caution. Moreover, reports of thromboembolic events, thrombocytopenia, and congenital malformations were rare. Funding Sanofi. Electronic supplementary material The online version of this article (10.1007/s12325-019-01124-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Barry Jacobson
- Department of Haematology and Molecular Medicine, University of Witwatersrand, 1 Jan Smuts Ave, Johannesburg, South Africa
| | - Virendra Rambiritch
- Department of Pharmacology, University of KwaZulu-Natal, University Rd, Westville, South Africa
| | - Dara Paek
- Doctor Evidence, 301 Arizona Ave, Santa Monica, CA, USA
| | - Tobias Sayre
- Doctor Evidence, 301 Arizona Ave, Santa Monica, CA, USA
| | - Poobalan Naidoo
- Sanofi Affiliate, Medical, 2 Bond St, Grand Central, Midrand, South Africa
- Department of Health Informatics, School of Health Professions, Rutgers, State University of New Jersey, 57 US Highway 1, New Brunswick, NJ, USA
| | - Jenny Shan
- Sanofi Global, Medical, 54-56 Rue la Boétie, Paris, France
| | - Rory Leisegang
- Department of Pharmaceutical Biosciences, Uppsala University, 752 36, Uppsala, Sweden.
- FAMCRU, The Department of Paediatrics & Child Health, Stellenbosch University, Tygerberg, Cape Town, South Africa.
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Koot D, McMaster A, Nel M, van Tonder A, Barret A, Naidoo P. Medical Science Liaisons (MSL) in Africa: a perspective. Pan Afr Med J 2019; 33:313. [PMID: 31692862 PMCID: PMC6815476 DOI: 10.11604/pamj.2019.33.313.15143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 08/07/2019] [Indexed: 11/22/2022] Open
Abstract
The role of a Medical Science Liaison (MSL) is of growing importance to pharmaceutical, biotechnology, diagnostic and medical device companies. Through scientific engagement MSLs add value to clinical practice, ultimately benefiting patients. The MSL role is dynamic and encompasses in-depth product and disease knowledge together with the ability to communicate relevant, unbiased scientific information concisely and timely. Tasks are focused on contributing towards the advancement of medical knowledge, scientific data generation and dissemination. Professional relationships are developed, fostering collaboration between external experts and typically the medical affairs departments of pharmaceutical companies through a credible liaison. Through such relationships, critical insights are shared that shape the development pipeline, promote successful clinical translation and guide the market deployment strategy of therapeutic interventions through-out their life cycle. Despite the rising number of MSLs in the field and the implicit medical value of the role, there remains a lack of understanding for what the roles of a MSL entails. In Africa, where exponential growth of the pharmaceutical industry is expected, the number of MSLs will increase rapidly. Given the complexities of the African continent, the MSLs in this burgeoning environment will face various challenges including remote locations, time-constraints, regulatory and bureaucratic hurdles and importantly physician misperception of the MSL role that collectively may thwart the goal of meaningful scientific engagement; but these challenges can be surmounted through astute proactive planning and utilization of opportunities including digital communication strategies.
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Affiliation(s)
- Dwayne Koot
- Sanofi Medical Affairs, Midrand, South Africa
| | | | - Monique Nel
- Sanofi Medical Affairs, Midrand, South Africa
| | | | - Alan Barret
- Sanofi Medical Affairs, Midrand, South Africa
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Blom DJ, Breedt J, Burgess LJ, Ebrahim IO, Ellis G, Soma P, van der Walt E, Naidoo P, van Tonder A, Raal FJ. Long-term safety and efficacy of alirocumab in South African patients with heterozygous familial hypercholesterolaemia: the ODYSSEY Open-Label Extension study. Cardiovasc J Afr 2019; 30:279-284. [PMID: 31512717 DOI: 10.5830/cvja-2019-039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 06/21/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Alirocumab reduces low-density lipoprotein cholesterol (LDL-C) levels by up to 61%. The ODYSSEY Open-Label Extension study investigated the effect of alirocumab in patients with heterozygous familial hypercholesterolaemia (HeFH) over 144 weeks. METHODS Eligible patients with HeFH had completed an earlier double-blind, randomised, placebo-controlled parent study. Patients were initiated on 75 mg alirocumab Q2W subcutaneous (SC) unless baseline LDL-C was > 8.9 mmol/l, in which case they received 150 mg alirocumab Q2W. Dose titration to 150 mg Q2W was at the investigator's discretion. RESULTS The study enrolled 167 patients and the parent study mean (± SD) baseline LDL-C level was 3.65 ± 1.9 mmol/l. Mean LDL-C level was reduced by 48.7% at week 144; mean on-treatment LDL-C was 2.30 ± 1.24 mmol/l. Eight patients reported injection-site reactions, with one treatment discontinuation. Treatment emergent anti-drug antibodies were identified in five patients but these did not affect the efficacy. CONCLUSIONS Alirocumab effectively and safely reduced LDL-C in these patients.
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Affiliation(s)
- Dirk J Blom
- Department of Medicine, Division of Lipidology and Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa.
| | | | - Lesley J Burgess
- Tread Research, Department of Cardiology, Faculty of Medicine and Health Science, University of Stellenbosch, Stellenbosch, South Africa
| | | | - Graham Ellis
- Synexus Helderberg Clinical Trial Centre, Somerset West, South Africa
| | - Prashilla Soma
- Clinical Research Unit, Department of Clinical Research, University of Pretoria, Pretoria, South Africa
| | - Eugene van der Walt
- Roodepoort Medicross Clinical Research Centre, Synexus Affiliated Site, Roodepoort, South Africa
| | | | | | - Frederick J Raal
- Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Dunbar R, Naidoo P, Beyers N, Langley I. Improving rifampicin-resistant tuberculosis diagnosis using Xpert ® MTB/RIF: modelling interventions and costs. Int J Tuberc Lung Dis 2019; 22:890-898. [PMID: 29991398 DOI: 10.5588/ijtld.17.0594] [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: 11/10/2022] Open
Abstract
SETTING Cape Town, South Africa. OBJECTIVE To model the diagnosis of rifampicin-resistant tuberculosis (RR-TB) and laboratory costs of smear/culture and Xpert-based algorithms and the effect of varying adherence and human immunodeficiency virus (HIV) testing in the Xpert-based algorithm. METHODS We used a validated operational model (100 000 population) and published laboratory cost data. We estimated the number and cost of RR-TB cases identified using the smear/culture- and Xpert-based algorithms. We modelled varying adherence and different levels of known HIV status against the Xpert-based algorithm. RESULTS The number of RR-TB cases identified increased from 603 with smear/culture to 1178 with the Xpert-based algorithm (100% adherence; 60% knew their HIV status). The overall laboratory cost increased from US$1 073 858 to US$2 430 050 and the cost per RR-TB case identified increased from US$1781 to US$2063 in the respective algorithms. When adherence to the Xpert-based algorithm was increased from 50% to 100% (60% knew their HIV status), the number of RR-TB cases identified increased from 721 to 1178. CONCLUSION The Xpert-based algorithm is efficient in identifying RR-TB, as the increase in costs is offset by the increase in the number of cases identified. Adherence to the Xpert-based algorithm is important to ensure that all presumptive TB cases receive the benefit of simultaneous TB and RR-TB testing.
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Affiliation(s)
- R Dunbar
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - P Naidoo
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - N Beyers
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - I Langley
- Centre for Applied Heath Research and Delivery, Liverpool School of Tropical Medicine, Liverpool, UK
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Blom DJ, Raal F, Amod A, Naidoo P, Lai YYE. Management of low-density lipoprotein cholesterol levels in South Africa: the International ChoLesterol management Practice Study (ICLPS). Cardiovasc J Afr 2019; 30:15-23. [PMID: 30720848 DOI: 10.5830/cvja-2018-054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/22/2018] [Indexed: 11/06/2022] Open
Abstract
The International Cholesterol Management Practice Study (ICLPS) South Africa investigated achievement of European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline low-density lipoprotein cholesterol (LDL-C) targets in real-world clinical practice. Demographic data, clinical characteristics, cardiovascular risk factors, lipid-modifying medications, lipid values and investigator's assessment of cardiovascular risk were recorded for 396 patients on stable lipid-modifying therapy. Most (98.7%) patients received statins; 25.1% of statin-treated patients were receiving high-intensity statins. Overall, 41.4% of patients achieved their LDL-C target; among 354 (89.4%) patients in whom cardiovascular disease risk, based on ESC Systematic Coronary Risk Estimation (SCORE) was calculated, achievement rate was 14.3% for moderate-risk (n = 7), 59.3% for high-risk (n = 123) and 32.3% for very high-risk patients (n = 223). Half of Asian (54.7%) and black African (53.2%) patients were at LDL-C target compared with 29.8% of European/Caucasian and 27.3% of 'other' patients. Improved guideline adherence and greater use of combination therapy may increase LDL-C goal achievement.
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Affiliation(s)
- Dirk J Blom
- Department of Medicine, Division of Lipidology and Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa.
| | - Frederick Raal
- Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Aslam Amod
- The Centre for Diabetes and Endocrinology, Life Chatsmed Garden Hospital, Woodhurst, Chatsworth, South Africa
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Patel N, Naidoo P, Candy G, Kruger CJ. Surgical infections at a regional hospital in Gauteng: reasons for delay to care and profile of pathology. S AFR J SURG 2019. [DOI: 10.17159/2078-5151/2018/v56n4a2681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
Knee osteoarthritis is a chronic degenerative joint disease characterized by destruction of articular cartilage with resultant para-articular bone changes. It is a major cause of disability in older persons and is managed by surgical and nonsurgical interventions. Pharmacotherapy includes acetaminophen, nonsteroidal anti-inflammatory agents, and intra-articular steroids. Another treatment option is viscosupplementation with intra-articular injection of hyaluronan (HA). The full mechanism of action of exogenous HA is uncertain, but studies indicate that it may promote endogenous HA production, reduce inflammation, prevent degeneration of cartilage and promote cartilage regeneration. Clinically, HA may improve symptoms of osteoarthritis and delay time to total knee replacement surgery. However, clinical studies are heterogenous and of varying quality, and thus there is a need for more robust studies to determine the place of viscosupplementation in the management of knee osteoarthritis.
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Affiliation(s)
- David Webb
- Pattacus Medical, Randburg, South Africa
| | - Poobalan Naidoo
- Medical Affairs, Sanofi House, Midrand, South Africa, .,Department of Health Informatics, School of Health Professions, Rutgers, State University of New Jersey, NJ, USA,
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Naidoo P, Esmail A, Peter JG, Davids M, Fadul M, Dheda K. Does the use of adjunct urine lipopolysaccharide lipoarabinomannan in HIV-infected hospitalized patients reduce the utilization of healthcare resources? A post hoc analysis of the LAM multi-country randomized controlled trial. Int J Infect Dis 2018; 79:37-43. [PMID: 30292891 DOI: 10.1016/j.ijid.2018.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/25/2018] [Accepted: 09/28/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends the use of adjunctive urine lipopolysaccharide lipoarabinomannan (LAM) testing in hospitalized HIV-infected persons with suspected tuberculosis (TB) and a CD4 count <100cells/ml. However, the recommendation is conditional, and uptake by individual treatment programmes depends on perceived additional benefit. The aim of this study was to determine whether adjunctive LAM testing has additional clinical benefits including a reduction in healthcare-related use of resources. METHODS A post hoc analysis was performed of a published multicentre, multi-country, randomized controlled trial that showed an approximate 20% mortality benefit in HIV-infected hospitalized patients who underwent adjunctive LAM testing as part of their diagnostic workup. In that parent study, adult HIV-infected hospitalized patients with suspected TB (n=2528) were randomly allocated to either routine diagnostics (smear microscopy, Xpert MTB/RIF, and culture; n=1271), or routine diagnostics plus adjunctive urine LAM testing (n=1257). Data were further analyzed to determine whether there were other potential benefits of LAM usage based on CD4 count and illness severity. Aspects evaluated included: (1) the reduction in number of diagnostic sputum samples tested, (2) the utilization of additional imaging, (3) disease resolution based on follow-up signs and symptoms of illness severity, and (4) the reduction in hospital readmission. RESULTS Adjuvant LAM did not reduce the number of diagnostic sputum samples requested, the need for additional imaging, or the hospital readmission rate. However, adjunctive LAM was associated with a more rapid rate of disease resolution (dyspnoea) in the severely ill subgroup. Higher LAM grade (grades 4 and 5), compared to lower grade positivity (≤3), was associated with lower use of ultrasound, lower Karnofsky performance score, lower CD4 cell count, and shorter time to culture positivity. CONCLUSIONS Although, adjunct LAM was associated with a mortality benefit in the parent study, no benefit could be demonstrated in the secondary analysis with respect to the number of diagnostic sputum samples requested, the use of additional imaging, or hospital readmission rates. However, given the limitations of the present study, further appropriately designed studies are required to determine the effect of adjunct urine LAM on the utilization of healthcare resources.
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Affiliation(s)
- Poobalan Naidoo
- Department of Internal Medicine, RK Khan Hospital, Department of Internal Medicine, University of Kwa-Zulu Natal, Chatsworth, Kwa-Zulu Natal, South Africa.
| | - Aliasgar Esmail
- Centre for Lung Infection and Immunity, Division of Pulmonology and University of Cape Town Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Jonathan G Peter
- Division of Allergology and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Malika Davids
- Centre for Lung Infection and Immunity, Division of Pulmonology and University of Cape Town Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Mohammed Fadul
- Centre for Lung Infection and Immunity, Division of Pulmonology and University of Cape Town Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Keertan Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology and University of Cape Town Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
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Naidoo P, Etheredge HR, Rambiritch V, Singh A, Mahoney S, Naidu V. Non-referral of potential organ donors in South Africa: insights, challenges and ethical dilemmas. Pan Afr Med J 2018; 29:223. [PMID: 30100977 PMCID: PMC6080966 DOI: 10.11604/pamj.2018.29.223.14756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/14/2018] [Indexed: 11/25/2022] Open
Abstract
Traditionally, minimal potential organ donor referrals emanate from general medicine departments. We use a clinical vignette to draw attention to challenges related to referral of potential organ donors from general internal medicine departments. In addition, we provide potential solutions to overcome challenges and reflect on the ethical issues of non-referral of potential organ donors. It is hoped that this paper will increase the awareness of organ donation in the medical fraternity in Africa and thus mitigate critical shortages of organs for transplantation.
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Affiliation(s)
- Poobalan Naidoo
- King Edward VIII Tertiary Hospital, Department of Internal Medicine, South Africa
| | - Harriet Rosanne Etheredge
- Wits Donald Gordon Medical Centre, Johannesburg and Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Virendra Rambiritch
- University of KwaZulu-Natal, Biomedical Research Ethics Committee, KwaZulu-Natal, South Africa
| | - Akira Singh
- King Edward VIII Tertiary Hospital, Department of Internal Medicine, South Africa
| | - Scott Mahoney
- King Edward VIII Tertiary Hospital, Department of Internal Medicine, South Africa
| | - Vanesha Naidu
- King Edward VIII Tertiary Hospital, Department of Radiology, South Africa
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Naidoo P, Mothilal R, Blom DJ. Therapeutic Management of Dyslipidemia Patients at Very High Cardiovascular Risk (CARDIO TRACK): Protocol for the Observational Registry Study. JMIR Res Protoc 2018; 7:e163. [PMID: 29959115 PMCID: PMC6045791 DOI: 10.2196/resprot.9248] [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: 10/23/2017] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 11/17/2022] Open
Abstract
Background Dyslipidemia is a major modifiable risk factor for atherosclerotic cardiovascular disease. Current South African guidelines recommend titrating lipid-lowering therapy (LLT) to low-density lipoprotein cholesterol (LDL-C) targets stratified by cardiovascular risk. The LDL-C goal for very high-risk patients is <1.8 mmol/L. In international studies, approximately 30% of patients do not achieve this goal despite receiving maximally tolerated statin doses. There is, however, a paucity of data on LDL-C goal achievement in very high-risk South African patients receiving maximal statin doses. Objective The goal of the research it to assess LDL-C goal achievement in, and clinical characteristics of, very high cardiovascular risk dyslipidemic patients receiving maximal tolerated statin doses with or without ezetimibe. Methods This is an observational, cross-sectional South African registry study that plans to include up to 30 sites and 500 study participants. Adult patients with very high cardiovascular risk status receiving stable, maximally tolerated statin doses (with or without ezetimibe) will be eligible for inclusion. Results Funding has been awarded and enrollment began on November 15, 2017, and was completed on April 13, 2018, with 507 participants. Database lock was done on June 21, 2018. The statistical analysis has commenced and we expect the final clinical study report to be completed by October 2018. Conclusions This study will document the adequacy of LLT in those at highest risk and will thus fill an important data gap in South Africa. This data may be useful in assessing the need for novel LLTs like proprotein convertase subtilisin/kexin 9 inhibitors that substantially lower cholesterol levels in addition to optimal statin therapy. Registered Report Identifier RR1-10.2196/9248
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Affiliation(s)
- Poobalan Naidoo
- Department of Medical Affairs, Sanofi South Africa, Johannesburg, South Africa
| | - Rashem Mothilal
- Department of Medical Affairs, Sanofi South Africa, Johannesburg, South Africa
| | - Dirk Jacobus Blom
- Division of Lipidology and Hatter Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Abstract
We report a case of Marfan syndrome (MFS) in a South African patient, which is extraordinary because of the large constellation of clinical, radiological and vascular anomalies in a single patient. A literature search from 1950 to date did not show a similar report of such extensive clinical characteristics of MFS.
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Affiliation(s)
- Poobalan Naidoo
- RK Khan Regional Hospital, Department of Internal Medicine and University of Kwa-Zulu Natal, South Africa
| | - Naresh Ranjith
- RK Khan Regional Hospital, Department of Internal Medicine and University of Kwa-Zulu Natal, South Africa
| | - Zuzile Zikalala
- RK Khan Regional Hospital, Department of Radiology and University of Kwa-Zulu Natal, South Africa
| | - Scott Mahoney
- King Edward VIII Tertiary Hospital, Department of Internal Medicine, South Africa
| | - Kevin Ho
- Steve Biko Academic Hospital, Department of Cardiology and University of Pretoria, South Africa
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Abstract
Paraoxonase-1 (PON1) is a high-density lipoprotein-associated esterase and is speculated to play a role in several human diseases including diabetes mellitus and atherosclerosis. Low PON1 activity has been associated with increased risk of major cardiovascular events, therefore a variety of studies have been conducted to establish the cardioprotective properties and clinical relevance of PON1. The major aim of this review was to highlight the important studies and to subsequently assess if PON1 has clinical relevance. A review of the literature showed that there is currently insufficient data to suggest that PON1 has clinical relevance. It is our opinion that robust studies are required to clarify the clinical relevance of PON1.
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Affiliation(s)
| | | | - Robert Chilton
- Department of Medicine, Division of Cardiology and Interventional Cardiology, University of Texas Health Science Center at San Antonia, San Antonia, TX, USA
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Naidoo P, Naidoo RN, Ramkaran P, Muttoo S, Asharam K, Chuturgoon AA. Maternal miRNA-146a G/C rs2910164 variation, HIV/AIDS and nitrogen oxide pollution exposure collectively affects foetal growth. Hum Exp Toxicol 2018; 38:82-94. [PMID: 29896975 DOI: 10.1177/0960327118781902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE: Nitrogen oxide (NOx) pollution and human immunodeficiency virus (HIV)/AIDS intensify inflammation during pregnancy and linked with adverse birth outcomes (ABOs). MicroRNA (miRNA)-146a plays a crucial role in regulating inflammation in the NF-κB pathway. The G/C rs2910164 dampens miRNA-146a activity and linked with inflammatory diseases. The present study investigated whether HIV/AIDS and NOx exposure throughout pregnancy further intensifies ABO in Black South African women genotyped for the rs2910164. METHODS: Pregnant women ( n = 300) were subdivided into low, medium and high NOx exposure groups, genotyped for the miRNA-146a G/C rs2910164 using polymerase chain reaction-restriction fragment length polymorphism, and further stratified based on HIV status. RESULTS: Unstratified data (HIV+ and HIV- mothers combined): Mothers from the high NOx group with the variant C-allele had low blood iron levels ( p = 0.0238), and had babies with reduced birthweights ( p = 0.0283). As NOx increased, the prevalence of preterm birth and low birth weight also increased in mothers with the variant C-allele versus wildtype G-allele. HIV-infected mothers: In all NOx exposure groups, mothers with the variant C-allele had higher systolic blood pressure (low: p = 0.0386, medium: p = 0.0367 and high: p = 0.0109) and had babies with lower Appearance, Pulse, Grimace, Activity and Respiration scores at 1 min (low: p = 0.0190, medium: p = 0.0301 and high: p = 0.0361). CONCLUSION: Maternal rs2910164 variant C-allele, NOx pollution and HIV/AIDS might collectively play a role in intensifying gestational hypertension and ABO.
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Affiliation(s)
- P Naidoo
- 1 Discipline of Medical Biochemistry and Chemical Pathology, University of KwaZulu-Natal, Durban, South Africa
| | - R N Naidoo
- 2 Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
| | - P Ramkaran
- 1 Discipline of Medical Biochemistry and Chemical Pathology, University of KwaZulu-Natal, Durban, South Africa
| | - S Muttoo
- 2 Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
| | - K Asharam
- 2 Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
| | - A A Chuturgoon
- 1 Discipline of Medical Biochemistry and Chemical Pathology, University of KwaZulu-Natal, Durban, South Africa
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Dunbar R, Naidoo P, Beyers N, Langley I. High laboratory cost predicted per tuberculosis case diagnosed with increased case finding without a triage strategy. Int J Tuberc Lung Dis 2018; 21:1026-1034. [PMID: 28826453 DOI: 10.5588/ijtld.17.0156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Cape Town, South Africa. OBJECTIVE To model the effects of increased case finding and triage strategies on laboratory costs per tuberculosis (TB) case diagnosed. METHODS We used a validated operational model and published laboratory cost data. We modelled the effect of varying the proportion with TB among presumptive cases and Xpert cartridge price reductions on cost per TB case and per additional TB case diagnosed in the Xpert-based vs. smear/culture-based algorithms. RESULTS In our current scenario (18.3% with TB among presumptive cases), the proportion of cases diagnosed increased by 8.7% (16.7% vs. 15.0%), and the cost per case diagnosed increased by 142% (US$121 vs. US$50). The cost per additional case diagnosed was US$986. This would increase to US$1619 if the proportion with TB among presumptive cases was 10.6%. At 25.9-30.8% of TB prevalence among presumptive cases and a 50% reduction in Xpert cartridge price, the cost per TB case diagnosed would range from US$50 to US$59 (comparable to the US$48.77 found in routine practice with smear/culture). CONCLUSION The operational model illustrates the effect of increased case finding on laboratory costs per TB case diagnosed. Unless triage strategies are identified, the approach will not be sustainable, even if Xpert cartridge prices are reduced.
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Affiliation(s)
- R Dunbar
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - P Naidoo
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - N Beyers
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - I Langley
- Centre for Applied Heath Research and Delivery, Liverpool School of Tropical Medicine, Liverpool, UK
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Dunbar R, Naidoo P, Beyers N, Langley I. Operational modelling: the mechanisms influencing TB diagnostic yield in an Xpert ® MTB/RIF-based algorithm. Int J Tuberc Lung Dis 2018; 21:381-388. [PMID: 28284252 DOI: 10.5588/ijtld.16.0432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Cape Town, South Africa. OBJECTIVE To compare the diagnostic yield for smear/culture and Xpert® MTB/RIF algorithms and to investigate the mechanisms influencing tuberculosis (TB) yield. METHOD We developed and validated an operational model of the TB diagnostic process, first with the smear/culture algorithm and then with the Xpert algorithm. We modelled scenarios by varying TB prevalence, adherence to diagnostic algorithms and human immunodeficiency virus (HIV) status. This enabled direct comparisons of diagnostic yield in the two algorithms to be made. RESULTS Routine data showed that diagnostic yield had decreased over the period of the Xpert algorithm roll-out compared to the yield when the smear/culture algorithm was in place. However, modelling yield under identical conditions indicated a 13.3% increase in diagnostic yield from the Xpert algorithm compared to smear/culture. The model demonstrated that the extensive use of culture in the smear/culture algorithm and the decline in TB prevalence are the main factors contributing to not finding an increase in diagnostic yield in the routine data. CONCLUSION We demonstrate the benefits of an operational model to determine the effect of scale-up of a new diagnostic algorithm, and recommend that policy makers use operational modelling to make appropriate decisions before new diagnostic algorithms are scaled up.
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Affiliation(s)
- R Dunbar
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - P Naidoo
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - N Beyers
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - I Langley
- Centre for Applied Health Research and Delivery, Liverpool School of Tropical Medicine, Liverpool, UK
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Snow K, Hesseling AC, Naidoo P, Graham SM, Denholm J, du Preez K. Tuberculosis in adolescents and young adults: epidemiology and treatment outcomes in the Western Cape. Int J Tuberc Lung Dis 2018; 21:651-657. [PMID: 28482959 DOI: 10.5588/ijtld.16.0866] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Western Cape Province, South Africa. OBJECTIVES To characterise tuberculosis (TB) epidemiology, disease presentation and treatment outcomes among adolescents (age 10-19 years) and young adults (age 20-24 years) in the Western Cape. DESIGN A retrospective, cross-sectional review of routine patient-level data from the Electronic TB Register (ETR.Net) for 2013. Site of TB disease, human immunodeficiency virus (HIV) status and TB treatment outcomes were analysed by 5-year age groups (<5, 5-9, 10-14, 15-19, 20-24 and 25 years of age). TB notification rates were calculated using census data. RESULTS Adolescents and young adults comprised 18.0% of all new TB notifications in 2013. The notification rate was 141 TB cases/100 000 person-years (py) among 10-14 year olds, 418/100 000 py among 15-19 year olds and 627/100 000 py among 20-24 year olds. HIV prevalence among TB patients was 10.9% in 10-14 year olds, 8.8% in 15-19 year olds and 27.2% in 20-24 year olds. Older adolescents (age 15-19 years) and young adults (age 20-24 years) with HIV co-infection had poor treatment outcomes: 15.6% discontinued treatment prematurely and 4.0% died. CONCLUSIONS Young people in the Western Cape suffer a substantial burden of TB, and those with TB-HIV co-infection are at high risk of treatment discontinuation.
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Affiliation(s)
- K Snow
- Centre for International Child Health, University of Melbourne, Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - A C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - P Naidoo
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - S M Graham
- Centre for International Child Health, University of Melbourne, Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - J Denholm
- Victorian Tuberculosis Program, Melbourne Health, Melbourne, Victoria, Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia
| | - K du Preez
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Naidoo P, Dunbar R, du Toit E, van Niekerk M, Squire SB, Beyers N, Madan J. Comparing laboratory costs of smear/culture and Xpert ® MTB/RIF-based tuberculosis diagnostic algorithms. Int J Tuberc Lung Dis 2018; 20:1377-1385. [PMID: 27725051 DOI: 10.5588/ijtld.16.0081] [Citation(s) in RCA: 8] [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: 11/10/2022] Open
Abstract
SETTING Cape Town, South Africa, where Xpert® MTB/RIF was introduced as a screening test for all presumptive tuberculosis (TB) cases. OBJECTIVE To compare laboratory costs of smear/culture- and Xpert-based tuberculosis (TB) diagnostic algorithms in routine operational conditions. METHODS Economic costing was undertaken from a laboratory perspective, using an ingredients-based costing approach. Cost allocation was based on reviews of standard operating procedures and laboratory records, timing of test procedures, measurement of laboratory areas and manager interviews. We analysed laboratory test data to assess overall costs and cost per pulmonary TB and multidrug-resistant TB (MDR-TB) case diagnosed. Costs were expressed as 2013 Consumer Price Index-adjusted values. RESULTS Total TB diagnostic costs increased by 43%, from US$440 967 in the smear/culture-based algorithm (April-June 2011) to US$632 262 in the Xpert-based algorithm (April-June 2013). The cost per TB case diagnosed increased by 157%, from US$48.77 (n = 1601) to US$125.32 (n = 1281). The total cost per MDR-TB case diagnosed was similar, at US$190.14 and US$183.86, with 95 and 107 cases diagnosed in the respective algorithms. CONCLUSION The introduction of the Xpert-based algorithm resulted in substantial cost increases. This was not matched by the expected increase in TB diagnostic efficacy, calling into question the sustainability of this expensive new technology.
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Affiliation(s)
- P Naidoo
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - R Dunbar
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - E du Toit
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - M van Niekerk
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - S B Squire
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - N Beyers
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - J Madan
- Warwick Medical School, University of Warwick, Coventry, UK
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Naidoo P, Sewpaul R, Nyembezi A, Reddy P, Louw K, Desai R, Stein DJ. The association between biopsychosocial factors and disability in a national health survey in South Africa. PSYCHOL HEALTH MED 2017; 23:653-660. [PMID: 29280386 DOI: 10.1080/13548506.2017.1417606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The association between psychosocial factors and disability is less clear. This study investigated the biological and psychosocial (employment and psychological distress) factors associated with level of disability in an adult sample in South Africa. Data were analysed from a cross-sectional survey among adults aged 18-64 (n = 4974). Multiple linear regression was used to investigate the associations of the selected variables with disability. The mean percentage score on the WHODAS scale of disability was 5.31% (95% CI: 4.74-5.88). Age (p < 0.001) and race (p = 0.0002) were significantly associated with disability, and history of stroke (β = 7.19, 95% CI: 3.19-11.20) and heart-related conditions (β = 2.08, 95% CI: [0.23-3.93) showed positive associations. Of the psychosocial variables, psychological distress (β = 10.49 [8.63-12.35]) showed a strong positive association while employment (-1.62 [-2.36 to -0.88]) showed a negative association with disability. The association between demographic factors, medical conditions and increased disability confirms the findings in the literature. The finding that psychological distress is associated with increased disability has not been frequently reported. This study highlights specific psychosocial targets that may be usefully addressed by health policies and interventions in order to improve disability management.
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Affiliation(s)
- P Naidoo
- a Department of Psychology , University of the Western Cape , Cape Town , South Africa.,b Heart and Stroke Foundation South Africa , Cape Town , South Africa
| | - R Sewpaul
- c Human Sciences Research Council , Cape Town , South Africa
| | - A Nyembezi
- c Human Sciences Research Council , Cape Town , South Africa
| | - P Reddy
- c Human Sciences Research Council , Cape Town , South Africa.,d Faculty of Community and Health Sciences, Department of Social Work , University of the Western Cape , Cape Town , South Africa
| | - K Louw
- e Department of Psychiatry and MRC Unit on Anxiety & Stress Disorders , University of Cape Town , Cape Town , South Africa
| | - R Desai
- c Human Sciences Research Council , Cape Town , South Africa
| | - D J Stein
- e Department of Psychiatry and MRC Unit on Anxiety & Stress Disorders , University of Cape Town , Cape Town , South Africa
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Karpińska M, Wlazło M, Ramjugernath D, Naidoo P, Domańska U. Assessment of certain ionic liquids for separation of binary mixtures based on gamma infinity data measurements. RSC Adv 2017. [DOI: 10.1039/c6ra25208g] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Limiting activity coefficients for 64 solutes in [BzMIM][NTf2] and [BzMIM][DCA], the gas–liquid partition coefficients, KL, thermodynamic functions and selectivity for hexane/hex-1-ene, cyclohexane/cyclohexene and ethylbenzene/styrene separation were presented.
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Affiliation(s)
- M. Karpińska
- Department of Physical Chemistry
- Faculty of Chemistry
- Warsaw University of Technology
- 00-664 Warsaw
- Poland
| | - M. Wlazło
- Department of Physical Chemistry
- Faculty of Chemistry
- Warsaw University of Technology
- 00-664 Warsaw
- Poland
| | - D. Ramjugernath
- Thermodynamic Research Unit
- School of Chemical Engineering
- University of KwaZulu-Natal
- Howard College Campus
- Durban 4001
| | - P. Naidoo
- Thermodynamic Research Unit
- School of Chemical Engineering
- University of KwaZulu-Natal
- Howard College Campus
- Durban 4001
| | - U. Domańska
- Department of Physical Chemistry
- Faculty of Chemistry
- Warsaw University of Technology
- 00-664 Warsaw
- Poland
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Rambiritch V, Naidoo P, Pillai G. Glibenclamide population pharmacokinetic/pharmacodynamic modeling in South African type 2 diabetic subjects. Clin Pharmacol 2016; 8:141-153. [PMID: 27713650 PMCID: PMC5044993 DOI: 10.2147/cpaa.s102674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Indexed: 11/23/2022] Open
Abstract
Aim Patients and methods Results Conclusion
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Affiliation(s)
| | - Poobalan Naidoo
- Department of Internal Medicine, RK Khan Regional Hospital, Chatsworth, South Africa
- Correspondence: Poobalan Naidoo, Department of Internal Medicine, RK Khan Regional Hospital, Chatsworth 4092, South Africa, Tel +27 71 893 7672, Fax +27 31 469 6000, Email
| | - Goonaseelan Pillai
- Scientific Capability Development, Novartis Pharma AG, Basel, Switzerland
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Naidoo P, Pillay D, Saman S. Specialist physician-led public sector health services in rural KwaZulu-Natal: positive signs. S Afr Fam Pract (2004) 2016. [DOI: 10.1080/20786190.2014.976975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Naidoo P, Wing J, Rambiritch V. Effect of Sitagliptin and Metformin on Prediabetes Progression to Type 2 Diabetes - A Randomized, Double-Blind, Double-Arm, Multicenter Clinical Trial: Protocol for the Sitagliptin and Metformin in PreDiabetes (SiMePreD) Study. JMIR Res Protoc 2016; 5:e145. [PMID: 27491324 PMCID: PMC4990713 DOI: 10.2196/resprot.5073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 01/23/2016] [Accepted: 01/24/2016] [Indexed: 12/28/2022] Open
Abstract
Background The high prevalence and incidence of type 2 diabetes mellitus (DM), and its associated morbidity and mortality, has prompted growing international interest and effort in the primary prevention of this disease. Primary prevention is possible since type 2 DM is preceded by prediabetes, offering a window opportunity to treat patients, and prevent the emergence of advanced disease. Sitagliptin is an oral dipeptidyl peptidase-IV inhibitor that preserves existing beta cell function and increases beta cell mass. These two effects have been demonstrated both in vitro and in animal studies, and current clinical data show that sitagliptin is safe. Metformin, a biguanide, reduces insulin resistance and inhibits hepatic gluconeogenesis, and has an excellent safety profile. The combination of metformin and sitagliptin, targeting both characteristics of prediabetes (insulin resistance and progressive beta cell degeneration), may potentially slow or halt the progression from prediabetes to type 2 DM. This paper describes the rationale and design of the Sitagliptin and Metformin in PreDiabetes (SiMePreD) study. Objective The aim of this study is to determine the effect of sitagliptin and metformin on progression from prediabetes to type 2 DM. The objectives of the study are to determine the effects of metformin and placebo on glycemic endpoints, the effects of sitagliptin and metformin on glycemic endpoints, the effects of metformin and placebo on incidence of cardiovascular disease and death, and the effects of sitagliptin and metformin on incidence of cardiovascular disease and death. Methods This is a randomized, double-blind, multicenter clinical study that will determine if the combination of metformin and sitagliptin is effective in preventing the progression from prediabetes to type 2 DM. The study will contain two arms (metformin/sitagliptin and metformin/placebo). Primary endpoints include the number of subjects progressing from prediabetes to type 2 DM, the number of cardiovascular events, and the number of deaths. The planned duration of the study is five years, and 410 subjects will be included in each group. Data analyses will include clinically relevant measures (eg, numbers needed to treat and numbers needed to harm) and will be performed according to the intention-to-treat principle. Results This study is currently in the process of acquiring research funding. Conclusions The SiMePreD study is the first study to investigate the utility of sitagliptin in combination with metformin for the primary prevention of type 2 DM.
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Affiliation(s)
- Poobalan Naidoo
- University of Witwatersrand, Faculty of Health Sciences, Department of Endocrinology, Gauteng, South Africa.
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Abstract
While childhood psychopathology may not necessarily be expected to vary between urban and rural children, social and political factors could be influential in the variances in presentation across these different environments. A comparative investigation was undertaken in the KwaZulu-Natal region to examine childhood presentations at (i) an urban psychological clinic in a low socio-economic environment, and (ii) a few visiting psychological clinics serving rural and peri-urban communities. Data were collected over a five-year period. The results revealed several notable differences, for example, attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (other than ADHD) were significantly more prevalent in the urban sample. However, mental retardation, post-traumatic stress disorder and sexual abuse were significantly more common in the rural/peri-urban sample. The results are discussed within the context of children's life experiences, available facilities, and psychopathology detection rates in these two types of environments.
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Affiliation(s)
- A.L. Pillay
- Department of Medically Applied Psychology, University of Natal Medical School and Midlands Hospital, P.O. Box 370, Pietermaritzburg 3200, South Africa
| | - P. Naidoo
- Community Psychiatric Services, KwaZulu-Natal, South Africa
| | - M.R. Lockhat
- Department of Psychology, University of the Western Cape, Belville, South Africa
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Colvin CJ, Leon N, Wills C, van Niekerk M, Bissell K, Naidoo P. Global-to-local policy transfer in the introduction of new molecular tuberculosis diagnostics in South Africa. Int J Tuberc Lung Dis 2016; 19:1326-38. [PMID: 26467585 DOI: 10.5588/ijtld.15.0262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Lack of innovation in diagnostics has contributed to tuberculosis (TB) remaining a global health challenge. It is critical to understand how new diagnostic technologies are translated into policies and how these are implemented. OBJECTIVE To examine policy transfer for two rapid molecular diagnostic tests, GenoType(®) MDRTBplus and Xpert(®) MTB/RIF, to understand policy development, uptake and implementation in South Africa. METHODS A policy transfer analysis framework integrating the key dimensions of policy transfer into one coherent model was used. Two phases of key informant interviews were undertaken with a wide range of stakeholders. RESULTS Both tests were developed through innovative partnerships and responded to urgent public health needs. GenoType was introduced through a process that was more inclusive than that for Xpert. National policy and planning processes were opaque for both tests. Their implementation, maintenance and expansion suffered from poor communication and coordination, insufficient attention to resource implications, technical challenges and a lack of broader health systems thinking. CONCLUSION Our analysis identified the risks and benefits of partnerships for technological innovation, the complex intersections between global and national actors and the impact of health systems on policy transfer, and the risks of rescue- and technology-focused thinking in addressing public health challenges.
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Affiliation(s)
- C J Colvin
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - N Leon
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - C Wills
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - M van Niekerk
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - K Bissell
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - P Naidoo
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Rambiritch V, Naidoo P, Maharaj B, Pillai G. Population pharmacokinetic modeling of glibenclamide in poorly controlled South African type 2 diabetic subjects. Clin Pharmacol 2016; 8:83-92. [PMID: 27471411 PMCID: PMC4948726 DOI: 10.2147/cpaa.s102676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Indexed: 11/23/2022] Open
Abstract
Aim The aim of this study was to describe the pharmacokinetics (PK) of glibenclamide in poorly controlled South African type 2 diabetic subjects using noncompartmental and model-based methods. Methods A total of 24 subjects with type 2 diabetes were administered increasing doses (0 mg/d, 2.5 mg/d, 5 mg/d, 10 mg/d, and 20 mg/d) of glibenclamide daily at 2-week intervals. Plasma glibenclamide, glucose, and insulin determinations were performed. Blood sampling times were 0 minute, 30 minutes, 60 minutes, 90 minutes, and 120 minutes (post breakfast sampling) and 240 minutes, 270 minutes, 300 minutes, 330 minutes, 360 minutes, and 420 minutes (post lunch sampling) on days 14, 28, 42, 56, and 70 for doses of 0 mg, 2.5 mg, 5.0 mg, 10 mg, and 20 mg, respectively. Blood sampling was performed after the steady state was reached. A total of 24 individuals in the data set contributed to a total of 841 observation records. The PK was analyzed using noncompartmental analysis methods, which were implemented in WinNonLin®, and population PK analysis using NONMEM®. Glibenclamide concentration data were log transformed prior to fitting. Results A two-compartmental disposition model was selected after evaluating one-, two-, and three-compartmental models to describe the time course of glibenclamide plasma concentration data. The one-compartment model adequately described the data; however, the two-compartment model provided a better fit. The three-compartment model failed to achieve successful convergence. A more complex model, to account for enterohepatic recirculation that was observed in the data, was unsuccessful. Conclusion In South African diabetic subjects, glibenclamide demonstrates linear PK and was best described by a two-compartmental model. Except for the absorption rate constant, the other PK parameters reported in this study are comparable to those reported in the scientific literature. The study is limited by the small study sample size and inclusion of poorly controlled type 2 diabetic subjects.
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Affiliation(s)
| | - Poobalan Naidoo
- Department of Internal Medicine, RK Khan Regional Hospital, Chatsworth, South Africa
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Naidoo P. Status asthmaticus with pseudo-dextrocardia, complicated by iatrogenic tension pneumothorax. Pan Afr Med J 2016; 24:31. [PMID: 27583095 PMCID: PMC4992367 DOI: 10.11604/pamj.2016.24.31.9552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/12/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
- Poobalan Naidoo
- Khan Regional Hospital, University of Kwazulu-natal, Nelson Mandela College of Medicine, Department of Internal Medicine, Durban, South Africa
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