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Byrne BJ, Schoser B, Kishnani PS, Bratkovic D, Clemens PR, Goker-Alpan O, Ming X, Roberts M, Vorgerd M, Sivakumar K, van der Ploeg AT, Goldman M, Wright J, Holdbrook F, Jain V, Benjamin ER, Johnson F, Das SS, Wasfi Y, Mozaffar T. Long-term safety and efficacy of cipaglucosidase alfa plus miglustat in individuals living with Pompe disease: an open-label phase I/II study (ATB200-02). J Neurol 2024; 271:1787-1801. [PMID: 38057636 PMCID: PMC10973052 DOI: 10.1007/s00415-023-12096-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/08/2023]
Abstract
Cipaglucosidase alfa plus miglustat (cipa + mig) is a novel, two-component therapy for Pompe disease. We report data from the Phase I/II ATB200-02 study for up to 48 months of treatment. Four adult cohorts, including one non-ambulatory ERT-experienced (n = 6) and three ambulatory cohorts, (two enzyme replacement therapy [ERT]-experienced cohorts [2-6 years (n = 11) and ≥ 7 years (n = 6)]), one ERT-naïve cohort (n = 6), received 20 mg/kg intravenous-infused cipa plus 260 mg oral mig biweekly. Change from baseline (CFBL) for multiple efficacy endpoints at 12, 24, 36, and 48 months, pharmacodynamics, pharmacokinetics, safety, and immunogenicity data were assessed. Six-minute walking distance (% predicted) improved at 12, 24, 36, and 48 months: pooled ambulatory ERT-experienced cohorts, mean(± standard deviation [SD]) CFBL: 6.1(± 7.84), n = 16; 5.4(± 10.56), n = 13; 3.4(± 14.66), n = 12; 5.9(± 17.36), n = 9, respectively; ERT-naïve cohort: 10.7(± 3.93), n = 6; 11.0(± 5.06), n = 6; 9.0(± 7.98), n = 5; 11.7(± 7.69), n = 4, respectively. Percent predicted forced vital capacity was generally stable in ERT-experienced cohorts, mean(± SD) CFBL - 1.2(± 5.95), n = 16; 1.0(± 7.96), n = 13; - 0.3(± 6.68), n = 10; 1.0(± 6.42), n = 6, respectively, and improved in the ERT-naïve cohort: 3.2(± 8.42), n = 6; 4.7(± 5.09), n = 6; 6.2(± 3.35), n = 5; 8.3(± 4.50), n = 4, respectively. Over 48 months, CK and Hex4 biomarkers improved in ambulatory cohorts. Overall, cipa + mig was well tolerated with a safety profile like alglucosidase alfa. ATB200-02 results show the potential benefits of cipa + mig as a long-term treatment option for Pompe disease. Trial registration number: NCT02675465 January 26, 2016.
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Affiliation(s)
| | - Benedikt Schoser
- Friedrich-Baur-Institute at the Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Drago Bratkovic
- PARC Research Clinic, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Paula R Clemens
- Department of Neurology, University of Pittsburgh School of Medicine and VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Ozlem Goker-Alpan
- Lysosomal and Rare Disorders Research and Treatment Center, Fairfax, VA, USA
| | - Xue Ming
- Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
- Guam Regional Medical City, Dededo, Guam
| | | | - Matthias Vorgerd
- Department of Neurology, University Hospital Bergmannsheil, Heimer Institute for Muscle Research, Bochum, Germany
| | | | | | | | | | | | - Vipul Jain
- Amicus Therapeutics, Inc., Princeton, NJ, USA
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Dong S, Sun J, Ming X, Weber U, Schuy C, Hu W, Sheng Y. Development of porous structure for broadening Bragg-peak in scanning carbon-ion radiotherapy: Monte Carlo simulation and experimental validation. Phys Med 2024; 120:103325. [PMID: 38493583 DOI: 10.1016/j.ejmp.2024.103325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/15/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
PURPOSE The present study aimed to develop a porous structure with plug-ins (PSP) to broaden the Bragg peak width (BPW, defined as the distance in water between the proximal and distal 80% dose) of the carbon ion beam while maintaining a sharp distal falloff width (DFW, defined as the distance along the beam axis where the dose in water reduces from 80% to 20%). METHODS The binary voxel models of porous structure (PS) and PSP were established in the Monte Carlo code FLUKA and the corresponding physical models were manufactured by 3D printing. Both experiment and simulation were performed for evaluating the modulation capacity of PS and PSP. BPWs and DFWs derived from each integral depth dose curves were compared. Fluence homogeneity of 430 MeV/u carbon-ion beam passing through the PSP was recorded by analyzing radiochromic films at six different locations downstream the PSP in the experiment. Additionally, by changing the beam spot size and incident position on the PSP, totally 48 different carbon-ion beams were simulated and corresponding deviations of beam metrics were evaluated to test the modulating stability of PSP. RESULTS According to the measurement data, the use of PSP resulted in an average increase of 0.63 mm in BPW and a decrease of 0.74 mm in DFW compared to PS. The 2D radiation field inhomogeneities were lower than 3 % when the beam passing through a ≥ 10 cm PMMA medium. Furthermore, employing a spot size of ≥ 6 mm ensures that beam metric deviations, including BPW, DFW, and range, remain within a deviation of 0.1 mm across various incident positions. CONCLUSION The developed PSP demonstrated its capability to effectively broaden the BPW of carbon ion beams while maintaining a sharp DFW comparing to PS. The superior performance of PSP, indicates its potential for clinical use in the future.
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Affiliation(s)
- Sixue Dong
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of radiation oncology(20dz2261000); Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
| | - Jiayao Sun
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of radiation oncology(20dz2261000); Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
| | - Xue Ming
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of radiation oncology(20dz2261000); Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
| | - Uli Weber
- Biophysics GSI Helmholtz Center for Heavy Ion Research GmbH, Darmstadt, Germany
| | - Christoph Schuy
- Biophysics GSI Helmholtz Center for Heavy Ion Research GmbH, Darmstadt, Germany
| | - Weigang Hu
- Shanghai Key Laboratory of radiation oncology(20dz2261000); Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Clinical Research Center for Radiation Oncology.
| | - Yinxiangzi Sheng
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201315, China; Shanghai Key Laboratory of radiation oncology(20dz2261000); Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy.
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Ming X, Mao J, Ma N, Chen J, Wang W, Sheng Y, Wu K. Intensity-modulated proton and carbon-ion radiotherapy using a fixed-beam system for locally advanced lung cancer: dosimetric comparison with x-ray radiotherapy and normal tissue complication probability (NTCP) evaluation. Phys Med Biol 2024; 69:015025. [PMID: 38064747 DOI: 10.1088/1361-6560/ad13d1] [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: 09/21/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
Objective. To assess the dosimetric consequences and the normal tissue complication probability (NTCP) for the organs at risk (OARs) in intensity-modulated particle radiotherapy of proton (IMPT) and carbon-ion (IMCT) using a fixed-beam delivery system when compared with intensity-modulated photon radiotherapy (IMRT) for locally advanced small-cell lung cancer.Approach. The plans were all designed under the same total relative biological effectiveness (RBE)-weighted prescription dose, in which the planning target volume (PTV) of the internal gross target volume(IGTV) and the PTV of the clinical target volume was irradiated with 69.3 Gy (RBE) and 63 Gy (RBE), respectively, using a simultaneously integrated boosting (SIB) technique. NTCPs were estimated for heart, lung, esophagus and spinal cord by Lyman-Kutcher-Burman (LKB) and logistic models. Dose escalation was simulated under the desired NTCP values (0.05, 0.10 and 0.50) of the three radiation techniques.Main results. Under the similar target coverage, almost all OARs were significantly better spared (p< 0.05) when using the particle radiotherapy except for D1cc (the dose to 1 cm3of the volume) of the proximal bronchial tree (p> 0.05). At least 57.6% of mean heart dose, 28.8% of mean lung dose and 19.1% of mean esophageal dose were reduced compared with IMRT. The mean NTCP of radiation-induced pneumonitis (RP) in the ipsilateral lung was 0.39 ± 0.33 (0.39 ± 0.31) in IMPT plans and 0.36 ± 0.32 (0.35 ± 0.30) in IMCT plans compared with 0.66 ± 0.30 (0.64 ± 0.28) in IMRT plans by LKB (logistic) models. The target dose could be escalated to 78.3/76.9 Gy (RBE) in IMPT/IMCT plans compared with 61.7 Gy (RBE) in IMRT plans when 0.50 of NTCP in terms of RP in the ipsilateral lung was applied.Significance. This study presents the potential of better control of the side effects and improvement of local control originating from the dosimetric advantage with the application of IMPT and IMCT with the SIB technique for locally advanced lung cancer, even with limited beam directions.
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Affiliation(s)
- Xue Ming
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People's Republic of China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People's Republic of China
| | - Jingfang Mao
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People's Republic of China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People's Republic of China
| | - Ningyi Ma
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People's Republic of China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People's Republic of China
| | - Jian Chen
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People's Republic of China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People's Republic of China
| | - Weiwei Wang
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People's Republic of China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People's Republic of China
| | - Yinxiangzi Sheng
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai, Fudan University Cancer Hospital, People's Republic of China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People's Republic of China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People's Republic of China
| | - Kailiang Wu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People's Republic of China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People's Republic of China
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Ma N, Ming X, Chen J, Wu KL, Lu J, Jiang G, Mao J. Dosimetric rationale and preliminary experience in proton plus carbon-ion radiotherapy for esophageal carcinoma: a retrospective analysis. Radiat Oncol 2023; 18:195. [PMID: 38041122 PMCID: PMC10693034 DOI: 10.1186/s13014-023-02371-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/29/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Concurrent chemoradiotherapy has been standard of care for unresectable esophageal carcinoma. There were no reports on proton radiotherapy (PRT) plus carbon-ion radiotherapy (CIRT) with pencil beam scanning (PBS) for esophageal carcinoma. This study evaluated the tolerability and efficiency of proton and sequential carbon-ion boost radiotherapy for esophageal carcinoma. METHODS From April 2017 to July 2020, 20 patients with primary esophageal carcinoma at stages II-IV were treated with PRT plus sequential CIRT with PBS. A median relative biological effectiveness-weighted PRT dose of 50 Gy in 25 fractions, and a sequential CIRT dose of 21 Gy in 7 fractions were delivered. Respiratory motion management was used if the tumor moved > 5 mm during the breathing cycle. A dosimetric comparison of photon intensity-modulated radiotherapy (IMRT), PRT, and CIRT was performed. The median times and rates of survivals were estimated using the Kaplan-Meier method. Comparison of the dose-volume parameters of the organs at risk employed the Wilcoxon matched-pairs test. RESULTS Twenty patients (15 men and 5 women, median age 70 years) were included in the analysis. With a median follow-up period of 25.0 months, the 2-year overall survival and progression-free survival rates were 69.2% and 57.4%, respectively. The patients tolerated radiotherapy and chemotherapy well. Grades 1, 2, 3, and 4 acute hematological toxicities were detected in 25%, 30%, 10%, and 30% of patients, respectively. Grades 3-5 acute non-hematological toxicities were not observed. Late toxicity events included grades 1, 2, and 3 in 50%, 20%, and 10% (pulmonary and esophageal toxicity in each) of patients. Grades 4-5 late toxicities were not noted. PRT or CIRT produced lower doses to organs at risk than did photon IMRT, especially the maximum dose delivered to the spinal cord and the mean doses delivered to the lungs and heart. CONCLUSIONS PRT plus CIRT with PBS appears to be a safe and effective treatment for esophageal carcinoma. PRT and CIRT delivered lower doses to organs at risk than did photon IMRT. Further investigation is warranted.
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Affiliation(s)
- Ningyi Ma
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kang Xin Road, Shanghai, 201315, China
| | - Xue Ming
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Jian Chen
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kang Xin Road, Shanghai, 201315, China
| | - Kai-Liang Wu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kang Xin Road, Shanghai, 201315, China
| | - Jiade Lu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kang Xin Road, Shanghai, 201315, China
| | - Guoliang Jiang
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kang Xin Road, Shanghai, 201315, China
| | - Jingfang Mao
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kang Xin Road, Shanghai, 201315, China.
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Stein TP, Schluter MD, Steer RA, Ming X. Bisphenol-A and phthalate metabolism in children with neurodevelopmental disorders. PLoS One 2023; 18:e0289841. [PMID: 37703261 PMCID: PMC10499243 DOI: 10.1371/journal.pone.0289841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/24/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND The etiology of autism spectrum (ASD) and Attention Deficit/Hyperactivity (ADHD) disorders are multifactorial. Epidemiological studies have shown associations with environmental pollutants, such as plasticizers. This study focused on two of these compounds, the Bisphenol-A (BPA) and Diethylhexyl Phthalate (DEHP). The major pathway for BPA and DEHP excretion is via glucuronidation. Glucuronidation makes insoluble substances more water-soluble allowing for their subsequent elimination in urine. HYPOTHESIS Detoxification of these two plasticizers is compromised in children with ASD and ADHD. Consequently, their tissues are more exposed to these two plasticizers. METHODS We measured the efficiency of glucuronidation in three groups of children, ASD (n = 66), ADHD (n = 46) and healthy controls (CTR, n = 37). The children were recruited from the clinics of Rutgers-NJ Medical School. A urine specimen was collected from each child. Multiple mass spectrometric analyses including the complete metabolome were determined and used to derive values for the efficiency of glucuronidation for 12 varied glucuronidation pathways including those for BPA and MEHP. RESULTS (1) Both fold differences and metabolome analyses showed that the three groups of children were metabolically different from each other. (2) Of the 12 pathways examined, only the BPA and DEHP pathways discriminated between the three groups. (3) Glucuronidation efficiencies for BPA were reduced by 11% for ASD (p = 0.020) and 17% for ADHD (p<0.001) compared to controls. DEHP showed similar, but not significant trends. CONCLUSION ASD and ADHD are clinically and metabolically different but share a reduction in the efficiency of detoxification for both BPA and DEHP with the reductions for BPA being statistically significant.
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Affiliation(s)
- T. Peter Stein
- Department of Surgery, Rowan University-School of Osteopathic Medicine, Stratford, NJ, United States of America
| | - Margaret D. Schluter
- Department of Surgery, Rowan University-School of Osteopathic Medicine, Stratford, NJ, United States of America
| | - Robert A. Steer
- Department of Psychiatry, Rowan University-School of Osteopathic Medicine, Stratford, NJ, United States of America
| | - Xue Ming
- Departments of Neurosciences and Neurology, Rutgers University–New Jersey Medical School, Newark, NJ, United States of America
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Ming X, Zhang YJ, Zhu X, Li Q, He C, Liu Y, Huang T, Liu G, Zheng B, Yang H, Sun J, Xi X, Wen HH. Absence of near-ambient superconductivity in LuH 2±xN y. Nature 2023; 620:72-77. [PMID: 37168015 PMCID: PMC10396964 DOI: 10.1038/s41586-023-06162-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 03/16/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
A recent study demonstrated near-ambient superconductivity in nitrogen-doped lutetium hydride1. This stimulated a worldwide interest in exploring room-temperature superconductivity at low pressures. Here, by using a high-pressure and high-temperature synthesis technique, we have obtained nitrogen-doped lutetium hydride (LuH2±xNy), which has a dark-blue colour and a structure with the space group [Formula: see text] as evidenced by X-ray diffraction. This structure is the same as that reported in ref. 1, with a slight difference in lattice constant. Raman spectroscopy of our samples also showed patterns similar to those observed in ref. 1. Energy-dispersive X-ray spectroscopy confirmed the presence of nitrogen in the samples. We observed a metallic behaviour from 350 K to 2 K at ambient pressure. On applying pressures from 2.1 GPa to 41 GPa, we observed a gradual colour change from dark blue to violet to pink-red. By measuring the resistance at pressures ranging from 0.4 GPa to 40.1 GPa, we observed a progressively improved metallic behaviour; however, superconductivity was not observed above 2 K. Temperature dependence of magnetization at high pressure shows a very weak positive signal between 100 K and 320 K, and the magnetization increases with an increase in magnetic field at 100 K. All of these are not expected for superconductivity above 100 K. Thus, we conclude the absence of near-ambient superconductivity in this nitrogen-doped lutetium hydride at pressures below 40.1 GPa.
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Affiliation(s)
- Xue Ming
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Ying-Jie Zhang
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Xiyu Zhu
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China.
| | - Qing Li
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China.
| | - Chengping He
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Yuecong Liu
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Tianheng Huang
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Gan Liu
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Bo Zheng
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Huan Yang
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Jian Sun
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Xiaoxiang Xi
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China
| | - Hai-Hu Wen
- National Laboratory of Solid State Microstructures, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, China.
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Hong Z, Yang Z, Mei X, Li P, Bao C, Wang Z, Cai X, Ming X, Wang W, Guo X, Yu X, Zhang Q. A retrospective study of adjuvant proton radiotherapy for breast cancer after lumpectomy: a comparison of conventional-dose and hypofractionated dose. Radiat Oncol 2023; 18:56. [PMID: 36959653 PMCID: PMC10035215 DOI: 10.1186/s13014-023-02213-8] [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: 08/25/2022] [Accepted: 01/22/2023] [Indexed: 03/25/2023] Open
Abstract
Purpose This study aimed to compare the adverse reactions of conventional-dose and hypofractionated dose of proton therapy for breast cancer.
Materials and methods Breast cancer patients treated with proton radiotherapy in conventional-dose or hypofractionated dose were studied retrospectively.
Result From January 2017 to December 2019, our center treated 50 patients following lumpectomy with proton radiotherapy. According to the AJCC 8th Edition standard, there were stage I in 26 patients, stage II in 22 patients, and stage III in 2 patients. A total of 14 patients received intensity-modulated proton therapy at a dose of 50 Gy in 25 fractions, followed by a 10 Gy 4 fractionated boost to the lumpectomy cavity, while 36 received 40.05 Gy in 15 fractions, simultaneous integrated boost (SIB) 48 Gy to the lumpectomy cavity. Median follow-up time for 40.05 Gy group was 35.6 months (15–43 months). Median follow-up time for 50 Gy group was 46.8 months (36–68 months). For acute toxicity, the grade 1 and 2 radiodermatitis in conventional-dose group were 35.7% and 57.1%, respectively. In hypofractionated dose group, the grade 1 and 2 radiodermatitis were 91.7% and 8.3%, respectively. The radiodermatitis is hypofractionneted dose better than conventional-dose significantly. Grade 1 radiation-induced esophagitis in conventional-dose group and hypofractionated dose group were 85.71% and 60%, respectively. For late toxicity, no patients developed radiation-induced pneumonitis and rib fracture in conventional-dose group. Three patients presented grade 1 pneumonitis; one patient presented graded 2 pneumonitides and two patients presented rib fracture in hypofractionated dose group. One presented hypothyroidism in hypofractionated dose group. All patients were satisfied with breast shape. The one- and two-year OS and DFS for conventional-dose group were 100 and 100; 100 and 92.9%, respectively. The one- and two-year OS and DFS for hypofractionated dose group were 100 and 100; 100 and 100%, respectively. Conclusion Proton radiation therapy can significantly reduce the normal tissue dose in breast cancer patients' hearts, lungs, and other organs. Hypofractionated proton therapy shortens the treatment course with mild radiation-related adverse effects, and has a better effect on addressing the acute adverse reactions than conventional proton radiotherapy.
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Affiliation(s)
- ZhengShan Hong
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kangxin Road, Pudong, Shanghai, 201321 China
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - ZhaoZhi Yang
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- grid.8547.e0000 0001 0125 2443Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xin Mei
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kangxin Road, Pudong, Shanghai, 201321 China
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- grid.8547.e0000 0001 0125 2443Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ping Li
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kangxin Road, Pudong, Shanghai, 201321 China
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Cihang Bao
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kangxin Road, Pudong, Shanghai, 201321 China
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
| | - Zheng Wang
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kangxin Road, Pudong, Shanghai, 201321 China
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Xin Cai
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kangxin Road, Pudong, Shanghai, 201321 China
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Xue Ming
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- grid.452404.30000 0004 1808 0942Department of Radiation Physics, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - WeiWei Wang
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- grid.452404.30000 0004 1808 0942Department of Radiation Physics, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - XiaoMao Guo
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kangxin Road, Pudong, Shanghai, 201321 China
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- grid.8547.e0000 0001 0125 2443Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - XiaoLi Yu
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kangxin Road, Pudong, Shanghai, 201321 China
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- grid.8547.e0000 0001 0125 2443Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qing Zhang
- grid.452404.30000 0004 1808 0942Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kangxin Road, Pudong, Shanghai, 201321 China
- grid.513063.2Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
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Wu JY, Xu B, Zhu XJ, Ming X, Luo H, Mao X, Gu J, Zhou JF, Xiao Y. [PD-1 inhibitor in chronic active Epstein-Barr virus infection: a report of six cases and literature review]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:165-168. [PMID: 36948875 PMCID: PMC10033261 DOI: 10.3760/cma.j.issn.0253-2727.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Affiliation(s)
- J Y Wu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - B Xu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - X J Zhu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - X Ming
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - H Luo
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - X Mao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - J Gu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - J F Zhou
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Xiao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Barbayannis G, Bandari M, Zheng X, Baquerizo H, Pecor KW, Ming X. Academic Stress and Mental Well-Being in College Students: Correlations, Affected Groups, and COVID-19. Front Psychol 2022; 13:886344. [PMID: 35677139 PMCID: PMC9169886 DOI: 10.3389/fpsyg.2022.886344] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023] Open
Abstract
Academic stress may be the single most dominant stress factor that affects the mental well-being of college students. Some groups of students may experience more stress than others, and the coronavirus disease 19 (COVID-19) pandemic could further complicate the stress response. We surveyed 843 college students and evaluated whether academic stress levels affected their mental health, and if so, whether there were specific vulnerable groups by gender, race/ethnicity, year of study, and reaction to the pandemic. Using a combination of scores from the Perception of Academic Stress Scale (PAS) and the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), we found a significant correlation between worse academic stress and poor mental well-being in all the students, who also reported an exacerbation of stress in response to the pandemic. In addition, SWEMWBS scores revealed the lowest mental health and highest academic stress in non-binary individuals, and the opposite trend was observed for both the measures in men. Furthermore, women and non-binary students reported higher academic stress than men, as indicated by PAS scores. The same pattern held as a reaction to COVID-19-related stress. PAS scores and responses to the pandemic varied by the year of study, but no obvious patterns emerged. These results indicate that academic stress in college is significantly correlated to psychological well-being in the students who responded to this survey. In addition, some groups of college students are more affected by stress than others, and additional resources and support should be provided to them.
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Affiliation(s)
- Georgia Barbayannis
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Mahindra Bandari
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Xiang Zheng
- Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Humberto Baquerizo
- Office for Diversity and Community Engagement, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Keith W. Pecor
- Department of Biology, The College of New Jersey, Ewing, NJ, United States
| | - Xue Ming
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, United States
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10
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Ming X, Wang W, Shahnazi K, Sun J, Zhang Q, Li P, Hong Z, Sheng Y. Dosimetric comparison between carbon, proton and photon radiation for renal retroperitoneal soft tissue sarcoma recurrence or metastasis after radical nephrectomy. Int J Radiat Biol 2021; 98:183-190. [PMID: 34802361 DOI: 10.1080/09553002.2022.2009144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To compare the dosimetric difference between various modalities in the radiation treatment for renal retroperitoneal soft tissue sarcoma recurrence or metastasis (RRSTSRM) after radical nephrectomy, and assess the dosimetric advantage on protecting the organs at risk (OARs) in the carbon and proton radiotherapy for the patients with a single kidney. METHODS A total of 12 patients with RRSTSRM who underwent radical nephrectomy were enrolled in this study. Carbon, proton, and photon radiotherapy were implemented for treatment planning. The prescription dose was fulfilled by simultaneously integrated boosting technique, with giving the planning target volume-1 (PTV-1) 51Gy (RBE) and planning target volume-2 (PTV-2) 60 Gy (RBE). Doses in the patient's spinal cord, stomach, duodenum, bowel, colon, and contralateral kidney were evaluated. The normal tissue complication probability (NTCP) of the duodenum, bowel, colon, and contralateral kidney was derived under Lyman-Kutcher-Burman (LKB) estimation. RESULTS In the carbon plans, the percentage volume of 95% prescription dose (V95%) covering PTV-1 (PTV-2) was 95.93% ± 3.42% (95.61% ± 4.26%). No significant dosimetric difference on the target was obtained between the four radiation modalities (P > .05). The percentage volume of receiving 40 Gy (RBE) [V40Gy (RBE)] in the duodenum could be reduced from 12.94% ± 15.99% in the IMRT plans to 6.36% ± 8.79% (8.44% ± 12.35%) in the carbon (proton) plans (P < .05). The V40Gy (RBE) in the bowel could be reduced from 13.48% ± 13.12% in the IMRT plans to 7.04% ± 9.32% (7.34% ± 9.89%) in the carbon (proton) plans (P < .05). The mean value of NTCP for the duodenum was 0.43 ± 0.47 (0.45 ± 0.48) by using carbon (proton) radiation. The value was 0.05 (0.03) lower than the IMRT plans on average, with a reduction of 0.20 (0.13) for the patients with lesions <5 mm away from the duodenum. The mean doses of the contralateral kidney were 0.28 ± 0.37 Gy (RBE) [0.28 ± 0.40 Gy (RBE)] in the IMCT (IMPT) plans, which was 92.43% (92.43%) lower than the value in the IMRT plans respectively (P < .05). CONCLUSION Compared to the conventional radiation techniques, particle radiotherapy of carbon and proton could significantly spare more OARs in the treatment for RRSTSRM after radical nephrectomy. Patients, especially those whose residuals are close to the duodenum would potentially benefit from the particle radiation therapy for RRSTSRM on the decrease in radiation-related side-effect.
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Affiliation(s)
- Xue Ming
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Weiwei Wang
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Kambiz Shahnazi
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Jiayao Sun
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Qing Zhang
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Ping Li
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Zhengshan Hong
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Yinxiangzi Sheng
- Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
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11
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Ma NY, Chen J, Ming X, Jiang GL, Lu JJ, Wu KL, Mao J. Preliminary Safety and Efficacy of Proton Plus Carbon-Ion Radiotherapy With Concurrent Chemotherapy in Limited-Stage Small Cell Lung Cancer. Front Oncol 2021; 11:766822. [PMID: 34858845 PMCID: PMC8631778 DOI: 10.3389/fonc.2021.766822] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/11/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives This study aimed to investigate the tolerance and effect of proton plus carbon-ion radiotherapy with concurrent chemotherapy in limited-stage small cell lung cancer using the pencil beam scanning technique. Materials and Methods From March 2017 to April 2020, 25 patients with limited-stage small cell lung cancer treated with combined proton and carbon-ion radiotherapy were analyzed. The primary lesions and involved lymph nodes were irradiated using 2-4 portals. Proton and sequential carbon-ion beams were delivered with a median dose of 67.1 (range, 63-74.8) GyE as fraction doses of 2.0-2.2 GyE with proton beams in 20-23 fractions and 3.0-3.8 GyE with carbon ions in 5-8 fractions. Chemotherapy was delivered concurrently with radiotherapy in all patients. Results At the last follow-up, the 2-year overall and locoregional progression-free survival rates were 81.7% and 66.7%, respectively. Radiochemotherapy was well tolerated, with grade 1, 2, and 3 acute toxicities occurring in 12.0%, 68.0%, and 20.0% of patients, respectively. All grade 3 acute toxicities were hematologically related changes. One patient experienced grade 3 acute non-hematological toxicity in the esophagus, and one other patient had grade 3 bronchial obstruction accompanied by obstructive atelectasis as a late side effect. Conclusion Proton plus carbon-ion radiotherapy using pencil beam scanning yielded promising survival rates and tolerability in patients with limited-stage small cell lung cancer. A prospective clinical study is warranted to validate the therapeutic efficacy of particle radiotherapy in combination with chemotherapy in limited-stage small cell lung cancer.
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Affiliation(s)
- Ning-Yi Ma
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.,Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Jian Chen
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.,Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Xue Ming
- Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.,Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.,Department of Radiation Physics, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Guo-Liang Jiang
- Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.,Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Fudan University, Shanghai, China
| | - Jiade J Lu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.,Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Kai-Liang Wu
- Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.,Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Fudan University, Shanghai, China
| | - Jingfang Mao
- Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.,Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Fudan University, Shanghai, China
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12
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Rubenstein S, Grew E, Clouser K, Kwok A, Veerapandiyan A, Kornitzer J, Pecor K, Ming X. COVID-19 in Pediatric Inpatients: A Multi-Center Observational Study of Factors Associated with Negative Short-Term Outcomes. Children (Basel) 2021; 8:children8110951. [PMID: 34828664 PMCID: PMC8620202 DOI: 10.3390/children8110951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/12/2021] [Accepted: 10/19/2021] [Indexed: 04/23/2023]
Abstract
Most cases of COVID-19 in children and adolescents are mild or asymptomatic, but a small number of individuals may develop severe disease, requiring PICU admission and/or mechanical ventilation. We assessed the factors associated with negative short-term outcomes of COVID-19 in 82 pediatric patients at three hospitals within the United States during the spring and summer of 2020 using medical records, laboratory data, and imaging studies of all patients admitted with a positive RT-PCR test for SARS-CoV-2. We found that older patients were more likely to have an extended hospital stay, and those with high BMIs (over 25) were more likely to be admitted to the PICU during the early pandemic. In addition, older patients, those with high BMIs, and those with underlying medical conditions, were more likely to receive respiratory support. Given the association of age, BMI, and underlying medical conditions with more severe COVID-19, clinicians should keep these factors in mind when treating patients.
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Affiliation(s)
- Sara Rubenstein
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (S.R.); (E.G.); (J.K.)
| | - Emily Grew
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (S.R.); (E.G.); (J.K.)
| | - Katharine Clouser
- Pediatric Hospital Medicine, Hackensack University Medical Center, Hackensack, NJ 07601, USA;
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Alexander Kwok
- Division of Pediatric Neurology, University of Arkansas for Medical Sciences, Little Rock, AR 72005, USA; (A.K.); (A.V.)
| | - Aravindhan Veerapandiyan
- Division of Pediatric Neurology, University of Arkansas for Medical Sciences, Little Rock, AR 72005, USA; (A.K.); (A.V.)
| | - Jeffrey Kornitzer
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (S.R.); (E.G.); (J.K.)
- Division of Neurology, New Jersey Pediatric Neuroscience Institute, Morristown, NJ 07960, USA
- Division of Child Neurology, St. Joseph’s Children’s Hospital, Paterson, NJ 07503, USA
| | - Keith Pecor
- Department of Biology, The College of New Jersey, Ewing, NJ 08628, USA;
| | - Xue Ming
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (S.R.); (E.G.); (J.K.)
- Correspondence:
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He C, Ming X, Li Q, Zhu X, Si J, Wen HH. Synthesis and physical properties of perovskite Sm 1-xSr xNiO 3( x= 0, 0.2) and infinite-layer Sm 0.8Sr 0.2NiO 2nickelates. J Phys Condens Matter 2021; 33:265701. [PMID: 33902020 DOI: 10.1088/1361-648x/abfb90] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
Recently, superconductivity at about 9-15 K was discovered in Nd1-xSrxNiO2(Nd-112,x≈ 0.125-0.25) infinite-layer thin films, which has stimulated enormous interests in related rare-earth nickelates. Usually, the first step to synthesize this 112 phase is to fabricate theRNiO3(R-113,R: rare-earth element) phase, however, it was reported that the 113 phase is very difficult to be synthesized successfully due to the formation of unusual Ni3+oxidation state. And the difficulty of preparation is enhanced as the ionic radius of rare-earth element decreases. In this work, we report the synthesis and investigation on multiple physical properties of polycrystalline perovskites Sm1-xSrxNiO3(x= 0, 0.2) in which the ionic radius of Sm3+is smaller than that of Pr3+and Nd3+in related superconducting thin films. The structural and compositional analyses conducted by x-ray diffraction and energy dispersive x-ray spectrum reveal that the samples mainly contain the perovskite phase of Sm1-xSrxNiO3with small amount of NiO impurities. Magnetization and resistivity measurements indicate that the parent phase SmNiO3undergoes a paramagnetic-antiferromagnetic transition at about 224 K on a global insulating background. In contrast, the Sr-doped sample Sm0.8Sr0.2NiO3shows a metallic behavior from 300 K down to about 12 K, while below 12 K the resistivity exhibits a slight logarithmic increase. Meanwhile, from the magnetization curves, we can see that a possible spin-glass state occurs below 12 K in Sm0.8Sr0.2NiO3. Using a soft chemical reduction method, we also obtain the infinite-layer phase Sm0.8Sr0.2NiO2with square NiO2planes. The compound shows an insulating behavior which can be described by the three-dimensional variable-range-hopping model. And superconductivity is still absent in the polycrystalline Sm0.8Sr0.2NiO2.
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Affiliation(s)
- Chengping He
- Center for Superconducting Physics and Materials, National Laboratory of Solid State Microstructures and Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, People's Republic of China
| | - Xue Ming
- Center for Superconducting Physics and Materials, National Laboratory of Solid State Microstructures and Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, People's Republic of China
| | - Qing Li
- Center for Superconducting Physics and Materials, National Laboratory of Solid State Microstructures and Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, People's Republic of China
| | - Xiyu Zhu
- Center for Superconducting Physics and Materials, National Laboratory of Solid State Microstructures and Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, People's Republic of China
| | - Jin Si
- Center for Superconducting Physics and Materials, National Laboratory of Solid State Microstructures and Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, People's Republic of China
| | - Hai-Hu Wen
- Center for Superconducting Physics and Materials, National Laboratory of Solid State Microstructures and Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing 210093, People's Republic of China
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14
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Pecor KW, Barbayannis G, Yang M, Johnson J, Materasso S, Borda M, Garcia D, Garla V, Ming X. Quality of Life Changes during the COVID-19 Pandemic for Caregivers of Children with ADHD and/or ASD. Int J Environ Res Public Health 2021; 18:3667. [PMID: 33915884 PMCID: PMC8037979 DOI: 10.3390/ijerph18073667] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [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] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 12/21/2022]
Abstract
The COVID-19 pandemic has presented many challenges to caregivers of children. Families with children with attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) are an understudied but potentially vulnerable population to changes during the outbreak. As such, the aim of this study was to contrast quality of life for caregivers of children with ADHD and/or ASD, before and during the pandemic, compared to caregivers of neurotypical (NT) children. Total, Parent Health-Related Quality of Life, and Family Functioning Summary Scores from the Family Impact Module of the Pediatric Quality of Life InventoryTM were contrasted among caregivers of children with ADHD, ASD, comorbid ADHD and ASD, and NT development. For all scores, caregivers of ADHD and/or ASD children reported lower quality of life, both before and during the pandemic, in comparison to caregivers of NT children. For all diagnoses, quality of life decreased during the pandemic, but caregivers of children with ADHD and/or ASD reported a greater decrease in quality of life than caregivers for NT children. There are limitations to this study in terms of the composition of the sample and the survey methodology, but we are able to conclude that caregivers of children with ADHD and/or ASD have been disproportionately affected by the pandemic, and it is imperative that these families receive additional resources and support to improve their quality of life.
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Affiliation(s)
- Keith W. Pecor
- Department of Biology, The College of New Jersey, Ewing, NJ 08628, USA;
| | - Georgia Barbayannis
- Department of Neurology, Rutgers University-New Jersey Medical School, Newark, NJ 07103, USA; (G.B.); (J.J.); (D.G.)
| | - Max Yang
- College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA; (M.Y.); (S.M.)
| | - Jacklyn Johnson
- Department of Neurology, Rutgers University-New Jersey Medical School, Newark, NJ 07103, USA; (G.B.); (J.J.); (D.G.)
| | - Sarah Materasso
- College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA; (M.Y.); (S.M.)
| | - Mauricio Borda
- Department of Neurology, Montefiore Medical Center, Bronx, NY 10467, USA;
| | - Disleidy Garcia
- Department of Neurology, Rutgers University-New Jersey Medical School, Newark, NJ 07103, USA; (G.B.); (J.J.); (D.G.)
| | - Varsha Garla
- College of Arts and Sciences, Vanderbilt University, Nashville, TN 37212, USA;
| | - Xue Ming
- Department of Neurology, Rutgers University-New Jersey Medical School, Newark, NJ 07103, USA; (G.B.); (J.J.); (D.G.)
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15
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Ming X, Ray C, Bandari M. Beyond the PPE shortage: Improperly fitting personal protective equipment and COVID-19 transmission among health care professionals. Hosp Pract (1995) 2020; 48:246-247. [PMID: 32713215 DOI: 10.1080/21548331.2020.1802172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Personal protective equipment (PPE) use is required when caring for COVID-19 patients. Proper mask fitting is essential in prevention of infectious agent transmission at hospital setting.Methods and Results: We describe three cases of health care professionals (HCP) in a COVID-19 designated ward with positive SARS-CoV-2 RT-PCR results, and were found to have improperly fitted masks.Conclusion: These cases of improperly fitting masks in HCP may have contributed to their eventual COVID-19 infection. These cases raise the important issue of PPE fitting. Abbreviations: Personal Protective Equipment (PPE), Health Care Professional (HCP), Real-time PCR (RT-PCR).
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Affiliation(s)
- Xue Ming
- Neurology, Rutgers New Jersey Medical School , Morganville, New Jersey, USA
| | - Carly Ray
- Neurology, Rutgers New Jersey Medical School , Newark, New Jersey, USA
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16
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Ray C, Ming X. Climate Change and Human Health: A Review of Allergies, Autoimmunity and the Microbiome. Int J Environ Res Public Health 2020; 17:ijerph17134814. [PMID: 32635435 PMCID: PMC7369820 DOI: 10.3390/ijerph17134814] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/24/2022]
Abstract
The impact of climate change on human health is a topic of critical importance. While only recently beginning to gain attention, it is clear that immediate action is necessary to minimize this impact. In our review, we will outline a subset of these effects in detail. We will examine how climate change has worsened respiratory allergic disease. We will discuss how climate change has altered antigen exposure, possibly disrupting antigen-specific tolerance by the immune system, leading, in turn, to an increase in the prevalence of immunologic diseases. Finally, we will explore how the loss of biodiversity related to climate change may affect the microbiome, potentially leading to dysbiosis, inflammatory, autoimmune and neurologic diseases.
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Affiliation(s)
| | - Xue Ming
- Correspondence: ; Tel.: +1-973-972-2922
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17
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Abstract
As COVID‐19 impacts medical education worldwide, lack of patient contact and in‐person courses creates concern for medical students. This commentary presents a call to action from students who want to be educated and prepared for their futures.
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Affiliation(s)
- Cara Theoret
- Rutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Xue Ming
- Rutgers New Jersey Medical SchoolNewarkNew JerseyUSA
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18
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Abstract
RATIONALE Wiedemann-Steiner syndrome (WDSTS, online mendelian inheritance in man 605130) is a rare autosomal dominant disorder characterized by hypertrichosis cubiti. Here, we report a Chinese boy who do not show the characteristic of hypertrichosis cubiti, and was misdiagnosed as blepharophimosis-ptosis-epicanthus inversus syndrome at first. We found a de novo frameshift mutation (p.Glu390Lysfs*10) in the KMT2A gene, which was not reported before. Our study increases the cohort of Chinese WDSTS patients, and expand the WDSTS phenotypic and variation spectrum. PATIENT CONCERNS The patient demonstrated typical craniofacial features of blepharophimosis-ptosis-epicanthus inversus syndrome, including small palpebral fissures, ptosis, telecanthus, and epicanthus inversus, besides he had congenital heart disease (ventricular septal defects), strabismus, hypotonia, amblyopia, delayed speech and language development, delayed psychomotor development, and amblyopia (HP:0000646) which was not reported before. DIAGNOSIS FOXL2 gene was cloned and sequenced, however, there was no mutation detected in this patient. The result of Chromosomal microarray analysis was normal. The patient was diagnosed as WDSTS by whole exome sequencing. INTERVENTIONS The patient received cardiac surgery, frontalis suspension and regular speech and occupational therapy. He also treated with growth hormone (GH). OUTCOMES The patient's symptoms are improved after cardiac surgery and frontalis suspension, he can express himself well now and had a 10 cm gain in height. LESSONS As the relationship between genotype and phenotype becomes more and more clear, WES is incredibly powerful tool to diagnose the disease of WDSTS.
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Affiliation(s)
- Liu Jinxiu
- Yinfeng Medical Laboratory, Jinan Shandong
| | | | - Xue Ming
- Genetics Diagnostic Lab, Tai’an Maternity and Child Care Hospital, Tai’an, China
| | - Liu CS. Jonathan
- SoftGenetics LLC, 100 Oakwood Ave, State College, Pennsylvania 16803, USA
| | - Liu Xiangju
- Genetics Diagnostic Lab, Tai’an Maternity and Child Care Hospital, Tai’an, China
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Ming X, Li N, Nie D, Gou J, Xue L, Li Z. A prognostic index model for predicting long-term recurrence of uterine leiomyoma after initial myomectomy in women aged 18-44 years. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz426.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Na L, Hu T, Ming X, Li Z. The BOT patients fail to benefit from surgical staging procedures in prognosis and fertility outcomes: A retrospective analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz426.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Schoser B, Kishnani P, Bratkovic D, Byrne B, Clemens P, Goker-Alpan O, Ming X, Roberts M, Schwenkreis P, Sivakumar K, van der Ploeg A, Sitaraman S, Barth J, Lagast H, Mozaffar T. PRECLINICAL APPROACHES AND EARLY CLINICAL RESULTS. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Oh DM, Johnson J, Shah B, Bhat S, Nuoman R, Ming X. Treatment of vagus nerve stimulator-induced sleep-disordered breathing: A case series. Epilepsy Behav Rep 2019; 12:100325. [PMID: 31497754 PMCID: PMC6719281 DOI: 10.1016/j.ebr.2019.100325] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/04/2019] [Accepted: 05/27/2019] [Indexed: 11/05/2022] Open
Abstract
Objective Vagus nerve stimulation (VNS) is a treatment option for patients with drug-resistant seizures, but it is also associated with sleep-disordered breathing (SDB). We present four patients with VNS who underwent polysomnography (PSG) concurrently with VNS stimulation monitoring and adjustment, and positive airway pressure (PAP) treatment. We demonstrate the importance of sleep apnea screening prior to VNS placement and the dilemma of optimizing VNS settings. Background VNS is a common adjunct therapy for refractory epilepsy. Despite its low side effect profile, complications of VNS include delayed arrhythmias, laryngopharyngeal dysfunction, obstructive sleep apnea, and tonsillar pain mimicking glossopharyngeal neuralgia. Risk of developing or exacerbating existing obstructive sleep apnea (OSA) limits the VNS settings, as there appears to be a dose dependent effect. OSA can further cause sleep fragmentation and cause hypoxia, potentially worsening seizures. Methods Four patients with drug-resistant epilepsy with VNS underwent PSG with concurrent VNS leads to monitor correlation of SDB and VNS. AHI was calculated to quantify SDB, and it was scored as non-VNS related when the VNS was off, and VNS-induced when the onset of SDB corresponded to VNS activation. Subsequent PAP and VNS adjustment was performed to treat the SDB episodes. Results Three out of four patients had non-VNS associated SDB, which improved with PAP treatment. All four patients had VNS-induced SDB episodes but none improved with PAP. The VNS-induced SDB events decreased in a dose dependent manner, when VNS was adjusted down and disappeared when turned off completely. Conclusion Our case series provides further evidence of VNS-induced SDB secondary to VNS. PAP treatment alone is ineffective for VNS-induced SDB. Screening for OSA before VNS implant is crucial; further research is needed to establish optimal VNS parameters for prevention andminimization of VNS-induced SDB along with other possible treatments. Further evidence of VNS-induced SDB as a side effect of VNS PAP treatment alone is not effective in eliminating VNS-induced SDB VNS setting titration showed dose-dependent effect on SDB Screening of primary OSA before and after VNS implant is crucial
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Affiliation(s)
- Daniel M Oh
- Rutgers New Jersey Medical School, Department of Neurology, 150 Bergen St., Newark, NJ 07103, United States of America
| | - Jacklyn Johnson
- Rutgers New Jersey Medical School, Department of Neurology, 150 Bergen St., Newark, NJ 07103, United States of America
| | - Bankim Shah
- Riverside Medical Group, Bayonne Sleep Medicine, 432 Broadway, Bayonne, NJ 07002, United States of America
| | - Sushanth Bhat
- Seton Hall University, New Jersey Neuroscience Institute, Sleep Medicine Center, 65 James St., Edison, NJ 08820, United States of America
| | - Rolla Nuoman
- Rutgers New Jersey Medical School, Department of Neurology, 150 Bergen St., Newark, NJ 07103, United States of America
| | - Xue Ming
- Rutgers New Jersey Medical School, Department of Neurology, 150 Bergen St., Newark, NJ 07103, United States of America.,Seton Hall University, New Jersey Neuroscience Institute, Sleep Medicine Center, 65 James St., Edison, NJ 08820, United States of America
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Bin W, Ming X, Wen-Xia C. TRAF1 meditates lipopolysaccharide-induced acute lung injury by up regulating JNK activation. Biochem Biophys Res Commun 2019; 511:49-56. [PMID: 30760405 DOI: 10.1016/j.bbrc.2019.01.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/08/2019] [Indexed: 01/11/2023]
Abstract
Acute lung injury (ALI) is served as a severe life-threatening disease. However, the pathogenesis that contributes to ALI has not been fully understood. Tumor necrosis factor receptor-associated factor 1 (TRAF1) interacts with multiple regulators, performing its diverse role in biological functions. However, the effects of TRAF1 on ALI remain unknown. In this study, we attempted to explore the role of TRAF1 in ALI progression. The findings suggested that TRAF1-knockout (KO) markedly attenuated LPS-induced severe mortality rate in murine animals. LPS-elicited histological alterations in pulmonary tissues were significantly alleviated by TRAF1-deletion. Additionally, TRAF1 knockout effectively attenuated lung injury, as evidenced by the reduced lung wet/dry (W/D) weight ratio, as well as decreased bronchoalveolar lavage fluid (BALF) protein levels and neutrophil infiltration. Meanwhile, TRAF1 deletion markedly lessened inflammation, oxidative stress and apoptosis in BALF and/or lung tissues. The levels of pro-inflammatory cytokines stimulated by LPS were down-regulated by TRAF1 ablation, along with the inactivation of nuclear factor κB (NF-κB). LPS-promoted reactive oxygen species (ROS) generation was decreased in TRAF1-KO mice, partly through the improvement of anti-oxidants. Apoptosis was also inhibited by TRAF1 deletion in lung tissues of LPS-challenged mice through the suppression of cleaved Caspase-3. Moreover, TRAF1 knockout significantly decreased c-Jun N-terminal kinase (JNK) activation and its down-streaming signal of c-Jun in pulmonary samples of LPS-induced mice. Importantly, the in vitro study suggested that promoting JNK activation markedly abrogated TRAF1 knockdown-attenuated inflammation, ROS production and apoptosis in LPS-exposed A549 cells. Therefore, our experimental results provided evidence that TRAF1 suppression effectively protected LPS-induced ALI against inflammation, oxidative stress and apoptosis through the suppression of JNK activity.
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Affiliation(s)
- Wan Bin
- Department of Pediatrics, Renmin Hospital of Hubei University of Medicine, Shiyan, 442000, China
| | - Xue Ming
- Department of Pediatrics, Pediatrics of Traditional Chinese Medicine Hospital of Baoji City, Baoji, 721001, China
| | - Chen Wen-Xia
- Department of Pediatrics, Ankang Central Hospital, Ankang, 725000, China.
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Silverstein S, Veerapandiyan A, Hayes-Rosen C, Ming X, Kornitzer J. A novel intronic homozygous mutation in the AMT gene of a patient with nonketotic hyperglycinemia and hyperammonemia. Metab Brain Dis 2019; 34:373-376. [PMID: 30350008 DOI: 10.1007/s11011-018-0317-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/12/2018] [Indexed: 10/28/2022]
Abstract
Nonketotic Hyperglycinemia is an autosomal recessive disorder characterized by defects in the mitochondrial glycine cleavage system. Most patients present soon after birth with seizures and hypotonia, and infants that survive the newborn period often have profound intellectual disability and intractable seizures. Here we present a case report of a 4-year-old girl with NKH as well as hyperammonemia, an uncommon finding in NKH. Genetic analysis found a previously unreported homozygous mutation (c.878-1 G > A) in the AMT gene. Maximum Entropy Principle modeling predicted that this mutation most likely breaks the splice site at the border of intron 7 and exon 8 of the AMT gene. Treatment with L-Arginine significantly reduced both the proband's glycine and ammonia levels, in turn aiding in control of seizures and mental status. This is the first time the use of L-Arginine is reported to successfully treat elevated glycine levels.
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Affiliation(s)
- Sarah Silverstein
- Department of Neurology, Rutgers University-New Jersey Medical School, 90 Bergen Street, DOC 8100, Newark, NJ, 07103, USA
| | - Aravindhan Veerapandiyan
- Department of Pediatrics, Division of Neurology, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Caroline Hayes-Rosen
- Department of Neurology, Rutgers University-New Jersey Medical School, 90 Bergen Street, DOC 8100, Newark, NJ, 07103, USA
| | - Xue Ming
- Department of Neurology, Rutgers University-New Jersey Medical School, 90 Bergen Street, DOC 8100, Newark, NJ, 07103, USA
| | - Jeffrey Kornitzer
- Department of Neurology, Rutgers University-New Jersey Medical School, 90 Bergen Street, DOC 8100, Newark, NJ, 07103, USA.
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Mulvey MA, Veerapandiyan A, Marks DA, Ming X. Electronic health record cue identifies epilepsy patients at risk for obstructive sleep apnea. Neurol Clin Pract 2018; 8:468-471. [PMID: 30588375 DOI: 10.1212/cpj.0000000000000502] [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] [Received: 02/23/2018] [Accepted: 05/21/2018] [Indexed: 11/15/2022]
Abstract
Background Prior studies have reported that patients with epilepsy have a higher prevalence of obstructive sleep apnea (OSA) that contributes to poor seizure control. Detection and treatment of OSA can improve seizure control in some patients with epilepsy. In this study, we sought to develop, implement, and evaluate the effectiveness of an electronic health record (EHR) alert to screen for OSA in patients with epilepsy. Methods A 3-month retrospective chart review was conducted of all patients with epilepsy >18 years of age who were evaluated in our epilepsy clinics prior to the intervention. An assessment for obstructive sleep apnea (AOSA) consisting of 12 recognized risk factors for OSA was subsequently developed and embedded in the EHR. The AOSA was utilized for a 3-month period. Patients identified with 2 or more risk factors were referred for polysomnography. A comparison was made to determine if there was a difference in the number of patients at risk for OSA detected and referred for polysomnography with and without an EHR alert to screen for OSA. Results There was a significant increase in OSA patient recognition. Prior to the EHR alert, 25/346 (7.23%) patients with epilepsy were referred for a polysomnography. Postintervention, 405/414 patients were screened using an EHR alert for AOSA and 134/405 (33.1%) were referred for polysomnography (p < 0.001). Conclusion An intervention with AOSA cued in the EHR demonstrated markedly improved identification of epilepsy patients at risk for OSA and referral for polysomnography.
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Affiliation(s)
- Martha A Mulvey
- Department of Neurology (MAM, DAM, XM), Rutgers New Jersey Medical School, Newark; and Department of Neurology (AV), University of Rochester Medical Center, NY
| | - Aravindhan Veerapandiyan
- Department of Neurology (MAM, DAM, XM), Rutgers New Jersey Medical School, Newark; and Department of Neurology (AV), University of Rochester Medical Center, NY
| | - David A Marks
- Department of Neurology (MAM, DAM, XM), Rutgers New Jersey Medical School, Newark; and Department of Neurology (AV), University of Rochester Medical Center, NY
| | - Xue Ming
- Department of Neurology (MAM, DAM, XM), Rutgers New Jersey Medical School, Newark; and Department of Neurology (AV), University of Rochester Medical Center, NY
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Veerapandiyan A, Aravindhan A, Takahashi JH, Segal D, Pecor K, Ming X. Use of Head Computed Tomography (CT) in the Pediatric Emergency Department in Evaluation of Children With New-Onset Afebrile Seizure. J Child Neurol 2018; 33:708-712. [PMID: 29987971 DOI: 10.1177/0883073818786086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Cranial computed tomography (CT) is not recommended in the routine evaluation of children with first afebrile seizure due to its low yield. The objective was to assess the current practice in our pediatric emergency department regarding the use of head CT in children with first afebrile seizure and to identify the factors that lead to ordering a head CT. METHODS Medical records of patients between 1 month and 18 years old evaluated at our emergency department for presentation of first afebrile seizure between 2010 and 2014 were retrospectively reviewed. Data extracted include age, gender, seizure type, single or multiple seizures at presentation, seizure duration, predisposing conditions to seizures (ie, history of developmental delay), and whether a head CT was performed. Contingency tables with chi-square analyses were used to determine which variables were associated with increased use of head CT. RESULTS Of 155 patients (88M/67F) included in the study, 72 (46.5%) underwent head CT and only 3 had clinically significant findings that did not require acute management. There were no differences in CT use by age, sex, seizure type, seizure number, seizure risk factors, or findings on physical examination. Head CT was performed more frequently in cases with seizures ≥5 minutes and unknown seizure duration ( P = .04). CONCLUSION Despite existing evidence, the emergent head CT rate was high in our cohort. Children with seizure duration of ≥5 minutes or of unknown duration were more likely to undergo head CT in our emergency department.
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Affiliation(s)
| | | | | | - Devorah Segal
- 4 Department of Neurology, Weill Cornell Medical College, New York, NY, USA
| | - Keith Pecor
- 5 Department of Biology, The College of New Jersey, Ewing, NJ, USA
| | - Xue Ming
- 3 Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
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27
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Schoser B, Bratkovic D, Byrne B, Clemens P, Geberhiwot T, Goker-Alpan O, Kishnani P, Ming X, Mozaffar T, Schwenkreis P, Sivakumar K, van der Ploeg A, Wright J, Johnson F, Sitaraman S, Barth J, Sathe S, Roberts M. NEW THERAPEUTIC APPROACHES AND THEIR READOUT. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.243] [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: 10/28/2022]
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Fowlie G, Cohen N, Ming X. The Perturbance of Microbiome and Gut-Brain Axis in Autism Spectrum Disorders. Int J Mol Sci 2018; 19:ijms19082251. [PMID: 30071612 PMCID: PMC6121241 DOI: 10.3390/ijms19082251] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 07/22/2018] [Accepted: 07/30/2018] [Indexed: 12/18/2022] Open
Abstract
Gastrointestinal problems have been documented in Autism Spectrum Disorder (ASD). Studies have found that these disturbances may be associated with an altered gut microbiome in ASD. Furthermore, in ASD, these alterations are implicated in increased gut permeability, or “leaky gut”, which allows bacterial metabolites to cross the gut barrier, impacting neurodevelopment during early childhood in susceptible subjects by way of gut-brain axis. In our review, we will discuss the interaction of gut microbiota and brain development in ASD and the signaling mechanisms underlying this interaction. We will also explore the potential for treatment of ASD by targeting the microbiome with probiotics. Finally, this paper will attempt to provide significance to the aggregation of the research in this area of research; providing our interpretations and assessments of future of this field.
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Affiliation(s)
- Greta Fowlie
- Department of Neurology, Rutgers New Jersey Medical School, 90 Bergen Street, DOC 8100, Newark, NJ 07103, USA.
| | - Nicholas Cohen
- Department of Neurology, Rutgers New Jersey Medical School, 90 Bergen Street, DOC 8100, Newark, NJ 07103, USA.
| | - Xue Ming
- Department of Neurology, Rutgers New Jersey Medical School, 90 Bergen Street, DOC 8100, Newark, NJ 07103, USA.
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Ming X, Chen N, Ray C, Brewer G, Kornitzer J, Steer RA. A Gut Feeling: A Hypothesis of the Role of the Microbiome in Attention-Deficit/Hyperactivity Disorders. Child Neurol Open 2018; 5:2329048X18786799. [PMID: 30023407 PMCID: PMC6047248 DOI: 10.1177/2329048x18786799] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/25/2018] [Accepted: 06/12/2018] [Indexed: 01/14/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurologic disorder characterized by hyperactivity/impulsivity and/or inattentiveness, with genetic and environmental factors contributing to the disorder. With the growing recognition of the microbiome’s role in many neurological disorders, the authors propose that it may also be implicated in ADHD. Here, we describe several evolving areas of research to support this hypothesis. First, a unique composition of gut bacteria has been identified and linked to behaviors in ADHD. Second, our research found an increased incidence of 2 gastrointestinal symptoms (constipation and flatulence) in children with ADHD, as compared to controls. Finally, emerging data may be interpreted to suggest that immune dysregulation in ADHD be associated with an altered microbiome, low-grade inflammation, and gastrointestinal dysfunction. Although more studies are needed to elucidate exact mechanisms and causality, we propose that an altered microbiome, gastrointestinal symptoms, and immune dysregulation may be associated with the ADHD phenotypes.
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Affiliation(s)
- Xue Ming
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Neil Chen
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Carly Ray
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Gretchen Brewer
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Jeffrey Kornitzer
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Robert A Steer
- Department of Surgery, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
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Thulasi V, Steer RA, Monteiro IM, Ming X. Overall severities of gastrointestinal symptoms in pediatric outpatients with and without autism spectrum disorder. Autism 2018; 23:524-530. [PMID: 29499612 DOI: 10.1177/1362361318757564] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In order to determine the effectiveness of a Gastrointestinal Severity Index to screen for gastrointestinal disorders, the Gastrointestinal Severity Index was administered to 135 children with autism spectrum disorders and 146 comparisons with and without gastrointestinal disorders. The mean Gastrointestinal Severity Index scores of the groups were 3.53 ± 1.78, 3.15 ± 1.99, 0.81 ± 1.25, and 0.29 ± 0.76 (comparative pediatric patients with gastrointestinal disorder = autism spectrum disorder + gastrointestinal disorder > autism spectrum disorder-gastrointestinal disorder > comparative pediatric patients without gastrointestinal disorder, respectively), Ps < 0.05. Receiver operating characteristic curves and areas under the receiver operating characteristic curves were calculated to ascertain which Gastrointestinal Severity Index cutoff scores yielded the highest sensitivity and specificity rates for the diagnosis of gastrointestinal disorders. The area under the receiver operating characteristic curve (0.97) for the comparison group was higher (P < 0.001) than the area under the receiver operating characteristic curve (0.85) for autism spectrum disorder children indicating that the Gastrointestinal Severity Index was more effective in screening for gastrointestinal disorders in comparisons. However, the same Gastrointestinal Severity Index cutoff score of 2 and above yielded, respectively, sensitivity and specificity rates of 92% and 93% for comparisons and 80% and 79% for autism spectrum disorder children. The negative and positive predictive values based on these sensitivity and specificity rates were calculated for a range of prevalences of gastrointestinal disorders and indicated that the Gastrointestinal Severity Index may be useful for screening children with and without autism spectrum disorder for gastrointestinal symptoms.
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Thulasi V, Veerapandiyan A, Pletcher BA, Tong CM, Ming X. A Case of Brown-Vialetto-Van Laere Syndrome Due To a Novel Mutation in SLC52A3 Gene: Clinical Course and Response to Riboflavin. Child Neurol Open 2017; 4:2329048X17725610. [PMID: 28856173 PMCID: PMC5570109 DOI: 10.1177/2329048x17725610] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 04/17/2017] [Revised: 05/30/2017] [Accepted: 06/23/2017] [Indexed: 11/15/2022] Open
Abstract
Brown-Vialetto-Van Laere syndrome is a rare disorder characterized by motor, sensory, and cranial neuronopathies, associated with mutations in SLC52A2 and SLC52A3 genes that code for human riboflavin transporters RFVT2 and RFVT3, respectively. The authors describe the clinical course of a 6-year-old girl with Brown-Vialetto-Van Laere syndrome and a novel homozygous mutation c.1156T>C in the SLC52A3 gene, who presented at the age of 2.5 years with progressive brain stem dysfunction including ptosis, facial weakness, hearing loss, dysphagia, anarthria with bilateral vocal cord paralysis, and ataxic gait. She subsequently developed respiratory failure requiring tracheostomy and worsening dysphagia necessitating a gastrostomy. Following riboflavin supplementation, resolution of facial diplegia and ataxia, improvements in ptosis, and bulbar function including vocalization and respiration were noted. However, her sensorineural hearing loss remained unchanged. Similar to other cases of Brown-Vialetto-Van Laere syndrome, our patient responded favorably to early riboflavin supplementation with significant but not complete neurologic recovery.
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Affiliation(s)
- Venkatraman Thulasi
- Division of Pediatric Neurology, Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Aravindhan Veerapandiyan
- Division of Pediatric Neurology, Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Beth A Pletcher
- Division of Clinical Genetics, Department of Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Chun M Tong
- Division of Pediatric Neurology, Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Xue Ming
- Division of Pediatric Neurology, Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
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Veerapandiyan A, Enner S, Thulasi V, Ming X. A Rare Syndrome of GRID2 Deletion in 2 Siblings. Child Neurol Open 2017; 4:2329048X17726168. [PMID: 28856174 PMCID: PMC5570108 DOI: 10.1177/2329048x17726168] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/27/2017] [Accepted: 07/03/2017] [Indexed: 11/23/2022] Open
Abstract
The Glutamate receptor, ionotropic, delta 2 gene codes for an ionotropic glutamate delta-2 receptor, which is selectively expressed in cerebellar Purkinje cells, and facilitates cerebellar synapse organization and transmission. The phenotype associated with the deletion of Glutamate receptor, ionotropic, delta 2 gene in humans was initially defined in 2013. In this case report, the authors describe 2 brothers who presented with developmental delay, tonic upward gaze, nystagmus, oculomotor apraxia, hypotonia, hyperreflexia, and ataxia. They were found to have a homozygous intragenic deletion within the Glutamate receptor, ionotropic, delta 2 gene at exon 2. Our patients serve as an addition to the literature of previously reported children with this rare clinical syndrome associated with Glutamate receptor, ionotropic, delta 2 deletion.
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Affiliation(s)
- Aravindhan Veerapandiyan
- Division of Pediatric Neurology, Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Stephanie Enner
- Division of Pediatric Neurology, Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Venkatraman Thulasi
- Division of Pediatric Neurology, Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Xue Ming
- Division of Pediatric Neurology, Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
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Pecor K, Wang XT, Ming X. Gender and Sleep Health in High School Students: A Cross-Cultural Study. Glob J Health Sci 2016. [DOI: 10.5539/gjhs.v9n5p124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
<p><strong>BACKGROUND & OBJECTIVE:</strong> Many recent studies have shown that sleep health is important for overall health and performance. However, adolescents often report poor sleep health, such as short duration and low quality sleep. In some cases, sleep characteristics are independent of gender and culture, but not in others. In this study, we tested for effects of gender, culture, and their interaction on measures of sleep health (adequacy and quality) for adolescents in an American population and a Chinese population.</p><p><strong>METHODS:</strong> A common survey instrument was administered to high school students in New Jersey, USA and Wen Zhou, PRC. Students were asked to answer questions about their sleep duration, perception of sleep adequacy, daytime sleepiness, and napping for typical school days and weekends. Our final sample included 2,986 female students (2,059 American and 837 Chinese) and 2,544 male students (1,764 American and 780 Chinese).</p><p><strong>RESULTS:</strong> Differences in sleep duration were minor or absent, but differences in sleep health were substantial. Females were more likely than males to report inadequate sleep and daytime sleepiness, for both school days and weekends, and higher hypersomnolence scores. Chinese students were more likely than American students to report inadequate sleep and daytime sleepiness, for both school days and weekends, and higher hypersomnolence scores, with the exception that perception of adequate sleep did not differ between Chinese and American males on weekends. Especially dramatic was the difference in hypersomnolence, in which 74% of Chinese students reported inadequate sleep, sleepiness, and a nap for a typical school day, compared to only 29% of American students.</p><p><strong>CONCLUSIONS:</strong> The results suggest the presence of gender and cultural differences in sleep quality that yield divergent outcomes for similar sleep durations.</p>
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Yu Y, Montani J, Ming X, Yang Z. p38 Mitogen-activated protein kinase is invovled in arginase-II-mediated enos-uncoupling in aging and obesity. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Veerapandiyan A, Chaudhari A, Traba CM, Ming X. Novel mutation in mitochondrial DNA in 2 siblings with Leigh syndrome. Neurol Genet 2016; 2:e99. [PMID: 27574709 PMCID: PMC4988465 DOI: 10.1212/nxg.0000000000000099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/13/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Aravindhan Veerapandiyan
- Department of Neurology (A.V., A.C., S.M.), Division of Pediatric Neurology, and Department of Pediatrics (C.M.T.), Rutgers New Jersey Medical School, Newark
| | - Amit Chaudhari
- Department of Neurology (A.V., A.C., S.M.), Division of Pediatric Neurology, and Department of Pediatrics (C.M.T.), Rutgers New Jersey Medical School, Newark
| | - Christin M Traba
- Department of Neurology (A.V., A.C., S.M.), Division of Pediatric Neurology, and Department of Pediatrics (C.M.T.), Rutgers New Jersey Medical School, Newark
| | - Xue Ming
- Department of Neurology (A.V., A.C., S.M.), Division of Pediatric Neurology, and Department of Pediatrics (C.M.T.), Rutgers New Jersey Medical School, Newark
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Abstract
The authors present the case of a child with megalencephaly-capillary malformation syndrome who developed a rapidly progressive holocord syringomyelia that was treated surgically. A 3-year-old boy with megalencephaly-capillary malformation-polymicrogyria (MCAP) syndrome presented with several months of right leg weakness, worsening scoliosis, and increased seizures. An MRI study of the brain demonstrated a Chiari I malformation and massively dilated syringomyelia extending from C-2 to the conus medullaris. The patient underwent an urgent suboccipital craniectomy with C1-3 laminectomies to relieve the CSF outflow obstruction with significant clinical improvement. Surgery was complicated by bleeding from intracranial vascular malformations. This report describes a very rapidly developing, massive holocord syringomyelia related to CSF obstruction due to an unusual congenital brain malformation and associated vascular overgrowth at the site. Serial, premorbid MRI studies demonstrated the very rapid progression from no Chiari malformation, to progressively greater cerebellar tonsillar herniation, to holocord syrinx. This complication has never been reported in MCAP syndrome and should be considered in any affected MCAP patient with a progressive neurological decline, even if previous spine imaging findings were normal. Surgical complications due to hemorrhage also need to be considered in this vascular brain malformation.
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Affiliation(s)
| | | | | | - Maureen T Barry
- Radiology, Rutgers New Jersey Medical School, Newark, New Jersey
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Pecor K, Kang L, Henderson M, Yin S, Radhakrishnan V, Ming X. Sleep health, messaging, headaches, and academic performance in high school students. Brain Dev 2016; 38:548-53. [PMID: 26740076 DOI: 10.1016/j.braindev.2015.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 11/05/2015] [Accepted: 12/14/2015] [Indexed: 12/21/2022]
Abstract
AIM We tested for associations of bedtime, sleep duration, instant messaging, and chronic headaches with hypersomnolence and academic performance in a sample of high school students in New Jersey, USA. METHODS Students were surveyed anonymously and asked to report their sleep and messaging habits, headache status, and overall grades. RESULTS We found that greater hypersomnolence was associated with later bedtimes, shorter sleep durations, and the presence of chronic headaches, but not with messaging after lights out. Also, we found that academic performance was lower in students who messaged after lights out, but it was not affected by headache status, bedtime, or sleep duration. CONCLUSIONS These results are consistent with other studies that have demonstrated associations between headaches and hypersomnolence and between instant messaging habits and academic performance. They also add to a growing literature on the relationships among use of electronic devices, sleep health, and academic performance by adolescents.
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Affiliation(s)
- Keith Pecor
- Department of Biology, The College of New Jersey, Ewing, NJ, USA.
| | - Lilia Kang
- Communication High School, Wall, NJ, USA
| | | | - Sunny Yin
- Tenafly High School, Tenafly, NJ, USA
| | | | - Xue Ming
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA; Neuroscience Institute of New Jersey, Sleep Medicine Division, JFK Medical Center, Seton Hall University, Edison, NJ, USA
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Grover K, Pecor K, Malkowski M, Kang L, Machado S, Lulla R, Heisey D, Ming X. Effects of Instant Messaging on School Performance in Adolescents. J Child Neurol 2016; 31:850-7. [PMID: 26762509 DOI: 10.1177/0883073815624758] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/12/2015] [Indexed: 11/17/2022]
Abstract
Instant messaging may compromise sleep quality and school performance in adolescents. We aimed to determine associations between nighttime messaging and daytime sleepiness, self-reported sleep parameters, and/or school performance. Students from 3 high schools in New Jersey completed anonymous questionnaires assessing sleep duration, daytime sleepiness, messaging habits, and academic performance. Of the 2,352 students sampled, 1,537 responses were contrasted among grades, sexes, and messaging duration, both before and after lights out. Students who reported longer duration of messaging after lights out were more likely to report a shorter sleep duration, higher rate of daytime sleepiness, and poorer academic performance. Messaging before lights out was not associated with higher rates of daytime sleepiness or poorer academic performance. Females reported more messaging, more daytime sleepiness, and better academic performance than males. There may be an association between text messaging and school performance in this cohort of students.
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Affiliation(s)
- Karan Grover
- Department of Neurosciences, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - Keith Pecor
- Department of Biology, The College of New Jersey, Ewing, NJ, USA
| | | | - Lilia Kang
- Communications High School, Wall Township, NJ, USA
| | | | | | | | - Xue Ming
- Department of Neurosciences, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ, USA Sleep Medicine Division, New Jersey Neuroscience Institute, JFK Medical Center, Seton Hall University, Edison, NJ, USA
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Abstract
BACKGROUND The effects of gender, headaches, and their interaction on sleep health (sleep duration, sleep onset and continuity, and indications of hypersomnolence) have not been well studied. MATERIALS AND METHODS For American adolescents, we contrasted sleep health variables between males (n = 378) and females (n = 372) and between individuals with chronic headaches (n = 102 females and 60 males) and without chronic headaches (n = 270 females and 318 males) using data from surveys. RESULTS Not all measures of sleep health differed between groups, but the following patterns were observed for the measures that did differ. Females reported shorter sleep durations on school nights (p = 0.001), increased likelihood of sleepiness on school days (p < 0.05), and higher hypersomnolence scores compared with males (p = 0.005). Individuals with headaches reported shorter sleep durations on weekends (p = 0.009) and higher hypersomnolence scores (p = 0.009) than individuals without headaches. Interestingly, females with headaches reported worse sleep health than females without headaches for multiple measures. Males with headaches did not differ from males without headaches, except for greater waking at night (p = 0.04). CONCLUSIONS These results are consistent with other studies of gender-based differences in sleep health and emphasize the importance of recognizing the risk of headache in female adolescents and treating that condition to prevent additional sleep health issues.
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Affiliation(s)
- Xue Ming
- 1 Department of Neurology, Rutgers New Jersey Medical School , Newark, New Jersey.,2 Neuroscience Institute of New Jersey, Sleep Medicine Division, JFK Medical Center, Seton Hall University , Edison, New Jersey
| | - Varsha Radhakrishnan
- 1 Department of Neurology, Rutgers New Jersey Medical School , Newark, New Jersey
| | - Lilia Kang
- 3 Communication High School , Wall, New Jersey
| | - Keith Pecor
- 4 Department of Biology, The College of New Jersey , Ewing, New Jersey
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Ming X, Patel R, Kang V, Chokroverty S, Julu PO. Respiratory and autonomic dysfunction in children with autism spectrum disorders. Brain Dev 2016; 38:225-32. [PMID: 26235973 DOI: 10.1016/j.braindev.2015.07.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 07/02/2015] [Accepted: 07/06/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Cardiac parasympathetic hypofunction has been reported in autism spectrum disorders (ASD). This usually is linked to respiratory dysrhythmia which has been documented in some children with ASD. OBJECTIVES This study evaluated the cardiorespiratory functions in ASD to elucidate the physiologic basis of behaviors. METHODS Nineteen children with ASD and 18 age matched controls underwent autonomic function monitoring at a defined resting state using the NeuroScope. The non-invasive real time beat-to-beat blood pressure was measured by Portapres and fed into the NeuroScope where heart rate, cardiac vagal tone and cardiac sensitivity to baroreceptor were derived from the EKG and blood pressure waveforms using the Vagosoft software; and respiratory rate and rhythm were measured simultaneously by plethysmograph. Respiration was analyzed breath by breath using our prior published methods. RESULTS Various respiratory dysrhythmias, particularly Biot's and Cheyne-Stokes respiration, were detected in children with ASD, who also exhibited greater variability in respiratory rhythm and amplitudes than controls. The respiratory dysrhythmia in children with ASD was associated with a lower cardiac vagal activity. CONCLUSION The Biot's breathing and Cheyne-Stokes respiration coupled with cardiac vagal hypofunction in ASD suggest a brainstem dysfunction consistent with our previous findings. The low parasympathetic activity could explain in part the chronic sensory hyperarousal state in children with ASD.
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Affiliation(s)
- Xue Ming
- Department of Neurosciences and Neurology, New Jersey Medical School, Rutgers University, USA; New Jersey Neuroscience Institute, Sleep Medicine Center, JFK Medical Center, Seton Hall University, USA.
| | | | - Victor Kang
- School of Arts and Sciences, Johns Hopkins University, USA
| | - Sudhansu Chokroverty
- New Jersey Neuroscience Institute, Sleep Medicine Center, JFK Medical Center, Seton Hall University, USA
| | - Peter O Julu
- Division of Brain Sciences, Department of Medicine, Imperial College, UK; Swedish National Rett Center, Sweden; Department of Neuroscience, Breakspear Medical Group, UK
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Zhou L, Bai S, Zhang Y, Ming X, Zhang Y, Deng J. Imaging Dose and Cancer Risk in Image Guided Radiation Therapy of Cancers. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tsemo G, Agarwal N, Ming X, Pecor K. Procedure Use in Encephalitis, Epilepsy, and Meningitis: A Kids' Inpatient Database Study. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1556767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Georges Tsemo
- City College, City University of New York, New York, United States
| | - Nitin Agarwal
- Department of Neurosciences and Neurology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Xue Ming
- Department of Neurosciences and Neurology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Keith Pecor
- Department of Biology, The College of New Jersey, Ewing, New Jersey, United States
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Affiliation(s)
- Tami Wisniewski
- Department of Preventive Medicine & Community Health, New Jersey Medical School-UMDNJ Newark, NJ, USA
| | - Xue Ming
- Department of Neurology, New Jersey Medical School-UMDNJ, Newark, NJ, USA
| | - Michael Brimacombe
- Department of Preventive Medicine & Community Health, New Jersey Medical School-UMDNJ Newark, NJ, USA
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Pak J, Mulvey M, O'Sullivan T, Reddy C, Schwab J, Pecor K, Ming X. Sleep complaints in cerebral palsy and/or epilepsy: A pediatric sleep questionnaire study. J Pediatr Neurol 2015. [DOI: 10.3233/jpn-140652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jayoung Pak
- Department of Neurosciences and Neurology, Rutgers University-New Jersey Medical School, Newark, NJ, USA
| | - Martha Mulvey
- Department of Neurosciences and Neurology, Rutgers University-New Jersey Medical School, Newark, NJ, USA
| | | | - Chitra Reddy
- Department of Pediatrics, Rutgers University-New Jersey Medical School, Newark, NJ, USA
| | - Joseph Schwab
- Department of Pediatrics, Rutgers University-New Jersey Medical School, Newark, NJ, USA
| | - Keith Pecor
- Department of Biology, The College of New Jersey, Ewing, NJ, USA
| | - Xue Ming
- Department of Neurosciences and Neurology, Rutgers University-New Jersey Medical School, Newark, NJ, USA
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Xiong Y, Yu Y, Forbiteh M, Montani J, Yang Z, Ming X. Arginase-II induces endothelial autophagy suppression and smooth muscle cell mitochondrial dysfunction contributing to atherosclerotic plaque vulnerability. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Stein TP, Schluter MD, Steer RA, Guo L, Ming X. Bisphenol A Exposure in Children With Autism Spectrum Disorders. Autism Res 2015; 8:272-83. [PMID: 25641946 PMCID: PMC4474754 DOI: 10.1002/aur.1444] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 11/25/2014] [Indexed: 01/27/2023]
Abstract
The etiology of autism spectrum disorders (ASD) is believed to involve genetic and environmental components. This study focused on the plasticizer, Bisphenol-A (BPA). The major pathway for BPA metabolism and excretion is via glucuronidation. To determine whether there was a relationship between BPA exposure and ASD, urine specimens were collected from 46 children with ASD and 52 controls. Free and total BPA concentrations were determined by mass spectrometry. The fraction glucuronidated was calculated from the difference. A metabolomics study was done to investigate metabolite distribution in the urine. (i) Most of the BPA excreted in the urine was as the glucuronide; (ii) about 20% of the ASD children had BPA levels beyond the 90th percentile (>50 ng/mL) of the frequency distribution for the total sample of 98 children; (iii) Mann-Whitney U tests and multiple regression analyses found significant differences (P < 0.05) between the groups in total and % bound BPA; and (iv) the metabolomics analyses showed the number of absolute partial correlations >|0.30| between metabolite concentrations and total BPA was ∼3 times greater with the ASD group than the controls (P < 0.001), and the number of absolute partial correlations > |0.30| for % bound BPA was ∼15 times higher with ASD (P < 0.001). The results suggest there is an association between BPA and ASD.
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Affiliation(s)
- T Peter Stein
- Department of Surgery, Rowan University-SOM, 2 Medical Center Drive, Stratford, New Jersey, 08084
| | - Margaret D Schluter
- Department of Surgery, Rowan University-SOM, 2 Medical Center Drive, Stratford, New Jersey, 08084
| | - Robert A Steer
- Department of Psychiatry, Rowan University-SOM, 2 Medical Center Drive, Stratford, New Jersey, 08084
| | - Lining Guo
- Metabolon Inc., 617 Davis Drive, Suite 400, Durham, North Carolina, 27713
- Department of Neurosciences and Neurology, Rutgers University -New Jersey Medical School, 90 Bergen Street, Newark, New Jersey, 07103
| | - Xue Ming
- Sleep Medicine Center, JFK Hospital, Seton Hall University, Edison, New Jersey, 08820
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Magid-Bernstein J, Mahajan K, Lincoln J, Ming X, Rohowsky-Kochan C. Case report: cytokine and CD4+ T-cell profiles of monozygotic twins with autism and divergent comorbidities and drug treatment. J Child Neurol 2015; 30:386-90. [PMID: 24736120 DOI: 10.1177/0883073814529821] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Autism spectrum disorders are neurodevelopmental disorders that are thought to be caused by a gene-by-environment interaction and in which various immune alterations are reported. We investigate CD4(+) T-cell cytokine profiles and subpopulations in 19-year-old monozygotic twins with autism and different comorbidities. CD4(+) T cells from the twin with epilepsy produce more interferon-gamma, less interleukin-17, and have an increased interferon-γ/interleukin-4 ratio. CD4(+) T cells from the twin with multiple sclerosis exhibit a cytokine profile similar to an age and gender-matched control and a higher percentage of T regulatory (Treg) cells. The twins' mother's T cells produce very high levels of both interleukin-17 and interferon-γ. Cytokine and CD4(+) T-cell abnormalities in the twins could contribute to or be a result of the manifestation of their divergent comorbidities. A proinflammatory, autoimmune-polarized cytokine profile is observed in this unique family with autism.
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Affiliation(s)
- Jessica Magid-Bernstein
- Department of Neurology and Neurosciences, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, NJ, USA
| | - Kedar Mahajan
- Department of Neurology, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - John Lincoln
- Department of Neurology, The University of Texas Medical School, Houston, TX, USA
| | - Xue Ming
- Department of Neurology and Neurosciences, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, NJ, USA
| | - Christine Rohowsky-Kochan
- Department of Neurology and Neurosciences, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, NJ, USA
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Yang B, Ming X, Cao C, Laing B, Yuan A, Porter MA, Hull-Ryde EA, Maddry J, Suto M, Janzen WP, Juliano RL. High-throughput screening identifies small molecules that enhance the pharmacological effects of oligonucleotides. Nucleic Acids Res 2015; 43:1987-96. [PMID: 25662226 PMCID: PMC4344505 DOI: 10.1093/nar/gkv060] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The therapeutic use of antisense and siRNA oligonucleotides has been constrained by the limited ability of these membrane-impermeable molecules to reach their intracellular sites of action. We sought to address this problem using small organic molecules to enhance the effects of oligonucleotides by modulating their intracellular trafficking and release from endosomes. A high-throughput screen of multiple small molecule libraries yielded several hits that markedly potentiated the actions of splice switching oligonucleotides in cell culture. These compounds also enhanced the effects of antisense and siRNA oligonucleotides. The hit compounds preferentially caused release of fluorescent oligonucleotides from late endosomes rather than other intracellular compartments. Studies in a transgenic mouse model indicated that these compounds could enhance the in vivo effects of a splice-switching oligonucleotide without causing significant toxicity. These observations suggest that selected small molecule enhancers may eventually be of value in oligonucleotide-based therapeutics.
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Affiliation(s)
- B Yang
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - X Ming
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - C Cao
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - B Laing
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - A Yuan
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - M A Porter
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - E A Hull-Ryde
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - J Maddry
- Southern Research Institute, Birmingham, AL 35205, USA
| | - M Suto
- Southern Research Institute, Birmingham, AL 35205, USA
| | - W P Janzen
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - R L Juliano
- UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
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Wu N, Ming X, Xiao J, Wu Z, Chen X, Shinawi M, Shen Y, Yu G, Liu J, Xie H, Gucev ZS, Liu S, Yang N, Al-Kateb H, Chen J, Zhang J, Hauser N, Zhang T, Tasic V, Liu P, Su X, Pan X, Liu C, Wang L, Shen J, Shen J, Chen Y, Zhang T, Zhang J, Choy KW, Wang J, Wang Q, Li S, Zhou W, Guo J, Wang Y, Zhang C, Zhao H, An Y, Zhao Y, Wang J, Liu Z, Zuo Y, Tian Y, Weng X, Sutton VR, Wang H, Ming Y, Kulkarni S, Zhong TP, Giampietro PF, Dunwoodie SL, Cheung SW, Zhang X, Jin L, Lupski JR, Qiu G, Zhang F. TBX6 null variants and a common hypomorphic allele in congenital scoliosis. N Engl J Med 2015; 372:341-50. [PMID: 25564734 PMCID: PMC4326244 DOI: 10.1056/nejmoa1406829] [Citation(s) in RCA: 203] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Congenital scoliosis is a common type of vertebral malformation. Genetic susceptibility has been implicated in congenital scoliosis. METHODS We evaluated 161 Han Chinese persons with sporadic congenital scoliosis, 166 Han Chinese controls, and 2 pedigrees, family members of which had a 16p11.2 deletion, using comparative genomic hybridization, quantitative polymerase-chain-reaction analysis, and DNA sequencing. We carried out tests of replication using an additional series of 76 Han Chinese persons with congenital scoliosis and a multicenter series of 42 persons with 16p11.2 deletions. RESULTS We identified a total of 17 heterozygous TBX6 null mutations in the 161 persons with sporadic congenital scoliosis (11%); we did not observe any null mutations in TBX6 in 166 controls (P<3.8×10(-6)). These null alleles include copy-number variants (12 instances of a 16p11.2 deletion affecting TBX6) and single-nucleotide variants (1 nonsense and 4 frame-shift mutations). However, the discordant intrafamilial phenotypes of 16p11.2 deletion carriers suggest that heterozygous TBX6 null mutation is insufficient to cause congenital scoliosis. We went on to identify a common TBX6 haplotype as the second risk allele in all 17 carriers of TBX6 null mutations (P<1.1×10(-6)). Replication studies involving additional persons with congenital scoliosis who carried a deletion affecting TBX6 confirmed this compound inheritance model. In vitro functional assays suggested that the risk haplotype is a hypomorphic allele. Hemivertebrae are characteristic of TBX6-associated congenital scoliosis. CONCLUSIONS Compound inheritance of a rare null mutation and a hypomorphic allele of TBX6 accounted for up to 11% of congenital scoliosis cases in the series that we analyzed. (Funded by the National Basic Research Program of China and others.).
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Affiliation(s)
- N Wu
- The authors' affiliations are listed in the Appendix
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