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Kumar MM, Choksey F, Jones A, Carroll C, Brownhill B, Cairns E, Bark J, Coffey K, Webster L, Wood L, Chambers M, Haynes S, Gormley S. Intraoperative cell salvage: a survey of UK practice. Br J Anaesth 2024; 132:995-997. [PMID: 38471988 DOI: 10.1016/j.bja.2024.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 03/14/2024] Open
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Nyenhuis SM, Dixon AE, Wood L, Lv N, Wittels NE, Ronneberg CR, Xiao L, Dosala S, Marroquin A, Barve A, Harmon W, Poynter ME, Parikh A, Camargo CA, Appel LJ, Ma J. Erratum to "The effects of the DASH dietary pattern on clinical outcomes and quality of life in adults with uncontrolled asthma: Design and methods of the ALOHA Trial" [Contemporary Clinical Trials 131 (2023) 107274]. Contemp Clin Trials 2024; 138:107373. [PMID: 38310039 PMCID: PMC10921235 DOI: 10.1016/j.cct.2023.107373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Nyenhuis SM, Dixon A, Wood L, Lv N, Wittels N, Ronneberg CR, Xiao L, Dosala S, Marroquin A, Barve A, Harmon W, Poynter M, Parikh A, Camargo CA, Appel L, Ma J. The effects of the DASH dietary pattern on clinical outcomes and quality of life in adults with uncontrolled asthma: Design and methods of the ALOHA Trial. Contemp Clin Trials 2023; 131:107274. [PMID: 37380019 PMCID: PMC10629484 DOI: 10.1016/j.cct.2023.107274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/31/2023] [Accepted: 06/25/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Poor diet quality is an important risk factor for increased asthma prevalence and poor asthma control. To address the question of whether adults with asthma can benefit from following a healthy diet, this trial will test the efficacy and mechanisms of action of a behavioral intervention promoting the Dietary Approaches to Stop Hypertension (DASH) dietary pattern with sodium reduction among patients with uncontrolled asthma. METHODS In this 2-arm randomized clinical trial, 320 racially/ethnically and socioeconomically diverse adults with uncontrolled asthma on standard controller therapy will be randomized to either a control or an intervention group and assessed at baseline, 3, 6 and 12 months. Control and intervention participants will receive education on lung health, asthma, and other general health topics; additionally, the intervention group will receive DASH behavioral counseling over 12 months. The primary hypothesis is that the DASH behavioral intervention, compared with the education-only control, will lead to significantly more participants with minimum clinically important improvement (responders) in asthma-specific quality of life at 12 months. Secondary hypotheses will test the intervention effects on other asthma (e.g., asthma control, lung function) and non-asthma outcomes (e.g., quality of life). Additionally, therapeutic (e.g., short chain fatty acids, cytokines) and nutritional biomarkers (e.g., dietary inflammatory index, carotenoids) will be assessed to understand the mechanisms of the intervention effect. CONCLUSION This trial can substantially advance asthma care by providing rigorous evidence on the benefits of a behavioral dietary intervention and mechanistic insights into the role of diet quality in asthma. CLINICALTRIALS gov #: NCT05251402.
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Wood L, Chintakuntlawar A, Price K, Kaczmar J, Conn G, Bedu-Addo F, Weiss J. Preliminary Safety of PDS0101 (Versamune +HPVmix) and Pembrolizumab Combination Therapy in Subjects with Recurrent/Metastatic Human Papillomavirus-16 Positive Oropharyngeal Squamous Cell Carcinoma (OPSCC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Clarke H, Wood L, Eveleigh C. Developing a pathway for the management of patients presenting with suspected myelopathy in secondary care. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wood L, Collins P, Young A. Chair based exercise: A proactive physiotherapy intervention to target reduced strength and balance in an ageing patient cohort. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wood L, Dunstan E. The influence of frailty on the efficacy of exercise for falls prevention – A systematic review, meta-analysis and meta-regression. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wood L, Hayden J, Ogilvie R. Specifying the treatment targets of exercise interventions: Do we? Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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The CONSERVE-HCW Research Group, Tiffany B, Bremner R, Cogo J, Zumbuhl J, Wood L, Arriola B, Wiley N, Sanders S. 209 Seroprevalence of Anti-SARS CoV-2 Nucleocapsid IgG in a Cohort of Healthcare Workers Over Nine Months. Ann Emerg Med 2021. [PMCID: PMC8536272 DOI: 10.1016/j.annemergmed.2021.09.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tiffany B, Cogo J, Bremner R, Zumbuhl J, Wood L, Sanders S. 32 Decay of Anti-SARS-CoV-2 Nucleocapsid IgG in Seropositive Health Care Workers Over Time. Ann Emerg Med 2021. [PMCID: PMC8335426 DOI: 10.1016/j.annemergmed.2021.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abi B, Acciarri R, Acero MA, Adamov G, Adams D, Adinolfi M, Ahmad Z, Ahmed J, Alion T, Monsalve SA, Alt C, Anderson J, Andreopoulos C, Andrews MP, Andrianala F, Andringa S, Ankowski A, Antonova M, Antusch S, Aranda-Fernandez A, Ariga A, Arnold LO, Arroyave MA, Asaadi J, Aurisano A, Aushev V, Autiero D, Azfar F, Back H, Back JJ, Backhouse C, Baesso P, Bagby L, Bajou R, Balasubramanian S, Baldi P, Bambah B, Barao F, Barenboim G, Barker GJ, Barkhouse W, Barnes C, Barr G, Monarca JB, Barros N, Barrow JL, Bashyal A, Basque V, Bay F, Alba JLB, Beacom JF, Bechetoille E, Behera B, Bellantoni L, Bellettini G, Bellini V, Beltramello O, Belver D, Benekos N, Neves FB, Berger J, Berkman S, Bernardini P, Berner RM, Berns H, Bertolucci S, Betancourt M, Bezawada Y, Bhattacharjee M, Bhuyan B, Biagi S, Bian J, Biassoni M, Biery K, Bilki B, Bishai M, Bitadze A, Blake A, Siffert BB, Blaszczyk FDM, Blazey GC, Blucher E, Boissevain J, Bolognesi S, Bolton T, Bonesini M, Bongrand M, Bonini F, Booth A, Booth C, Bordoni S, Borkum A, Boschi T, Bostan N, Bour P, Boyd SB, Boyden D, Bracinik J, Braga D, Brailsford D, Brandt A, Bremer J, Brew C, Brianne E, Brice SJ, Brizzolari C, Bromberg C, Brooijmans G, Brooke J, Bross A, Brunetti G, Buchanan N, Budd H, Caiulo D, Calafiura P, Calcutt J, Calin M, Calvez S, Calvo E, Camilleri L, Caminata A, Campanelli M, Caratelli D, Carini G, Carlus B, Carniti P, Terrazas IC, Carranza H, Castillo A, Castromonte C, Cattadori C, Cavalier F, Cavanna F, Centro S, Cerati G, Cervelli A, Villanueva AC, Chalifour M, Chang C, Chardonnet E, Chatterjee A, Chattopadhyay S, Chaves J, Chen H, Chen M, Chen Y, Cherdack D, Chi C, Childress S, Chiriacescu A, Cho K, Choubey S, Christensen A, Christian D, Christodoulou G, Church E, Clarke P, Coan TE, Cocco AG, Coelho JAB, Conley E, Conrad JM, Convery M, Corwin L, Cotte P, Cremaldi L, Cremonesi L, Crespo-Anadón JI, Cristaldo E, Cross R, Cuesta C, Cui Y, Cussans D, Dabrowski M, da Motta H, Peres LDS, David C, David Q, Davies GS, Davini S, Dawson J, De K, De Almeida RM, Debbins P, De Bonis I, Decowski MP, de Gouvêa A, De Holanda PC, De Icaza Astiz IL, Deisting A, De Jong P, Delbart A, Delepine D, Delgado M, Dell’Acqua A, De Lurgio P, de Mello Neto JRT, DeMuth DM, Dennis S, Densham C, Deptuch G, De Roeck A, De Romeri V, De Vries JJ, Dharmapalan R, Dias M, Diaz F, Díaz JS, Di Domizio S, Di Giulio L, Ding P, Di Noto L, Distefano C, Diurba R, Diwan M, Djurcic Z, Dokania N, Dolinski MJ, Domine L, Douglas D, Drielsma F, Duchesneau D, Duffy K, Dunne P, Durkin T, Duyang H, Dvornikov O, Dwyer DA, Dyshkant AS, Eads M, Edmunds D, Eisch J, Emery S, Ereditato A, Escobar CO, Sanchez LE, Evans JJ, Ewart E, Ezeribe AC, Fahey K, Falcone A, Farnese C, Farzan Y, Felix J, Fernandez-Martinez E, Fernandez Menendez P, Ferraro F, Fields L, Filkins A, Filthaut F, Fitzpatrick RS, Flanagan W, Fleming B, Flight R, Fowler J, Fox W, Franc J, Francis K, Franco D, Freeman J, Freestone J, Fried J, Friedland A, Fuess S, Furic I, Furmanski AP, Gago A, Gallagher H, Gallego-Ros A, Gallice N, Galymov V, Gamberini E, Gamble T, Gandhi R, Gandrajula R, Gao S, Garcia-Gamez D, García-Peris MÁ, Gardiner S, Gastler D, Ge G, Gelli B, Gendotti A, Gent S, Ghorbani-Moghaddam Z, Gibin D, Gil-Botella I, Girerd C, Giri AK, Gnani D, Gogota O, Gold M, Gollapinni S, Gollwitzer K, Gomes RA, Bermeo LVG, Fajardo LSG, Gonnella F, Gonzalez-Cuevas JA, Goodman MC, Goodwin O, Goswami S, Gotti C, Goudzovski E, Grace C, Graham M, Gramellini E, Gran R, Granados E, Grant A, Grant C, Gratieri D, Green P, Green S, Greenler L, Greenwood M, Greer J, Griffith WC, Groh M, Grudzinski J, Grzelak K, Gu W, Guarino V, Guenette R, Guglielmi A, Guo B, Guthikonda KK, Gutierrez R, Guzowski P, Guzzo MM, Gwon S, Habig A, Hackenburg A, Hadavand H, Haenni R, Hahn A, Haigh J, Haiston J, Hamernik T, Hamilton P, Han J, Harder K, Harris DA, Hartnell J, Hasegawa T, Hatcher R, Hazen E, Heavey A, Heeger KM, Heise J, Hennessy K, Henry S, Morquecho MAH, Herner K, Hertel L, Hesam AS, Hewes J, Higuera A, Hill T, Hillier SJ, Himmel A, Hoff J, Hohl C, Holin A, Hoppe E, Horton-Smith GA, Hostert M, Hourlier A, Howard B, Howell R, Huang J, Huang J, Hugon J, Iles G, Ilic N, Iliescu AM, Illingworth R, Ioannisian A, Itay R, Izmaylov A, James E, Jargowsky B, Jediny F, Jesùs-Valls C, Ji X, Jiang L, Jiménez S, Jipa A, Joglekar A, Johnson C, Johnson R, Jones B, Jones S, Jung CK, Junk T, Jwa Y, Kabirnezhad M, Kaboth A, Kadenko I, Kamiya F, Karagiorgi G, Karcher A, Karolak M, Karyotakis Y, Kasai S, Kasetti SP, Kashur L, Kazaryan N, Kearns E, Keener P, Kelly KJ, Kemp E, Ketchum W, Kettell SH, Khabibullin M, Khotjantsev A, Khvedelidze A, Kim D, King B, Kirby B, Kirby M, Klein J, Koehler K, Koerner LW, Kohn S, Koller PP, Kordosky M, Kosc T, Kose U, Kostelecký VA, Kothekar K, Krennrich F, Kreslo I, Kudenko Y, Kudryavtsev VA, Kulagin S, Kumar J, Kumar R, Kuruppu C, Kus V, Kutter T, Lambert A, Lande K, Lane CE, Lang K, Langford T, Lasorak P, Last D, Lastoria C, Laundrie A, Lawrence A, Lazanu I, LaZur R, Le T, Learned J, LeBrun P, Miotto GL, Lehnert R, de Oliveira MAL, Leitner M, Leyton M, Li L, Li S, Li SW, Li T, Li Y, Liao H, Lin CS, Lin S, Lister A, Littlejohn BR, Liu J, Lockwitz S, Loew T, Lokajicek M, Lomidze I, Long K, Loo K, Lorca D, Lord T, LoSecco JM, Louis WC, Luk KB, Luo X, Lurkin N, Lux T, Luzio VP, MacFarland D, Machado AA, Machado P, Macias CT, Macier JR, Maddalena A, Madigan P, Magill S, Mahn K, Maio A, Maloney JA, Mandrioli G, Maneira J, Manenti L, Manly S, Mann A, Manolopoulos K, Plata MM, Marchionni A, Marciano W, Marfatia D, Mariani C, Maricic J, Marinho F, Marino AD, Marshak M, Marshall C, Marshall J, Marteau J, Martin-Albo J, Martinez N, Caicedo DAM, Martynenko S, Mason K, Mastbaum A, Masud M, Matsuno S, Matthews J, Mauger C, Mauri N, Mavrokoridis K, Mazza R, Mazzacane A, Mazzucato E, McCluskey E, McConkey N, McFarland KS, McGrew C, McNab A, Mefodiev A, Mehta P, Melas P, Mellinato M, Mena O, Menary S, Mendez H, Menegolli A, Meng G, Messier MD, Metcalf W, Mewes M, Meyer H, Miao T, Michna G, Miedema T, Migenda J, Milincic R, Miller W, Mills J, Milne C, Mineev O, Miranda OG, Miryala S, Mishra CS, Mishra SR, Mislivec A, Mladenov D, Mocioiu I, Moffat K, Moggi N, Mohanta R, Mohayai TA, Mokhov N, Molina J, Bueno LM, Montanari A, Montanari C, Montanari D, Zetina LMM, Moon J, Mooney M, Moor A, Moreno D, Morgan B, Morris C, Mossey C, Motuk E, Moura CA, Mousseau J, Mu W, Mualem L, Mueller J, Muether M, Mufson S, Muheim F, Muir A, Mulhearn M, Muramatsu H, Murphy S, Musser J, Nachtman J, Nagu S, Nalbandyan M, Nandakumar R, Naples D, Narita S, Navas-Nicolás D, Nayak N, Nebot-Guinot M, Necib L, Negishi K, Nelson JK, Nesbit J, Nessi M, Newbold D, Newcomer M, Newhart D, Nichol R, Niner E, Nishimura K, Norman A, Norrick A, Northrop R, Novella P, Nowak JA, Oberling M, Del Campo AO, Olivier A, Onel Y, Onishchuk Y, Ott J, Pagani L, Pakvasa S, Palamara O, Palestini S, Paley JM, Pallavicini M, Palomares C, Pantic E, Paolone V, Papadimitriou V, Papaleo R, Papanestis A, Paramesvaran S, Park JC, Parke S, Parsa Z, Parvu M, Pascoli S, Pasqualini L, Pasternak J, Pater J, Patrick C, Patrizii L, Patterson RB, Patton SJ, Patzak T, Paudel A, Paulos B, Paulucci L, Pavlovic Z, Pawloski G, Payne D, Pec V, Peeters SJM, Penichot Y, Pennacchio E, Penzo A, Peres OLG, Perry J, Pershey D, Pessina G, Petrillo G, Petta C, Petti R, Piastra F, Pickering L, Pietropaolo F, Pillow J, Pinzino J, Plunkett R, Poling R, Pons X, Poonthottathil N, Pordes S, Potekhin M, Potenza R, Potukuchi BVKS, Pozimski J, Pozzato M, Prakash S, Prakash T, Prince S, Prior G, Pugnere D, Qi K, Qian X, Raaf JL, Raboanary R, Radeka V, Rademacker J, Radics B, Rafique A, Raguzin E, Rai M, Rajaoalisoa M, Rakhno I, Rakotondramanana HT, Rakotondravohitra L, Ramachers YA, Rameika R, Delgado MAR, Ramson B, Rappoldi A, Raselli G, Ratoff P, Ravat S, Razafinime H, Real JS, Rebel B, Redondo D, Reggiani-Guzzo M, Rehak T, Reichenbacher J, Reitzner SD, Renshaw A, Rescia S, Resnati F, Reynolds A, Riccobene G, Rice LCJ, Rielage K, Rigaut Y, Rivera D, Rochester L, Roda M, Rodrigues P, Alonso MJR, Rondon JR, Roeth AJ, Rogers H, Rosauro-Alcaraz S, Rossella M, Rout J, Roy S, Rubbia A, Rubbia C, Russell B, Russell J, Ruterbories D, Saakyan R, Sacerdoti S, Safford T, Sahu N, Sala P, Samios N, Sanchez MC, Sanders DA, Sankey D, Santana S, Santos-Maldonado M, Saoulidou N, Sapienza P, Sarasty C, Sarcevic I, Savage G, Savinov V, Scaramelli A, Scarff A, Scarpelli A, Schaffer T, Schellman H, Schlabach P, Schmitz D, Scholberg K, Schukraft A, Segreto E, Sensenig J, Seong I, Sergi A, Sergiampietri F, Sgalaberna D, Shaevitz MH, Shafaq S, Shamma M, Sharma HR, Sharma R, Shaw T, Shepherd-Themistocleous C, Shin S, Shooltz D, Shrock R, Simard L, Simos N, Sinclair J, Sinev G, Singh J, Singh J, Singh V, Sipos R, Sippach FW, Sirri G, Sitraka A, Siyeon K, Smargianaki D, Smith A, Smith A, Smith E, Smith P, Smolik J, Smy M, Snopok P, Nunes MS, Sobel H, Soderberg M, Salinas CJS, Söldner-Rembold S, Solomey N, Solovov V, Sondheim WE, Sorel M, Soto-Oton J, Sousa A, Soustruznik K, Spagliardi F, Spanu M, Spitz J, Spooner NJC, Spurgeon K, Staley R, Stancari M, Stanco L, Steiner HM, Stewart J, Stillwell B, Stock J, Stocker F, Stocks D, Stokes T, Strait M, Strauss T, Striganov S, Stuart A, Summers D, Surdo A, Susic V, Suter L, Sutera CM, Svoboda R, Szczerbinska B, Szelc AM, Talaga R, Tanaka HA, Oregui BT, Tapper A, Tariq S, Tatar E, Tayloe R, Teklu AM, Tenti M, Terao K, Ternes CA, Terranova F, Testera G, Thea A, Thompson JL, Thorn C, Timm SC, Todd J, Tonazzo A, Torti M, Tortola M, Tortorici F, Totani D, Toups M, Touramanis C, Trevor J, Trzaska WH, Tsai YT, Tsamalaidze Z, Tsang KV, Tsverava N, Tufanli S, Tull C, Tyley E, Tzanov M, Uchida MA, Urheim J, Usher T, Vagins MR, Vahle P, Valdiviesso GA, Valencia E, Vallari Z, Valle JWF, Vallecorsa S, Berg RV, de Water RGV, Forero DV, Varanini F, Vargas D, Varner G, Vasel J, Vasseur G, Vaziri K, Ventura S, Verdugo A, Vergani S, Vermeulen MA, Verzocchi M, de Souza HV, Vignoli C, Vilela C, Viren B, Vrba T, Wachala T, Waldron AV, Wallbank M, Wang H, Wang J, Wang Y, Wang Y, Warburton K, Warner D, Wascko M, Waters D, Watson A, Weatherly P, Weber A, Weber M, Wei H, Weinstein A, Wenman D, Wetstein M, While MR, White A, Whitehead LH, Whittington D, Wilking MJ, Wilkinson C, Williams Z, Wilson F, Wilson RJ, Wolcott J, Wongjirad T, Wood K, Wood L, Worcester E, Worcester M, Wret C, Wu W, Wu W, Xiao Y, Yang G, Yang T, Yershov N, Yonehara K, Young T, Yu B, Yu J, Zaki R, Zalesak J, Zambelli L, Zamorano B, Zani A, Zazueta L, Zeller GP, Zennamo J, Zeug K, Zhang C, Zhao M, Zhao Y, Zhivun E, Zhu G, Zimmerman ED, Zito M, Zucchelli S, Zuklin J, Zutshi V, Zwaska R. Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2021; 81:322. [PMID: 34720713 PMCID: PMC8550327 DOI: 10.1140/epjc/s10052-021-09007-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/23/2021] [Indexed: 06/13/2023]
Abstract
The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.
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Grants
- MR/T019530/1 Medical Research Council
- MR/T041323/1 Medical Research Council
- MSMT, Czech Republic
- NRF, South Korea
- Canadian Network for Research and Innovation in Machining Technology, Natural Sciences and Engineering Research Council of Canada
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- SERI, Switzerland
- Fundação de Amparo à Pesquisa do Estado de São Paulo
- U.S. Department of Energy
- CERN
- Türkiye Bilimsel ve Teknolojik Arastirma Kurumu
- The Royal Society, United Kingdom
- Canada Foundation for Innovation
- U.S. NSF
- FCT, Portugal
- CEA, France
- CNRS/IN2P3, France
- European Regional Development Fund
- Science and Technology Facilities Council
- H2020-EU, European Union
- IPP, Canada
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro
- CAM, Spain
- MSCA, European Union
- Instituto Nazionale di Fisica Nucleare
- Fundacção de Amparo à Pesquisa do Estado de Goiás
- Ministerio de Ciencia e Innovación
- Fundacion “La Caixa” Spain
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Tolley CL, Watson NW, Heed A, Einbeck J, Medows S, Wood L, Campbell L, Slight SP. The Impact of a Bedside Medication Scanning Device on Administration Errors in the Hospital Setting: A Prospective Observational Study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021. [PMCID: PMC8083621 DOI: 10.1093/ijpp/riab016.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
The medication administration process is complex and influenced by interruptions, multi-tasking and responding to patient’s needs and is consequently prone to errors.1 Over half (54.4%) of the 237 million medication errors estimated to have occurred in England each year were found to have taken place at the administration stage and 7.6% were associated with moderate or severe harm. The implementation of a Closed Loop Medication Administration solution aims to reduce medication administration errors and prevent patient harm.
Aim
We conducted the first evaluation to assess the impact of a novel optical medication scanning device, MedEye, on the rate of medication administration errors in solid oral dosage forms.
Methods
We performed a before and after study on one ward at a tertiary-care teaching hospital that used a commercial electronic prescribing and medication administration system and was implementing MedEye (a bedside tool for stopping and preventing medication administration errors). Pre-MedEye data collection occurred between Aug-Nov 2019 and post-MedEye data collection occurred between Feb-Mar 2020. We conducted direct observations of nursing drug administration rounds before and after the MedEye implementation. Observers recorded what they observed being administered (e.g., drug name, form, strength and quantity) and compared this to what was prescribed. Errors were classified as either a ‘timing’ error, ‘omission’ error or ‘other’ error. We calculated the rate and type of medication administration errors (MAEs) before and after the MedEye implementation. A sample size calculation suggested that approximately 10,000 medication administrations were needed. Data collection was reduced due to the COVID 19 pandemic and implementation delays.
Results
Trained pharmacists or nurses observed a total of 1,069 administrations of solid oral dosage forms before and 432 after the MedEye intervention was implemented. The percentage of MAEs pre-MedEye (69.1%) and post-MedEye (69.9%) remained almost the same. Non-timing errors (combination of ‘omission’ + ‘other’ errors) reduced from 51 (4.77%) to 11 (2.55%), which had borderline significance (p=0.05) however after adjusting for confounders, significance was lost. We also saw a non-significant reduction in ‘other’ error types (e.g., dose and documentation errors) following the implementation of MedEye from 34 (3.2%) to 7 (1.62%). An observer witnessed a nurse dispense the wrong medication (prednisolone) instead of the intended medication (furosemide) in the post-MedEye period. After receiving a notification from MedEye that an unexpected medication had been dispensed, the nurse corrected the dose thus preventing an error. We also identified one instance where the nurse correctly dispensed a prescribed medication (amlodipine) but this was mistakenly identified by the MedEye scanner as another prescribed medication (metoclopramide).
Conclusions
This is the first evaluation of a novel optical medication scanning device, MedEye on the rate of MAEs in one of the largest NHS trusts in England. We found a non-statistically significant reduction in non-timing error rates. This was notable because incidents within this category e.g., dose errors, are more likely to be associated with harm compared to timing errors.2 However, further research is needed to investigate the impact of MedEye on a larger sample size and range of medications.
References
1. Elliott, R., et al., Prevalence and economic burden of medication errors in the NHS in England. Rapid evidence synthesis and economic analysis of the prevalence and burden of medication error in the UK, 2018.
2. Poon, E.G., et al., Effect of bar-code technology on the safety of medication administration. New England Journal of Medicine, 2010. 362(18): p. 1698–1707.
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Vyas V, Wood L, Blythe H, Hunter R, Lall K, Finlay M, Longhi M. Epicardial adipose tissue CD4+ T cells as novel drivers in the development of atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Epicardial adipose tissue (EAT) is now a well-established independent risk factor for all forms of atrial fibrillation (AF). However, the cellular profile and immune mediators within EAT remain poorly defined.
Purpose
This study sought to define the immunological signature of EAT critical to its role in the development of both persistent AF and de novo post-operative AF (POAF).
Methods
Adult patients undergoing elective cardiac surgery with no prior AF history and those with pre-existing AF were recruited to undergo EAT sampling alongside subcutaneous adipose tissue (SAT) and pre-operative blood (adipose tissue and systemic controls respectively) sampling. The blood and tissue samples were immediately taken to the laboratory for immune cell isolation, flow cytometry and quantitative polymerase chain reaction (qPCR) analysis.
Results
A total of 71 patients were recruited including 9 patients with a prior history of AF. Of the 62 a priori sinus rhythm (SR) patients, 42 remained in SR post-operatively and 20 developed de novo POAF. No differences in absolute numbers of immune cells in the blood, EAT or SAT were detected on flow cytometry analysis between the three groups of patients. However, there was a significant increase (p<0.01) in EAT-resident CD4+ memory T cell populations in pre-existing AF patients and a trend towards significance (p=0.09) in POAF patients. qPCR analysis of immune mediator expression in EAT demonstrated pre-existing AF patients uniquely showed a significant reduction (p<0.005) in the pro-fibrotic mediator transforming growth factor-β (TGF-β) compared to the pre-existing AF patients (graph 1).
Conclusions and implications
Resident CD4+ memory T cell populations are locally and exclusively elevated in the EAT of pre-existing AF and POAF patients. This would suggest primed antigen-specific CD4+ T cells are present prior to the development of AF in patients who go on to develop de novo POAF. The reduced TGF-β levels observed in the EAT of AF patients indicates the EAT immune mediator profile differs to the underlying myocardial tissue, where increased TGF-β levels have previously been described in the persistent AF cohort. Therapies targeting this EAT-resident CD4+ T cell population would provide a novel approach to the management of the inflammatory components of AF genesis.
Graph 1
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Barts Charity, Abbott
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Wells J, Dudani S, Gan C, Stukalin I, Azad A, Liow E, Donskov F, Yuasa T, Pal S, De Velasco G, Wood L, Hansen A, Beuselinck B, Kollmannsberger C, Powles T, Mcgregor B, Duh M, Huynh L, Heng D. Real-world clinical effectiveness of second-line sunitinib following immuno-oncology therapy in patients with metastatic renal cell carcinoma. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33322-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Wood L, Foster N, Lewis M, Bishop A. Achieving consensus on the treatment targets of exercise in persistent non-specific low back pain: a modified nominal group workshop process. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Although immune-mediated therapies have been used in genitourinary (gu) malignancies for decades, recent advances with monoclonal antibody checkpoint inhibitors (cpis) have led to a number of promising treatment options. In renal cell carcinoma (rcc), cpis have been shown to have benefit over conventional therapies in a number of settings, and they are the standard of care for many patients with metastatic disease. Based on recent data, combinations of cpis and antiangiogenic therapies are likely to become a new standard approach in rcc. In urothelial carcinoma, cpis have been shown to have a role in the second-line treatment of metastatic disease, and a number of clinical trials are actively investigating cpis for other indications. In other gu malignancies, such as prostate cancer, results to date have been less promising. Immunotherapies continue to be an area of active study for all gu disease sites, with several clinical trials ongoing. In this review, we summarize the current evidence for cpi use in rcc, urothelial carcinoma, prostate cancer, testicular germ-cell tumours, and penile carcinoma. Ongoing clinical trials of interest are highlighted, as are the challenges that clinicians and patients will potentially face as immune cpis become a prominent feature in the treatment of gu cancers.
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Wiener JG, Gunnells D, Wood L, Chu DI, Cannon J, Kennedy GD, Morris MS. Early removal of catheters in an Enhanced Recovery Pathway (ERP) with intrathecal opioid injection does not affect postoperative urinary outcomes. Am J Surg 2019; 219:983-987. [PMID: 31590888 DOI: 10.1016/j.amjsurg.2019.09.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/21/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Postoperative urinary retention (POUR) and catheter-associated urinary tract infections (CAUTI) are associated with significantly longer hospital length-of-stay and increased costs.1 This study investigates the effect of early removal of urinary catheters on POUR and CAUTI in patients undergoing an ERP with a preoperative intrathecal injection. METHODS Retrospective cohort study of a prospectively maintained database of patients who underwent elective colorectal surgery in an Enhanced Recovery pathway was compared to historical National Surgical Quality Improvement Program cohort of patients. Primary outcomes measured are 30-day POUR and postoperative CAUTI rates. RESULTS The overall POUR rate of ERP patients compared to non-ERP patients was significantly less (8% vs. 13%, p < 0.05). CAUTI rates were not significantly different between pre-ERP and ERP patients (1.2 vs 2.3%, p = 0.19). CONCLUSIONS For patients undergoing ERP with a preoperative intrathecal opioid injection, early removal of urinary catheter significantly decreased POUR and did not significantly affect CAUTI rates. SUMMARY The effect of early removal of urinary catheters on postoperative urinary retention and catheter-associated UTI rates in patients undergoing an ERP with a single preoperative intrathecal opioid injection was studied. Early urinary catheter removal after intrathecal injection was associated with decreased rates of POUR and equivalent CAUTI rates.
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Wong ECL, Breau RH, Mallick R, Wood L, Pouliot F, Basappa NS, Tanguay S, Soulières D, So A, Heng D, Lavallée LT, Drachenberg D, Kapoor A. Renal cell carcinoma in the Canadian Indigenous population. ACTA ACUST UNITED AC 2019; 26:e367-e371. [PMID: 31285681 DOI: 10.3747/co.26.4707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Diagnosis and treatment of renal cell carcinoma (rcc) might be different in Indigenous Canadians than in non-Indigenous Canadians. In this cohort study, we compared rcc presentation and treatments in Indigenous and non-Indigenous Canadians. Methods Patients registered in the Canadian Kidney Cancer Information System treated at 16 institutions between 2011 and 2018 were included. Baseline patient, tumour, and treatment characteristics were compared between Indigenous and non-Indigenous Canadians. The primary objective was to determine if differences in rcc stage at diagnosis were evident between the groups. The secondary objective was to determine if treatments and outcomes were different between the groups. Results During the study period, 105 of the 4529 registered patients self-identified as Indigenous. Those patients were significantly younger at the time of clinical diagnosis (57.9 ± 11.3 years vs. 62.0 ± 12.1 years, p = 0.0006) and had a family history prevalence of rcc that was double the prevalence in the non-Indigenous patients (14% vs. 7%, p = 0.004). Clinical stage at diagnosis was similar in the two groups (p = 0.61). The disease was metastatic at presentation in 11 Indigenous Canadians (10%) and in 355 non-Indigenous Canadians (8%). Comorbid conditions that could affect the management of rcc-such as obesity, renal disease, diabetes mellitus, and smoking-were more common in Indigenous Canadians (p < 0.05). Indigenous Canadians experienced a lower rate of active surveillance (p = 0.01). Treatments and median time to treatments were similar in the two groups. Conclusions Compared with their non-Indigenous counterparts, Indigenous Canadian patients with rcc are diagnosed at an earlier age and at a similar clinical stage. Despite higher baseline comorbid conditions, clinical outcomes are not worse for Indigenous Canadians than for non-Indigenous Canadians.
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Smith HL, Stevens A, Minogue B, Sneddon S, Shaw L, Wood L, Adeniyi T, Xiao H, Lio P, Kimber SJ, Brison DR. Systems based analysis of human embryos and gene networks involved in cell lineage allocation. BMC Genomics 2019; 20:171. [PMID: 30836937 PMCID: PMC6399968 DOI: 10.1186/s12864-019-5558-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/22/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Little is understood of the molecular mechanisms involved in the earliest cell fate decision in human development, leading to the establishment of the trophectoderm (TE) and inner cell mass (ICM) stem cell population. Notably, there is a lack of understanding of how transcriptional networks arise during reorganisation of the embryonic genome post-fertilisation. RESULTS We identified a hierarchical structure of preimplantation gene network modules around the time of embryonic genome activation (EGA). Using network models along with eukaryotic initiation factor (EIF) and epigenetic-associated gene expression we defined two sets of blastomeres that exhibited diverging tendencies towards ICM or TE. Analysis of the developmental networks demonstrated stage specific EIF expression and revealed that histone modifications may be an important epigenetic regulatory mechanism in preimplantation human embryos. Comparison to published RNAseq data confirmed that during EGA the individual 8-cell blastomeres are transcriptionally primed for the first lineage decision in development towards ICM or TE. CONCLUSIONS Using multiple systems biology approaches to compare developmental stages in the early human embryo with single cell transcript data from blastomeres, we have shown that blastomeres considered to be totipotent are not transcriptionally equivalent. Furthermore we have linked the developmental interactome to individual blastomeres and to later cell lineage. This has clinical implications for understanding the impact of fertility treatments and developmental programming of long term health.
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Lewis PA, Mullany DV, Townsend S, Johnson J, Wood L, Courtney M, Joseph D, Walters DL. Trends in intra-aortic balloon counterpulsation: Comparison of a 669 record Australian dataset with the multinational Benchmark Counterpulsation Outcomes Registry. Anaesth Intensive Care 2019; 35:13-9. [PMID: 17323660 DOI: 10.1177/0310057x0703500101] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The aim of this study was to review and describe indications for intraaortic balloon counterpulsation (IABP) use and identify the impact these have on outcomes at an Australian cardiothoracic tertiary referral hospital. A secondary aim was comparison of the Australian practice with a large multinational IABP data registry. Patient demographics, IABP indication, IABP complication rate and mortality in 662 patients treated with IABP at The Prince Charles Hospital (TPCH), Brisbane, between January 1994 and December 2004 inclusive were compared with The Benchmark Counterpulsation Outcomes Registry. Data were collected between 1994 and 2000 by retrospective patient record review and prospectively using the Benchmark database from 2001 to 2004. Statistical analysis was undertaken usingSAS (v8.2) software. The mean age of patients managed with IABP at TPCH (71.6% male) was 63.4 years (SD 12.4). In-hospital mortality rate was 22% and the complication rate was 10.3%. TPCH indications for IABP were: weaning from cardiopulmonary bypass (34.2%); cardiogenic shock (24.4%); preoperative support (13%); catheter laboratory support (10.6%); refractory ventricular failure (7.3%); ischaemia related to intractable ventricular arrhythmias (4.5%); unstable refractory angina (4%); mechanical complications due to acute myocardial infarction (1.2%) and other (0.4%) (0.4% not reported). In comparison to Benchmark, IABP at TPCH demonstrated a prejudice toward intraoperative use (34.2% versus 16.6%; P= <0.0001) and an aversion to catheter laboratory support (10.6% versus 19%; P= <0.0001). TPCH and Benchmark IABP outcomes demonstrated comparable mortality (22% versus 20.8%; P=ns) but increased TPCH complications (10.3% vs. 6.2%; P= <0.0001) owing to a 2% difference in observed insertion site bleeding.
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Nazha S, Tanguay S, Kapoor A, Jewett M, Kollmannsberger C, Wood L, Bjarnason G, Heng D, Soulières D, Reaume N, Basappa N, Lévesque E, Dragomir A. Use of targeted therapy in patients with metastatic renal cell carcinoma: clinical and economic impact in a Canadian real-life setting. ACTA ACUST UNITED AC 2018; 25:e576-e584. [PMID: 30607126 DOI: 10.3747/co.25.4103] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction Outside of randomized controlled clinical trials, the understanding of the effectiveness and costs associated with targeted therapies for metastatic renal cell carcinoma (mrcc) is limited in Canada. The purpose of the present study was to use real-world prospective data to assess the effectiveness and cost of targeted therapies for patients with mrcc. Methods The Canadian Kidney Cancer Information System, a pan-Canadian database, was used to identify prospectively collected data relating to patients with mrcc. First- and subsequent-line time to treatment termination (ttt) was determined from therapy initiation time (sunitinib or pazopanib) to discontinuation of therapy. Kaplan-Meier survival curves were used to estimate the unadjusted and adjusted overall survival (os) by treatment. Unit treatment cost was used to estimate the cost by line of treatment and the total cost of therapy for the management of patients with mrcc. Results The study included 475 patients receiving sunitinib or pazopanib in the first-line setting. Patients were treated mostly with sunitinib (81%); 19% of patients were treated with pazopanib. The median ttt in the first line was 7.7 months for patients receiving sunitinib and 4.6 months for those receiving pazopanib (p < 0.001). The adjusted os was 32 months with sunitinib and 21 months with pazopanib (hazard ratio: 1.61; p < 0.01). The total median cost of first- and second-line treatments was $56,476 (interquartile range: $23,738-$130,447) for patients in the sunitinib group and $46,251 (interquartile range: $28,167-$91,394) for those in the pazopanib group. Conclusions For the two therapies, os differed significantly, with a higher median os being observed in the sunitinib group. The cost of treatment was higher in the sunitinib group, which is to be expected with longer survival.
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Stephens N, Johnson S, Wood L, Mills J, Shapiro A, Trujillo E, Duffy K, Taylor C, Spees C. Malnutrition Screening: A Screening Tool for Outpatient Oncology Patients, Leveraging EMR Data. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chi K, Taavitsainen S, Iqbal N, Ferrario C, Ong M, Wadhwa D, Hotte S, Lo G, Tran B, Azad A, Wood L, Gingerich J, North S, Pezaro C, Ruether D, Sridhar S, Annala M, Bacon J, Wyatt A. A randomized phase II study of cabazitaxel (CAB) vs (ABI) abiraterone or (ENZ) enzalutamide in poor prognosis metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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