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Blitzer GC, Paz C, Glassey A, Ganz OR, Giri J, Pennati A, Meyers RO, Bates AM, Nickel KP, Weiss M, Morris ZS, Mattison RJ, McDowell KA, Croxford E, Chappell RJ, Glazer TA, Rogus-Pulia NM, Galipeau J, Kimple RJ. Functionality of bone marrow mesenchymal stromal cells derived from head and neck cancer patients - A FDA-IND enabling study regarding MSC-based treatments for radiation-induced xerostomia. Radiother Oncol 2024; 192:110093. [PMID: 38224919 PMCID: PMC10922976 DOI: 10.1016/j.radonc.2024.110093] [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: 07/05/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/17/2024]
Abstract
PURPOSE Salivary dysfunction is a significant side effect of radiation therapy for head and neck cancer (HNC). Preliminary data suggests that mesenchymal stromal cells (MSCs) can improve salivary function. Whether MSCs from HNC patients who have completed chemoradiation are functionally similar to those from healthy patients is unknown. We performed a pilot clinical study to determine whether bone marrow-derived MSCs [MSC(M)] from HNC patients could be used for the treatment of RT-induced salivary dysfunction. METHODS An IRB-approved pilot clinical study was undertaken on HNC patients with xerostomia who had completed treatment two or more years prior. Patients underwent iliac crest bone marrow aspirate and MSC(M) were isolated and cultured. Culture-expanded MSC(M) were stimulated with IFNγ and cryopreserved prior to reanimation and profiling for functional markers by flow cytometry and ELISA. MSC(M) were additionally injected into mice with radiation-induced xerostomia and the changes in salivary gland histology and salivary production were examined. RESULTS A total of six subjects were enrolled. MSC(M) from all subjects were culture expanded to > 20 million cells in a median of 15.5 days (range 8-20 days). Flow cytometry confirmed that cultured cells from HNC patients were MSC(M). Functional flow cytometry demonstrated that these IFNγ-stimulated MSC(M) acquired an immunosuppressive phenotype. IFNγ-stimulated MSC(M) from HNC patients were found to express GDNF, WNT1, and R-spondin 1 as well as pro-angiogenesis and immunomodulatory cytokines. In mice, IFNγ-stimulated MSC(M) injection after radiation decreased the loss of acinar cells, decreased the formation of fibrosis, and increased salivary production. CONCLUSIONS MSC (M) from previously treated HNC patients can be expanded for auto-transplantation and are functionally active. Furthermore IFNγ-stimulated MSC(M) express proteins implicated in salivary gland regeneration. This study provides preliminary data supporting the feasibility of using autologous MSC(M) from HNC patients to treat RT-induced salivary dysfunction.
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Ringer SK, Schmid A, Weiss M, Ohlerth S, Spielmann N, Clausen NG. Non-surgical external jugular vein catheterization using an ear vein access in piglets. Lab Anim 2023; 57:642-649. [PMID: 37077144 DOI: 10.1177/00236772231167224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
The objective of this study was to investigate the feasibility of external jugular vein catheterization through an ear vein in piglets. Forty-six sevoflurane-midazolam anaesthetized piglets were included. External jugular vein catheterization was conducted through the ear vein using the Seldinger technique. Part 1 (n = 27): optimal puncture site was based on the deltoid tuberosity as a landmark to reach the external jugular vein. The final position of the catheter was verified in 25 piglets using computer tomography. Catheterization time was recorded and patency of the catheter assessed by repeated blood sampling for up to 4 h. Part 2 (n = 19): ear vein catheterization was without taking into account any landmarks. Functionality for blood sampling was evaluated as described in part 1. Catheter advancement was possible in 25/27 and 18/19 piglets in parts 1 and 2, respectively. Median (range) time required for successful catheterization was 1.95 (1-10) min (n = 38). The deltoid tuberosity was a good landmark to reach the external jugular vein. But blood sampling was also possible through catheters ending slightly cranial to the external jugular vein. Despite successful catheter advancement, blood sampling was not possible from one catheter in each part of the study (total: two piglets). One of these catheters presented luminal damage, while the other one presented as normal after being removed from the animal. Summarizing, central vein catheterization through the ear vein was feasible in 93.5% and repeated blood sampling was possible in 89.1% of the piglets (n = 46).
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Denke C, Jaschinski U, Riessen R, Bercker S, Spies C, Ragaller M, Weiss M, Dey K, Michalsen A, Briegel J, Pohrt A, Sprung CL, Avidan A, Hartog CS. End-of-life practices in 11 German intensive care units : Results from the ETHICUS-2 study. Med Klin Intensivmed Notfmed 2023; 118:663-673. [PMID: 36169693 PMCID: PMC10624715 DOI: 10.1007/s00063-022-00961-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/09/2022] [Accepted: 08/30/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND End-of-life care is common in German intensive care units (ICUs) but little is known about daily practice. OBJECTIVES To study the practice of end-of-life care. METHODS Prospectively planned, secondary analysis comprising the German subset of the worldwide Ethicus‑2 Study (2015-2016) including consecutive ICU patients with limitation of life-sustaining therapy or who died. RESULTS Among 1092 (13.7%) of 7966 patients from 11 multidisciplinary ICUs, 967 (88.6%) had treatment limitations, 92 (8.4%) died with failed CPR, and 33 (3%) with brain death. Among patients with treatment limitations, 22.3% (216/967) patients were discharged alive from the ICU. More patients had treatments withdrawn than withheld (556 [57.5%] vs. 411 [42.5%], p < 0.001). Patients with treatment limitations were older (median 73 years [interquartile range (IQR) 61-80] vs. 68 years [IQR 54-77]) and more had mental decision-making capacity (12.9 vs. 0.8%), advance directives (28.6 vs. 11.2%), and information about treatment wishes (82.7 vs 33.3%, all p < 0.001). Physicians reported discussing treatment limitations with patients with mental decision-making capacity and families (91.3 and 82.6%, respectively). Patient wishes were unknown in 41.3% of patients. The major reason for decision-making was unresponsiveness to maximal therapy (34.6%). CONCLUSIONS Treatment limitations are common, based on information about patients' wishes and discussion between stakeholders, patients and families. However, our findings suggest that treatment preferences of nearly half the patients remain unknown which affects guidance for treatment decisions.
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Blitzer GC, Glazer T, Burr A, Gustafson S, Ganz O, Meyers R, McDowell KA, Nickel KP, Mattison RJ, Weiss M, Chappell R, Rogus-Pulia NM, Galipeau J, Kimple RJ. Marrow-Derived Autologous Stromal Cells for the Restoration of Salivary Hypofunction (MARSH): A pilot, first-in-human study of interferon gamma-stimulated marrow mesenchymal stromal cells for treatment of radiation-induced xerostomia. Cytotherapy 2023; 25:1139-1144. [PMID: 37589639 PMCID: PMC10615723 DOI: 10.1016/j.jcyt.2023.07.009] [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: 04/21/2023] [Revised: 07/07/2023] [Accepted: 07/25/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AIMS Xerostomia, or the feeling of dry mouth, is a significant side effect of radiation therapy for patients with head and neck cancer (HNC). Preliminary data suggest that mesenchymal stromal/stem cells (MSCs) can improve salivary function. We performed a first-in-human pilot study of interferon gamma (IFNγ)-stimulated autologous bone marrow-derived MSCs, or MSC(M), for the treatment of radiation-induced xerostomia (RIX). Here we present the primary safety and secondary efficacy endpoints. METHODS A single-center pilot clinical trial was conducted investigating the safety and tolerability of autologous IFNγ-stimulated MSC(M). The study was conducted under an approved Food and Drug Administration Investigational New Drug application using an institutional review board-approved protocol (NCT04489732). Patients underwent iliac crest bone marrow aspirate and MSC(M) were isolated, cultured, stimulated with IFNγ and cryopreserved for later use. Banked cells were thawed and allowed to recover in culture before patients received a single injection of 10 × 106 MSC(M) into the right submandibular gland under ultrasound guidance. The primary objective was determination of safety and tolerability by evaluating dose-limiting toxicity (DLT). A DLT was defined as submandibular pain >5 on a standard 10-point pain scale or any serious adverse event (SAE) within 1 month after injection. Secondary objectives included analysis of efficacy as measured by salivary quantification and using three validated quality of life instruments. Quantitative results are reported as mean and standard deviation. RESULTS Six patients with radiation-induced xerostomia who had completed radiation at least 2 years previously (average 7.8 years previously) were enrolled in the pilot study. The median age was 71 (61-74) years. Five (83%) patients were male. Five patients (83%) were treated with chemoradiation and one patient (17%) with radiation alone. Grade 1 pain was seen in 50% of patients after submandibular gland injection; all pain resolved within 4 days. No patients reported pain 1 month after injection, with no SAE or other DLTs reported 1 month after injection. The analysis of secondary endpoints demonstrated a trend of increased salivary production. Three patients (50%) had an increase in unstimulated saliva at 1 and 3 months after MSC(M) injection. Quality of life surveys also showed a trend toward improvement. CONCLUSIONS Injection of autologous IFNγ-stimulated MSC(M) into a singular submandibular gland of patients with RIX is safe and well tolerated in this pilot study. A trend toward an improvement in secondary endpoints of salivary quantity and quality of life was observed. This first-in-human study provides support for further investigation into IFNγ-stimulated MSC(M) injected in both submandibular glands as an innovative approach to treat RIX and improve quality of life for patients with HNC.
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Eckelmann BJ, Blitzer GC, Smilowitz JB, Trask D, Weiss M, Weber S, Abbott D, Varley P, Neuman H, Maloney JD, Hinshaw JL, Morris BA, Merfeld E, Howard SP, Bradley KA, Baschnagel AM, Bassetti MF, Hennessey DW, Morris Z. Initial Results of a Phase II Trial of Hypofractionated Radiation Therapy for Inoperable Soft Tissue Sarcoma. Int J Radiat Oncol Biol Phys 2023; 117:S147-S148. [PMID: 37784374 DOI: 10.1016/j.ijrobp.2023.06.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) For patients with soft tissue sarcoma (STS) who cannot or choose not to have surgery, radiation can provide local tumor control in both palliative and definitive settings. Conventionally fractionated radiation provides modest (< 50%) rates of local control (LC) for STS at 2 years. To our knowledge, no prospective studies to date have evaluated the safety and efficacy of dose-escalated hypofractionated radiation therapy as treatment of inoperable STS. We hypothesized that dose-escalated, hypofractionated radiation therapy (RT) for inoperable STS could achieve higher rates of LC than reported in trials of conventionally fractionated RT. MATERIALS/METHODS An IRB-approved single institution prospective phase II clinical trial of dose-escalated, hypofractionated RT as local control for STS was designed and completed planned accrual. Exclusion criteria included anti-cancer systemic therapy within the preceding two weeks. Patients underwent hypofractionated RT utilizing either CT-guided radiation (24, 50%) or MRI-guided radiation treatments (24, 50%). Data on patient characteristics, RT dose and fractionation, LC, toxicity, and overall survival (OS) was collected. The primary endpoint was local tumor control (stable, partial, or complete response according to RECIST) at 2-years after completion of radiation. Secondary endpoints were acute and late toxicity, rates of complete response, 5-year local tumor control, and progression-free and overall survival. Acute toxicity was graded on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale during treatment and at 3 months following RT. RESULTS Forty-eight patients were enrolled, 17 with non-metastatic localized disease and 31 with metastatic disease. Median patient age was 64. Twenty-five men and 23 women were treated. Ninety-six total lesions were treated (36 lung, 7 extremity, 37 abdominopelvic, 16 other). Radiation dose per fraction ranged from 6-12 Gy for a total of 1-12 fractions (median dose was 52.5 Gy in 6 fractions. Median patient follow-up is 8.6 months (range 1 - 36 months). Six patients (13%) did not complete initial 3-month follow-up imaging. Of the 40 patients who have undergone 3-month follow up imaging, 32 (80%) had stable disease, 5 (12.5%) had partial response, 0 had complete response, and 3 (7.5%) had disease progression. Median PFS was 17.2 months at time of last follow up. Median OS was 12.9 months at time of last follow up. Twenty-five patients (52%) experienced an acute toxicity likely or possibly related to radiation. Three (6%) patients experienced CTACE grade 3 or greater treatment-related toxicity (pain, weakness, decreased range of motion, dermatitis). CONCLUSION In this initial report of a prospective, single-institution clinical trial of hypofractionated RT for STS not undergoing resection, we report low rates of acute grade 3 or greater toxicity and high rates of tumor response. We will continue to follow these patients to assess late toxicity and durability of tumor control.
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Weiss M, Holzer MT, Muehlensiepen F, Ignatyev Y, Fiehn C, Bauhammer J, Schmidt J, Schlüter S, Dihkan A, Scheibner D, Schneider U, Valor-Mendez L, Corte G, Gupta L, Chinoy H, Lundberg I, Cavagna L, Distler JHW, Schett G, Knitza J. Healthcare utilization and unmet needs of patients with antisynthetase syndrome: An international patient survey. Rheumatol Int 2023; 43:1925-1934. [PMID: 37452880 PMCID: PMC10435645 DOI: 10.1007/s00296-023-05372-9] [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: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023]
Abstract
Antisynthease syndrome (ASSD) is a rare, complex and understudied autoimmune disease. Internet-based studies can overcome barriers of traditional on-site research and are therefore very appealing for rare diseases. The aim of this study was to investigate patient-reported symptoms, diagnostic delay, symptoms, medical care, health status, working status, disease knowledge and willingness to participate in research of ASSD patients by conducting an international web-based survey. The multilingual questionnaire was created by an international group of rheumatologists and patients and distributed online. 236 participants from 22 countries completed the survey. 184/236 (78.0%) were female, mean age (SD) was 49.6 years (11.3) and most common antisynthetase antibody was Jo-1 (169/236, 71.6%). 79/236 (33.5%) reported to work full-time. Median diagnostic delay was one year. The most common symptom at disease onset was fatigue 159/236 (67.4%), followed by myalgia 130/236 (55.1%). The complete triad of myositis, arthritis and lung involvement verified by a clinician was present in 42/236 (17.8%) at disease onset and in 88/236 (37.3%) during the disease course. 36/236 (15.3%) reported to have been diagnosed with fibromyalgia and 40/236 (16.3%) with depression. The most reported immunosuppressive treatments were oral corticosteroids 179/236 (75.9%), followed by rituximab 85/236 (36.0%). 73/236 (30.9%) had received physiotherapy treatment. 71/236 (30.1%) reported to know useful online information sources related to ASSD. 223/236 (94.5%) were willing to share health data for research purposes once a year. Our results reiterate that internet-based research is invaluable for cooperating with patients to foster knowledge in rare diseases.
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Blitzer GC, Glazer T, Gustafson S, Burr A, Mattison R, Ganz O, Meyers R, McDowell K, Weiss M, Nickel KP, Chappell RJ, Pulia N, Gallipeau J, Kimple RJ. A Pilot, First in Human Study of Autologous IFN-Gamma Stimulated Mesenchymal Stromal Cells for Treatment of Radiation-Induced Xerostomia. Int J Radiat Oncol Biol Phys 2023; 117:S152. [PMID: 37784385 DOI: 10.1016/j.ijrobp.2023.06.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) There are no existing effective treatments for radiation-induced xerostomia (RIX), a common side effect of head and neck radiation. Mesenchymal stromal cells (MSCs) exhibit regenerative effects in multiple tissues and may represent an effective cell therapy for the treatment of RIX. Here we present the primary safety and secondary efficacy endpoints of a first-in-human pilot study of IFNγ-stimulated autologous bone marrow- derived MSCs [MSC(M)] for the treatment of RIX. MATERIALS/METHODS We conducted a single-center clinical trial investigating the safety and tolerability of autologous IFNγ-stimulated MSC(M). The study was conducted under an FDA-IND and approved by the local IRB. Patients underwent bone marrow aspiration, MSC(M) were then culture-expanded, stimulated with IFNγ, and cryopreserved. Banked IFNγ-stimulated MSC(M) were thawed, allowed to recover, and then 10 × 106 MSC(M) were injected transcutaneously via ultrasound guidance into one submandibular gland. The primary objective was safety and tolerability determined by dose-limiting toxicity (DLT) defined as submandibular pain > 5 on a standard 10-point pain scale or any serious adverse event (SAE) within one month after injection. Secondary objectives included analysis of efficacy as measured by salivary quantification and using 3 validated quality of life instruments. Quantitative results are reported as mean and standard deviation (SD). RESULTS Six radiation-induced xerostomia patients with head and neck cancer who had completed radiation at least 2 years earlier were enrolled. The median age was 71 (61-74) and 5 (83%) patients were male. Five patients (83%) were treated with chemoradiation and one patient (17%) with radiation alone. The average dose of radiation to the injected submandibular gland was 59.9 Gy. Three patients (50%) reported a pain score of 1 after submandibular gland injection, all pain resolved within 4 days. No patients reported pain 1 month after injection, with no SAEs or other DLTs reported 1 month after injection. The analysis of secondary endpoints demonstrated a trend of increased salivary production. The mean unstimulated saliva was 0.13 mL/min (SD 0.17) at baseline and increased to 0.14 mL/min (SD 0.12) at 1 month after injection and 0.19 mL/min (SD 0.21) at 3-months. Quality of life surveys also showed a trend towards improvement. CONCLUSION Injection of autologous IFNγ-stimulated MSC(M) into the submandibular gland of patients with RIX is safe and well tolerated. A trend towards an improvement in secondary endpoints of salivary quantity and quality of life was observed. This first-in-human pilot study provides support for further investigation into IFNγ-stimulated MSC(M) as an innovative, potentially curative, remedy to treat RIX. A phase I dose-escalation study injecting into bilateral submandibular glands is scheduled to begin accrual in the spring of 2023.
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Hammersen J, Birndt S, Döhner K, Reuken P, Stallmach A, Sauerbrey P, La Rosée F, Pfirrmann M, Fabisch C, Weiss M, Träger K, Bremer H, Russo S, Illerhaus G, Drömann D, Schneider S, La Rosée P, Hochhaus A. The JAK1/2 inhibitor ruxolitinib in patients with COVID-19 triggered hyperinflammation: the RuxCoFlam trial. Leukemia 2023; 37:1879-1886. [PMID: 37507425 PMCID: PMC10457200 DOI: 10.1038/s41375-023-01979-w] [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: 05/29/2023] [Revised: 07/12/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
Dysregulated hyperinflammatory response is key in the pathogenesis in patients with severe COVID-19 leading to acute respiratory distress syndrome and multiorgan failure. Whilst immunosuppression has been proven to be effective, potential biological targets and optimal timing of treatment are still conflicting. We sought to evaluate efficacy and safety of the Janus Kinase 1/2 inhibitor ruxolitinib, employing the previously developed COVID-19 Inflammation Score (CIS) in a prospective multicenter open label phase II trial (NCT04338958). Primary objective was reversal of hyperinflammation (CIS reduction of ≥25% at day 7 in ≥20% of patients). In 184 patients with a CIS of ≥10 (median 12) ruxolitinib was commenced at an initial dose of 10 mg twice daily and applied over a median of 14 days (range, 2-31). On day 7, median CIS declined to 6 (range, 1-13); 71% of patients (CI 64-77%) achieved a ≥25% CIS reduction accompanied by a reduction of markers of inflammation. Median cumulative dose was 272.5 mg/d. Treatment was well tolerated without any grade 3-5 adverse events related to ruxolitinib. Forty-four patients (23.9%) died, all without reported association to study drug. In conclusion, ruxolitinib proved to be safe and effective in a cohort of COVID-19 patients with defined hyperinflammation.
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Aprile E, Abe K, Agostini F, Ahmed Maouloud S, Althueser L, Andrieu B, Angelino E, Angevaare JR, Antochi VC, Antón Martin D, Arneodo F, Baudis L, Baxter AL, Bazyk M, Bellagamba L, Biondi R, Bismark A, Brookes EJ, Brown A, Bruenner S, Bruno G, Budnik R, Bui TK, Cai C, Cardoso JMR, Cichon D, Cimental Chavez AP, Colijn AP, Conrad J, Cuenca-García JJ, Cussonneau JP, D'Andrea V, Decowski MP, Di Gangi P, Di Pede S, Diglio S, Eitel K, Elykov A, Farrell S, Ferella AD, Ferrari C, Fischer H, Flierman M, Fulgione W, Fuselli C, Gaemers P, Gaior R, Gallo Rosso A, Galloway M, Gao F, Glade-Beucke R, Grandi L, Grigat J, Guan H, Guida M, Hammann R, Higuera A, Hils C, Hoetzsch L, Hood NF, Howlett J, Iacovacci M, Itow Y, Jakob J, Joerg F, Joy A, Kato N, Kara M, Kavrigin P, Kazama S, Kobayashi M, Koltman G, Kopec A, Kuger F, Landsman H, Lang RF, Levinson L, Li I, Li S, Liang S, Lindemann S, Lindner M, Liu K, Loizeau J, Lombardi F, Long J, Lopes JAM, Ma Y, Macolino C, Mahlstedt J, Mancuso A, Manenti L, Marignetti F, Marrodán Undagoitia T, Martens K, Masbou J, Masson D, Masson E, Mastroianni S, Messina M, Miuchi K, Mizukoshi K, Molinario A, Moriyama S, Morå K, Mosbacher Y, Murra M, Müller J, Ni K, Oberlack U, Paetsch B, Palacio J, Peres R, Peters C, Pienaar J, Pierre M, Pizzella V, Plante G, Qi J, Qin J, Ramírez García D, Singh R, Sanchez L, Dos Santos JMF, Sarnoff I, Sartorelli G, Schreiner J, Schulte D, Schulte P, Schulze Eißing H, Schumann M, Scotto Lavina L, Selvi M, Semeria F, Shagin P, Shi S, Shockley E, Silva M, Simgen H, Takeda A, Tan PL, Terliuk A, Thers D, Toschi F, Trinchero G, Tunnell C, Tönnies F, Valerius K, Volta G, Weinheimer C, Weiss M, Wenz D, Wittweg C, Wolf T, Wu VHS, Xing Y, Xu D, Xu Z, Yamashita M, Yang L, Ye J, Yuan L, Zavattini G, Zhong M, Zhu T. First Dark Matter Search with Nuclear Recoils from the XENONnT Experiment. PHYSICAL REVIEW LETTERS 2023; 131:041003. [PMID: 37566859 DOI: 10.1103/physrevlett.131.041003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/22/2023] [Indexed: 08/13/2023]
Abstract
We report on the first search for nuclear recoils from dark matter in the form of weakly interacting massive particles (WIMPs) with the XENONnT experiment, which is based on a two-phase time projection chamber with a sensitive liquid xenon mass of 5.9 ton. During the (1.09±0.03) ton yr exposure used for this search, the intrinsic ^{85}Kr and ^{222}Rn concentrations in the liquid target are reduced to unprecedentedly low levels, giving an electronic recoil background rate of (15.8±1.3) events/ton yr keV in the region of interest. A blind analysis of nuclear recoil events with energies between 3.3 and 60.5 keV finds no significant excess. This leads to a minimum upper limit on the spin-independent WIMP-nucleon cross section of 2.58×10^{-47} cm^{2} for a WIMP mass of 28 GeV/c^{2} at 90% confidence level. Limits for spin-dependent interactions are also provided. Both the limit and the sensitivity for the full range of WIMP masses analyzed here improve on previous results obtained with the XENON1T experiment for the same exposure.
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Aprile E, Abe K, Ahmed Maouloud S, Althueser L, Andrieu B, Angelino E, Angevaare JR, Antochi VC, Antón Martin D, Arneodo F, Baudis L, Baxter AL, Bazyk M, Bellagamba L, Biondi R, Bismark A, Brookes EJ, Brown A, Bruenner S, Bruno G, Budnik R, Bui TK, Cai C, Cardoso JMR, Cichon D, Cimental Chavez AP, Clark M, Colijn AP, Conrad J, Cuenca-García JJ, Cussonneau JP, D'Andrea V, Decowski MP, Di Gangi P, Di Pede S, Diglio S, Eitel K, Elykov A, Farrell S, Ferella AD, Ferrari C, Fischer H, Flierman M, Fulgione W, Fuselli C, Gaemers P, Gaior R, Gallo Rosso A, Galloway M, Gao F, Glade-Beucke R, Grandi L, Grigat J, Guan H, Guida M, Hammann R, Higuera A, Hils C, Hoetzsch L, Hood NF, Howlett J, Iacovacci M, Itow Y, Jakob J, Joerg F, Joy A, Kato N, Kara M, Kavrigin P, Kazama S, Kobayashi M, Koltman G, Kopec A, Kuger F, Landsman H, Lang RF, Levinson L, Li I, Li S, Liang S, Lindemann S, Lindner M, Liu K, Loizeau J, Lombardi F, Long J, Lopes JAM, Ma Y, Macolino C, Mahlstedt J, Mancuso A, Manenti L, Marignetti F, Marrodán Undagoitia T, Martens K, Masbou J, Masson D, Masson E, Mastroianni S, Messina M, Miuchi K, Mizukoshi K, Molinario A, Moriyama S, Morå K, Mosbacher Y, Murra M, Müller J, Ni K, Oberlack U, Paetsch B, Palacio J, Pellegrini Q, Peres R, Peters C, Pienaar J, Pierre M, Pizzella V, Plante G, Pollmann TR, Qi J, Qin J, Ramírez García D, Singh R, Sanchez L, Dos Santos JMF, Sarnoff I, Sartorelli G, Schreiner J, Schulte D, Schulte P, Schulze Eißing H, Schumann M, Scotto Lavina L, Selvi M, Semeria F, Shagin P, Shi S, Shockley E, Silva M, Simgen H, Takeda A, Tan PL, Terliuk A, Thers D, Toschi F, Trinchero G, Tunnell C, Tönnies F, Valerius K, Volta G, Weinheimer C, Weiss M, Wenz D, Wittweg C, Wolf T, Wu VHS, Xing Y, Xu D, Xu Z, Yamashita M, Yang L, Ye J, Yuan L, Zavattini G, Zhong M, Zhu T. Searching for Heavy Dark Matter near the Planck Mass with XENON1T. PHYSICAL REVIEW LETTERS 2023; 130:261002. [PMID: 37450817 DOI: 10.1103/physrevlett.130.261002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 07/18/2023]
Abstract
Multiple viable theoretical models predict heavy dark matter particles with a mass close to the Planck mass, a range relatively unexplored by current experimental measurements. We use 219.4 days of data collected with the XENON1T experiment to conduct a blind search for signals from multiply interacting massive particles (MIMPs). Their unique track signature allows a targeted analysis with only 0.05 expected background events from muons. Following unblinding, we observe no signal candidate events. This Letter places strong constraints on spin-independent interactions of dark matter particles with a mass between 1×10^{12} and 2×10^{17} GeV/c^{2}. In addition, we present the first exclusion limits on spin-dependent MIMP-neutron and MIMP-proton cross sections for dark matter particles with masses close to the Planck scale.
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Weiss M, Assier H, Hotz C, Hua C, Thomas L, Wolkenstein P, Ingen-Housz-Oro S. Acute generalized exanthematous pustulosis: Clinico-biological profile and inducing drugs in 83 patients. J Eur Acad Dermatol Venereol 2023; 37:e776-e778. [PMID: 36734481 DOI: 10.1111/jdv.18940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/01/2023] [Indexed: 02/04/2023]
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Dupree J, Dunn RL, Yan P, Suh D, Marsh EE, Dalton V, Norton EC, Weiss M. Impact of different legislative in-vitro fertilization coverage mandates on male infertility care. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00276-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Boksán K, Dechant M, Weiss M, Hellwig A, Stemmler M. A meta-analysis on the effects of incarceration-based opioid substitution treatment. MEDICINE, SCIENCE, AND THE LAW 2023; 63:53-60. [PMID: 35934979 DOI: 10.1177/00258024221118971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: Opioid substitution treatment (OST) is a common treatment for individuals who use opioids; however, empirical evidence on the effects of OST during incarceration is scarce. Our aim was to conduct a meta-analysis on the effects of incarceration-based OST on substance use, treatment engagement post-release and re-incarceration. Method: We searched for studies on individuals who were incarcerated and treated with OST, compared to a comparison group. Studies were only included if they reported data post-release. Results: N = 15 studies met the inclusion criteria. We found less opioid use, less other drug use, higher treatment engagement post-release and less re-incarceration among treated individuals compared to the comparison group. Moderator analyses showed some influence of length of follow-up period and study quality. Conclusions: Incarceration-based OST reduces drug use, re-incarceration and leads to higher treatment engagement after release. More research is needed on the effects of incarceration-based OST on secondary outcomes (e.g. health and social integration) and on factors that moderate these effects.
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Weiss M, Nikisher B, Haran H, Tefft K, Adams J, Edwards JG. High throughput screen of small molecules as potential countermeasures to galactic cosmic radiation induced cellular dysfunction. LIFE SCIENCES IN SPACE RESEARCH 2022; 35:76-87. [PMID: 36336373 DOI: 10.1016/j.lssr.2022.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/23/2022] [Accepted: 06/16/2022] [Indexed: 06/16/2023]
Abstract
Space travel increases galactic cosmic ray exposure to flight crews and this is significantly elevated once travel moves beyond low Earth orbit. This includes combinations of high energy protons and heavy ions such as 56Fe or 16O. There are distinct differences in the biological response to low-energy transfer (x-rays) or high-energy transfer (High-LET). However, given the relatively low fluence rate of exposure during flight operations, it might be possible to manage these deleterious effects using small molecules currently available. Virtually all reports to date examining small molecule management of radiation exposure are based on low-LET challenges. To that end an FDA approved drug library (725 drugs) was used to perform a high throughput screen of cultured cells following exposure to galactic cosmic radiation. The H9c2 myoblasts, ES-D3 pluripotent cells, and Hy926 endothelial cell lines were exposed to a single exposure (75 cGy) using the 5-ion GCRsim protocol developed at the NASA Space Radiation Laboratory (NSRL). Following GCR exposure cells were maintained for up to two weeks. For each drug (@10µM), a hierarchical cumulative score was developed incorporating measures of mitochondrial and cellular function, oxidant stress and cell senescence. The top 160 scores were retested following a similar protocol using 1µM of each drug. Within the 160 drugs, 33 are considered to have an anti-inflammatory capacity, while others also indirectly suppressed pro-inflammatory pathways or had noted antioxidant capacity. Lead candidates came from different drug classes that included angiotensin converting enzyme inhibitors or AT1 antagonists, COX2 inhibitors, as well as drugs mediated by histamine receptors. Surprisingly, different classes of anti-diabetic medications were observed to be useful including sulfonylureas and metformin. Using a hierarchical decision structure, we have identified several lead candidates. That no one drug or even drug class was completely successful across all parameters tested suggests the complexity of managing the consequences of galactic cosmic radiation exposure.
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Holtdirk F, Zindler T, Mehnert A, Bültmann O, Weiss M, Mayer J, Meyer B, Specht A, Bröde P, Claus M, Watzl C, Cheng F. Digital health applications to support patients with breast cancer: Effects of two tailored, dialogue-based programs on quality of life. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01501-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Aprile E, Abe K, Agostini F, Ahmed Maouloud S, Althueser L, Andrieu B, Angelino E, Angevaare JR, Antochi VC, Antón Martin D, Arneodo F, Baudis L, Baxter AL, Bellagamba L, Biondi R, Bismark A, Brown A, Bruenner S, Bruno G, Budnik R, Bui TK, Cai C, Capelli C, Cardoso JMR, Cichon D, Clark M, Colijn AP, Conrad J, Cuenca-García JJ, Cussonneau JP, D'Andrea V, Decowski MP, Di Gangi P, Di Pede S, Di Giovanni A, Di Stefano R, Diglio S, Eitel K, Elykov A, Farrell S, Ferella AD, Ferrari C, Fischer H, Fulgione W, Gaemers P, Gaior R, Gallo Rosso A, Galloway M, Gao F, Gardner R, Glade-Beucke R, Grandi L, Grigat J, Guida M, Hammann R, Higuera A, Hils C, Hoetzsch L, Howlett J, Iacovacci M, Itow Y, Jakob J, Joerg F, Joy A, Kato N, Kara M, Kavrigin P, Kazama S, Kobayashi M, Koltman G, Kopec A, Kuger F, Landsman H, Lang RF, Levinson L, Li I, Li S, Liang S, Lindemann S, Lindner M, Liu K, Loizeau J, Lombardi F, Long J, Lopes JAM, Ma Y, Macolino C, Mahlstedt J, Mancuso A, Manenti L, Marignetti F, Marrodán Undagoitia T, Martens K, Masbou J, Masson D, Masson E, Mastroianni S, Messina M, Miuchi K, Mizukoshi K, Molinario A, Moriyama S, Morå K, Mosbacher Y, Murra M, Müller J, Ni K, Oberlack U, Paetsch B, Palacio J, Paschos P, Peres R, Peters C, Pienaar J, Pierre M, Pizzella V, Plante G, Qi J, Qin J, Ramírez García D, Reichard S, Rocchetti A, Rupp N, Sanchez L, Dos Santos JMF, Sarnoff I, Sartorelli G, Schreiner J, Schulte D, Schulte P, Schulze Eißing H, Schumann M, Scotto Lavina L, Selvi M, Semeria F, Shagin P, Shi S, Shockley E, Silva M, Simgen H, Stephen J, Takeda A, Tan PL, Terliuk A, Thers D, Toschi F, Trinchero G, Tunnell C, Tönnies F, Valerius K, Volta G, Wei Y, Weinheimer C, Weiss M, Wenz D, Wittweg C, Wolf T, Xu D, Xu Z, Yamashita M, Yang L, Ye J, Yuan L, Zavattini G, Zhong M, Zhu T. Search for New Physics in Electronic Recoil Data from XENONnT. PHYSICAL REVIEW LETTERS 2022; 129:161805. [PMID: 36306777 DOI: 10.1103/physrevlett.129.161805] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
We report on a blinded analysis of low-energy electronic recoil data from the first science run of the XENONnT dark matter experiment. Novel subsystems and the increased 5.9 ton liquid xenon target reduced the background in the (1, 30) keV search region to (15.8±1.3) events/(ton×year×keV), the lowest ever achieved in a dark matter detector and ∼5 times lower than in XENON1T. With an exposure of 1.16 ton-years, we observe no excess above background and set stringent new limits on solar axions, an enhanced neutrino magnetic moment, and bosonic dark matter.
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Schänzler VM, Riedel M, Riedel F, Strizek B, Gembruch U, Weiss M, Mustea A, Egger EK, Recker F. Erratum: PJ – EPAs und die Frauenheilkunde – Evaluation des Ist- und Soll-Zustands und dessen Diskrepanz. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/a-1969-6768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Aprile E, Abe K, Agostini F, Ahmed Maouloud S, Alfonsi M, Althueser L, Angelino E, Angevaare JR, Antochi VC, Antón Martin D, Arneodo F, Baudis L, Baxter AL, Bellagamba L, Biondi R, Bismark A, Brown A, Bruenner S, Bruno G, Budnik R, Capelli C, Cardoso JMR, Cichon D, Cimmino B, Clark M, Colijn AP, Conrad J, Cuenca-García JJ, Cussonneau JP, D'Andrea V, Decowski MP, Gangi PD, Pede SD, Giovanni AD, Stefano RD, Diglio S, Elykov A, Farrell S, Ferella AD, Fischer H, Fulgione W, Gaemers P, Gaior R, Galloway M, Gao F, Glade-Beucke R, Grandi L, Grigat J, Higuera A, Hils C, Hiraide K, Hoetzsch L, Howlett J, Iacovacci M, Itow Y, Jakob J, Joerg F, Kato N, Kavrigin P, Kazama S, Kobayashi M, Koltman G, Kopec A, Landsman H, Lang RF, Levinson L, Li I, Liang S, Lindemann S, Lindner M, Liu K, Lombardi F, Long J, Lopes JAM, Ma Y, Macolino C, Mahlstedt J, Mancuso A, Manenti L, Manfredini A, Marignetti F, Marrodán Undagoitia T, Martens K, Masbou J, Masson D, Masson E, Mastroianni S, Messina M, Miuchi K, Mizukoshi K, Molinario A, Moriyama S, Morå K, Mosbacher Y, Murra M, Ni K, Oberlack U, Palacio J, Peres R, Pienaar J, Pierre M, Pizzella V, Plante G, Qi J, Qin J, Ramírez García D, Reichard S, Rocchetti A, Rupp N, Sanchez L, Dos Santos JMF, Sartorelli G, Schreiner J, Schulte D, Schulze Eißing H, Schumann M, Lavina LS, Selvi M, Semeria F, Shagin P, Shockley E, Silva M, Simgen H, Takeda A, Tan PL, Terliuk A, Therreau C, Thers D, Toschi F, Trinchero G, Tunnell C, Tönnies F, Valerius K, Volta G, Wei Y, Weinheimer C, Weiss M, Wenz D, Westermann J, Wittweg C, Wolf T, Xu Z, Yamashita M, Yang L, Ye J, Yuan L, Zavattini G, Zhang Y, Zhong M, Zhu T, Zopounidis JP, Laubenstein M, Nisi S. Material radiopurity control in the XENONnT experiment. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2022; 82:599. [PMID: 35821975 PMCID: PMC9270421 DOI: 10.1140/epjc/s10052-022-10345-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/19/2022] [Indexed: 11/18/2022]
Abstract
The selection of low-radioactive construction materials is of the utmost importance for rare-event searches and thus critical to the XENONnT experiment. Results of an extensive radioassay program are reported, in which material samples have been screened with gamma-ray spectroscopy, mass spectrometry, and \documentclass[12pt]{minimal}
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\begin{document}$$^{222}$$\end{document}222Rn emanation measurements. Furthermore, the cleanliness procedures applied to remove or mitigate surface contamination of detector materials are described. Screening results, used as inputs for a XENONnT Monte Carlo simulation, predict a reduction of materials background (\documentclass[12pt]{minimal}
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\begin{document}$$\sim $$\end{document}∼17%) with respect to its predecessor XENON1T. Through radon emanation measurements, the expected \documentclass[12pt]{minimal}
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\begin{document}$$^{222}$$\end{document}222Rn activity concentration in XENONnT is determined to be 4.2 (\documentclass[12pt]{minimal}
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\begin{document}$$^{+0.5}_{-0.7}$$\end{document}-0.7+0.5) \documentclass[12pt]{minimal}
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\begin{document}$$\upmu $$\end{document}μBq/kg, a factor three lower with respect to XENON1T. This radon concentration will be further suppressed by means of the novel radon distillation system.
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Aprile E, Abe K, Agostini F, Ahmed Maouloud S, Alfonsi M, Althueser L, Angelino E, Angevaare J, Antochi V, Antón Martin D, Arneodo F, Baudis L, Baxter A, Bellagamba L, Bernard A, Biondi R, Bismark A, Brown A, Bruenner S, Bruno G, Budnik R, Capelli C, Cardoso J, Cichon D, Cimmino B, Clark M, Colijn A, Conrad J, Cuenca-García J, Cussonneau J, D’Andrea V, Decowski M, Di Gangi P, Di Pede S, Di Giovanni A, Di Stefano R, Diglio S, Elykov A, Farrell S, Ferella A, Fischer H, Fulgione W, Gaemers P, Gaior R, Galloway M, Gao F, Glade-Beucke R, Grandi L, Grigat J, Higuera A, Hils C, Hoetzsch L, Howlett J, Iacovacci M, Itow Y, Jakob J, Joerg F, Joy A, Kato N, Kavrigin P, Kazama S, Kobayashi M, Koltman G, Kopec A, Landsman H, Lang R, Levinson L, Li I, Li S, Liang S, Lindemann S, Lindner M, Liu K, Lombardi F, Long J, Lopes J, Ma Y, Macolino C, Mahlstedt J, Mancuso A, Manenti L, Manfredini A, Marignetti F, Marrodán Undagoitia T, Martens K, Masbou J, Masson D, Masson E, Mastroianni S, Messina M, Miuchi K, Mizukoshi K, Molinario A, Moriyama S, Morå K, Mosbacher Y, Murra M, Müller J, Ni K, Oberlack U, Paetsch B, Palacio J, Peres R, Pienaar J, Pierre M, Pizzella V, Plante G, Qi J, Qin J, Ramírez García D, Reichard S, Rocchetti A, Rupp N, Sanchez L, dos Santos J, Sarnoff I, Sartorelli G, Schreiner J, Schulte D, Schulze Eißing H, Schumann M, Scotto Lavina L, Selvi M, Semeria F, Shagin P, Shi S, Shockley E, Silva M, Simgen H, Takeda A, Tan PL, Terliuk A, Thers D, Toschi F, Trinchero G, Tunnell C, Tönnies F, Valerius K, Volta G, Wei Y, Weinheimer C, Weiss M, Wenz D, Wittweg C, Wolf T, Xu Z, Yamashita M, Yang L, Ye J, Yuan L, Zavattini G, Zhang Y, Zhong M, Zhu T, Zopounidis J. Emission of single and few electrons in XENON1T and limits on light dark matter. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.022001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Parakrama R, Sidiqi B, Demyan L, Pasha S, Pinto D, Zavadsky T, Zou X, Patruni S, Kapusta A, Standring O, Weiss M, Herman J, King D. P-10 Standardization of a neoadjuvant therapy (NAT) pathway for pancreatic cancer across a geographically large and diverse healthcare system improves patient care and successful completion of NAT. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Zizek D, Topalovic M, Stublar J, Mrak M, Jan M, Weiss M. Conduction system pacing in paediatric patients: a single centre experience. Europace 2022. [DOI: 10.1093/europace/euac053.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Paediatric patients with conduction abnormalities are generally exposed to life-long dyssynchronous pacing from a very early age. Thus, preservation of cardiac function during chronic ventricular pacing is important. Conduction system pacing (CSP) with His bundle pacing (HBP) or left bundle branch pacing (LBBP) is an alternative method to standard right ventricular (RV) pacing that may preserve physiological ventricular activation and avoid potential pacing-induced cardiomyopathy (1). However, data on feasibility and safety of various CSP approaches in paediatric patients with or without congenital heart disease (CHD) is scarce and mainly relies on case studies (2-4).
Purpose
To assess feasibility and outcomes of different CSP techniques in paediatric patients.
Methods
Consecutive paediatric patients in whom CSP was attempted in our centre between November 2019 and December 2021 were analysed. Acute implant success rate, complications, fluoroscopy times, and CSP pacing parameters during follow-up were assessed.
To reduce radiation exposure, minimal fluoroscopy technique with three-dimensional (3D) electro-anatomical mapping (EAM) was also used in some cases. Geometry of right atrium and RV, along with mapping of His signal for HBP and potential LBBP sites in the RV septum were created using a decapolar catheter from the right femoral vein. Once relevant anatomy was obtained, HBP or LBBP was attempted using commercially available CSP tools. The pacing lead tip was visualised using the 3D EAM system. Transient fluoroscopy was used only for perpendicular placement of the sheath to the RV septum during LBBP, sheath removal, lead loop assessment to allow linear growth, and atrial lead placement.
Results
Six patients (100% female, age 9.3 ± 3.9 years, weight 41.8 ± 22.9 kg, baseline QRS 111.5 ± 6.3ms, CHD 50%, previous device 33%) with congenital complete AV block received CSP. One patient received HBP and 5 LBBP. The procedure was acutely successful in all patients (100%), pacing thresholds were low (0.56 ± 0.18V at 0.5ms) and there were no perioperative complications. During mean follow-up of 11.8 ± 7.8 months pacing parameters remained stable. However, significant rise of the pacing threshold (> 2.5V) was registered in the HBP patient, in whom lead revision was performed. Three-dimensional EAM was utilised in 3 patients (1 HBP, 2 LBBP). The use of minimal fluoroscopy technique with 3D EAM reduced fluoroscopy time (4.0, 3.2, 4.5 min vs. 9.5, 11.0, 8.0 min) without increasing procedural time (80, 70, 50 min vs. 110, 60, 75 min) compared to standard fluoroscopy technique.
Conclusion
Conduction system pacing is feasible and safe in paediatric patients with or without CHD. Additional utilisation of 3D EAM could reduce radiation exposure, without increasing procedural time. Future long-term studies should be considered to provide the ground for wider clinical adoption of CSP in paediatric population.
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De Oliveira Paludo A, Duarte Jr D, Kowalski A, Weiss M, Carvalhal E, Berger M, Berger A. Robotic assisted partial nephrectomy and mixed reality - first surgical planning experience with brainlab elements and magic leap 1. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02308-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Blitzer G, Yadav P, Bayouth J, Smilowitz J, Trask D, Weiss M, Weber S, Abbott D, Varley P, Neuman H, Maloney J, Hinshaw J, Morris B, Merfeld E, Howard S, Bradley K, Baschnagel A, Bassetti M, Parkes A, Hennessey D, Morris Z. Interim Results of a Phase II Trial on Hypofractionated Radiation Therapy for Inoperable Soft Tissue Sarcoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Weiss M, Danese S, Ruiz K, Kjelstrom S, Buckley M, Leitenberger A, Bollmann-Jenkins M, Larson S, DeNittis A, Martinez D. A Survey of Breast Cancer Patients’ Use of Cannabis During Radiation Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.642] [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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Grivas P, Khaki AR, Wise-Draper TM, French B, Hennessy C, Hsu CY, Shyr Y, Li X, Choueiri TK, Painter CA, Peters S, Rini BI, Thompson MA, Mishra S, Rivera DR, Acoba JD, Abidi MZ, Bakouny Z, Bashir B, Bekaii-Saab T, Berg S, Bernicker EH, Bilen MA, Bindal P, Bishnoi R, Bouganim N, Bowles DW, Cabal A, Caimi PF, Chism DD, Crowell J, Curran C, Desai A, Dixon B, Doroshow DB, Durbin EB, Elkrief A, Farmakiotis D, Fazio A, Fecher LA, Flora DB, Friese CR, Fu J, Gadgeel SM, Galsky MD, Gill DM, Glover MJ, Goyal S, Grover P, Gulati S, Gupta S, Halabi S, Halfdanarson TR, Halmos B, Hausrath DJ, Hawley JE, Hsu E, Huynh-Le M, Hwang C, Jani C, Jayaraj A, Johnson DB, Kasi A, Khan H, Koshkin VS, Kuderer NM, Kwon DH, Lammers PE, Li A, Loaiza-Bonilla A, Low CA, Lustberg MB, Lyman GH, McKay RR, McNair C, Menon H, Mesa RA, Mico V, Mundt D, Nagaraj G, Nakasone ES, Nakayama J, Nizam A, Nock NL, Park C, Patel JM, Patel KG, Peddi P, Pennell NA, Piper-Vallillo AJ, Puc M, Ravindranathan D, Reeves ME, Reuben DY, Rosenstein L, Rosovsky RP, Rubinstein SM, Salazar M, Schmidt AL, Schwartz GK, Shah MR, Shah SA, Shah C, Shaya JA, Singh SRK, Smits M, Stockerl-Goldstein KE, Stover DG, Streckfuss M, Subbiah S, Tachiki L, Tadesse E, Thakkar A, Tucker MD, Verma AK, Vinh DC, Weiss M, Wu JT, Wulff-Burchfield E, Xie Z, Yu PP, Zhang T, Zhou AY, Zhu H, Zubiri L, Shah DP, Warner JL, Lopes G. Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium. Ann Oncol 2021; 32:787-800. [PMID: 33746047 PMCID: PMC7972830 DOI: 10.1016/j.annonc.2021.02.024] [Citation(s) in RCA: 202] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/18/2021] [Accepted: 02/28/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies. PATIENTS AND METHODS Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients). RESULTS A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality. CONCLUSIONS Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies. CLINICAL TRIAL IDENTIFIER NCT04354701.
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