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Weng W, Choudhury R, Sapp J, Tang A, Healey J, Nault I, Rivard L, Greiss I, Parkash R. NT-PROBNP PREDICTS RECURRENCE AFTER CATHETER ABLATION IN A HYPERTENSIVE POPULATION UNDERGOING AGGRESSIVE BLOOD PRESSURE MANAGEMENT: A SUB-STUDY OF SMAC-AF. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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McGregor H, Conrad M, Woodhead G, Ruiz D, Tang A, Khan A, Hennemeyer C. 04:03 PM Abstract No. 285 First in human gallbladder cryoablation to treat cholecystitis. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Yuan Y, Yost S, Blanchard S, Yin H, Li M, Robinson K, Tang A, Martinez N, Leong L, Somlo G, Tank Patel N, Waisman J, Portnow J, Hurria A, Luu TH, Mortimer J. Abstract P6-18-18: Phase I trial of eribulin and everolimus in patients with metastatic triple negative breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Alteration of PI3K/Akt/mTOR pathway is the most common genomic abnormality detected in triple negative breast cancer (TNBC). Everolimus acts synergistically with eribulin in inducing apoptosis in TNBC cell lines and xenografts in our preclinical study. This phase I trial was designed to test the safety and tolerability of combining eribulin and everolimus in patients (pts) with metastatic TNBC.
Methods: The overall objective of this study was to describe the safety and toxicities of the combination. The secondary objective was to assess activity based on response rate (RR) and progression free survival (PFS). Eligibility criteria included pts with metastatic TNBC, ECOG 0-2, 0-3 lines of prior chemotherapy in metastatic setting, and prior treatment with anthracycline and/or taxane therapy. The study utilized the toxicity equivalence range (TEQR) design with a target equivalence range for dose-limiting toxicities (DLTs) of 0.20-0.35. The recommended phase 2 dose (RP2D) will be the dose closest to the target of 0.25 below 0.51 based on isotonic regression.Three dosing levels of the combinations were tested: level A1 (everolimus 5mg daily; eribulin 1.4 mg/m2 days 1, 8 every 3 weeks), level A2 (everolimus 7.5mg daily; eribulin 1.4 mg/m2, days 1, 8 every 3 weeks), level B1(everolimus 5mg daily; eribulin 1.1 mg/m2 days 1, 8 every 3 weeks). Nanostring RNA analysis and genomic mutation analysis were conducted in 16 pts with available tumor tissue.
Results: A total of 27 pts were enrolled. Median age was 55 years (range 36-76). Two pts were ineligible due to HER2+ on repeat biopsy and were only included in the toxicity analysis. Dose level B1 (everolimus 5mg daily and eribulin 1.1 mg/m2 days 1, 8 every 3 weeks) was determined to be the RP2D doses. The DLTs were neutropenia, stomatitis and hyperglycemia. Across all cycles, 59% (16/27) had a ≥ Gr3 toxicity attributed to treatment at the possible or above level. 44% (12/27) had Gr3 heme-toxicities. The most common toxicities were ≥ Gr3 neutropenia (10 pts), Gr3 lymphopenia (6 pts) and ≥ Gr3 leukopenia (7 pts). 33% (9/27) had Gr3 non-heme toxicities. The most common were Gr3 stomatitis (3 pts), Gr3 hyperglycemia (3 pts) and Gr3 fatigue (5 pts). The median number of cycles completed was 4 (0-8). 68% (17/25) had a dose modification or hold, 14 of 25 (56%) were for eribulin and 15 of 25 (60%) were for everolimus. Of 25 eligible pts, 8 (32%) achieved a best response as partial response, 11 (44%) had stable disease and 6 (24%) had progression. 80% (20/25) experienced progression by RECIST or showed clinical progression, and the median time to progression was 2.7 mo (95% CI (2.2, 4.6)). At the time of this analysis, 16 participants had died, median OS was 6.3 mo (95% CI (5.3, undefined)). Two pts are still being followed on treatment. PI3K-Akt-mTOR pathway genes and mutations profiles were studied.
Conclusion: Eribulin 1.1 mg/m2 days 1, 8 and everolimus 5mg daily was defined as the RP2D. Genomic analysis is currently underway to understand the molecular mechanisms of resistance.
Citation Format: Yuan Y, Yost S, Blanchard S, Yin H, Li M, Robinson K, Tang A, Martinez N, Leong L, Somlo G, Tank Patel N, Waisman J, Portnow J, Hurria A, Luu T-H, Mortimer J. Phase I trial of eribulin and everolimus in patients with metastatic triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-18.
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El Hajjaji I, Chen L, Almehmadi F, Sidhu K, Deif B, Leong-Sit P, Roberts J, Tang A. NETWORK META-ANALYSIS ON THE EFFICACY OF ANTIARRHYTHMIC DRUGS FOR THE TERMINATION OF VENTRICULAR TACHYCARDIA. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Yuan Y, Hou W, Padam S, Frankel P, Sedrak M, Portnow J, Mortimer J, Yeon C, Hurria A, Tang A, Martinez N, Lee P. Peripheral blood mononuclear cell biomarkers predict response to immune checkpoint inhibitor therapy in metastatic breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Almehmadi F, Roberts J, Gula L, Duffett S, Lee A, Skanes A, El Hajjaji I, Manlucu J, Yee R, Tang A, Leong-Sit P, Klein G. PARA-HISIAN PACING DURING SINUS RHYTHM: DERIVING FORMAL VALUES TO DETERMINE THE PRESENCE OF A SEPTAL ACCESSORY PATHWAY. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.338] [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] Open
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Wong J, Ip M, Tang A, Wei V, Wong S, Riley S, Read J, Kwok K. Prevalence and risk factors of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) carriage in Asia-Pacific region from 2000 to 2016: A systematic review and meta-analysis. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Na S, Zhang J, Zhou X, Tang A, Huang D, Xu Q, Xue D, Qiu J. Plumbagin-mediating GLUT1 suppresses the growth of human tongue squamous cell carcinoma. Oral Dis 2018; 24:920-929. [PMID: 29080392 DOI: 10.1111/odi.12799] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 12/14/2022]
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Tang A, Powell-Chandler A, Roberts A, Hale B, Jones H, Evans M, Davies M. NELA year 3: A mortality review and quality improvement project. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.538] [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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Raghavan P, Tang A, Bilaloglu S, Bayona C, Stone J, Wilfred M, Hung C, Yousefi A, Caughey M. Dose-response relationship during motor learning with bimanual-to-unimanual training. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.066] [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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Zhang J, Yan R, Wu C, Wang H, Yang G, Zhong Y, Liu Y, Wan L, Tang A. Spermatogenesis-associated 48 is essential for spermatogenesis in mice. Andrologia 2018; 50:e13027. [PMID: 29700843 DOI: 10.1111/and.13027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2018] [Indexed: 01/03/2023] Open
Abstract
Azoospermia, oligospermia and teratozoospermia all seriously impact male reproductive health. Spermatogenesis is a complex and precisely regulated process in which germ cells proliferate and differentiate and involves the regulation of multiple testis-specific genes. Here, we identified testis-specific gene spermatogenesis-associated 48 (SPATA48), the expression of which was age-dependent, indicating that it is involved in spermatogenesis. In humans and mice with azoospermia, expression of SPATA48 disappeared in the testis. Spata48-/- knockout male mice had smaller testis and defective spermatogenesis compared to wild-type (WT) mice. This study can help in the exploration of the genetic basis of male infertility and identify new targets for the diagnosis and treatment of male infertility.
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Mierzwa M, Casper K, Redmond K, Barrett W, Takiar V, Tang A, Mark J, Wilson K, Wise-Draper T, Sadraei N, Huth B. Phase 2 Trial of Adjuvant Concurrent Cetuximab and Radiation for High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mierzwa M, Biesiada J, Zhang X, Kuhnell D, Redmond K, Huth B, Takiar V, Wise-Draper T, Sadraei N, Tang A, Mark J, Casper K, Medvedovic M, Langevin S. Whole-Exome Sequencing of Aggressive Cutaneous Head and Neck Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yuan Y, Frankel P, Synold T, Lee P, Yost S, Martinez N, Tang A, Mendez B, Schmolze D, Apple S, Hurria A, Waisman J, Somlo G, Tank N, Sedrak M, Mortimer J. Abstract OT1-05-02: A phase II clinical trial of the combination of pembrolizumab and selective androgen receptor modulator GTx-024 in patients with advanced androgen receptor positive triple negative breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot1-05-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Androgen receptor (AR) targeted therapy and immunotherapy represent one of the most promising strategies for metastatic triple negative breast cancer (mTNBC), which accounts for 15-20% of all breast cancers. As a nonsteroidal selective androgen receptor modulator (SARM), GTx-024 demonstrated preclinical activity in AR+ TNBC PDX model. Pembrolizumab is a highly selective humanized monoclonal antibody of the programmed cell death 1 receptor (PD-1). The complementary modes of action and low potential for overlapping toxicity make the combination promising in patients with AR+ mTNBC.
Trial Design: This is an open-label Phase 2 study for AR+ mTNBC. Eligible participants receive pembrolizumab 200mg IV every 3 weeks in combination with GTx-024 18mg po daily.
Eligibility Criteria: Eligible patients must have AR+ (>10%, 1+ by IHC) TNBC; failed up to 2 lines of therapy in metastatic setting; and have measurable disease per RECIST1.1. Patients are excluded if they have had prior checkpoint inhibitors or AR targeted agents. Patients with current or prior use of testosterone, testosterone-like agents, androgenic compounds, or anti-androgens (including systemic steroids and immunosuppressive medications)are excluded, as well as current or prior history of noninfectious pneumonitis requiring systemic steroid therapy.
Specific Aims: The primary objective is to evaluate the safety/tolerability of GTx-024 and pembrolizumab and determine the response rate (CR or PR via RECIST 1.1) in patients with advanced AR+ TNBC. We will use clinical benefit rate (CBR), duration of response (DOR), PFS, and OS to test the efficacy of this novel drug combination.
Statistical Design: A Simon's MiniMax two-stage Phase 2 design will be utilized. Based on the previously reported response rate associated with single agent pembrolizumab (19%), we consider a response rate of 19% for the combination as discouraging, and a 39% response rate as encouraging. As a result, we will initially accrue 15 patients (including 6 patients from safety lead-in treated at the tolerable dose). If 2 or fewer patients respond, we will stop accrual for futility. Otherwise, the study will accrue an additional 14 patients for a total of 29 patients. With 29 patients, if only 8 or fewer respond (≤27.6%), the study will be considered discouraging unless secondary evidence of clinical benefit is substantial. With more than 8 patients responding out of the 29 patients, the combination would be considered promising. This design has 85% power to declare a true response rate of 39% as promising (power), and a 10% probability of declaring a true 19% response rate as encouraging (type I error). The probability of early termination if the true response rate is 19% is 44%.
Target Accrual: 29
Study Contact: Yuan Yuan MD PhD, City of Hope Comprehensive Cancer Center; Duarte, CA 91030; Email: yuyuan@coh.org
Citation Format: Yuan Y, Frankel P, Synold T, Lee P, Yost S, Martinez N, Tang A, Mendez B, Schmolze D, Apple S, Hurria A, Waisman J, Somlo G, Tank N, Sedrak M, Mortimer J. A phase II clinical trial of the combination of pembrolizumab and selective androgen receptor modulator GTx-024 in patients with advanced androgen receptor positive triple negative breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT1-05-02.
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Huang Z, Footitt S, Tang A, Finch-Savage WE. Predicted global warming scenarios impact on the mother plant to alter seed dormancy and germination behaviour in Arabidopsis. PLANT, CELL & ENVIRONMENT 2018; 41:187-197. [PMID: 29044545 DOI: 10.1111/pce.13082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/29/2017] [Accepted: 09/18/2017] [Indexed: 05/11/2023]
Abstract
Seed characteristics are key components of plant fitness that are influenced by temperature in their maternal environment, and temperature will change with global warming. To study the effect of such temperature changes, Arabidopsis thaliana plants were grown to produce seeds along a uniquely designed polyethylene tunnel having a thermal gradient reflecting local global warming predictions. Plants therefore experienced the same variations in temperature and light conditions but different mean temperatures. A range of seed-related plant fitness estimates were measured. There were dramatic non-linear temperature effects on the germination behaviour in two contrasting ecotypes. Maternal temperatures lower than 15-16 °C resulted in significantly greater primary dormancy. In addition, the impact of nitrate in the growing media on dormancy was shown only by seeds produced below 15-16 °C. However, there were no consistent effects on seed yield, number, or size. Effects on germination behaviour were shown to be a species characteristic responding to temperature and not time of year. Elevating temperature above this critical value during seed development has the potential to dramatically alter the timing of subsequent seed germination and the proportion entering the soil seed bank. This has potential consequences for the whole plant life cycle and species fitness.
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Tang A, Radwan R, Harris D. Conservative Management of Colovesical Fistulas Secondary to Diverticular Disease: A Systematic Review. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.162] [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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Exner D, Kavanagh K, Hruczkowski T, Hersi A, Thibault B, Philippon F, Yee R, Guertin M, Tang A, Huikuri H. CAN AMBULATORY ELECTROCARDIOGRAPHIC (HOLTER) TESTING ACCURATELY DIFFERENTIATE PATIENTS AT HIGHER VERSUS LOWER RISK OF DEATH AFTER MYOCARDIAL INFRACTION? Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.220] [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] Open
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Parkash R, Nault I, Rivard L, Gula L, Essebag V, Nery P, Tung S, Raymond J, Sterns L, Doucette S, Wells G, Tang A, Stevenson W, Sapp J. EFFECT OF BASELINE ANTIARRHYTHMIC DRUG ON OUTCOMES WITH ABLATION IN ISCHEMIC VENTRICULAR TACHYCARDIA: A VANISH SUBSTUDY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.136] [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] Open
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Sapp J, Coyle K, Parkash R, Healey J, Gray C, Gardner M, Sterns L, Essebag V, Hruczkowski T, Blier L, Wells G, Tang A, Stevenson W, Coyle D. COST EFFECTIVENESS OF VENTRICULAR TACHYCARDIA ABLATION VERSUS ESCALATION OF ANTIARRHYTHMIC DRUG THERAPY IN THE VANISH TRIAL. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Leong-Sit P, Kelly S, Peterson J, Tang A, Wells G, Sapp J. THE VANISH STUDY IN CONTEXT - A NETWORK META-ANALYSIS OF TREATMENTS TO PREVENT VENTRICULAR TACHYCARDIA IN PATIENTS WITH ISCHEMIC CARDIOMYOPATHY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.053] [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] Open
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Weng W, Bernick J, Wells G, Tardif J, Tang A, Sapp J, Gray C, Gardner M, Healey J, Parkash R. PREDICTORS OF ATRIAL FIBRILLATION AFTER CATHETER ABLATION IN A HYPERTENSIVE POPULATION: A SUB-STUDY OF SMAC-AF. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Elsokkari I, Parkash R, Gray C, Gardner M, Abdel Wahab A, Doucette S, Tang A, Wells G, Stevenson W, Sapp J. DOES PRIOR REVASCULARIZATION IMPACT OUTCOMES OF PATIENTS WITH ISCHEMIC CARDIOMYOPATHY AND VENTRICULAR TACHYCARDIA RESULTS FROM VANISH CLINICAL TRIAL. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.132] [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] Open
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Gula L, Leong-Sit P, Tang A, Parkash R, Sarrazin J, Thibault B, Essebag V, Deyell M, Lane C, Nery P, Veenhuyzen G, Redfearn D, Healey J, Roux J, Doucette S, Sapp J. QUALITY OF LIFE IN PATIENTS WITH ABLATION OR MEDICAL THERAPY FOR VENTRICULAR ARRHYTHMIAS: A SUBSTUDY OF VANISH. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.129] [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] Open
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Tang A, Hong I, Boddington L, Reynolds J, Garrett A, Etherington S, Rodger J. P135 Intermittent theta burst increases action potential threshold and spike firing in cortical layer 5 pyramidal neurons. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sykes M, Tang A, Rodger J, Reynolds J. Low intensity rTMS does not change excitability in cortical layer V as measured by in vivo local field potentials. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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