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Simon J, Shapiro M, Larkin L, Kim N, Patel S, Kingsberg S. Onset of Flibanserin Treatment Effect in Postmenopausal Women Assessed by Subdomain Scores of the Female Sexual Function Index (FSFI). J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.050] [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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Jeong S, Park J, Kim N, Kim H. Hypovascular Cellular Tumor in Primary Central Nervous System Lymphoma is Associated with Treatment Resistance: Tumor Habitat Analysis Using Physiologic MRI. AJNR Am J Neuroradiol 2022; 43:40-47. [PMID: 34824097 PMCID: PMC8757556 DOI: 10.3174/ajnr.a7351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE The microenvironment of lymphomas is known to be highly variable and closely associated with treatment resistance and survival. We tried to develop a physiologic MR imaging-based spatial habitat analysis to identify regions associated with treatment resistance to facilitate the prediction of tumor response after initial chemotherapy in patients with primary central nervous system lymphoma. MATERIALS AND METHODS Eighty-one patients with pathologically confirmed primary central nervous system lymphoma were enrolled. Pretreatment physiologic MR imaging was performed, and K-means clustering was used to separate voxels into 3 spatial habitats according to ADC and CBV values. Associations of spatial habitats and clinical and conventional imaging predictors with time to progression were analyzed using Cox proportional hazards modeling. The performance of statistically significant predictors for time to progression was assessed using the concordance probability index. RESULTS The 3 spatial habitats of hypervascular cellular tumor, hypovascular cellular tumor, and hypovascular hypocellular tumor were identified. A large hypovascular cellular habitat was most significantly associated with short time to progression (hazard ratio, 2.83; P = . 017). The presence of an atypical finding (hazard ratio, 4.41; P = . 016), high performance score (hazard ratio, 5.82; P = . 04), and high serum lactate dehydrogenase level (hazard ratio, 1.01; P = .013) was significantly associated with time to progression. A predictive model constructed using the habitat score and other imaging parameters showed a concordance probability index for prediction of time to progression of 0.70 (95% CI, 0.54-0.87). CONCLUSIONS A hypovascular cellular tumor habitat is associated with treatment resistance in primary central nervous system lymphoma, and its assessment may refine prechemotherapy imaging-based response prediction for patients with primary central nervous system lymphoma.
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Choi E, Byun E, Kwon SU, Kim N, Suh CH, Kwon H, Han Y, Kwon TW, Cho YP. Carotid Plaque Composition Assessed by CT Predicts Subsequent Cardiovascular Events among Subjects with Carotid Stenosis. AJNR Am J Neuroradiol 2021; 42:2199-2206. [PMID: 34711554 DOI: 10.3174/ajnr.a7338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 07/28/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Currently, the characteristics of carotid plaques are considered important factors for identifying subjects at high risk of stroke. This study aimed to test the hypothesis that carotid plaque composition assessed by CTA is associated with an increased risk of future major adverse cardiovascular events among asymptomatic subjects with moderate-to-severe carotid artery stenosis. MATERIALS AND METHODS This single-center, retrospective cohort study included 194 carotid plaques from 176 asymptomatic subjects with moderate-to-severe carotid artery stenosis. The association of CTA-determined plaque composition with the risk of subsequent adverse cardiovascular events was analyzed. RESULTS During a median follow-up of 41 months, the adverse cardiovascular event incidence among 194 carotid plaques was 19.6%. There were significant differences in plaque Hounsfield units (P < .001) and spotty calcium presence (P < .001) between carotid plaques from subjects with and without subsequent adverse cardiovascular events. Multivariable analysis revealed carotid plaque Hounsfield unit density (P < .001) and spotty calcium (P < .001) as independent predictors of subsequent adverse cardiovascular events. In association with moderate carotid artery stenosis, the plaque Hounsfield unit values were significantly lower among carotid plaques from subjects who experienced subsequent adverse cardiovascular events (P = .002), strokes (P = .01), and cardiovascular deaths (P = .04); the presence of spotty calcium was significantly associated with the occurrence of adverse cardiovascular events (P = .001), acute coronary syndrome (P = .01), and cardiovascular death (P = .04). CONCLUSIONS Carotid plaque Hounsfield unit density and spotty calcium were independent predictors of a greater risk of adverse cardiovascular event occurrence.
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Kazemimoghadam M, Chi W, Rahimi A, Kim N, Alluri P, Nwachukwu C, Lu W, Gu X. Saliency-Guided Deep Learning Network for Automatic Target Delineation in Post-Operative Stereotactic Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.519] [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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Song Y, Lim J, Lim T, Im K, Kim N, Nam Y, Jeon Y, Ko H, Park I, Shin J, Cho S. Human mesenchymal stem cells derived from umbilical cord and bone marrow exert immunomodulatory effects in different mechanisms. Cytotherapy 2021. [DOI: 10.1016/s1465324921003455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kim N, Im K, Jeon Y, Oh E, Chung N, Lee J, Song Y, Lee J, Cho S. A prospective phase I/II clinical study evaluating the clinical and immune responses of repeated MSCs infusions in steroid-refractory chronic GVHD patients. Cytotherapy 2021. [DOI: 10.1016/s1465324921002978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ryu K, Lee T, Baek D, Park J, Kim N. A study on accumulator analysis for the valve performance evaluation system of nuclear power plants. KERNTECHNIK 2021. [DOI: 10.1515/kern-2019-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
To evaluate the valves used in the nuclear power plants are working properly under the required conditions, the performance and capacity test should be performed. In the test system, the accumulator was employed to control the large amount of high pressure and high temperature steam generated in the boiler precisely. In the accumulating process, the steam is often condensed. In order to prevent condensation, it is needed to install heaters and preheat the accumulator. However, if the size of the accumulator becomes large, the installation of the heater may not be easy. Therefore, when the test is conducted, the system was preheated by the latent heat generated from the phase change. Insufficient thermal insulation may cause temperature differences and it can cause mechanical problems in the accumulator structure. If insulation is sufficient, the temperature difference is indicated by the height. As the cooled condensate moves downwards, the condensate is discharged by the drain valve control and the temperature difference of the structure can be disappeared. The results of this paper can be applied to the conceptualization of equipment that uses latent heat and for the design of high-precision steam experimental devices or the design of high-capacity steam utilization systems.
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Kim N, Chang J, Keum K, Suh C, Kim Y. A 40 Gy in 15 Fractions and Volumetric-Modulated Arc Therapy (VMAT) can Reduce Radiation-Related Toxicity in Patients with Breast Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Moon J, Lee W, Lee B, Lee J, Yang A, Yang G, Kim J, Kim T, Kim N, Yoon H, Cho J, Lee C, Choi S. PO-1032: Clinical Features and Treatment Outcome of Resectable Pulmonary Large Cell Neuroendocrine Carcinoma. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01049-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lee HJ, Lee JY, Lee MJ, Kim HK, Kim N, Kim GU, Lee JS, Park HW, Chang HS, Yang DH, Choe J, Byeon JS. Association of low skeletal muscle mass with the presence of advanced colorectal neoplasm: integrative analysis using three skeletal muscle mass indices. Colorectal Dis 2020; 22:1293-1303. [PMID: 32363686 DOI: 10.1111/codi.15103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/14/2020] [Indexed: 02/08/2023]
Abstract
AIM This study aimed to evaluate an association between colorectal neoplasm (CRN) and skeletal muscle mass using three widely accepted skeletal muscle mass indices (SMIs) in a large population at average risk. METHOD We performed a cross-sectional study using a screening colonoscopy database of 33 958 asymptomatic subjects aged 40-75 years. Appendicular skeletal muscle mass (ASM) was measured using a bioelectrical impedance analyser. ASM adjusted for height squared (ASM/ht2 ), weight (ASM/wt) and body mass index (ASM/BMI) were used as indices for muscle mass. Logistic regression models were used to evaluate the association between SMIs and CRN. RESULTS In a multivariable-adjusted model, the risk of an advanced CRN increased linearly with decreasing quartiles for all three SMIs. The adjusted odds ratios (ORs) for advanced CRN in quartiles 1, 2 and 3 of ASM/wt compared with that in quartile 4 were 1.279, 1.196 and 1.179, respectively (Ptrend = 0.017); for ASM/BMI, ORs were 1.307, 1.144 and 1.091, respectively (Ptrend = 0.002); and for ASM/ht2 , ORs were 1.342, 1.169 and 1.062, respectively (Ptrend = 0.002). The risk of distally located advanced CRN was higher in quartile 1 than in quartile 4 for all three SMIs (ASM/wt, OR = 1.356; ASM/BMI, OR = 1.383; ASM/ht2 , OR = 1.430). CONCLUSION Our study demonstrated that low skeletal muscle mass was consistently associated with the presence of advanced CRN in a population at average risk regardless of the operational definition of the SMI, and it was particularly associated with distal advanced CRN.
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Mallipattu SK, Jawa R, Moffitt R, Hajagos J, Fries B, Nachman S, Gan TJ, Saltz M, Saltz J, Kaushansky K, Skopicki H, Abell-Hart K, Chaudhri I, Deng J, Garcia V, Gayen S, Kurc T, Bolotova O, Yoo J, Dhaliwal S, Nataraj N, Sun S, Tsai C, Wang Y, Abbasi S, Abdullah R, Ahmad S, Bai K, Bennett-Guerrero E, Chua A, Gomes C, Griffel M, Kalogeropoulos A, Kiamanesh D, Kim N, Koraishy F, Lingham V, Mansour M, Marcos L, Miller J, Poovathor S, Rubano J, Rutigliano D, Sands M, Santora C, Schwartz J, Shroyer K, Spitzer S, Stopeck A, Talamini M, Tharakan M, Vosswinkel J, Wertheim W, Mallipattu SK, Jawa R, Moffitt R, Hajagos J, Fries B, Nachman S, Gan TJ, Saltz M, Saltz J, Kaushansky K, Skopicki H, Abell-Hart K, Chaudhri I, Deng J, Garcia V, Gayen S, Kurc T, Bolotova O, Yoo J, Dhaliwal S, Nataraj N, Sun S, Tsai C, Wang Y, Abbasi S, Abdullah R, Ahmad S, Bai K, Bennett-Guerrero E, Chua A, Gomes C, Griffel M, Kalogeropoulos A, Kiamanesh D, Kim N, Koraishy F, Lingham V, Mansour M, Marcos L, Miller J, Poovathor S, Rubano J, Rutigliano D, Sands M, Santora C, Schwartz J, Shroyer K, Spitzer S, Stopeck A, Talamini M, Tharakan M, Vosswinkel J, Wertheim W. Geospatial Distribution and Predictors of Mortality in Hospitalized Patients With COVID-19: A Cohort Study. Open Forum Infect Dis 2020; 7:ofaa436. [PMID: 33117852 PMCID: PMC7543608 DOI: 10.1093/ofid/ofaa436] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/09/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The global coronavirus disease 2019 (COVID-19) pandemic offers the opportunity to assess how hospitals manage the care of hospitalized patients with varying demographics and clinical presentations. The goal of this study was to demonstrate the impact of densely populated residential areas on hospitalization and to identify predictors of length of stay and mortality in hospitalized patients with COVID-19 in one of the hardest hit counties internationally. METHODS This was a single-center cohort study of 1325 sequentially hospitalized patients with COVID-19 in New York between March 2, 2020, to May 11, 2020. Geospatial distribution of study patients' residences relative to population density in the region were mapped, and data analysis included hospital length of stay, need and duration of invasive mechanical ventilation (IMV), and mortality. Logistic regression models were constructed to predict discharge dispositions in the remaining active study patients. RESULTS The median age of the study cohort (interquartile range [IQR]) was 62 (49-75) years, and more than half were male (57%) with history of hypertension (60%), obesity (41%), and diabetes (42%). Geographic residence of the study patients was disproportionately associated with areas of higher population density (r s = 0.235; P = .004), with noted "hot spots" in the region. Study patients were predominantly hypertensive (MAP > 90 mmHg; 670, 51%) on presentation with lymphopenia (590, 55%), hyponatremia (411, 31%), and kidney dysfunction (estimated glomerular filtration rate < 60 mL/min/1.73 m2; 381, 29%). Of the patients with a disposition (1188/1325), 15% (182/1188) required IMV and 21% (250/1188) developed acute kidney injury. In patients on IMV, the median (IQR) hospital length of stay in survivors (22 [16.5-29.5] days) was significantly longer than that of nonsurvivors (15 [10-23.75] days), but this was not due to prolonged time on the ventilator. The overall mortality in all hospitalized patients was 15%, and in patients receiving IMV it was 48%, which is predicted to minimally rise from 48% to 49% based on logistic regression models constructed to project disposition in the remaining patients on ventilators. Acute kidney injury during hospitalization (odds ratioE, 3.23) was the strongest predictor of mortality in patients requiring IMV. CONCLUSIONS This is the first study to collectively utilize the demographics, clinical characteristics, and hospital course of COVID-19 patients to identify predictors of poor outcomes that can be used for resource allocation in future waves of the pandemic.
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Kim N, Park M, Yook T, Kim J. PND4 Exploratory Cost-Effectiveness Analysis of Thread Embedding Acupuncture Plus Usual Care Versus Usual Care Alone for Treating Sequelae in Bell's Palsy Patients: An Economic Evaluation Alongside a Clinical Trial. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kyung Y, Kim T, Ham S, Lee W, Lim B, Lee D, Chae H, You D, Song C, Jeong I, Hong B, Hong J, Ahn H, Kim N, Kim C. Fully automated evaluation of contact surface area between renal cell carcinoma and kidney parenchyma using deep convolutional neural net. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33953-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Huh D, Roh Y, Kim N. 639 Association of clinical and demographic factors with phototherapy outcomes in patients with atopic dermatitis. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.650] [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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Goldstein S, Minton J, Gagnon C, Kim N, Goldstein I. 037 Open-Label Pilot, Prospective Vulvoscopic Study of Daily Administration of Prasterone Vaginal Inserts in Women with Moderate to Severe Dyspareunia. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.273] [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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Goldstein S, Williams J, Kim N, Goldstein I. 049 A Double-Blind, Sham Controlled Prospective Pilot Study of Urinary Stress Incontinence and Sexual Function in Women After 6 Treatments with HIFEM Technology (Emsella): Interim Analysis. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.285] [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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Simon J, Millheiser L, Clayton A, Kingsberg S, Kim N. 084 Improvements in Female Sexual Function Index (FSFI) Domains Over Time after Flibanserin Treatment in Premenopausal Women with Hypoactive Sexual Desire Disorder (HSDD). J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kim N, Park M. PULMONARY CAPILLARY HEMANGIOMATOSIS UNEXPECTEDLY FOUND IN A SYSTEMIC SCLEROSIS PATIENT WITH PULMONARY ARTERY HYPERTENSION: A CASE REPORT. Chest 2020. [DOI: 10.1016/j.chest.2020.05.180] [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] Open
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Mease PJ, Bhutani MK, Hur P, Yi E, Kim N. SAT0385 CAN MISCLASSIFICATION BETWEEN SPONDYLOARTHRITIS (SPA) AND RHEUMATOID ARTHRITIS (RA) OCCUR? SPA-RELATED CLINICAL MANIFESTATIONS AMONG RA AND SPA PATIENTS - A SYSTEMATIC LITERATURE REVIEW. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Delayed diagnosis is associated with worse outcomes and poor treatment responses in patients with SpA, including psoriatic arthritis (PsA) and axial spondyloarthritis.1Misclassification may be associated with this delay, as SpA and RA, especially seronegative RA, may present with similar manifestations such as joint pain, swelling, fatigue, and disability. Key features that typically distinguish SpA from RA include spine pain, dactylitis, enthesitis, psoriasis, and nail psoriasis.2Increased physician awareness of the potential overlap and distinctions between SpA and RA manifestations is needed for the early diagnosis and appropriate treatment for SpA.Objectives:To identify and summarise the published literature on the prevalence of SpA-related clinical manifestations among patients with RA and SpA.Methods:Publications were retrieved from Embase®, Cochrane, MEDLINE®, and MEDLINE® In-Process databases. Studies were included if they were non-interventional, recruited patients with RA and SpA, or patients with seronegative/seropositive RA, and reported the following manifestations: enthesitis, dactylitis, axial symptoms, psoriasis, or nail psoriasis. Two reviewers assessed each citation against predefined eligibility criteria, with discrepancies reconciled by a third independent reviewer.Results:Of the 4479 publications retrieved, 18 studies were included (Figure 1). All studies compared SpA populations to patients with RA. Of the 18 studies, 11 studies reported patients with only PsA, 2 studies reported patients with only ankylosing spondylitis (AS), and 5 studies reported mixed SpA populations. Three studies each reported data pertaining to seropositive/seronegative RA and early RA, defined as symptom onset <1 year. The majority (N=12) of studies used ultrasound imaging to identify manifestations of interest. Enthesitis (N=17) was the most frequently evaluated manifestation while axial symptoms (N=2) was least evaluated. Of the studies reporting enthesitis, the majority (N=14) reported a higher prevalence of enthesitis in the SpA cohort compared to the RA cohort. The remaining studies (N=3) reported no significant difference in enthesitis between the SpA and RA cohorts. Notably, these 3 studies comprised of the 2 studies evaluating only AS patients, and all 3 studies evaluated late RA patients. In contrast, the 3 studies that reported early RA and PsA patients found a significantly higher prevalence of enthesitis in early PsA vs. early RA cohort. Two of the 3 studies reporting RA serostatus found a higher prevalence of enthesitis, psoriasis, and/or nail psoriasis in the SpA population compared to seronegative and seropositive RA cohorts. All studies reporting axial symptoms, dactylitis, psoriasis, and nail psoriasis found a higher prevalence of the corresponding manifestation in the SpA vs. RA cohort.Conclusion:While this review found a higher prevalence of key SpA-related clinical manifestations in SpA vs. RA, overlap was present suggesting that misclassification could occur. Differences in the prevalence of manifestations were also seen in the early vs. late RA populations as well as by RA serostatus. This suggests that an earlier and comprehensive evaluation, including advanced imaging of peripheral manifestations such as enthesitis, dactylitis, axial symptoms, and skin signs such as psoriasis and nail disease, among RA and SpA patients may reduce misclassification and inappropriate treatment. Further research is needed to confirm these findings.References:[1]Seo et al. Clin Rheumatol. 2015;34:1397-1405.[2]Merola et al. RMD. 2018;4:e000656.Acknowledgments:This study was sponsored by Novartis Pharmaceuticals Corporation, East Hanover, NJ.Disclosure of Interests:Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau, Mohit Kumar Bhutani Employee of: Novartis Healthcare Pvt Ltd, Peter Hur Employee of: Novartis Pharmaceuticals Corporation, Esther Yi Employee of: Novartis Pharmaceuticals Corporation, Nina Kim Employee of: Postdoctoral fellow at the University of Texas at Austin and Baylor Scott and White Health, providing services to Novartis Pharmaceuticals Corporation
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Mease PJ, Blachley T, Glynn M, Dube B, Mclean R, Kim N, Hur P, Ogdie A. SAT0429 SECUKINUMAB IMPROVES CLINICAL AND PATIENT-REPORTED OUTCOMES AT 6 MONTHS AMONG PATIENTS WITH PSORIATIC ARTHRITIS IN THE US-BASED CORRONA PSORIATIC ARTHRITIS/SPONDYLOARTHRITIS (PsA/SpA) REGISTRY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Secukinumab, an interleukin-17 antagonist approved for the treatment of PsA, improves all PsA manifestations in the GRAPPA-OMERACT core domain set.1Few US-based studies have evaluated the real-world effectiveness of secukinumab in patients with PsA.Objectives:To examine clinical and patient-reported outcomes (PROs) in patients with PsA enrolled in the Corrona PsA/SpA registry initiating secukinumab with ≥ 1 follow-up visit.Methods:Included were adult patients with PsA in the Corrona registry who initiated secukinumab after April 1, 2017 and remained on secukinumab at their 6-month (window, 5-8 months) follow-up visit. The primary outcome was achievement of minimal disease activity (MDA) at 6 months among patients not in MDA at secukinumab initiation. MDA was defined as meeting 5 of the 7 following criteria: tender joint count (TJC) ≤ 1, swollen joint count (SJC) ≤ 1, psoriasis affected body surface area (BSA) < 3%, patient assessment of pain on visual analog scale (VAS) ≤ 15, patient global assessment VAS ≤ 20, HAQ-DI ≤ 0.5, and tender entheseal points ≤ 1 using the Leeds Enthesitis Index (LEI). Secondary outcomes included the proportion of patients who achieved resolution (0 sites) of TJC, SJC, enthesitis (using the LEI), and dactylitis among those with ≥ 1 site at initiation and improvement from baseline in clinical outcomes (BSA, nail psoriasis, physician global assessment, TJC, SJC, and DAPSA) and PROs (patient-reported pain, patient global assessment, HAQ-DI, and Work Productivity and Activity Impairment questionnaire) at 6 months. Outcomes were evaluated in the overall population and in potentially recalcitrant patients with failure of or intolerance to ≥ 3 previous biologics to examine if the later line biologic could be adequately effective.Results:A total of 100 patients with PsA who initiated and maintained secukinumab after 6 months were included. The mean (SD) age was 51.6 (11.6) years, 54.3% were male, and 96.8% were white. The mean (SD) symptom and disease duration were 10.8 (9.7) and 7.0 (7.0) years, respectively. Thirty patients (30.0%) initiated secukinumab 150 mg and 70 (70.0%) initiated secukinumab 300 mg. Most (83.0%) were biologic experienced; 17 patients initiated secukinumab as a 1st biologic, 34 as 2nd, 26 as 3rd, and 23 as ≥ 4th. At initiation, 75/90 patients (83.3%) were not in MDA; 26/71 (36.6%) of those with follow-up data available achieved MDA at 6 months (Figure 1). In the overall population, 28 patients (41.2%) with TJC ≥ 1, 24 (44.4%) with SJC ≥ 1, 17 (60.7%) with enthesitis, and 9 (75.0%) with dactylitis at initiation achieved resolution at 6 months (Table 1). Improvement was observed at 6 months in clinical outcomes and PROs in the overall population (Figures 1 and 2) and in patients who initiated secukinumab as a ≥ 4th-line biologic.Table 1.Resolution of Peripheral Arthritis, Enthesitis, and Dactylitis at 6 Months Among Patients With ≥ 1 Site at InitiationSecondary OutcomesInitiation,Mean (SD) [n]6-Month Follow-Up,Resolution (Count = 0), n (%)TJC (1-68)9.0 (9.7) [68]28 (41.2)SJC (1-66)4.7 (4.2) [54]24 (44.4)Enthesitis (1-6)1.9 (1.1) [28]17 (60.7)Dactylitis (1-20)2.1 (1.3) [12]9 (75.0)Conclusion:In the Corrona registry, most secukinumab initiators with PsA were biologic experienced and were not in MDA at time of initiation. Consistent with clinical trials, real-world patients treated with secukinumab achieved MDA as well as improvement in clinical manifestations, PROs, and work productivity.References:[1]Orbai AM, et al.J Rheumatol.2019 Oct 15. [Epub ahead of print].Disclosure of Interests:Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau, Taylor Blachley Employee of: Corrona, LLC, Meghan Glynn Shareholder of: Corrona, LLC – shareholder, Grant/research support from: Pfizer – grant/research support, Employee of: Corrona, LLC – employment, Blessing Dube Employee of: Corrona, LLC, Robert McLean Employee of: Corrona, LLC, Nina Kim Employee of: Postdoctoral fellow at the University of Texas at Austin and Baylor Scott and White Health, providing services to Novartis Pharmaceuticals Corporation, Peter Hur Employee of: Novartis Pharmaceuticals Corporation, Alexis Ogdie Grant/research support from: Pfizer to Penn, Novartis to Penn, Amgen to Forward/NDB, Consultant of: Abbvie, Amgen, Bristol-Myers Squibb, Celgene, Corrona, Janssen, Eli Lilly, Novartis, Pfizer
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Lee M, Lee K, Lee H, Kim N, Jeon J, Jeon S, Oh S, Kim S, Kim S, Lee Y. 0455 Role of Interaction Between Anterior Insula Response to Sleep-Related Pictures and Stress Levels on Sleep Disturbance. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Literature suggests that stress may play an important role in sleep disturbance. Individuals with higher stress levels often showed hyperarousal to stressful events, possibly leading to sleep disturbance. Hyperarousal is also one of features of stress-related sleep disturbance. Here, we examined the extent to which stress levels interact with neural activity in response to sleep-related information to predict sleep disturbance.
Methods
Forty eight healthy adults (26 females, age = 35.7 ± 10.5) without sleep disorders based on nocturnal polysomnography participated in this study. They were viewing sleep-related pictures (e.g., bedroom and sunset) and non-sleep related, neutral pictures (e.g., kitchen and landscape) during fMRI scanning. They also completed questionnaires assessing stress levels and sleep disturbance using Life Experience Survey (LES) and Pittsburgh Sleep Quality Index (PSQI), respectively. Activity in response to sleep-related pictures compared to neutral pictures was extracted from our region-of-interest (ROI), the anterior insula, and entered into our moderation models. The SPSS macro PROCESS (Hayes, 2013) was used to conduct moderation analyses. Given a significant correlation between age and PSQI scores, age was included as a covariate.
Results
Our moderation analyses showed that interactions between stress levels and anterior insula response to sleep-related pictures significantly predicted sleep disturbance. Simple slope analyses showed that at higher anterior insula response, higher stress levels were associated with greater sleep disturbance, but at lower anterior insula response, stress was not significantly associated with sleep disturbance. These results indicate that individuals with high levels of stress were more likely to experience sleep disturbance if they showed greater anterior insula response to sleep-related pictures (i.e., hyperarousal in response to sleep-related information).
Conclusion
The current findings suggest that interactions between stress levels and neural substrates of hyperarousal, particularly the anterior insula, may play a critical role in sleep disturbance.
Support
Brain Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (Study No.: 2016M3C7A1904338 and NRF-2018R1D1A1B07049704).
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Lee K, Lee H, Jeon J, Jeon S, Kim N, Oh S, Lee M, Kim S, Lee Y. 0064 Heightened Neural Responses to Negative Words in Shift Workers Using the Stroop Task. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.062] [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
Introduction
Shift work is known to have a negative impact on a wide range of health problems such as sleep disturbance, cognitive impairment, and emotional disorders (e.g., anxiety and depression). It is important to understand underlying mechanisms for negative impact of shift work on health problems. This study aimed to investigate psychological and neural mechanisms associated with shift work.
Methods
Thirty six shift workers (28 females, age = 29.9 ± 7.4) and 35 non-shift workers (20 females, age = 30.5 ± 5.5) participated in this study. They were performing the word Stroop task during fMRI scanning. This task included sleep-related words and negative words to investigate neural substrates associated with sleep-related information and emotional information processing. Neutral words were included as control stimuli. The participants also completed questionnaires assessing sleep-related problems such as Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale, and emotion-related problems such as Beck Depression Inventory and Beck Anxiety Inventory. Two-sample t-tests were conducted to find group differences in self-report measures and neural response to sleep-related words and negative words compared to neutral words.
Results
Relative to non-shift workers, shift workers showed greater sleep disturbance (i.e., higher PSQI), but they did not show any evidence of emotion-related problems. Shift workers also demonstrated greater neural response to negative words (vs. neutral words) in several prefrontal regions (e.g., dorsal anterior cingulate cortex and dorsolateral prefrontal cortex), anterior insula and caudate compared to non-shift workers. However, shift workers did not show significantly different neural response to sleep-related words (vs. neutral words) compared to non-shift workers.
Conclusion
The result from this study provides supporting evidence that shift work is associated with subjective sleep disturbance. Shift workers’ heightened neural response to negative information may reflect their increased sensitivity to negative information, that may contribute to sleep disturbance.
Support
Brain Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (Study No.: 2016M3C7A1904338 and NRF-2018R1D1A1B07049704).
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Kang S, Ma H, Cho S, Kang J, Kim N. 0073 Left Anterior Cingulate Hyperarousal During Sleep Anxiety-Inducing Emotional Tasks Performance in Patients with Insomnia Disorder. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Patients with insomnia frequently experience sleep/insomnia-related anxiety; this anxiety has been associated with hyperarousal. We investigated the underlying brain function changes in patients with insomnia during emotional task performance that induced sleep/insomnia-related anxiety.
Methods
Functional magnetic resonance imaging (fMRI) was performed during emotional task performance in healthy individuals and patients with insomnia who met the diagnostic criteria of insomnia disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and had chronic insomnia for more than 6 months. The participants underwent fMRI scanning during three types of emotional task performance—insomnia-anxiety task, reading sentences that cause insomnia-related anxiety; general-anxiety task, reading sentences that cause anxiety for everyone; and neutral task, reading neutral sentences that do not cause emotional anxiety. The images obtained from fMRI and blood oxygen level-dependent (BOLD) signal changes were compared between patients with insomnia and healthy controls. Interim analysis was performed with the data of 13 patients with insomnia and 9 controls.
Results
The brain activity in the left anterior cingulate was higher during insomnia-anxiety task performance than that during general-anxiety task performance in the insomnia group (voxel-wise uncorrected p < 0.05; cluster size, 100). In the insomnia group, the brain activity during insomnia-anxiety task performance was not lower in any brain area than that during general-anxiety task performance.
Conclusion
We show that patients with chronic insomnia experience sleep anxiety related with hyperarousal in the left anterior cingulate area. Additional subject recruitment and re-analysis are needed to confirm the findings of this interim analysis.
Support
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03032431).
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Kim N, Im K, Jeon Y, Oh E, Chung N, Lee J, Song Y, Lee J, Cho S. A Prospective Phase I/II Clinical Study Evaluating the Clinical and Immune Responses of Repeated MSCs Infusions in Steroid-Refractory Chronic GVHD Patients. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bird E, Hsiao A, Kerr K, Kim N, Madani M, Kligerman S, Contijoch F. Quantification of CTEPH Disease Burden on CT Angiogram Correlates with Patient Presurgical Hemodynamic Severity and Hemodynamic Improvement after PTE Surgery. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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