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MATHEW E, George J, Gracious N, Kumar S, Vineetha N. POS-749 SINGLE LOW DOSE RITUXIMAB AS INDUCTION AGENT IN KIDNEY TRANSPLANTATION. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Al-Mugotir M, Lovelace JJ, George J, Bessho M, Pal D, Struble L, Kolar C, Rana S, Natarajan A, Bessho T, Borgstahl GEO. Selective killing of homologous recombination-deficient cancer cell lines by inhibitors of the RPA:RAD52 protein-protein interaction. PLoS One 2021; 16:e0248941. [PMID: 33784323 DOI: 10.1371/journal.pone.0248941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 03/09/2021] [Indexed: 12/29/2022] Open
Abstract
Synthetic lethality is a successful strategy employed to develop selective chemotherapeutics against cancer cells. Inactivation of RAD52 is synthetically lethal to homologous recombination (HR) deficient cancer cell lines. Replication protein A (RPA) recruits RAD52 to repair sites, and the formation of this protein-protein complex is critical for RAD52 activity. To discover small molecules that inhibit the RPA:RAD52 protein-protein interaction (PPI), we screened chemical libraries with our newly developed Fluorescence-based protein-protein Interaction Assay (FluorIA). Eleven compounds were identified, including FDA-approved drugs (quinacrine, mitoxantrone, and doxorubicin). The FluorIA was used to rank the compounds by their ability to inhibit the RPA:RAD52 PPI and showed mitoxantrone and doxorubicin to be the most effective. Initial studies using the three FDA-approved drugs showed selective killing of BRCA1-mutated breast cancer cells (HCC1937), BRCA2-mutated ovarian cancer cells (PE01), and BRCA1-mutated ovarian cancer cells (UWB1.289). It was noteworthy that selective killing was seen in cells known to be resistant to PARP inhibitors (HCC1937 and UWB1 SYr13). A cell-based double-strand break (DSB) repair assay indicated that mitoxantrone significantly suppressed RAD52-dependent single-strand annealing (SSA) and mitoxantrone treatment disrupted the RPA:RAD52 PPI in cells. Furthermore, mitoxantrone reduced radiation-induced foci-formation of RAD52 with no significant activity against RAD51 foci formation. The results indicate that the RPA:RAD52 PPI could be a therapeutic target for HR-deficient cancers. These data also suggest that RAD52 is one of the targets of mitoxantrone and related compounds.
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Chungath RR, Witham MD, Clarke CL, Hutcheon A, Gandy S, Gingles C, Priba L, Nicholas S, Cavin I, Sumukadas D, Struthers AD, George J. 42 Is Mitochondrial Function Measured by 31P Magnetic Resonance Spectroscopy Associated with Physical Performance in Older People with Functional Impairment? Age Ageing 2021. [DOI: 10.1093/ageing/afab030.03] [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
Background
Mitochondrial dysfunction has been proposed as a therapeutic target to improve muscle strength and endurance, but the contribution that mitochondrial dysfunction makes to impaired skeletal muscle performance in older people remains unclear. We studied the relationship between phosphocreatine recovery rate (a measure of skeletal muscle mitochondrial function) and physical performance in older people.
Methods
We analysed data from the Allopurinol in Functional Impairment (ALFIE) trial. Participants aged 65 and over, who were unable to walk 400 m in six minutes, underwent 31P magnetic resonance spectroscopy of the calf after exercise at baseline and at 20 weeks follow up. The phosphocreatine recovery half-life time (t-half) was derived as a measure of mitochondrial function. Participants also undertook the 6-minute walk distance, the Short Physical Performance Battery test (SPPB), and had muscle mass measured using bio-impedance analysis. Bivariate correlations and multivariable regression analyses were conducted to determine associations between t-half and baseline factors.
Results
One hundred and seventeen people underwent baseline 31P magnetic resonance spectroscopy, mean age 80.4 years (SD 6.0); 56 (48%) were female. Mean 6-minute walk was 291 m (SD 80) and mean SPPB score was 8.4 (SD 1.9). T-half was significantly correlated with SPPB score (r = 0.22, p = 0.02) but not with 6-minute walk distance (r = 0.10, p = 0.29). In multivariable linear regression, muscle mass and weight, but not t-half, were independently associated with SPPB score and with 6-minute walk distance. The change in t-half between baseline and 20 weeks was not significantly associated with the change in SPPB (r = 0.03, p = 0.79) or with the change in 6-minute walk distance (r = −0.11, p = 0.28).
Conclusion
Muscle mass, but not phosphocreatine recovery time, was associated with Short Physical Performance Battery score and 6-minute walk distance in this cohort of older people with functional impairment.
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George J, Bhattacharyya D. Biocarbon reinforced polypropylene composite: An investigation of mechanical and filler behavior through advanced dynamic atomic force microscopy and X-ray micro CT. EXPRESS POLYM LETT 2021. [DOI: 10.3144/expresspolymlett.2021.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Lacaze L, Touboulic S, Boudjema K, George J, Delamarre J, Le Gouevec F, Chauvin A, Val-Laillet D, Thibault R. A minipig model of marasmus malnutrition: molecular phenotyping and microbiota analyses. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.042] [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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Shek D, Read S, Nagrial A, Carlino M, George J, Gao B, Ahlenstiel G. 12P The correlation between non-coding RNA and response rate to immune-checkpoint inhibitors. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.497] [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] Open
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Poon SS, George J, Obaid D, Kumar P. Myocardial infarction and ventricular fibrillation due to iatrogenic right coronary artery occlusion following tricuspid valve annuloplasty: a case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-4. [PMID: 33442598 PMCID: PMC7793041 DOI: 10.1093/ehjcr/ytaa328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/11/2020] [Accepted: 08/26/2020] [Indexed: 11/13/2022]
Abstract
Background Iatrogenic right coronary artery (RCA) injury is a rare complication of tricuspid valve annuloplasty. Given that surgical intervention is increasingly favoured for tricuspid regurgitation, it is of great importance to recognize potential complications following tricuspid valve surgery. Case summary A 72-year-old man underwent surgical mitral and tricuspid valve repair. The early post-operative course was complicated by recurrent ventricular fibrillation episodes. Due to haemodynamic instability, a re-sternotomy and another cardiopulmonary bypass run were required. The patient subsequently underwent coronary angiography study which confirmed RCA occlusion. The occluded posterior left ventricular (PLV) branch was reopened by balloon angioplasty. However, despite multiple attempts it was not possible to pass a coronary guide wire into the posterior descending artery (PDA). An intravascular ultrasound examination revealed that the ostium of the PDA was compressed by external factors leaving a narrow slit-like appearance with no accessible lumen. Subsequently, a drug-eluting stent was placed into the PLV branch. The PDA was not accessible on repeated re-canalization attempts. The patient later successfully recovered from the right ventricular myocardial infarction. Discussion Right coronary artery occlusion should be considered as a differential diagnosis for significant rhythm disturbances and haemodynamic instability in the peri- and post-operative period following tricuspid valve annuloplasty. A low threshold for diagnostic angiography is needed to avoid potential delay in life-saving revascularization.
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Tshori S, Livschitz S, Volodarsky I, Fabrikant J, George J. Evaluation of ATTR-cardiac amyloidosis employing Tc-99m pyrophosphate scintigraphy using planar, SPECT and gated SPECT imaging on dedicated cardiac CZT camera. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Recent recognition that ATTR cardiac amyloidosis (ATTR-CA) is not uncommon and the emergence of novel therapeutic opportunities resulted in the publication of “Expert Consensus Recommendations for Multimodality Imaging in Cardiac Amyloidosis”. However, almost all data were derived from general purpose NaI cameras, while new cardiac dedicated CZT cameras are becoming more widespread.
Purpose
To evaluate Tc-99m pyrophosphate (PYP) scintigraphy on D-SPECT cardio dedicated CZT camera (Spectrum Dynamics) in suspected ATTR-CA patients.
Methods
Seventy three consecutive patients suspected for ATTR-CA underwent planar (5 min), SPECT and gated SPECT (10 min, 8 bins) scintigraphy 89±26 min after injection of Tc99m-PYP 740 MBq, followed by late scintigraphy after 92±36 min in 65 consecutive patients. Perguini visual score, planar H/CL and SPECT derived H/CL ratio were evaluated by two blinded independent experienced readers. Diagnosis was based on visual interpretation after blood pool and monoclonal gammopathy were excluded.
Results
Very good to excellent planar and SPECT image quality was observed in almost all patients. PYP scintigraphy was positive in 6/73 patients, with left ventricular wall uptake clearly evident in the planar images of most patients. There was perfect agreement between readers regarding positive/negative interpretation. There was also substantial inter-observer agreement regarding the Perguini scoring (Cohen's k with linear weighting 0.819, 95% CI 0.701–0.937). Inter-observer agreement for H/CL ratio was also good (Pearson's correlation coefficient r(71)=0.873). SPECT and gated SPECT images were helpful only in one positive patient, and did not have an added value in any of the negative studies. Slightly better images were observed during late scintigraphy, but there was no change in interpretation, and H/CL ratio was not significantly changed (median difference −0.01, IQR 0.09). Alas, Inter-observer agreement of H/CL ratio was lower (Pearson's correlation coefficient r(64)=0.633). We also evaluated H/CL ratio derived from SPECT based application of the camera manufacturer. Agreement between early planar and early SPECT based H/CL ratio was good for both readers (r(69)=0.778 and r(66)=0.747), but inter-observer agreement was lower (r(66)=0.697).
Conclusions
ATTR PYP scintigraphy using cardiac dedicated CZT camera yielded excellent images in almost all patients, and uptake in the left ventricular wall could be easily identified in positive patients. Inter-observer agreement was excellent for both visual scoring and planar H/CL ratio. Early planar images were high quality, and limited additional diagnostic value was observed for both SPECT and gated SPECT scintigraphy and from later acquisition.
Funding Acknowledgement
Type of funding source: None
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George J, Partouche J, Chmura S, Aydogan B. PO-1520: Evaluation of treatment planning performance of a new BgRT platform for SBRT of multiple metastases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01538-3] [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]
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Balyimez S, Pitroda S, Partouche J, George J, Angela D, Cal H, Aydogan B. PO-1463: Evaluation of Plan Quality of a New BgRT Delivery Platform for Spine SBRT. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01481-x] [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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Kubota R, Hayashi N, Kinoshita K, Saito T, Ozaki K, Ueda Y, Tsuchishima M, Tsutsumi M, George J. Inhibition of γ-glutamyltransferase ameliorates ischaemia-reoxygenation tissue damage in rats with hepatic steatosis. Br J Pharmacol 2020; 177:5195-5207. [PMID: 32910829 DOI: 10.1111/bph.15258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/20/2020] [Accepted: 09/07/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND PURPOSE Hepatic steatosis may be associated with an increased γ-glutamyltransferase (γ-GT) levels. Ischaemia-reoxygenation (IR) injury causes several deleterious effects. We evaluated the protective effects of a selective inhibitor of γ-GT in experimentally induced IR injury in rats with obesity and steatosis. EXPERIMENTAL APPROACH Otsuka Long-Evans Tokushima Fatty (OLETF) rats with hepatic steatosis were used in the current study. The portal vein and hepatic artery of left lateral and median lobes were clamped to induce ischaemia. Before clamping, 1 ml of saline (IR group) or 1-ml saline containing 1 mg·kg-1 body weight of GGsTop (γ-GT inhibitor; IR-GGsTop group) was injected into the liver via the inferior vena cava. Blood flow was restored after at 30 min of the start of ischaemia. Blood was collected before, at 30 min after ischaemia and at 2 h and 6 h after reoxygenation. All the animals were killed at 6 h and the livers were collected. KEY RESULTS Treatment with GGsTop resulted in significant reduction of serum ALT, AST and γ-GT levels and hepatic γ-GT, malondialdehyde, 4-hydroxy-2-nonenal and HMGB1 at 6 h after reoxygenation. Inhibition of γ-GT retained normal hepatic glutathione levels. There was prominent hepatic necrosis in IR group, which is significantly reduced in IR-GGsTop group. CONCLUSION AND IMPLICATIONS Treatment with GGsTop significantly increased hepatic glutathione content, reduced hepatic MDA, 4-HNE and HMGB1 levels and, remarkably, ameliorated hepatic necrosis after ischaemia-reoxygenation. The results indicated that GGsTop could be an appropriate therapeutic agent to reduce IR-induced liver injury in obesity and steatosis.
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Daniels SL, Lee MJ, George J, Kerr K, Moug S, Wilson TR, Brown SR, Wyld L. Prehabilitation in elective abdominal cancer surgery in older patients: systematic review and meta-analysis. BJS Open 2020; 4:1022-1041. [PMID: 32959532 PMCID: PMC7709363 DOI: 10.1002/bjs5.50347] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 07/24/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Prehabilitation has emerged as a strategy to prepare patients for elective abdominal cancer surgery with documented improvements in postoperative outcomes. The aim of this study was to assess the evidence for prehabilitation interventions of relevance to the older adult. METHODS Systematic searches were conducted using MEDLINE, Web of Science, Scopus, CINAHL and PsychINFO. Studies of preoperative intervention (prehabilitation) in patients undergoing abdominal cancer surgery reporting postoperative outcomes were included. Age limits were not set as preliminary searches revealed this would be too restrictive. Articles were screened and selected based on PRISMA guidelines, and assessment of bias was performed. Qualitative, quantitative and meta-analyses of data were conducted as appropriate. RESULTS Thirty-three studies (3962 patients) were included. Interventions included exercise, nutrition, psychological input, comprehensive geriatric assessment and optimization, smoking cessation and multimodal (two or more interventions). Nine studies purposely selected high-risk, frail or older patients. Thirty studies were at moderate or high risk of bias. Ten studies individually reported benefits in complication rates, with meta-analyses for overall complications demonstrating significant benefit: multimodal (risk difference -0·1 (95 per cent c.i. -0·18 to -0·02); P = 0·01, I2 = 18 per cent) and nutrition (risk difference -0·18 (-0·26 to -0·10); P < 0·001, I2 = 0 per cent). Seven studies reported reductions in length of hospital stay, with no differences on meta-analysis. CONCLUSION The conclusions of this review are limited by the quality of the included studies, and the heterogeneity of interventions and outcome measures reported. Exercise, nutritional and multimodal prehabilitation may reduce morbidity after abdominal surgery, but data specific to older patients are sparse.
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Abbott R, Abbott TD, Abraham S, Acernese F, Ackley K, Adams C, Adhikari RX, Adya VB, Affeldt C, Agathos M, Agatsuma K, Aggarwal N, Aguiar OD, Aich A, Aiello L, Ain A, Ajith P, Akcay S, Allen G, Allocca A, Altin PA, Amato A, Anand S, Ananyeva A, Anderson SB, Anderson WG, Angelova SV, Ansoldi S, Antier S, Appert S, Arai K, Araya MC, Areeda JS, Arène M, Arnaud N, Aronson SM, Arun KG, Asali Y, Ascenzi S, Ashton G, Aston SM, Astone P, Aubin F, Aufmuth P, AultONeal K, Austin C, Avendano V, Babak S, Bacon P, Badaracco F, Bader MKM, Bae S, Baer AM, Baird J, Baldaccini F, Ballardin G, Ballmer SW, Bals A, Balsamo A, Baltus G, Banagiri S, Bankar D, Bankar RS, Barayoga JC, Barbieri C, Barish BC, Barker D, Barkett K, Barneo P, Barone F, Barr B, Barsotti L, Barsuglia M, Barta D, Bartlett J, Bartos I, Bassiri R, Basti A, Bawaj M, Bayley JC, Bazzan M, Bécsy B, Bejger M, Belahcene I, Bell AS, Beniwal D, Benjamin MG, Bentley JD, Bergamin F, Berger BK, Bergmann G, Bernuzzi S, Berry CPL, Bersanetti D, Bertolini A, Betzwieser J, Bhandare R, Bhandari AV, Bidler J, Biggs E, Bilenko IA, Billingsley G, Birney R, Birnholtz O, Biscans S, Bischi M, Biscoveanu S, Bisht A, Bissenbayeva G, Bitossi M, Bizouard MA, Blackburn JK, Blackman J, Blair CD, Blair DG, Blair RM, Bobba F, Bode N, Boer M, Boetzel Y, Bogaert G, Bondu F, Bonilla E, Bonnand R, Booker P, Boom BA, Bork R, Boschi V, Bose S, Bossilkov V, Bosveld J, Bouffanais Y, Bozzi A, Bradaschia C, Brady PR, Bramley A, Branchesi M, Brau JE, Breschi M, Briant T, Briggs JH, Brighenti F, Brillet A, Brinkmann M, Brockill P, Brooks AF, Brooks J, Brown DD, Brunett S, Bruno G, Bruntz R, Buikema A, Bulik T, Bulten HJ, Buonanno A, Buscicchio R, Buskulic D, Byer RL, Cabero M, Cadonati L, Cagnoli G, Cahillane C, Calderón Bustillo J, Callaghan JD, Callister TA, Calloni E, Camp JB, Canepa M, Cannon KC, Cao H, Cao J, Carapella G, Carbognani F, Caride S, Carney MF, Carullo G, Casanueva Diaz J, Casentini C, Castañeda J, Caudill S, Cavaglià M, Cavalier F, Cavalieri R, Cella G, Cerdá-Durán P, Cesarini E, Chaibi O, Chakravarti K, Chan C, Chan M, Chandra K, Chao S, Charlton P, Chase EA, Chassande-Mottin E, Chatterjee D, Chaturvedi M, Chatziioannou K, Chen HY, Chen X, Chen Y, Cheng HP, Cheong CK, Chia HY, Chiadini F, Chierici R, Chincarini A, Chiummo A, Cho G, Cho HS, Cho M, Christensen N, Chu Q, Chua S, Chung KW, Chung S, Ciani G, Ciecielag P, Cieślar M, Ciobanu AA, Ciolfi R, Cipriano F, Cirone A, Clara F, Clark JA, Clearwater P, Clesse S, Cleva F, Coccia E, Cohadon PF, Cohen D, Colleoni M, Collette CG, Collins C, Colpi M, Constancio M, Conti L, Cooper SJ, Corban P, Corbitt TR, Cordero-Carrión I, Corezzi S, Corley KR, Cornish N, Corre D, Corsi A, Cortese S, Costa CA, Cotesta R, Coughlin MW, Coughlin SB, Coulon JP, Countryman ST, Couvares P, Covas PB, Coward DM, Cowart MJ, Coyne DC, Coyne R, Creighton JDE, Creighton TD, Cripe J, Croquette M, Crowder SG, Cudell JR, Cullen TJ, Cumming A, Cummings R, Cunningham L, Cuoco E, Curylo M, Canton TD, Dálya G, Dana A, Daneshgaran-Bajastani LM, D'Angelo B, Danilishin SL, D'Antonio S, Danzmann K, Darsow-Fromm C, Dasgupta A, Datrier LEH, Dattilo V, Dave I, Davier M, Davies GS, Davis D, Daw EJ, DeBra D, Deenadayalan M, Degallaix J, De Laurentis M, Deléglise S, Delfavero M, De Lillo N, Del Pozzo W, DeMarchi LM, D'Emilio V, Demos N, Dent T, De Pietri R, De Rosa R, De Rossi C, DeSalvo R, de Varona O, Dhurandhar S, Díaz MC, Diaz-Ortiz M, Dietrich T, Di Fiore L, Di Fronzo C, Di Giorgio C, Di Giovanni F, Di Giovanni M, Di Girolamo T, Di Lieto A, Ding B, Di Pace S, Di Palma I, Di Renzo F, Divakarla AK, Dmitriev A, Doctor Z, Donovan F, Dooley KL, Doravari S, Dorrington I, Downes TP, Drago M, Driggers JC, Du Z, Ducoin JG, Dupej P, Durante O, D'Urso D, Dwyer SE, Easter PJ, Eddolls G, Edelman B, Edo TB, Edy O, Effler A, Ehrens P, Eichholz J, Eikenberry SS, Eisenmann M, Eisenstein RA, Ejlli A, Errico L, Essick RC, Estelles H, Estevez D, Etienne ZB, Etzel T, Evans M, Evans TM, Ewing BE, Fafone V, Fairhurst S, Fan X, Farinon S, Farr B, Farr WM, Fauchon-Jones EJ, Favata M, Fays M, Fazio M, Feicht J, Fejer MM, Feng F, Fenyvesi E, Ferguson DL, Fernandez-Galiana A, Ferrante I, Ferreira EC, Ferreira TA, Fidecaro F, Fiori I, Fiorucci D, Fishbach M, Fisher RP, Fittipaldi R, Fitz-Axen M, Fiumara V, Flaminio R, Floden E, Flynn E, Fong H, Font JA, Forsyth PWF, Fournier JD, Frasca S, Frasconi F, Frei Z, Freise A, Frey R, Frey V, Fritschel P, Frolov VV, Fronzè G, Fulda P, Fyffe M, Gabbard HA, Gadre BU, Gaebel SM, Gair JR, Galaudage S, Ganapathy D, Ganguly A, Gaonkar SG, García-Quirós C, Garufi F, Gateley B, Gaudio S, Gayathri V, Gemme G, Genin E, Gennai A, George D, George J, Gergely L, Ghonge S, Ghosh A, Ghosh A, Ghosh S, Giacomazzo B, Giaime JA, Giardina KD, Gibson DR, Gier C, Gill K, Glanzer J, Gniesmer J, Godwin P, Goetz E, Goetz R, Gohlke N, Goncharov B, González G, Gopakumar A, Gossan SE, Gosselin M, Gouaty R, Grace B, Grado A, Granata M, Grant A, Gras S, Grassia P, Gray C, Gray R, Greco G, Green AC, Green R, Gretarsson EM, Griggs HL, Grignani G, Grimaldi A, Grimm SJ, Grote H, Grunewald S, Gruning P, Guidi GM, Guimaraes AR, Guixé G, Gulati HK, Guo Y, Gupta A, Gupta A, Gupta P, Gustafson EK, Gustafson R, Haegel L, Halim O, Hall ED, Hamilton EZ, Hammond G, Haney M, Hanke MM, Hanks J, Hanna C, Hannam MD, Hannuksela OA, Hansen TJ, Hanson J, Harder T, Hardwick T, Haris K, Harms J, Harry GM, Harry IW, Hasskew RK, Haster CJ, Haughian K, Hayes FJ, Healy J, Heidmann A, Heintze MC, Heinze J, Heitmann H, Hellman F, Hello P, Hemming G, Hendry M, Heng IS, Hennes E, Hennig J, Heurs M, Hild S, Hinderer T, Hoback SY, Hochheim S, Hofgard E, Hofman D, Holgado AM, Holland NA, Holt K, Holz DE, Hopkins P, Horst C, Hough J, Howell EJ, Hoy CG, Huang Y, Hübner MT, Huerta EA, Huet D, Hughey B, Hui V, Husa S, Huttner SH, Huxford R, Huynh-Dinh T, Idzkowski B, Iess A, Inchauspe H, Ingram C, Intini G, Isac JM, Isi M, Iyer BR, Jacqmin T, Jadhav SJ, Jadhav SP, James AL, Jani K, Janthalur NN, Jaranowski P, Jariwala D, Jaume R, Jenkins AC, Jiang J, Johns GR, Johnson-McDaniel NK, Jones AW, Jones DI, Jones JD, Jones P, Jones R, Jonker RJG, Ju L, Junker J, Kalaghatgi CV, Kalogera V, Kamai B, Kandhasamy S, Kang G, Kanner JB, Kapadia SJ, Karki S, Kashyap R, Kasprzack M, Kastaun W, Katsanevas S, Katsavounidis E, Katzman W, Kaufer S, Kawabe K, Kéfélian F, Keitel D, Keivani A, Kennedy R, Key JS, Khadka S, Khalili FY, Khan I, Khan S, Khan ZA, Khazanov EA, Khetan N, Khursheed M, Kijbunchoo N, Kim C, Kim GJ, Kim JC, Kim K, Kim W, Kim WS, Kim YM, Kimball C, King PJ, Kinley-Hanlon M, Kirchhoff R, Kissel JS, Kleybolte L, Klimenko S, Knowles TD, Knyazev E, Koch P, Koehlenbeck SM, Koekoek G, Koley S, Kondrashov V, Kontos A, Koper N, Korobko M, Korth WZ, Kovalam M, Kozak DB, Kringel V, Krishnendu NV, Królak A, Krupinski N, Kuehn G, Kumar A, Kumar P, Kumar R, Kumar R, Kumar S, Kuo L, Kutynia A, Lackey BD, Laghi D, Lalande E, Lam TL, Lamberts A, Landry M, Lane BB, Lang RN, Lange J, Lantz B, Lanza RK, La Rosa I, Lartaux-Vollard A, Lasky PD, Laxen M, Lazzarini A, Lazzaro C, Leaci P, Leavey S, Lecoeuche YK, Lee CH, Lee HM, Lee HW, Lee J, Lee K, Lehmann J, Leroy N, Letendre N, Levin Y, Li AKY, Li J, Li K, Li TGF, Li X, Linde F, Linker SD, Linley JN, Littenberg TB, Liu J, Liu X, Llorens-Monteagudo M, Lo RKL, Lockwood A, London LT, Longo A, Lorenzini M, Loriette V, Lormand M, Losurdo G, Lough JD, Lousto CO, Lovelace G, Lück H, Lumaca D, Lundgren AP, Ma Y, Macas R, Macfoy S, MacInnis M, Macleod DM, MacMillan IAO, Macquet A, Magaña Hernandez I, Magaña-Sandoval F, Magee RM, Majorana E, Maksimovic I, Malik A, Man N, Mandic V, Mangano V, Mansell GL, Manske M, Mantovani M, Mapelli M, Marchesoni F, Marion F, Márka S, Márka Z, Markakis C, Markosyan AS, Markowitz A, Maros E, Marquina A, Marsat S, Martelli F, Martin IW, Martin RM, Martinez V, Martynov DV, Masalehdan H, Mason K, Massera E, Masserot A, Massinger TJ, Masso-Reid M, Mastrogiovanni S, Matas A, Matichard F, Mavalvala N, Maynard E, McCann JJ, McCarthy R, McClelland DE, McCormick S, McCuller L, McGuire SC, McIsaac C, McIver J, McManus DJ, McRae T, McWilliams ST, Meacher D, Meadors GD, Mehmet M, Mehta AK, Mejuto Villa E, Melatos A, Mendell G, Mercer RA, Mereni L, Merfeld K, Merilh EL, Merritt JD, Merzougui M, Meshkov S, Messenger C, Messick C, Metzdorff R, Meyers PM, Meylahn F, Mhaske A, Miani A, Miao H, Michaloliakos I, Michel C, Middleton H, Milano L, Miller AL, Millhouse M, Mills JC, Milotti E, Milovich-Goff MC, Minazzoli O, Minenkov Y, Mishkin A, Mishra C, Mistry T, Mitra S, Mitrofanov VP, Mitselmakher G, Mittleman R, Mo G, Mogushi K, Mohapatra SRP, Mohite SR, Molina-Ruiz M, Mondin M, Montani M, Moore CJ, Moraru D, Morawski F, Moreno G, Morisaki S, Mours B, Mow-Lowry CM, Mozzon S, Muciaccia F, Mukherjee A, Mukherjee D, Mukherjee S, Mukherjee S, Mukund N, Mullavey A, Munch J, Muñiz EA, Murray PG, Nagar A, Nardecchia I, Naticchioni L, Nayak RK, Neil BF, Neilson J, Nelemans G, Nelson TJN, Nery M, Neunzert A, Ng KY, Ng S, Nguyen C, Nguyen P, Nichols D, Nichols SA, Nissanke S, Nitz A, Nocera F, Noh M, North C, Nothard D, Nuttall LK, Oberling J, O'Brien BD, Oganesyan G, Ogin GH, Oh JJ, Oh SH, Ohme F, Ohta H, Okada MA, Oliver M, Olivetto C, Oppermann P, Oram RJ, O'Reilly B, Ormiston RG, Ortega LF, O'Shaughnessy R, Ossokine S, Osthelder C, Ottaway DJ, Overmier H, Owen BJ, Pace AE, Pagano G, Page MA, Pagliaroli G, Pai A, Pai SA, Palamos JR, Palashov O, Palomba C, Pan H, Panda PK, Pang PTH, Pankow C, Pannarale F, Pant BC, Paoletti F, Paoli A, Parida A, Parker W, Pascucci D, Pasqualetti A, Passaquieti R, Passuello D, Patricelli B, Payne E, Pearlstone BL, Pechsiri TC, Pedersen AJ, Pedraza M, Pele A, Penn S, Perego A, Perez CJ, Périgois C, Perreca A, Perriès S, Petermann J, Pfeiffer HP, Phelps M, Phukon KS, Piccinni OJ, Pichot M, Piendibene M, Piergiovanni F, Pierro V, Pillant G, Pinard L, Pinto IM, Piotrzkowski K, Pirello M, Pitkin M, Plastino W, Poggiani R, Pong DYT, Ponrathnam S, Popolizio P, Porter EK, Powell J, Prajapati AK, Prasai K, Prasanna R, Pratten G, Prestegard T, Principe M, Prodi GA, Prokhorov L, Punturo M, Puppo P, Pürrer M, Qi H, Quetschke V, Quinonez PJ, Raab FJ, Raaijmakers G, Radkins H, Radulesco N, Raffai P, Rafferty H, Raja S, Rajan C, Rajbhandari B, Rakhmanov M, Ramirez KE, Ramos-Buades A, Rana J, Rao K, Rapagnani P, Raymond V, Razzano M, Read J, Regimbau T, Rei L, Reid S, Reitze DH, Rettegno P, Ricci F, Richardson CJ, Richardson JW, Ricker PM, Riemenschneider G, Riles K, Rizzo M, Robertson NA, Robinet F, Rocchi A, Rodriguez-Soto RD, Rolland L, Rollins JG, Roma VJ, Romanelli M, Romano R, Romel CL, Romero-Shaw IM, Romie JH, Rose CA, Rose D, Rose K, Rosińska D, Rosofsky SG, Ross MP, Rowan S, Rowlinson SJ, Roy PK, Roy S, Roy S, Ruggi P, Rutins G, Ryan K, Sachdev S, Sadecki T, Sakellariadou M, Salafia OS, Salconi L, Saleem M, Salemi F, Samajdar A, Sanchez EJ, Sanchez LE, Sanchis-Gual N, Sanders JR, Santiago KA, Santos E, Sarin N, Sassolas B, Sathyaprakash BS, Sauter O, Savage RL, Savant V, Sawant D, Sayah S, Schaetzl D, Schale P, Scheel M, Scheuer J, Schmidt P, Schnabel R, Schofield RMS, Schönbeck A, Schreiber E, Schulte BW, Schutz BF, Schwarm O, Schwartz E, Scott J, Scott SM, Seidel E, Sellers D, Sengupta AS, Sennett N, Sentenac D, Sequino V, Sergeev A, Setyawati Y, Shaddock DA, Shaffer T, Sharifi S, Shahriar MS, Sharma A, Sharma P, Shawhan P, Shen H, Shikauchi M, Shink R, Shoemaker DH, Shoemaker DM, Shukla K, ShyamSundar S, Siellez K, Sieniawska M, Sigg D, Singer LP, Singh D, Singh N, Singha A, Singhal A, Sintes AM, Sipala V, Skliris V, Slagmolen BJJ, Slaven-Blair TJ, Smetana J, Smith JR, Smith RJE, Somala S, Son EJ, Soni S, Sorazu B, Sordini V, Sorrentino F, Souradeep T, Sowell E, Spencer AP, Spera M, Srivastava AK, Srivastava V, Staats K, Stachie C, Standke M, Steer DA, Steinke M, Steinlechner J, Steinlechner S, Steinmeyer D, Stevenson S, Stocks D, Stops DJ, Stover M, Strain KA, Stratta G, Strunk A, Sturani R, Stuver AL, Sudhagar S, Sudhir V, Summerscales TZ, Sun L, Sunil S, Sur A, Suresh J, Sutton PJ, Swinkels BL, Szczepańczyk MJ, Tacca M, Tait SC, Talbot C, Tanasijczuk AJ, Tanner DB, Tao D, Tápai M, Tapia A, Tapia San Martin EN, Tasson JD, Taylor R, Tenorio R, Terkowski L, Thirugnanasambandam MP, Thomas M, Thomas P, Thompson JE, Thondapu SR, Thorne KA, Thrane E, Tinsman CL, Saravanan TR, Tiwari S, Tiwari S, Tiwari V, Toland K, Tonelli M, Tornasi Z, Torres-Forné A, Torrie CI, Tosta E Melo I, Töyrä D, Travasso F, Traylor G, Tringali MC, Tripathee A, Trovato A, Trudeau RJ, Tsang KW, Tse M, Tso R, Tsukada L, Tsuna D, Tsutsui T, Turconi M, Ubhi AS, Udall R, Ueno K, Ugolini D, Unnikrishnan CS, Urban AL, Usman SA, Utina AC, Vahlbruch H, Vajente G, Valdes G, Valentini M, van Bakel N, van Beuzekom M, van den Brand JFJ, Van Den Broeck C, Vander-Hyde DC, van der Schaaf L, Van Heijningen JV, van Veggel AA, Vardaro M, Varma V, Vass S, Vasúth M, Vecchio A, Vedovato G, Veitch J, Veitch PJ, Venkateswara K, Venugopalan G, Verkindt D, Veske D, Vetrano F, Viceré A, Viets AD, Vinciguerra S, Vine DJ, Vinet JY, Vitale S, Vivanco FH, Vo T, Vocca H, Vorvick C, Vyatchanin SP, Wade AR, Wade LE, Wade M, Walet R, Walker M, Wallace GS, Wallace L, Walsh S, Wang JZ, Wang S, Wang WH, Ward RL, Warden ZA, Warner J, Was M, Watchi J, Weaver B, Wei LW, Weinert M, Weinstein AJ, Weiss R, Wellmann F, Wen L, Weßels P, Westhouse JW, Wette K, Whelan JT, Whiting BF, Whittle C, Wilken DM, Williams D, Willis JL, Willke B, Winkler W, Wipf CC, Wittel H, Woan G, Woehler J, Wofford JK, Wong ICF, Wright JL, Wu DS, Wysocki DM, Xiao L, Yamamoto H, Yang L, Yang Y, Yang Z, Yap MJ, Yazback M, Yeeles DW, Yu H, Yu H, Yuen SHR, Zadrożny AK, Zadrożny A, Zanolin M, Zelenova T, Zendri JP, Zevin M, Zhang J, Zhang L, Zhang T, Zhao C, Zhao G, Zhou M, Zhou Z, Zhu XJ, Zimmerman AB, Zucker ME, Zweizig J. GW190521: A Binary Black Hole Merger with a Total Mass of 150 M_{⊙}. PHYSICAL REVIEW LETTERS 2020; 125:101102. [PMID: 32955328 DOI: 10.1103/physrevlett.125.101102] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/19/2020] [Accepted: 07/09/2020] [Indexed: 06/08/2023]
Abstract
On May 21, 2019 at 03:02:29 UTC Advanced LIGO and Advanced Virgo observed a short duration gravitational-wave signal, GW190521, with a three-detector network signal-to-noise ratio of 14.7, and an estimated false-alarm rate of 1 in 4900 yr using a search sensitive to generic transients. If GW190521 is from a quasicircular binary inspiral, then the detected signal is consistent with the merger of two black holes with masses of 85_{-14}^{+21} M_{⊙} and 66_{-18}^{+17} M_{⊙} (90% credible intervals). We infer that the primary black hole mass lies within the gap produced by (pulsational) pair-instability supernova processes, with only a 0.32% probability of being below 65 M_{⊙}. We calculate the mass of the remnant to be 142_{-16}^{+28} M_{⊙}, which can be considered an intermediate mass black hole (IMBH). The luminosity distance of the source is 5.3_{-2.6}^{+2.4} Gpc, corresponding to a redshift of 0.82_{-0.34}^{+0.28}. The inferred rate of mergers similar to GW190521 is 0.13_{-0.11}^{+0.30} Gpc^{-3} yr^{-1}.
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Millstein J, Budden T, Goode EL, Anglesio MS, Talhouk A, Intermaggio MP, Leong HS, Chen S, Elatre W, Gilks B, Nazeran T, Volchek M, Bentley RC, Wang C, Chiu DS, Kommoss S, Leung SCY, Senz J, Lum A, Chow V, Sudderuddin H, Mackenzie R, George J, Fereday S, Hendley J, Traficante N, Steed H, Koziak JM, Köbel M, McNeish IA, Goranova T, Ennis D, Macintyre G, Silva De Silva D, Ramón Y Cajal T, García-Donas J, Hernando Polo S, Rodriguez GC, Cushing-Haugen KL, Harris HR, Greene CS, Zelaya RA, Behrens S, Fortner RT, Sinn P, Herpel E, Lester J, Lubiński J, Oszurek O, Tołoczko A, Cybulski C, Menkiszak J, Pearce CL, Pike MC, Tseng C, Alsop J, Rhenius V, Song H, Jimenez-Linan M, Piskorz AM, Gentry-Maharaj A, Karpinskyj C, Widschwendter M, Singh N, Kennedy CJ, Sharma R, Harnett PR, Gao B, Johnatty SE, Sayer R, Boros J, Winham SJ, Keeney GL, Kaufmann SH, Larson MC, Luk H, Hernandez BY, Thompson PJ, Wilkens LR, Carney ME, Trabert B, Lissowska J, Brinton L, Sherman ME, Bodelon C, Hinsley S, Lewsley LA, Glasspool R, Banerjee SN, Stronach EA, Haluska P, Ray-Coquard I, Mahner S, Winterhoff B, Slamon D, Levine DA, Kelemen LE, Benitez J, Chang-Claude J, Gronwald J, Wu AH, Menon U, Goodman MT, Schildkraut JM, Wentzensen N, Brown R, Berchuck A, Chenevix-Trench G, deFazio A, Gayther SA, García MJ, Henderson MJ, Rossing MA, Beeghly-Fadiel A, Fasching PA, Orsulic S, Karlan BY, Konecny GE, Huntsman DG, Bowtell DD, Brenton JD, Doherty JA, Pharoah PDP, Ramus SJ. Prognostic gene expression signature for high-grade serous ovarian cancer. Ann Oncol 2020; 31:1240-1250. [PMID: 32473302 PMCID: PMC7484370 DOI: 10.1016/j.annonc.2020.05.019] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Median overall survival (OS) for women with high-grade serous ovarian cancer (HGSOC) is ∼4 years, yet survival varies widely between patients. There are no well-established, gene expression signatures associated with prognosis. The aim of this study was to develop a robust prognostic signature for OS in patients with HGSOC. PATIENTS AND METHODS Expression of 513 genes, selected from a meta-analysis of 1455 tumours and other candidates, was measured using NanoString technology from formalin-fixed paraffin-embedded tumour tissue collected from 3769 women with HGSOC from multiple studies. Elastic net regularization for survival analysis was applied to develop a prognostic model for 5-year OS, trained on 2702 tumours from 15 studies and evaluated on an independent set of 1067 tumours from six studies. RESULTS Expression levels of 276 genes were associated with OS (false discovery rate < 0.05) in covariate-adjusted single-gene analyses. The top five genes were TAP1, ZFHX4, CXCL9, FBN1 and PTGER3 (P < 0.001). The best performing prognostic signature included 101 genes enriched in pathways with treatment implications. Each gain of one standard deviation in the gene expression score conferred a greater than twofold increase in risk of death [hazard ratio (HR) 2.35, 95% confidence interval (CI) 2.02-2.71; P < 0.001]. Median survival [HR (95% CI)] by gene expression score quintile was 9.5 (8.3 to -), 5.4 (4.6-7.0), 3.8 (3.3-4.6), 3.2 (2.9-3.7) and 2.3 (2.1-2.6) years. CONCLUSION The OTTA-SPOT (Ovarian Tumor Tissue Analysis consortium - Stratified Prognosis of Ovarian Tumours) gene expression signature may improve risk stratification in clinical trials by identifying patients who are least likely to achieve 5-year survival. The identified novel genes associated with the outcome may also yield opportunities for the development of targeted therapeutic approaches.
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George J, Kumar KK, Vijayakumar G, Ravishankar M. Functional Outcome of Surgically Managed Perilunate Injuries. Indian J Orthop 2020; 54:270-276. [PMID: 33194101 PMCID: PMC7609469 DOI: 10.1007/s43465-020-00225-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/03/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Perilunate injuries are rare and quite often missed. We present our experience and outcomes, surgically managing these difficult injuries. METHODS We analysed data from 14 patients who underwent open reduction and internal fixation of perilunate injuries. All patients underwent open reduction and fixation through the dorsal approach. Fractures were fixed with either K-wires or Headless compression screws. At regular intervals radiographs, range of motion, grip strength, modified Mayo score, Quick DASH score and Lyon wrist scores were collected. RESULTS The average age of our patients was 29.2. Average time to surgical intervention was 11.3 days. The mean follow-up period was 42.3 months. modified Mayo wrist score, QuickDASH score and Lyon wrist scores were 77.86, 1.62 and 80.86, respectively. Wrist flexion/extension arc was 101.43. Wrist radial/ulnar deviation was 50.0. Mean grip strength was 69.93% of the opposite side. Radiological evidence of wrist arthritis and lunate avascular necrosis was seen in 8 (57.14%) and 4 (28.6%) cases, respectively. CONCLUSION Early open reduction of perilunate injuries gives reliable results, in spite of radiological evidence of wrist arthritis in a majority of the cases.
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Bhui K, Prasad S, George J, Shukla Y. Corrigendum to "Bromelain inhibits COX-2 expression by blocking the activation of MAPK regulated NF-kappa B against skin tumor-initiation triggering mitochondrial death pathway" [Canc. Lett. (2009) 282(2) 167-76 doi:10.1016/j.canlet.2009.03.003]. Cancer Lett 2020; 480:48. [PMID: 32035655 DOI: 10.1016/j.canlet.2020.01.017] [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]
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Targher G, Mantovani A, Byrne CD, Wang XB, Yan HD, Sun QF, Pan KH, Zheng KI, Chen YP, Eslam M, George J, Zheng MH. Detrimental effects of metabolic dysfunction-associated fatty liver disease and increased neutrophil-to-lymphocyte ratio on severity of COVID-19. DIABETES & METABOLISM 2020; 46:505-507. [PMID: 32505652 PMCID: PMC7270805 DOI: 10.1016/j.diabet.2020.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 12/19/2022]
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Morgan JL, George J, Holmes G, Martin C, Reed MWR, Ward S, Walters SJ, Cheung KL, Audisio RA, Wyld L. Breast cancer surgery in older women: outcomes of the Bridging Age Gap in Breast Cancer study. Br J Surg 2020; 107:1468-1479. [DOI: 10.1002/bjs.11617] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/23/2019] [Accepted: 03/15/2020] [Indexed: 01/04/2023]
Abstract
Abstract
Background
Breast cancer surgery in older women is variable and sometimes non-standard owing to concerns about morbidity. Bridging the Age Gap in Breast Cancer is a prospective multicentre cohort study aiming to determine factors influencing treatment selection and outcomes from surgery for older patients with breast cancer.
Methods
Women aged at least 70 years with operable breast cancer were recruited from 57 UK breast units between 2013 and 2018. Associations between patient and tumour characteristics and type of surgery in the breast and axilla were evaluated using univariable and multivariable analyses. Oncological outcomes, adverse events and quality-of-life (QoL) outcomes were monitored for 2 years.
Results
Among 3375 women recruited, surgery was performed in 2816 patients, of whom 24 with inadequate data were excluded. Sixty-two women had bilateral tumours, giving a total of 2854 surgical events. Median age was 76 (range 70–95) years. Breast surgery comprised mastectomy in 1138 and breast-conserving surgery in 1716 procedures. Axillary surgery comprised axillary lymph node dissection in 575 and sentinel node biopsy in 2203; 76 had no axillary surgery. Age, frailty, dementia and co-morbidities were predictors of mastectomy (multivariable odds ratio (OR) for age 1·06, 95 per cent c.i. 1·05 to 1·08). Age, frailty and co-morbidity were significant predictors of no axillary surgery (OR for age 0·91, 0·87 to 0·96). The rate of adverse events was moderate (551 of 2854, 19·3 per cent), with no 30-day mortality. Long-term QoL and functional independence were adversely affected by surgery.
Conclusion
Breast cancer surgery is safe in women aged 70 years or more, with serious adverse events being rare and no mortality. Age, ill health and frailty all influence surgical decision-making. Surgery has a negative impact on QoL and independence, which must be considered when counselling patients about choices.
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Targher G, Mantovani A, Wang XB, Yan HD, Sun QF, Pan KH, Byrne CD, Zheng KI, Chen YP, Eslam M, George J, Zheng MH. Patients with diabetes are at higher risk for severe illness from COVID-19. DIABETES & METABOLISM 2020; 46:335-337. [PMID: 32416321 PMCID: PMC7255326 DOI: 10.1016/j.diabet.2020.05.001] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 01/21/2023]
Abstract
It is currently uncertain whether people with diabetes are at higher risk of severe illness from coronavirus disease 2019 (COVID-19). We found that diabetes was associated with an approximately 4-fold increased risk of having severe/critical COVID-19 illness. This association was independent of age, sex, obesity, hypertension and smoking. These findings highlight the urgent need for a multidisciplinary team-based approach to management of this patient population.
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George J. Metabolism and interactions of antileprosy drugs. Biochem Pharmacol 2020; 177:113993. [PMID: 32339493 DOI: 10.1016/j.bcp.2020.113993] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/21/2020] [Indexed: 01/29/2023]
Abstract
Leprosy is a chronic infectious disease caused my Mycobacterium leprae that primarily affects peripheral nervous system and extremities and is prevalent in tropical countries. Treatment for leprosy with multidrug regimens is very effective compared to monotherapy especially in multibacillary cases. The three major antileprosy drugs currently in use are 4, 4'-diaminodiphenyl sulfone (DDS, dapsone), rifampicin, and clofazimine. During multidrug therapy, the potent antibiotic rifampicin induces the metabolism of dapsone, which results in decreased plasma half-life of dapsone and its metabolites. Furthermore, rifampicin induces its own metabolism and decreases its half-life during monotherapy. Rifampicin upregulates several hepatic microsomal drug-metabolizing enzymes, especially cytochrome P450 (CYP) family that in turn induce the metabolism of dapsone. Clofazimine lacks significant induction of any drug-metabolizing enzyme including CYP family and does not interact with dapsone metabolism. Rifampicin does not induce clofazimine metabolism during combination treatment. Administration of dapsone in the acetylated form (acedapsone) can release the drug slowly into circulation up to 75 days and could be useful for the effective treatment of paucibacillary cases along with rifampicin. This review summarizes the major aspects of antileprosy drug metabolism and drug interactions and the role of cytochrome P450 family of drug metabolizing enzymes, especially CYP3A4 during multidrug regimens for the treatment of leprosy.
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Lamba H, Kherallah R, Hudson S, Mondal N, Chatterjee S, Civitello A, Nair A, George J, Shafii A, Loor G, Liao K. Do Women Have Inferior Outcomes to Men after LVAD Implantation- A Propensity-Matched Comparison. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.222] [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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Arora V, Strunk D, Furqan SH, Schweig L, Lefaiver C, George J, Prazad P. Optimizing antibiotic use for early onset sepsis: A tertiary NICU experience. J Neonatal Perinatal Med 2020; 12:301-312. [PMID: 30932898 DOI: 10.3233/npm-180075] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neonatal antibiotic use is associated with a greater risk of nosocomial infection, necrotizing enterocolitis, and mortality. It can induce drug-resistant pathogens that contribute to increased neonatal morbidity/mortality, healthcare costs, and length of stay. Prior to the antibiotic stewardship program, decisions to obtain blood cultures and empiric antibiotics for possible Early-onset Sepsis (EOS) in late preterm and term infants upon NICU admission were provider-dependent rather than algorithm-based. We aimed to decrease empiric antibiotic prescription from 70% to 56% (20% decrease) in infants ≥34 weeks gestation admitted to the NICU. METHODS The stewardship initiative comprised the following practice changes: (1) use of the Neonatal Sepsis Risk Calculator (SRC); and (2) a 36-hour time-out for prescribed empiric antibiotics. Data was retrospectively collected and analyzed for inborn infants pre-intervention (January 2015-December 2015; n = 263) and post-intervention (August 2016-September 2017; n = 279). Data regarding compliance with the new antibiotic guideline were collected and disseminated to the team every week. Overlap between CDC guidelines and calculator recommendations were studied. RESULTS Pre-and post-intervention outcomes were analyzed using chi-square tests. There was a significant post-intervention reduction in the rate of both antibiotic prescriptions (29.4% decline; 70.3% vs. 49.6%; p < 0.001) and sepsis evaluations (24.3% decline; 90.9% vs. 68.8%; p < 0.001). No difference (p = 0.271) in culture-positive EOS cases was observed. There was 92% overlap in blood culture recommendations and 95% overlap between antibiotic recommendations when current CDC guidelines were compared to the SRC. CONCLUSION A significant reduction in antibiotic use and sepsis evaluations was achieved for late preterm and term infants upon NICU admission. No clinical deterioration occurred in post-intervention infants who did not receive antibiotics. There is significant overlap between CDC guidelines and SRC recommendations.
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Meledin V, Haberman D, Gandelman G, Poles L, Goland G, George J, Gerafi A, Edri O, Shimoni S. P1510 Assessment of left ventricular relaxation time constant by noninvasive left ventricular pressure-strain loop: invasive validation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Left ventricular (LV) relaxation time constant, Tau (τ), is one of the best indexes to evaluate left ventricular diastolic function and is usually assessed invasively. Tau is the time constant of the exponential regression Pt =(P0-P∞)e-t/τ+P∞ that expresses left ventricular isovolumic pressure decay, where Pt is LV pressure (LVP) at time t, P0 is LVP at dP/dtmin and P∞ is the asymptotic pressure, to which relaxation would lead if completed without LV filling. Several noninvasive methods were developed to calculate Tau, however, they are time-consuming and complicated. Recently, a simple method regional left ventricular pressure–strain loops and myocardial work was introduced and validated. We hypothesize that left ventricular relaxation time constant can be derived and calculated from the LV pressure–strain loops.
Objective
To calculate noninvasively Tau using LV pressure–strain loops and compare it to invasive Tau assessment.
Methods
The study includes patients with preserved LV systolic function without significant valvular disease that were scheduled to elective coronary catheterization. During catheterization, a fluid-filled catheter was placed in the LV to measure pressure. Echocardiography was performed simultaneously with LV pressure recording. Three standard apical views were acquired and subsequently 2D strain analysis was performed using commercially available GE software and LV pressure–strain loops were calculated. Doppler signal was used for timing of valvular events. Tau was calculated by the equation τ =P/(-dP/dt) that is a derivative of the ventricular pressure decline P = P0e-t/τ+PB with respect to time. The pressure between peak negative dP/dt and the lowest LV pressure shortly after mitral valve opening was used for this calculation. The study was approved by the institutional ethics committee.
Results
Forty patients, (mean age 65.1 ± 10.9 years, 27 male, BSA1.93 ± 0.18 m2) were included in the study. Heart rate and the mean blood pressure at the time of catheterization were 69.9 ± 11.8 min-1 and 85.2 ± 18.8 mmHg, respectively. The mean LV end diastolic diameter was 44 ± 4 mm, the LV mass was 86.7 ± 25.2 g/m2, LVEF 58.4 ± 6.6% and GLS 21.0 ± 3.2%. Tau, calculated noninvasively using derivative method was significantly lower than invasively derived measurement (40.1 ± 13.4 vs 49.8 ± 7.7 msec, p = 0.002). However, a significant positive correlation was observed between the two methods (r =0.67, p <0.001, Figure).
Conclusions
This preliminary study demonstrates that Tau estimated by a noninvasive method using LV pressure–strain loops has a good correlation with Tau measured invasively. Therefore, Tau can be estimated noninvasively using novel left ventricular pressure–strain loop method.
Abstract P1510 Figure.
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Abbott BP, Abbott R, Abbott TD, Abraham S, Acernese F, Ackley K, Adams C, Adya VB, Affeldt C, Agathos M, Agatsuma K, Aggarwal N, Aguiar OD, Aiello L, Ain A, Ajith P, Akutsu T, Allen G, Allocca A, Aloy MA, Altin PA, Amato A, Ananyeva A, Anderson SB, Anderson WG, Ando M, Angelova SV, Antier S, Appert S, Arai K, Arai K, Arai Y, Araki S, Araya A, Araya MC, Areeda JS, Arène M, Aritomi N, Arnaud N, Arun KG, Ascenzi S, Ashton G, Aso Y, Aston SM, Astone P, Aubin F, Aufmuth P, AultONeal K, Austin C, Avendano V, Avila-Alvarez A, Babak S, Bacon P, Badaracco F, Bader MKM, Bae SW, Bae YB, Baiotti L, Bajpai R, Baker PT, Baldaccini F, Ballardin G, Ballmer SW, Banagiri S, Barayoga JC, Barclay SE, Barish BC, Barker D, Barkett K, Barnum S, Barone F, Barr B, Barsotti L, Barsuglia M, Barta D, Bartlett J, Barton MA, Bartos I, Bassiri R, Basti A, Bawaj M, Bayley JC, Bazzan M, Bécsy B, Bejger M, Belahcene I, Bell AS, Beniwal D, Berger BK, Bergmann G, Bernuzzi S, Bero JJ, Berry CPL, Bersanetti D, Bertolini A, Betzwieser J, Bhandare R, Bidler J, Bilenko IA, Bilgili SA, Billingsley G, Birch J, Birney R, Birnholtz O, Biscans S, Biscoveanu S, Bisht A, Bitossi M, Bizouard MA, Blackburn JK, Blair CD, Blair DG, Blair RM, Bloemen S, Bode N, Boer M, Boetzel Y, Bogaert G, Bondu F, Bonilla E, Bonnand R, Booker P, Boom BA, Booth CD, Bork R, Boschi V, Bose S, Bossie K, Bossilkov V, Bosveld J, Bouffanais Y, Bozzi A, Bradaschia C, Brady PR, Bramley A, Branchesi M, Brau JE, Briant T, Briggs JH, Brighenti F, Brillet A, Brinkmann M, Brisson V, Brockill P, Brooks AF, Brown DA, Brown DD, Brunett S, Buikema A, Bulik T, Bulten HJ, Buonanno A, Buskulic D, Buy C, Byer RL, Cabero M, Cadonati L, Cagnoli G, Cahillane C, Bustillo JC, Callister TA, Calloni E, Camp JB, Campbell WA, Canepa M, Cannon K, Cannon KC, Cao H, Cao J, Capocasa E, Carbognani F, Caride S, Carney MF, Carullo G, Diaz JC, Casentini C, Caudill S, Cavaglià M, Cavalier F, Cavalieri R, Cella G, Cerdá-Durán P, Cerretani G, Cesarini E, Chaibi O, 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Beuzekom MV, Brand JFJVD, Broeck CVD, Vander-Hyde DC, Schaaf LVD, Heijningen JVV, Putten MHPMV, Veggel AAV, Vardaro M, Varma V, Vass S, Vasúth M, Vecchio A, Vedovato G, Veitch J, Veitch PJ, Venkateswara K, Venugopalan G, Verkindt D, Vetrano F, Viceré A, Viets AD, Vine DJ, Vinet JY, Vitale S, Vivanco FH, Vo T, Vocca H, Vorvick C, Vyatchanin SP, Wade AR, Wade LE, Wade M, Walet R, Walker M, Wallace L, Walsh S, Wang G, Wang H, Wang J, Wang JZ, Wang WH, Wang YF, Ward RL, Warden ZA, Warner J, Was M, Watchi J, Weaver B, Wei LW, Weinert M, Weinstein AJ, Weiss R, Wellmann F, Wen L, Wessel EK, Weßels P, Westhouse JW, Wette K, Whelan JT, Whiting BF, Whittle C, Wilken DM, Williams D, Williamson AR, Willis JL, Willke B, Wimmer MH, Winkler W, Wipf CC, Wittel H, Woan G, Woehler J, Wofford JK, Worden J, Wright JL, Wu CM, Wu DS, Wu HC, Wu SR, Wysocki DM, Xiao L, Xu WR, Yamada T, Yamamoto H, Yamamoto K, Yamamoto K, Yamamoto T, Yancey CC, Yang L, Yap MJ, Yazback M, Yeeles DW, Yokogawa K, Yokoyama J, Yokozawa T, Yoshioka T, Yu H, Yu H, Yuen SHR, Yuzurihara H, Yvert M, Zadrożny AK, Zanolin M, Zeidler S, Zelenova T, Zendri JP, Zevin M, Zhang J, Zhang L, Zhang T, Zhao C, Zhao Y, Zhou M, Zhou Z, Zhu XJ, Zhu ZH, Zimmerman AB, Zucker ME, Zweizig J. Prospects for observing and localizing gravitational-wave transients with Advanced LIGO, Advanced Virgo and KAGRA. LIVING REVIEWS IN RELATIVITY 2020; 23:3. [PMID: 33015351 PMCID: PMC7520625 DOI: 10.1007/s41114-020-00026-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 05/27/2020] [Indexed: 05/05/2023]
Abstract
We present our current best estimate of the plausible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next several years, with the intention of providing information to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals for the third (O3), fourth (O4) and fifth observing (O5) runs, including the planned upgrades of the Advanced LIGO and Advanced Virgo detectors. We study the capability of the network to determine the sky location of the source for gravitational-wave signals from the inspiral of binary systems of compact objects, that is binary neutron star, neutron star-black hole, and binary black hole systems. The ability to localize the sources is given as a sky-area probability, luminosity distance, and comoving volume. The median sky localization area (90% credible region) is expected to be a few hundreds of square degrees for all types of binary systems during O3 with the Advanced LIGO and Virgo (HLV) network. The median sky localization area will improve to a few tens of square degrees during O4 with the Advanced LIGO, Virgo, and KAGRA (HLVK) network. During O3, the median localization volume (90% credible region) is expected to be on the order of 10 5 , 10 6 , 10 7 Mpc 3 for binary neutron star, neutron star-black hole, and binary black hole systems, respectively. The localization volume in O4 is expected to be about a factor two smaller than in O3. We predict a detection count of 1 - 1 + 12 ( 10 - 10 + 52 ) for binary neutron star mergers, of 0 - 0 + 19 ( 1 - 1 + 91 ) for neutron star-black hole mergers, and 17 - 11 + 22 ( 79 - 44 + 89 ) for binary black hole mergers in a one-calendar-year observing run of the HLV network during O3 (HLVK network during O4). We evaluate sensitivity and localization expectations for unmodeled signal searches, including the search for intermediate mass black hole binary mergers.
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Pellicori P, Pernille Ofstad A, Fitchett D, Zeller C, Wanner C, George J, Zinman B, Brueckmann M, Lindenfeld J. P2629Early benefits of empagliflozin in patients with type 2 diabetes with heart failure are not offset by increased adverse events: results from the EMPA-REG OUTCOME trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The cardiovascular (CV) benefits of sodium-glucose co-transporter-2 (SGLT2) inhibitors in patients with type 2 diabetes (T2D) have been demonstrated in long-term clinical trials. In the EMPA-REG OUTCOME trial, the SGLT2 inhibitor empagliflozin (EMPA), compared with placebo (PBO), significantly reduced the risk of CV death and hospitalisation for heart failure (HHF) in patients with T2D and established CV disease, with a median follow-up time of 3.1 years.
Purpose
To investigate the early benefits and safety associated with use of EMPA in patients enrolled in the EMPA-REG OUTCOME trial according to heart failure (HF) status at baseline.
Methods
We evaluated the effects of treatments on glycated haemoglobin (HbA1c) levels and on the clinical endpoints of HHF, HHF or CV death, and HHF or all-cause mortality (ACM), as well as the occurrence of adverse events (AEs), at 12 weeks, 6 months, and 1 year after randomisation. Outcomes data were explored descriptively at 12 weeks, and assessed by Cox regression models adjusting for baseline risk factors at 6 months, and 1 year, whereas safety data were explored descriptively. Effects on HbA1c were evaluated using a Mixed Model Repeated Measures (MMRM) model.
Results
A total of 7020 participants, 706 (10%) with investigator-reported HF at baseline, were randomised to PBO, or two different doses of EMPA (10 mg or 25 mg once daily). In patients with HF at baseline, the adjusted mean differences in HbA1c between pooled EMPA and PBO at 12 weeks, 6 months, and 1 year after randomisation were −0.55, −0.54 and −0.53%-point, respectively, p<0.001 vs PBO for all, with similar results in those without HF (p for interactions 0.822, 0.939 and 0.539 at 12 weeks, 6 months and 1 year, respectively). Already at 12 weeks, patients assigned to EMPA had a lower frequency of all evaluated clinical outcome events (HHF, HHF or CV death, HHF or ACM) compared with PBO, regardless of HF status. This effect was sustained and significant at 6 months and 1 year in those with and without HF (see Figure). During the same time frame, the rates of AEs were generally higher in those with HF than without HF, but were not increased by the use of EMPA. At 1 year, any AE occurred in 206 (84.4%) and 1694 (81.1%) patients with and without HF, respectively, on PBO vs 363 (78.6%) and 3246 (76.8%) patients with and without HF on EMPA; any serious AE at 1 year occurred in 79 (32.4%) and 447 (21.4%) patients with and without HF on PBO vs 105 (22.7%) and 764 (18.1%) of those with and without HF on EMPA.
Conclusions
In the EMPA-REG OUTCOME trial, EMPA led to early beneficial effects on morbidity and mortality outcomes in patients with T2D with or without HF, which were not offset by an increased risk of AEs.
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