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Abratenko P, An R, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Cianci D, Collin GH, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Escudero Sanchez L, Evans JJ, Fine R, Fiorentini Aguirre GA, Fitzpatrick RS, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Genty V, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hilgenberg C, Horton-Smith GA, Hourlier A, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kaleko D, Kalra D, Kamp N, Kaneshige N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, LaZur R, Lepetic I, Li K, Li Y, Lin K, Lister A, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Murphy M, Naples D, Navrer-Agasson A, Nebot-Guinot M, Neely RK, Newmark DA, Nowak J, Nunes M, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate SF, Patel N, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rice LCJ, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Russell B, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Sinclair J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Soleti SR, Spentzouris P, Spitz J, Stancari M, John JS, Strauss T, Sutton K, Sword-Fehlberg S, Szelc AM, Tang W, Terao K, Thomson M, Thorpe C, Totani D, Toups M, Tsai YT, Uchida MA, Usher T, Van De Pontseele W, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yarbrough G, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. Search for an Excess of Electron Neutrino Interactions in MicroBooNE Using Multiple Final-State Topologies. PHYSICAL REVIEW LETTERS 2022; 128:241801. [PMID: 35776450 DOI: 10.1103/physrevlett.128.241801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
We present a measurement of ν_{e} interactions from the Fermilab Booster Neutrino Beam using the MicroBooNE liquid argon time projection chamber to address the nature of the excess of low energy interactions observed by the MiniBooNE Collaboration. Three independent ν_{e} searches are performed across multiple single electron final states, including an exclusive search for two-body scattering events with a single proton, a semi-inclusive search for pionless events, and a fully inclusive search for events containing all hadronic final states. With differing signal topologies, statistics, backgrounds, reconstruction algorithms, and analysis approaches, the results are found to be either consistent with or modestly lower than the nominal ν_{e} rate expectations from the Booster Neutrino Beam and no excess of ν_{e} events is observed.
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Patel N, Teh W, Omoniyi O, Martin W, Weir-McCall J, D’Errico L, O’Sullivan M, Davies W, Costopoulos C, Costanzo P. 1069 ESSENTIAL FRAILTY TOOLSET AS A PREDICTOR OF PROLONGED LENGTH OF STAY AND DISCHARGE DESTINATION AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac125.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Frailty is associated with poor outcomes following transcatheter aortic valve implantation (TAVI). Rockwood is the widely used score for this population. In a recent trial, a more objective score, the Essential Frailty Toolset (EFT) outperformed Rockwood’s in predicting mortality and disability 1-year post-TAVI. Whether it predicts in-hospital length of stay (LOS) and discharge destination post-TAVI remains unclear.
Method
A cohort of patients undergoing TAVI for aortic stenosis was recruited, demographic characteristics collected, and frailty assessed with EFT and Rockwood scores. Primary outcomes were LOS post-TAVI, categorised as ‘not prolonged’ (≤2 days) or ‘prolonged’ (>2 days) and discharge destination, characterised as ‘home’ or ‘non-home’.
Results
86 patients were recruited, with median age 82 years (IQR 78–86). 54% were male. EFT identified 35% and Rockwood 11% as frail. 19% were cognitively impaired. 5 chair rises were completed by 70%, with 30% managing under 15 seconds. Median haemoglobin was 121 g/L (IQR 109.5–136). Median albumin was 36 g/L (IQR 33–39). 84% of procedures were transfemoral. 20% had moderate–severe left ventricular systolic dysfunction. Median LOS post-TAVI was 2 days (IQR 2–5). 94% were discharged home, 6% to referring local hospital or rehabilitation centre. 46% were NYHA class III-IV. A model for prolonged LOS including comorbidities, showed frailty determined by EFT (OR 4.80, CI 95% 1.52–15.2, p = 0.008) but not Rockwood (OR 5.00, CI 95% 0.865–29.0, p = 0.072) was the only significant independent predictor for prolonged LOS. A model adjusting for comorbidities also showed EFT to be an independent predictor for non-home discharge destination of borderline significance (OR 2.57 CI 95% 0.994–6.66, p = 0.051) but Rockwood was not (OR 1.38 CI95% 0.485–3.91, p = 0.548).
Conclusion
In a real-world elderly population, EFT score was a stronger, more independent predictor of prolonged LOS and non-home discharge post-TAVI, than Rockwood’s. EFT would be an effective pre-operative assessment tool for LOS and discharge destination for TAVI.
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Patel N, Chandrashekhar R. Expression of MMP2, MMP9 and PGP 9.5 in human aorta in patients with coronary artery disease. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.170] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Atherosclerosis has been recognised as inflammatory conditions which involves activation of MMPs of which increased MMP2 & MMP9 expression has been correlated with the development of human aortic plaques.The Sympathetic Nervous System exerts complex control over inflammation in atherosclerosis both: on systemic scale and at the regional level.Protein gene product9.5 (PGP9.5) is a cytoplasmic neuron & is a reliable marker for visualisation of the cardiovascular system innervation.There have been no studies in the existing literature on the expression of PGP 9.5 and MMP2, MMP9 on human aorta.Aim:To study the expression of MMP2, MMP9 and PGP9.5 in the human aorta & gain insights into atherosclerosis & neural modulation in the aorta.Materials &
Methods
This is a single centre, prospective cohort, pilot study with a sample size of 87 patients,done over 2 years at AIMS,Kochi.During CABG, punch biopsy of the aorta taken & processed.One paraffin embedded section used for routine H&E staining & others used for IHC.IHC detection kits use 3, 3’-DABChromogen as a substrate of HRP for visualisation of antigenic structures in the tissues.Positive & negative control tissue were run for all 3 Antibodies.Interpretation done as Diffuse/Focal & Intense/Moderate/ Weak classification based on intensity signals observed on IHC by an experienced Cardiac Pathologist.Results:7 Controls with well matched baseline characteristics: Controls-Aorta samples taken from patients who were undergoing Aortic Valve Surgery for Aortic Valve disease with normal coronaries documented on a coronary angiogram.65.9% of patients with Positive MMP2 & 28.6 % of patients in the Control group was found to have significant difference when compared to positive & negative outcomes amongst the 2 groups.89.3% of patients with positive MMP2 had significant co-relation with PGP9.5 levels expressed in the same specimen analysed.MMP9 also had a p value of 0.002 suggesting a significant co-relation between MMP9 & PGP9.5.Statistically significant Co-relation seen between the Age, CRP & the levels of MMP 9 expressed in the Aorta observed.MMP2 & MMP9 expression have a definite & significant co-expression with PGP9.5 expression in human aorta,suggesting a novel marker of neuromodulation in atherosclerotic process in human aorta.
Expression of MMP2, MMP9 and PGP 9.5 in human aorta in patients with coronary artery disease
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Patel SK, Patel RN, Patel AK, Patel N, Choquesillo-Lazarte D. Copper hydrazone complexes with different nuclearties and geometries: Synthesis, characterization, single crystal structures, Hirshfeld analysis and superoxide dismutase mimetic activities. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.132545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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DI Iorio M, Cook C, Vanni K, Patel N, D’silva K, Fu X, Wang J, Prisco L, Kowalski E, Zaccardelli A, Martin L, Qian G, Hsu T, Wallace Z, Sparks J. POS1234 DMARD DISRUPTION, INCREASED DISEASE ACTIVITY, AND PROLONGED SYMPTOM DURATION AFTER ACUTE COVID-19 AMONG PATIENTS WITH RHEUMATIC DISEASE: A PROSPECTIVE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSystemic autoimmune rheumatic disease (SARD) patients may be at risk for disease flare and prolonged symptom duration after COVID-19, perhaps related to DMARD disruption and immune activation.ObjectivesTo describe DMARD disruption and identify differences in SARD activity among patients with and without prolonged COVID-19 symptom duration.MethodsWe identified all SARD patients with confirmed COVID-19 at the Mass General Brigham healthcare system in Boston, USA; prospective recruitment is ongoing. Surveys were used to collect demographics, clinical characteristics, DMARD disruption, COVID-19 course, and SARD disease activity before and after COVID-19. The survey included validated instruments measuring disease activity, pain, fatigue, functional status, and respiratory quality of life. Prolonged symptom duration was defined as COVID-19 symptoms lasting ≥28 days. We compared differences in patient-reported measures between those with and without prolonged symptoms.ResultsWe analyzed survey responses from 174 COVID-19 survivors with SARDs (mean age 52±16 years, 81% female, 80% White). The most common SARDs were RA (40%) and SLE (14%). Fifty-one percent of the 127 respondents on any DMARD reported a disruption to their regimen at COVID-19 onset (Figure 1). Among individual DMARDs, 56-77% were reported to have any change, except for hydroxychloroquine (23%) and rituximab (46%). SARD flare after COVID-19 was reported by 41% of respondents (Table 1). Patient global assessment of SARD activity was worse after COVID-19 (mean 7.6±2.3 before vs. 6.6±2.9 after COVID-19, p<0.001). Prolonged symptom duration was reported by 45% of participants. Those with prolonged symptoms had a higher initial COVID-19 symptom count (median 7 vs. 4, p<0.001) and were more likely to be hospitalized for COVID-19 (28% vs. 17%, p=0.001). Respondents experiencing prolonged symptom duration had higher disease activity on RAPID3 (p=0.007) as well as more pain (p<0.001) and fatigue (p=0.03) compared to those without prolonged symptoms.Table 1.Acute COVID-19 course, SARD flare/activity, and patient-reported outcomes among COVID-19 survivors with SARDs.All COVID-19 survivors with SARDs (n=174)Prolonged symptom duration ≥28 days (n=78)No prolonged symptom duration/(n=96)p-value (prolonged vs. not)Acute COVID-19 courseCOVID-19 symptom duration, days, median [IQR]14 [9, 29]46 [30, 65]11 [7, 14]<0.0001Initial symptom count, median [IQR]6 [3, 8]7 [6, 9]4 [2, 7]<0.001Hospitalized, n (%)38 (22)22 (28)16 (17)0.001SARD flare/activitySelf-reported SARD flare after COVID-19, n (%)71 (41)38 (49)33 (34)0.15Disease activity by RAPID3, median [IQR]9 [4, 14]11.2 [6, 16]7 [3, 13]0.0067RAPID3 categorical score, n (%)0.13Remission (0)11 (7)4 (5)7 (7)Near remission (0.3-1.0)23 (14)5 (7)18 (19)Low severity (1.3-2.0)26 (15)10 (14)16 (17)Moderate severity (2.3-4.0)55 (33)27 (36)28 (29)High severity (4.3-10.0)54 (32)28 (38)26 (27)Patient-reported outcomesPain by SF-MPQ, median [IQR]2 [1, 2]2 [1, 2]1 [0, 2]0.0008Fatigue by FSI, median [IQR]53 [27, 84]66 [31, 91.5]43 [26, 76]0.031mHAQ, median [IQR]0.125 [0, 0.38]0.25 [0, 0.75]0.125 [0, 0.38]0.11Respiratory quality of life by SGRQ, global [IQR]15 [4, 29]16 [4, 36]10 [4, 26]0.49RAPID3, Routine Assessment of Patient Index Data 3; SF-MPQ, Short-form McGill Pain Questionnaire; FSI, Fatigue Symptom Inventory; mHAQ, modified Health Assessment Questionnaire; SGRQ, Saint George’s Respiratory Questionnaire.Figure 1.Frequency of baseline DMARD use and proportion with any disruption at COVID-19 onset.ConclusionDMARD disruption, SARD flare, and prolonged symptoms were common in this prospective study of COVID-19 survivors with SARDs. Those with prolonged COVID-19 symptom duration, defined as ≥28 days, had higher SARD activity, more pain, and more fatigue compared to those without prolonged symptoms. These findings suggest that post-acute sequelae of COVID-19 may have a large impact on underlying SARD activity and quality of life.Disclosure of InterestsMichael Di Iorio: None declared, Claire Cook: None declared, Kathleen Vanni: None declared, Naomi Patel Consultant of: Receives consulting fees from FVC Health unrelated to this work., Kristin D’Silva: None declared, Xiaoqing Fu: None declared, Jiaqi Wang: None declared, Lauren Prisco: None declared, Emily Kowalski: None declared, Alessandra Zaccardelli: None declared, Lily Martin: None declared, Grace Qian: None declared, Tiffany Hsu: None declared, Zachary Wallace Consultant of: Receives consulting fees from Viela Bio, Zenas BioPharma, and MedPace unrelated to this work., Grant/research support from: Receives research support from Bristol-Myers Squibb and Principia/Sanofi., Jeffrey Sparks Consultant of: Receives consultant fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer unrelated to this work., Grant/research support from: Receives research support from Bristol Myers Squibb.
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Patel N, Zhang Y, Jayne D, Merkel PA, Yue H, Bekker P, Stone JH. POS0833 DIFFERENCES BETWEEN AVACOPAN AND PREDNISONE FOR THE TREATMENT OF ANCA-ASSOCIATED VASCULITIS AT DIFFERENT THRESHOLDS OF GLUCOCORTICOID TOXICITY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundTreatment with glucocorticoids (GCs) for ANCA-associated vasculitis (AAV) is associated with substantial toxicity. The Glucocorticoid Toxicity Index (GTI) was developed to measure change in GC toxicity over time.1 Data from the composite GTI domains provide both an Aggregate Improvement Score (AIS) and a Cumulative Worsening Score (CWS) of GC toxicity, permitting the instrument to compare both improvement and worsening of GC toxicity across treatment groups. The GTI was a pre-specified secondary outcome in ADVOCATE, a randomized, double-blind, placebo-controlled trial in patients with AAV that aimed to replace a GC taper with avacopan, a complement C5a receptor inhibitor. Patients were randomized to either avacopan or a prednisone taper on a background of either cyclophosphamide or rituximab.2 In ADVOCATE, the median GC exposure was 400 mg vs. 2939 mg in the avacopan and prednisone groups, respectively, which is an 86% median reduction in GC exposure from all sources. Remission rates were comparable in the two groups at 26 weeks (72.3% vs. 70.1%, respectively), and avacopan was superior at 52 weeks (sustained remission in 65.7% vs. 54.9%).2ObjectivesTo compare GC toxicity between the treatment groups at three different thresholds of GC toxicity, beginning with the minimum detectable difference (MDD) of the GTI.MethodsThe MDD for the GTI (10 points) was calculated in the initial validation phase of the instrument. Thus, any GTI score > 10 points may be considered to represent a true change in GC toxicity. We compared the two groups at GTI thresholds of 10, 20, and 30 points for both the CWS and AIS. The CWS comprises a total of all GC-related toxicities that have occurred in the GTI between baseline and 26 weeks (time of primary outcome). The AIS, in contrast, allows toxicities to be added if they are new or subtracted if they improve. Higher CWS and AIS values indicate greater severity of GC toxicity. The two scores together capture the nuances of longitudinal GC toxicity across multiple domains. We compared the percentages of those in the two treatment groups who exceeded GTI threshold values of 10, 20, and 30 points in the CWS or AIS.ResultsThe percentages of patients exceeding the specified AIS thresholds differentiated the avacopan group from the prednisone group (48.2% vs. 60.4%, respectively, at the 10-point threshold, p=0.02; 29.5% vs. 45.1% at the 20-point threshold, p=0.003; and 18.1% vs. 33.5% at the 30-point threshold, p=0.001) (Table 1). The CWS differentiated avacopan from prednisone at the 20- and 30-point thresholds (57.8% vs 73.2%, respectively, at 20 points, p=0.002; 41.0% vs 55.5% at 30 points, p=0.007).Table 1.Percentages of Patients in ADVOCATE Exceeding Selected GTI Thresholds at Week 26GTI threshold/study groupn (%) exceeding CWS thresholdp-valuen (%) exceeding AIS thresholdp-valueGTI worsening > 10 points Avacopan (N = 164)138 (83.1%)0.14780 (48.2%)0.022 Prednisone (N = 166)144 (87.8%)99 (60.4%)GTI worsening > 20 points Avacopan (N = 164)96 (57.8%)0.00249 (29.5%)0.003 Prednisone (N = 166)120 (73.2%)74 (45.1%)GTI worsening > 30 points Avacopan (N = 164)68 (41.0%)0.00730 (18.1%)0.001 Prednisone (N = 166)91 (55.5%)55 (33.5%)AIS, Aggregate Improvement Score; CWS, Cumulative Worsening Score; GTI, Glucocorticoid Toxicity IndexConclusionAmong patients with AAV, treatment with avacopan was associated with lower GC toxicity across multiple GTI thresholds compared to treatment with prednisone, consistent with the substantial reduction in total GC exposure associated with avacopan. The GTI scores differentiated the two treatment groups effectively through a composite of GC toxicity domains.References[1]McDowell PJ, Stone JH, Zhang Y, et al. Quantification of Glucocorticoid-Associated Morbidity in Severe Asthma Using the Glucocorticoid Toxicity Index. J Allergy Clin Immunol Pract. 2021; 9:365-72.[2]Jayne DRW, Merkel PA, Schall TJ, et al. Avacopan for the Treatment of ANCA-Associated Vasculitis. N Engl J Med. 2021;384:599-609.Disclosure of InterestsNaomi Patel: None declared, Yuqing Zhang: None declared, David Jayne Speakers bureau: Amgen, Vifor, Consultant of: Astra-Zeneca, BMS, Boehringer-Ingelheim, Chemocentryx, GSK, Novartis, Otsuka, Roche/Genentech, Takeda, UCB & Vifor, Grant/research support from: GSK, Roche/Genentech, Peter A Merkel Consultant of: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, Immagene, InflaRx, Jannsen, Kiniksa, Kyverna, Magenta, MiroBio, Novartis, Pfizer, Regeneron, Sparrow, Takeda, Talaris, Grant/research support from: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Sanofi, Takeda, Huibin Yue Shareholder of: ChemoCentryx, Employee of: ChemoCentryx, Pirow Bekker Shareholder of: ChemoCentryx, Consultant of: ChemoCentryx, Employee of: ChemoCentryx, John H. Stone Shareholder of: Steritas, Consultant of: ChemoCentryx, Roche/Genentech, Sanofi, Bristol-Myers Squib, AbbVie, InflaRx, Kyverna, Novartis, Q32Bio, Zenas, Horizon, Grant/research support from: Roche/Genentech, Horizon, Sanofi, Bristol-Myers Squib
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Gilbert E, Figueroa-Parra G, Valenzuela-Almada M, Vallejo S, Neville MR, Patel N, Cook C, Fu X, Hagi R, McDermott G, Di Iorio M, Masto L, Vanni K, Kowalski E, Qian G, Wallace Z, Duarte-Garcia A, Sparks J. OP0251 IMPACT OF INTERSTITIAL LUNG DISEASE ON SEVERE COVID-19 OUTCOMES FOR PATIENTS WITH RHEUMATOID ARTHRITIS: A MULTICENTER STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2973] [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
BackgroundRA has been associated with poor COVID-19 outcomes, but few studies have investigated outcomes in RA features such as interstitial lung disease.ObjectivesTo assess COVID-19 outcomes in patients with RA overall, and those with and without ILD, compared to general population comparators.MethodsA multicenter, retrospective cohort study was conducted at Mayo Clinic (19 hospitals and affiliated outpatient centers in 4 states) and Mass General Brigham (14 hospitals and affiliated outpatient centers in New England). Consecutive patients with RA meeting ACR/EULAR criteria and a positive COVID-19 test from March 1, 2020 through June 6, 2021 were matched 1:5 on age, sex, race, and COVID-19 test date with general population comparators without RA. RA features assessed included: RA-ILD per Bongartz criteria [1], duration, rheumatoid factor (RF), cyclic citrullinated peptide antibody (CCP), bone erosions, and treatments. The primary outcome was a composite of hospitalization or death following COVID-19 diagnosis. We used multivariable Cox regression to investigate the association of RA, and features such as ILD, with COVID-19 outcomes compared to matched comparators.ResultsWe analyzed 582 patients with RA and 2892 comparators without RA, all with COVID-19. Mean age was 62 years, 51% were female, and 79% were White. Mean RA duration was 11 years, 67% were seropositive (52% RF+ and 54% CCP+), 27% had bone erosions, 28% were on steroids, and 79% were on DMARDs. 50/582 (9%) patients with RA had ILD.The COVID-19 hospitalization or death rate for RA patients was higher than comparators (3.0 per 1,000 days [95% CI 2.5-3.6] vs. 1.9 per 1,000 days [95% CI 1.7-2.1], respectively). Overall, RA patients had a 53% higher risk of hospitalization or death than comparators after adjustment (95% CI 1.20-1.94).Among those with RA-ILD, the hospitalization or death rate was significantly higher than comparators (10.9 [95% CI 6.7-15.2] vs. 2.5 per 1,000 days [1.8-3.2], respectively). RA-ILD was associated with nearly 3-fold higher risk for hospitalization or death than comparators (multivariable HR 2.84 [95% CI 1.64-4.91], Table 1). There was a significant interaction between RA/comparator status and presence/absence of ILD for risk of severe COVID-19 (p<0.001, Figure 1). The elevated risk for severe COVID-19 was similar for RA subgroups defined by serostatus or bone erosions.Table 1.Frequencies, proportions, and hazard ratios for COVID-19 outcomes, comparing all RA patients, and subgroups with or without RA-ILD, to matched comparators.COVID-19 OutcomesAll RA Patients (n=582)RA-ILD (n=50)RA Patients without ILD (n=532)Comparators (n=2,892)Hospitalization, n (%)121 (21)24 (48)97 (18)402 (14)Unadjusted HR (95% CI)1.58 (1.27, 1.96)2.65 (1.71, 4.09)1.43 (1.12, 1.82)Ref.Adjusted* HR (95% CI)1.45 (1.14, 1.83)2.35 (1.38, 4.00)1.31 (1.00, 1.70)Ref.Death, n (%)26 (4)9 (18)17 (3)63 (2)Unadjusted HR (95% CI)1.72 (0.98, 3.01)5.88 (2.07, 16.71)1.13 (0.56, 2.29)Ref.Adjusted* HR (95% CI)1.24 (0.66, 2.32)13.94 (4.30, 45.18)0.75 (0.35, 1.63)Ref.Hospitalization or death, n (%)126 (22)25 (50)101 (19)419 (14)Unadjusted HR (95% CI)1.66 (1.33, 2.07)3.01 (1.93, 4.70)1.47 (1.14, 1.89)Ref.Adjusted* HR (95% CI)1.53 (1.20, 1.94)2.84 (1.64, 4.91)1.34 (1.02, 1.77)Ref.*Adjusted for age, sex, race, and smokingFigure 1.Multivariable hazard ratios for the composite outcome of hospitalization or death from COVID-19, comparing all RA and subgroups by serostatus, bone erosions, and ILD to matched comparators without RA.ConclusionWe confirmed that RA was associated with severe COVID-19 outcomes compared to the general population. We found evidence that ILD may be an effect modifier for the relationship between RA and severe COVID-19 outcomes, but RA subgroups defined by serostatus and bone erosions had similarly elevated risk. These findings suggest that ILD or its treatment may be a major contributor to severe COVID-19 outcomes in RA.References[1]Bongartz, T, et al, Arthritis Rheum. 2010 Jun;62(6):1583-91.Disclosure of InterestsNone declared
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Ralli GP, Carter RD, McGowan DR, Cheng WC, Liu D, Teoh EJ, Patel N, Gleeson F, Harris AL, Lord SR, Buffa FM, Fenwick JD. Radiogenomic analysis of primary breast cancer reveals [18F]-fluorodeoxglucose dynamic flux-constants are positively associated with immune pathways and outperform static uptake measures in associating with glucose metabolism. Breast Cancer Res 2022; 24:34. [PMID: 35581637 PMCID: PMC9115966 DOI: 10.1186/s13058-022-01529-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/11/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND PET imaging of 18F-fluorodeoxygucose (FDG) is used widely for tumour staging and assessment of treatment response, but the biology associated with FDG uptake is still not fully elucidated. We therefore carried out gene set enrichment analyses (GSEA) of RNA sequencing data to find KEGG pathways associated with FDG uptake in primary breast cancers. METHODS Pre-treatment data were analysed from a window-of-opportunity study in which 30 patients underwent static and dynamic FDG-PET and tumour biopsy. Kinetic models were fitted to dynamic images, and GSEA was performed for enrichment scores reflecting Pearson and Spearman coefficients of correlations between gene expression and imaging. RESULTS A total of 38 pathways were associated with kinetic model flux-constants or static measures of FDG uptake, all positively. The associated pathways included glycolysis/gluconeogenesis ('GLYC-GLUC') which mediates FDG uptake and was associated with model flux-constants but not with static uptake measures, and 28 pathways related to immune-response or inflammation. More pathways, 32, were associated with the flux-constant K of the simple Patlak model than with any other imaging index. Numbers of pathways categorised as being associated with individual micro-parameters of the kinetic models were substantially fewer than numbers associated with flux-constants, and lay around levels expected by chance. CONCLUSIONS In pre-treatment images GLYC-GLUC was associated with FDG kinetic flux-constants including Patlak K, but not with static uptake measures. Immune-related pathways were associated with flux-constants and static uptake. Patlak K was associated with more pathways than were the flux-constants of more complex kinetic models. On the basis of these results Patlak analysis of dynamic FDG-PET scans is advantageous, compared to other kinetic analyses or static imaging, in studies seeking to infer tumour-to-tumour differences in biology from differences in imaging. Trial registration NCT01266486, December 24th 2010.
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Ardana I, Smith E, Maldonado V, Patel N, Pokharel S, Samsonraj R. Mesenchymal Stem/Stromal Cells: VALIDATION OF NOVEL GENOMIC BIOMARKER OF MESENCHYMAL STROMAL CELL SCALABILITY AND CORRELATIVE STUDIES ON SENESCENCE PHENOTYPES USEFUL FOR ALLOGENEIC CELL MANUFACTURING. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00234-1] [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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Abratenko P, An R, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Cianci D, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Fiorentini Aguirre GA, Fitzpatrick RS, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hilgenberg C, Horton-Smith GA, Hourlier A, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Kaneshige N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Lepetic I, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Murphy M, Naples D, Navrer-Agasson A, Nebot-Guinot M, Neely RK, Newmark DA, Nowak J, Nunes M, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate SF, Patel N, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rice LCJ, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Sinclair J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Spentzouris P, Spitz J, Stancari M, John JS, Strauss T, Sutton K, Sword-Fehlberg S, Szelc AM, Tang W, Terao K, Thorpe C, Totani D, Toups M, Tsai YT, Uchida MA, Usher T, Van De Pontseele W, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yarbrough G, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Measurement of Energy-Dependent Inclusive Muon Neutrino Charged-Current Cross Sections on Argon with the MicroBooNE Detector. PHYSICAL REVIEW LETTERS 2022; 128:151801. [PMID: 35499871 DOI: 10.1103/physrevlett.128.151801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
We report a measurement of the energy-dependent total charged-current cross section σ(E_{ν}) for inclusive muon neutrinos scattering on argon, as well as measurements of flux-averaged differential cross sections as a function of muon energy and hadronic energy transfer (ν). Data corresponding to 5.3×10^{19} protons on target of exposure were collected using the MicroBooNE liquid argon time projection chamber located in the Fermilab booster neutrino beam with a mean neutrino energy of approximately 0.8 GeV. The mapping between the true neutrino energy E_{ν} and reconstructed neutrino energy E_{ν}^{rec} and between the energy transfer ν and reconstructed hadronic energy E_{had}^{rec} are validated by comparing the data and Monte Carlo (MC) predictions. In particular, the modeling of the missing hadronic energy and its associated uncertainties are verified by a new method that compares the E_{had}^{rec} distributions between data and a MC prediction after constraining the reconstructed muon kinematic distributions, energy, and polar angle to those of data. The success of this validation gives confidence that the missing energy in the MicroBooNE detector is well modeled and underpins first-time measurements of both the total cross section σ(E_{ν}) and the differential cross section dσ/dν on argon.
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Singer-Englar T, Patel J, Kittleson M, Chang D, Patel N, Kim S, Azarbal B, Emerson D, Czer L, Kobashigawa J. Does the Degree of Diastolic Dysfunction in the First Year After Heart Transplant Affect Subsequent Outcomes? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Kransdorf E, Patel J, Kittleson M, Singer-Englar T, Patel N, Ravellette K, Kim S, Geft D, Czer L, Esmailian F, Kobashigawa J. The Effects of Hypomagnesemia Post Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.795] [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] Open
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Chen Q, Patel N, Emerson D, Kim S, Megna D, Catarino P, Singer-Englar T, Kittleson M, Patel J, Kobashigawa J, Esmailian F. Outcomes of Heart Re-Transplantation with Combined Kidney Transplant. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Kittleson M, Patel J, Kransdorf E, Singer-Englar T, Patel N, Rubio M, Musto N, Hamilton M, Emerson D, Czer L, Kobashigawa J. Are Markedly Oversized Donor Hearts Associated with Poor Outcome After Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Kittleson M, Patel J, Chang D, Patel N, Singer-Englar T, Oda M, Azarbal B, Trento A, Czer L, Kobashigawa J. Is Sacubitril/Valsartan a Risk Factor for Vasoplegia/Primary Graft Dysfunction After Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Dhillon M, Patel J, Kittleson M, Chang D, Patel N, Singer-Englar T, Hamilton M, Czer L, Megna D, Kobashigawa J. Experience with Eculizumab in Highly Sensitized Patients Undergoing Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.213] [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] Open
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Jamero G, Patel J, Kittleson M, Singer-Englar T, Patel N, Kim S, Nikolova A, Esmailian F, Czer L, Kobashigawa J. What is the Meaning of Culture Negative Leukocytosis Immediately After Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1642] [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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Velleca A, Kittleson M, Patel J, Singer-Englar T, Patel N, Washington C, Jamero G, Czer L, Esmailian F, Zakowski P, Kobashigawa J. COVID Pandemic and Social Mitigations Decrease Hospitalizations for Heart Transplant Patients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Chang D, Patel J, Kittleson M, Patel N, Singer-Englar T, Kim S, Emerson D, Zabner R, Zakowski P, Kobashigawa J. Is Donor/Recipient Cytomegalovirus Mismatch Truly Associated with Increased Risk for Cardiac Allograft Vasculopathy in the Current Era? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Allison Z, Kittleson M, Patel J, Kransdorf E, Singer-Englar T, Patel N, Geft D, Azarbal B, Czer L, Esmailian F, Kobashigawa J. Is Delayed Graft Function Worse in Simultaneous Heart-Kidney Transplant vs Kidney Transplant Alone? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Patel J, Kittleson M, Kransdorf E, Patel N, Singer-Englar T, Hu J, Kim S, Trento A, Czer L, Kobashigawa J. Are Calcineurin Inhibitor-Free Protocols Safe and Effective in the Long-Term After Heart Transplant? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Patel J, Kittleson M, Kransdorf E, Singer-Englar T, Patel N, Kim S, Hage A, Hamilton M, Czer L, Kobashigawa J. Treatment and Outcome of AL Amyloid After Heart Transplantation: Is It Viable? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Cole R, Moriguchi J, Kittleson M, Patel J, Chang D, Patel N, Singer-Englar T, Azarbal B, Emerson D, Czer L, Kobashigawa J. Do Temporary Mechanical Circulatory Support Devices Activate Sensitization Pathways in Patients Awaiting Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Kittleson M, Patel J, Chang D, Singer-Englar T, Patel N, Mishalani L, Kim S, Ramzy D, Czer L, Kobashigawa J. Who is at Risk for Seizures After Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Deen J, Patel J, Kittleson M, Chang D, Singer-Englar T, Patel N, Nikolova A, Ramzy D, Czer L, Kobashigawa J. Efficacy of Tocilizumab for Refractory Sensitized Patients Awaiting Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1402] [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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