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Cubberley A, Sharedalal P, Shah N, Essilfie G, Burkman G, Saltzman HE, Kutalek SP. P2857Implantable cardioverter defibrillator and pacemaker lead extraction: is it safe to do it again? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1166] [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
Background/Introduction
There are growing numbers of transvenous implantable devices for patients requiring permanent pacemakers (PPM) as well as Implantable Cardioverter Defibrillators (ICD). As such, there has been a concomitant increased need for lead extraction. Lead extraction is associated with increased morbidity and mortality (Hamid, 2010). Comparative outcomes of repeat lead extraction are not extensively studied.
Purpose
We compared demographics as well as major and minor adverse outcomes in patients undergoing first time vs. repeat lead extraction procedures.
Methods
In our single center study, 1278 extractions took place between January 2004 and December of 2018. Of these 1177 patients underwent PPM or ICD lead extraction for the first time; 101 patients underwent repeat extractions. Baseline characteristics including gender, history of coronary artery bypass graft (CABG) surgery, hypertension (HTN), systolic heart failure (HF) defined as ejection fraction <40%, hyperlipidemia (HLD), diabetes mellitus (DM), and coronary artery disease (CAD) were evaluated using chi-squared analysis. Adverse events, as defined by the 2017 HRS Expert Consensus Statement on Cardiovascular Implantable Electronic Device Lead Management and Extraction, were identified as major complications (death, cardiac arrest, cardiac perforation, coronary venous dissection, pericardial tamponade, or urgent cardiac surgery), and minor complications (coronary sinus dissection, pneumothorax, pocket bleeding requiring drainage, worsening tricuspid valve function, vegetation embolization, venous thrombosis, requirement of blood transfusion or lead migration).
Results
Comparing first time extractions vs repeat extractions, there was no significant difference in proportion of patients of female gender (32.4% vs. 28.3%, p=0.412), patients with prior CABG (23.0 vs. 23.4%, p=0.227), HTN (66.0% vs. 62.2%, p=0.462), HF (52.3% vs. 62.0%), HLD (39.6% vs 39.7%, p=0.682), DM (35.3% vs. 30.8%, p=0.387), or CAD (55.9% vs 56.0%, p=0.978). There was no significant difference in major complications (1.4% vs. 1.0%, p=0.749) and minor complications (3.5% vs 4.1%, p=0.741).
Conclusion
Patients undergoing repeat lead extractions showed very similar baseline demographics compared to first time lead extractions. Repeat extractions did not have increased rates of major or minor complications.
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Sen N, Tanwar S, Jain A, Mehta A, Shah N, Gokhroo RK, Dhall A. P630Role of Indian yoga with pranayam prevent ventricular remodeling and reduce mortality rate according to LV ejection fraction in post PCI patients of STEMI. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0238] [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: 11/14/2022] Open
Abstract
Abstract
Background
Coronary revascularization is fruitful management to relieve angina and reduce mortality as compare to medical management in significant coronary artery stenosis. Although measurement of left ventricular ejection fraction (LVEF) after acute myocardial infarction (MI) is a performance measure, little is known about the relationship between EF and post-discharge mortality among MI patients in contemporary clinical practice.
Objectives
To assessment of mortality according to left ventricular ejection fraction and compare between yoga group and non yoga group, so that we can evaluate the importance of yoga and pranayam.
Methods
2,470 patients (25 to 68 years of age) with STEMI were registered and managed with percutaneous coronary intervention at three centres from 2010 to 2012. Method was used to assess the association between left ventricular ejection fraction (LVEF) measured during the index hospitalization and 5-year mortality from date of registry. The relationship was examined with EF as a categorical variable, utilizing four clinically relevant categories (EF ≤34%, 35 to 45%, 46 to 54%, and ≥55%), and also with EF as a continuous variable. We divided two groups, group A was yoga with pranayam (n=1470) and group B was normal group (n=1000).
Results
Among STEMI patients we found a graded inverse association between EF category and mortality. For patients relevant categories (EF ≤34%, 35 to 45%, 46 to 54%, and ≥55%) mortality after 5 years was assessed by 21%, 14.3%, 12.2% and 11% in yoga, pranayam group (p<0.004). For patients relevant categories (EF ≤34%, 35 to 45%, 46 to 54%, and ≥55%) mortality after 5 years was assessed by 25%, 17.5%, 14.4% and 13% in normal group (p<0.004). LVEF was increased in yoga & pranayam group by 11±3% versus 4±1% non yoga group.
Conclusion
Yoga and Pranayam; breathing exercise may help to reduce metabolic stress, reduce oxygen demand and prevent ventricular remodeling. Low LVEF after STEMI remains an important risk factor for post-discharge mortality, even after extensive adjustment for patient and hospital characteristics. Routine yoga and pranayam; breathing exercise may reduce the mortality after myocardial infarction.
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Adam J, Adamczyk L, Adams JR, Adkins JK, Agakishiev G, Aggarwal MM, Ahammed Z, Alekseev I, Anderson DM, Aoyama R, Aparin A, Arkhipkin D, Aschenauer EC, Ashraf MU, Atetalla F, Attri A, Averichev GS, Bairathi V, Barish K, Bassill AJ, Behera A, Bellwied R, Bhasin A, Bhati AK, Bielcik J, Bielcikova J, Bland LC, Bordyuzhin IG, Brandenburg JD, Brandin AV, Bryslawskyj J, Bunzarov I, Butterworth J, Caines H, Calderón de la Barca Sánchez M, Cebra D, Chakaberia I, Chaloupka P, Chan BK, Chang FH, Chang Z, Chankova-Bunzarova N, Chatterjee A, Chattopadhyay S, Chen JH, Chen X, Cheng J, Cherney M, Christie W, Crawford HJ, Csanád M, Das S, Dedovich TG, Deppner IM, Derevschikov AA, Didenko L, Dilks C, Dong X, Drachenberg JL, Dunlop JC, Edmonds T, Elsey N, Engelage J, Eppley G, Esha R, Esumi S, Evdokimov O, Ewigleben J, Eyser O, Fatemi R, Fazio S, Federic P, Fedorisin J, Feng Y, Filip P, Finch E, Fisyak Y, Fulek L, Gagliardi CA, Galatyuk T, Geurts F, Gibson A, Gopal K, Grosnick D, Gupta A, Guryn W, Hamad AI, Hamed A, Harris JW, He L, Heppelmann S, Heppelmann S, Herrmann N, Holub L, Hong Y, Horvat S, Huang B, Huang HZ, Huang SL, Huang T, Huang X, Humanic TJ, Huo P, Igo G, Jacobs WW, Jena C, Jentsch A, Ji Y, Jia J, Jiang K, Jowzaee S, Ju X, Judd EG, Kabana S, Kagamaster S, Kalinkin D, Kang K, Kapukchyan D, Kauder K, Ke HW, Keane D, Kechechyan A, Kelsey M, Khyzhniak YV, Kikoła DP, Kim C, Kinghorn TA, Kisel I, Kisiel A, Kocan M, Kochenda L, Kosarzewski LK, Kramarik L, Kravtsov P, Krueger K, Kulathunga Mudiyanselage N, Kumar L, Kunnawalkam Elayavalli R, Kwasizur JH, Lacey R, Landgraf JM, Lauret J, Lebedev A, Lednicky R, Lee JH, Li C, Li W, Li W, Li X, Li Y, Liang Y, Licenik R, Lin T, Lipiec A, Lisa MA, Liu F, Liu H, Liu P, Liu P, Liu T, Liu X, Liu Y, Liu Z, Ljubicic T, Llope WJ, Lomnitz M, Longacre RS, Luo S, Luo X, Ma GL, Ma L, Ma R, Ma YG, Magdy Abdelwahab Abdelrahman N, Majka R, Mallick D, Margetis S, Markert C, Matis HS, Matonoha O, Mazer JA, Meehan K, Mei JC, Minaev NG, Mioduszewski S, Mishra D, Mohanty B, Mondal MM, Mooney I, Moravcova Z, Morozov DA, Nasim M, Nayak K, Nelson JM, Nemes DB, Nie M, Nigmatkulov G, Niida T, Nogach LV, Nonaka T, Odyniec G, Ogawa A, Oh K, Oh S, Okorokov VA, Page BS, Pak R, Panebratsev Y, Pawlik B, Pawlowska D, Pei H, Perkins C, Pintér RL, Pluta J, Porter J, Posik M, Pruthi NK, Przybycien M, Putschke J, Quintero A, Radhakrishnan SK, Ramachandran S, Ray RL, Reed R, Ritter HG, Roberts JB, Rogachevskiy OV, Romero JL, Ruan L, Rusnak J, Rusnakova O, Sahoo NR, Sahu PK, Salur S, Sandweiss J, Schambach J, Schmidke WB, Schmitz N, Schweid BR, Seck F, Seger J, Sergeeva M, Seto R, Seyboth P, Shah N, Shahaliev E, Shanmuganathan PV, Shao M, Shen F, Shen WQ, Shi SS, Shou QY, Sichtermann EP, Siejka S, Sikora R, Simko M, Singh J, Singha S, Smirnov D, Smirnov N, Solyst W, Sorensen P, Spinka HM, Srivastava B, Stanislaus TDS, Stefaniak M, Stewart DJ, Strikhanov M, Stringfellow B, Suaide AAP, Sugiura T, Sumbera M, Summa B, Sun XM, Sun Y, Sun Y, Surrow B, Svirida DN, Szymanski P, Tang AH, Tang Z, Taranenko A, Tarnowsky T, Thomas JH, Timmins AR, Tlusty D, Todoroki T, Tokarev M, Tomkiel CA, Trentalange S, Tribble RE, Tribedy P, Tripathy SK, Tsai OD, Tu B, Tu Z, Ullrich T, Underwood DG, Upsal I, Van Buren G, Vanek J, Vasiliev AN, Vassiliev I, Videbæk F, Vokal S, Voloshin SA, Wang F, Wang G, Wang P, Wang Y, Wang Y, Webb JC, Wen L, Westfall GD, Wieman H, Wissink SW, Witt R, Wu Y, Xiao ZG, Xie G, Xie W, Xu H, Xu N, Xu QH, Xu YF, Xu Z, Yang C, Yang Q, Yang S, Yang Y, Yang Z, Ye Z, Ye Z, Yi L, Yip K, Yoo IK, Zbroszczyk H, Zha W, Zhang D, Zhang L, Zhang S, Zhang S, Zhang XP, Zhang Y, Zhang Z, Zhao J, Zhong C, Zhou C, Zhu X, Zhu Z, Zurek M, Zyzak M. Polarization of Λ (Λ[over ¯]) Hyperons along the Beam Direction in Au+Au Collisions at sqrt[s_{NN}]=200 GeV. PHYSICAL REVIEW LETTERS 2019; 123:132301. [PMID: 31697517 DOI: 10.1103/physrevlett.123.132301] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/21/2019] [Indexed: 06/10/2023]
Abstract
The Λ (Λ[over ¯]) hyperon polarization along the beam direction has been measured in Au+Au collisions at sqrt[s_{NN}]=200 GeV, for the first time in heavy-ion collisions. The polarization dependence on the hyperons' emission angle relative to the elliptic flow plane exhibits a second harmonic sine modulation, indicating a quadrupole pattern of the vorticity component along the beam direction, expected due to elliptic flow. The polarization is found to increase in more peripheral collisions, and shows no strong transverse momentum (p_{T}) dependence at p_{T} greater than 1 GeV/c. The magnitude of the signal is about 5 times smaller than those predicted by hydrodynamic and multiphase transport models; the observed phase of the emission angle dependence is also opposite to these model predictions. In contrast, the kinematic vorticity calculations in the blast-wave model tuned to reproduce particle spectra, elliptic flow, and the azimuthal dependence of the Gaussian source radii measured with the Hanbury Brown-Twiss intensity interferometry technique reproduce well the modulation phase measured in the data and capture the centrality and transverse momentum dependence of the polarization signal.
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Adam J, Adamczyk L, Adams JR, Adkins JK, Agakishiev G, Aggarwal MM, Ahammed Z, Alekseev I, Anderson DM, Aoyama R, Aparin A, Arkhipkin D, Aschenauer EC, Ashraf MU, Atetalla F, Attri A, Averichev GS, Bairathi V, Barish K, Bassill AJ, Behera A, Bellwied R, Bhasin A, Bhati AK, Bielcik J, Bielcikova J, Bland LC, Bordyuzhin IG, Brandenburg JD, Brandin AV, Bryslawskyj J, Bunzarov I, Butterworth J, Caines H, Sánchez MCDLB, Cebra D, Chakaberia I, Chaloupka P, Chan BK, Chang FH, Chang Z, Chankova-Bunzarova N, Chatterjee A, Chattopadhyay S, Chen JH, Chen X, Cheng J, Cherney M, Christie W, Crawford HJ, Csanad M, Das S, Dedovich TG, Deppner IM, Derevschikov AA, Didenko L, Dilks C, Dong X, Drachenberg JL, Dunlop JC, Edmonds T, Elsey N, Engelage J, Eppley G, Esha R, Esumi S, Evdokimov O, Ewigleben J, Eyser O, Fatemi R, Fazio S, Federic P, Fedorisin J, Feng Y, Filip P, Finch E, Fisyak Y, Fulek L, Gagliardi CA, Galatyuk T, Geurts F, Gibson A, Grosnick D, Gupta A, Guryn W, Hamad AI, Hamed A, Harris JW, He L, Heppelmann S, Heppelmann S, Herrmann N, Holub L, Hong Y, Horvat S, Huang B, Huang HZ, Huang SL, Huang T, Huang X, Humanic TJ, Huo P, Igo G, Jacobs WW, Jentsch A, Jia J, Jiang K, Jowzaee S, Ju X, Judd EG, Kabana S, Kagamaster S, Kalinkin D, Kang K, Kapukchyan D, Kauder K, Ke HW, Keane D, Kechechyan A, Kelsey M, Kikoła DP, Kim C, Kinghorn TA, Kisel I, Kisiel A, Kocan M, Kochenda L, Kosarzewski LK, Kramarik L, Kravtsov P, Krueger K, Mudiyanselage NK, Kumar L, Elayavalli RK, Kwasizur JH, Lacey R, Landgraf JM, Lauret J, Lebedev A, Lednicky R, Lee JH, Li C, Li W, Li W, Li X, Li Y, Liang Y, Licenik R, Lin T, Lipiec A, Lisa MA, Liu F, Liu H, Liu P, Liu P, Liu X, Liu Y, Liu Z, Ljubicic T, Llope WJ, Lomnitz M, Longacre RS, Luo S, Luo X, Ma GL, Ma L, Ma R, Ma YG, Magdy N, Majka R, Mallick D, Margetis S, Markert C, Matis HS, Matonoha O, Mazer JA, Meehan K, Mei JC, Minaev NG, Mioduszewski S, Mishra D, Mohanty B, Mondal MM, Mooney I, Moravcova Z, Morozov DA, Nasim M, Nayak K, Nelson JM, Nemes DB, Nie M, Nigmatkulov G, Niida T, Nogach LV, Nonaka T, Odyniec G, Ogawa A, Oh K, Oh S, Okorokov VA, Page BS, Pak R, Panebratsev Y, Pawlik B, Pei H, Perkins C, Pinter RL, Pluta J, Porter J, Posik M, Pruthi NK, Przybycien M, Putschke J, Quintero A, Radhakrishnan SK, Ramachandran S, Ray RL, Reed R, Ritter HG, Roberts JB, Rogachevskiy OV, Romero JL, Ruan L, Rusnak J, Rusnakova O, Sahoo NR, Sahu PK, Salur S, Sandweiss J, Schambach J, Schmidke WB, Schmitz N, Schweid BR, Seck F, Seger J, Sergeeva M, Seto R, Seyboth P, Shah N, Shahaliev E, Shanmuganathan PV, Shao M, Shen F, Shen WQ, Shi SS, Shou QY, Sichtermann EP, Siejka S, Sikora R, Simko M, Singha S, Smirnov D, Smirnov N, Solyst W, Sorensen P, Spinka HM, Srivastava B, Stanislaus TDS, Stewart DJ, Strikhanov M, Stringfellow B, Suaide AAP, Sugiura T, Sumbera M, Summa B, Sun XM, Sun Y, Sun Y, Surrow B, Svirida DN, Szymanski P, Tang AH, Tang Z, Taranenko A, Tarnowsky T, Thomas JH, Timmins AR, Todoroki T, Tokarev M, Tomkiel CA, Trentalange S, Tribble RE, Tribedy P, Tripathy SK, Tsai OD, Tu B, Ullrich T, Underwood DG, Upsal I, Van Buren G, Vanek J, Vasiliev AN, Vassiliev I, Videbæk F, Vokal S, Voloshin SA, Wang F, Wang G, Wang P, Wang Y, Wang Y, Webb JC, Wen L, Westfall GD, Wieman H, Wissink SW, Witt R, Wu Y, Xiao ZG, Xie G, Xie W, Xu H, Xu N, Xu QH, Xu YF, Xu Z, Yang C, Yang Q, Yang S, Yang Y, Ye Z, Ye Z, Yi L, Yip K, Yoo IK, Zbroszczyk H, Zha W, Zhang D, Zhang L, Zhang S, Zhang S, Zhang XP, Zhang Y, Zhang Z, Zhao J, Zhong C, Zhou C, Zhu X, Zhu Z, Zurek MK, Zyzak M. Observation of Excess J/ψ Yield at Very Low Transverse Momenta in Au+Au Collisions at sqrt[s_{NN}]=200 GeV and U+U Collisions at sqrt[s_{NN}]=193 GeV. PHYSICAL REVIEW LETTERS 2019; 123:132302. [PMID: 31697545 DOI: 10.1103/physrevlett.123.132302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/21/2019] [Indexed: 06/10/2023]
Abstract
We report on the first measurements of J/ψ production at very low transverse momentum (p_{T}<0.2 GeV/c) in hadronic Au+Au collisions at sqrt[s_{NN}]=200 GeV and U+U collisions at sqrt[s_{NN}]=193 GeV. Remarkably, the inferred nuclear modification factor of J/ψ at midrapidity in Au+Au (U+U) collisions reaches about 24 (52) for p_{T}<0.05 GeV/c in the 60%-80% collision centrality class. This noteworthy enhancement cannot be explained by hadronic production accompanied by cold and hot medium effects. In addition, the dN/dt distribution of J/ψ for the very low p_{T} range is presented for the first time. The distribution is consistent with that expected from the Au nucleus and shows a hint of interference. Comparison of the measurements to theoretical calculations of coherent production shows that the excess yield can be described reasonably well and reveals a partial disruption of coherent production in semicentral collisions, perhaps due to the violent hadronic interactions. Incorporating theoretical calculations, the results strongly suggest that the dramatic enhancement of J/ψ yield observed at extremely low p_{T} originates from coherent photon-nucleus interactions. In particular, coherently produced J/ψ's in violent hadronic collisions may provide a novel probe of the quark-gluon plasma.
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Shah N, Jacob J, Househ Z, Shiner E, Baird L, Soudy H. Unchecked immunity: a unique case of sequential immune-related adverse events with Pembrolizumab. J Immunother Cancer 2019; 7:247. [PMID: 31511075 PMCID: PMC6740018 DOI: 10.1186/s40425-019-0727-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 09/02/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibition has dramatically transformed the treatment of malignant melanoma. With increasing use, their unique spectrum of immune-mediated toxicity has become apparent. CASE PRESENTATION We describe a case of sequential immune-related adverse events (irAEs) in a patient with metastatic melanoma treated with single-agent anti-programmed cell death-1 (PD-1) therapy, pembrolizumab. Although numerous cases of irAEs have been reported, sequential multi-organ involvement, including progressive atopic dermatitis, vitiligo, autoimmune nephritis, autoimmune hepatitis, and autoimmune encephalitis after cessation of therapy, has not been previously documented. CONCLUSIONS Immunosuppression resulted in clinical remission of each irAE, highlighting the importance of vigilance for autoimmune complications in patients treated with checkpoint inhibition, even after immunotherapy cessation.
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Wong J, Franco-Barraza J, Luong T, Avkshtol V, Costa DV, Francescone R, Shah N, Cukierman E, Meyer J. Concurrent Pulsed Low-Dose-Rate Radiation and Gemcitabine Reduces Desmoplastic Activation in the Pancreatic Tumor Microenvironment. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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107
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Shah N. Prenatal ultrasound signs of diencephalic-mesencephalic junction dysplasia. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 54:416-417. [PMID: 30549120 DOI: 10.1002/uog.20191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/02/2018] [Accepted: 12/07/2018] [Indexed: 06/09/2023]
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Panagiotopoulou IG, Shah N, Rowaiye B, Chandrakumaran K, Carr NJ, Moran B. Not all abdominal masses after colorectal cancer surgery are malignant: intra-abdominal fibromatosis masquerading as recurrence. Colorectal Dis 2019; 21:886-893. [PMID: 30927550 DOI: 10.1111/codi.14626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/16/2019] [Indexed: 12/26/2022]
Abstract
AIM Intra-abdominal fibromatosis is an unusual mesenchymal tumour that can be locally aggressive without any metastatic potential. Fibromatosis may simulate cancer recurrence on imaging surveillance for colorectal cancer follow-up. The optimal treatment of recurrent peritoneal malignancy is cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Confirmatory biopsy of lesions suspicious for colorectal cancer recurrence may not be feasible, thereby rendering surgery the safest option. Our aim was to determine the incidence of fibromatosis in a cohort of patients undergoing CRS and HIPEC for suspected colorectal cancer recurrence. METHODS One hundred and seventy-one CRS and HIPEC cases were performed at our Peritoneal Malignancy Institute between February 2007 and October 2018 for colorectal peritoneal metastases and were included in a prospectively maintained database. RESULTS A total of 49 (29%) of 171 cases were performed for primary colorectal cancer with peritoneal metastases, whereas 122 (71%) of 171 cases were performed for suspected colorectal cancer recurrence detected on surveillance imaging after primary colorectal cancer resection. On histological analysis of the resected specimen, five (4.1%) of 122 cases undergoing CRS and HIPEC for colorectal recurrence had fibromatosis. CONCLUSION Fibromatosis can masquerade as colorectal cancer recurrence. In this series it occurred with an incidence of 4.1% among a cohort of patients undergoing CRS and HIPEC for probable recurrence. Surgical resection may be the only option to confirm the diagnosis and rule out malignancy.
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Malik R, Luong T, Cao X, Han B, Shah N, Franco-Barraza J, Han L, Shenoy VB, Lelkes PI, Cukierman E. Rigidity controls human desmoplastic matrix anisotropy to enable pancreatic cancer cell spread via extracellular signal-regulated kinase 2. Matrix Biol 2019; 81:50-69. [PMID: 30412725 PMCID: PMC6504628 DOI: 10.1016/j.matbio.2018.11.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 02/06/2023]
Abstract
It is predicted that pancreatic ductal adenocarcinoma (PDAC) will become the second most lethal cancer in the US by 2030. PDAC includes a fibrous-like stroma, desmoplasia, encompassing most of the tumor mass, which is produced by cancer-associated fibroblasts (CAFs) and includes their cell-derived extracellular matrices (CDMs). Since elimination of desmoplasia has proven detrimental to patients, CDM reprogramming, as opposed to stromal ablation, is therapeutically desirable. Hence, efforts are being made to harness desmoplasia's anti-tumor functions. We conducted biomechanical manipulations, using variations of pathological and physiological substrates in vitro, to culture patient-harvested CAFs and generate CDMs that restrict PDAC growth and spread. We posited that extrinsic modulation of the environment, via substrate rigidity, influences CAF's cell-intrinsic forces affecting CDM production. Substrates used were polyacrylamide gels of physiological (~1.5 kPa) or pathological (~7 kPa) stiffnesses. Results showed that physiological substrates influenced CAFs to generate CDMs similar to normal/control fibroblasts. We found CDMs to be softer than the corresponding underlying substrates, and CDM fiber anisotropy (i.e., alignment) to be biphasic and informed via substrate-imparted morphological CAF aspect ratios. The biphasic nature of CDM fiber anisotropy was mathematically modeled and proposed a correlation between CAF aspect ratios and CDM alignment; regulated by extrinsic and intrinsic forces to conserve minimal free energy. Biomechanical manipulation of CDMs, generated on physiologically soft substrates, leads to reduction in nuclear translocation of pERK1/2 in KRAS mutated pancreatic cells. ERK2 was found essential for CDM-regulated tumor cell spread. In vitro findings correlated with in vivo observations; nuclear pERK1/2 is significantly high in human PDAC samples. The study suggests that altering underlying substrates enable CAFs to remodel CDMs and restrict pancreatic cancer cell spread in an ERK2 dependent manner.
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YEUNG W, Talbot B, Shah N, Palmer S, Mangos G, Gallagher M, Toussaint N, Badve S. SUN-292 BENEFITS AND HARMS OF VITAMIN D COMPOUNDS IN ADULTS WITH CHRONIC KIDNEY DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED CONTROLLED TRIALS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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111
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Molina A, Shah N, Krishnan A, Shah N, Burke J, Melear J, Spira A, Popplewell L, Andreadis C, Chhabra S, Sharman J, Kaufman J, Cohen J, Niesvizky R, Martin T, DiLea C, Kuriakose J, Matheny S, Leonard J. PRELIMINARY RESULTS OF A PHASE 1 DOSE ESCALATION STUDY OF THE FIRST-IN-CLASS ANTI-CD74 ANTIBODY DRUG CONJUGATE (ADC), STRO-001, IN ADVANCED B-CELL MALIGNANCIES. Hematol Oncol 2019. [DOI: 10.1002/hon.135_2630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Follows G, Santarsieri A, Sturgess K, Menne T, Osborne W, Creasey T, Ardeshna K, Behan S, Booth S, Collins G, Cwynarski K, Iyengar S, Jones S, Martinez-Calle N, McKay P, Nagumantry S, O'Mahony D, Rudge J, Shah N, Stafford G, Sternberg A, Uttenthal B, McMillan A. MODIFICATION OF ESCALATED BEACOPP WITH DACARBAZINE / PROCARBAZINE SUBSTITUTION REDUCES RED CELL TRANSFUSION REQUIREMENTS AND MAY SHORTEN TIME TO MENSTRUAL PERIOD RECOVERY. Hematol Oncol 2019. [DOI: 10.1002/hon.168_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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113
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Sylvetsky AC, Hiedacavage A, Shah N, Pokorney P, Baldauf S, Merrigan K, Smith V, Long MW, Black R, Robien K, Avena N, Gaine C, Greenberg D, Wootan MG, Talegawkar S, Colon‐Ramos U, Leahy M, Ohmes A, Mennella JA, Sacheck J, Dietz WH. From biology to behavior: a cross-disciplinary seminar series surrounding added sugar and low-calorie sweetener consumption. Obes Sci Pract 2019; 5:203-219. [PMID: 31275594 PMCID: PMC6587329 DOI: 10.1002/osp4.334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/06/2019] [Accepted: 02/10/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION This report presents a synopsis of a three-part, cross-sector, seminar series held at the George Washington University (GWU) in Washington, DC from February-April, 2018. The overarching goal of the seminar series was to provide a neutral forum for diverse stakeholders to discuss and critically evaluate approaches to address added sugar intake, with a key focus on the role of low-calorie sweeteners (LCS). METHODS During three seminars, twelve speakers from academic institutions, federal agencies, non-profit organizations, and the food and beverage industries participated in six interactive panel discussions to address: 1) Do Farm Bill Policies Impact Population Sugar Intake? 2) What is the Impact of Sugar-sweetened Beverage (SSB) Taxes on Health and Business? 3) Is Sugar Addictive? 4) Product Reformulation Efforts: Progress, Challenges, and Concerns? 5) Low-calorie Sweeteners: Helpful or Harmful, and 6) Are Novel Sweeteners a Plausible Solution? Discussion of each topic involved brief 15-minute presentations from the speakers, which were followed by a 25-minute panel discussion moderated by GWU faculty members and addressed questions generated by the audience. Sessions were designed to represent opposing views and stimulate meaningful debate. Given the provocative nature of the seminar series, attendee questions were gathered anonymously using Pigeonhole™, an interactive, online, question and answer platform. RESULTS This report summarizes each presentation and recapitulates key perspectives offered by the speakers and moderators. CONCLUSIONS The seminar series set the foundation for robust cross-sector dialogue necessary to inform meaningful future research, and ultimately, effective policies for lowering added sugar intakes.
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Kulkarni PG, Shah N, Waghela BN, Pathak CM, Pappachan A. Leishmania donovani adenylate kinase 2a prevents ATP-mediated cell cytolysis in macrophages. Parasitol Int 2019; 72:101929. [PMID: 31108219 DOI: 10.1016/j.parint.2019.101929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/12/2019] [Accepted: 05/16/2019] [Indexed: 01/09/2023]
Abstract
In Leishmania spp. ATP utilizing enzymes serves as a key role in preserving integrity of host cells for survival of parasite. Earlier reports suggested that Adenylate kinase (AK) a phosphotransferase enzyme released by Leishmania donovani secretome, involved in modulating levels of NTPs. In the present study, we cloned, expressed and characterized recombinant putative AK. Based on a sequence and phylogeny analysis, we identified the prominent features of the seven AK isoforms of Leishmania donovani and assigned our putative AK as LdAK2a. The Km value of LdAK2a for ATP and AMP substrate were 204 μM and 184 μM, respectively and Vmax was calculated as 1.6 μmol min-1 mg-1 protein. Ap5A, a known inhibitor of AK inhibited LdAK2a with estimated Ki values of 280 nM and 230 nM for ATP and AMP respectively. CD spectral studies were carried out to estimate its structural stability. Recombinant LdAK2a was found to prevent ATP mediated cell cytolysis of Raw 264.7 macrophages in vitro, which was determined by LDH assay and MMP assay. This is the first report which validates that Leishmanial AK2a can prevent ATP mediated cytolysis of macrophage cells and thereby probably play a role in preserving integrity of host cells for survival of parasite.
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Adam J, Adamczyk L, Adams JR, Adkins JK, Agakishiev G, Aggarwal MM, Ahammed Z, Alekseev I, Anderson DM, Aoyama R, Aparin A, Arkhipkin D, Aschenauer EC, Ashraf MU, Atetalla F, Attri A, Averichev GS, Bai X, Bairathi V, Barish K, Bassill AJ, Behera A, Bellwied R, Bhasin A, Bhati AK, Bielcik J, Bielcikova J, Bland LC, Bordyuzhin IG, Brandenburg JD, Brandin AV, Brown D, Bryslawskyj J, Bunzarov I, Butterworth J, Caines H, Calderón de la Barca Sánchez M, Cebra D, Chakaberia I, Chaloupka P, Chan BK, Chang FH, Chang Z, Chankova-Bunzarova N, Chatterjee A, Chattopadhyay S, Chen JH, Chen X, Chen X, Cheng J, Cherney M, Christie W, Contin G, Crawford HJ, Csanad M, Das S, Dedovich TG, Deppner IM, Derevschikov AA, Didenko L, Dilks C, Dong X, Drachenberg JL, Dunlop JC, Efimov LG, Elsey N, Engelage J, Eppley G, Esha R, Esumi S, Evdokimov O, Ewigleben J, Eyser O, Fatemi R, Fazio S, Federic P, Federicova P, Fedorisin J, Filip P, Finch E, Fisyak Y, Flores CE, Fulek L, Gagliardi CA, Galatyuk T, Geurts F, Gibson A, Grosnick D, Gunarathne DS, Guo Y, Gupta A, Guryn W, Hamad AI, Hamed A, Harlenderova A, Harris JW, He L, Heppelmann S, Heppelmann S, Herrmann N, Hirsch A, Holub L, Hong Y, Horvat S, Huang B, Huang HZ, Huang SL, Huang T, Huang X, Humanic TJ, Huo P, Igo G, Jacobs WW, Jentsch A, Jia J, Jiang K, Jowzaee S, Ju X, Judd EG, Kabana S, Kagamaster S, Kalinkin D, Kang K, Kapukchyan D, Kauder K, Ke HW, Keane D, Kechechyan A, Kikoła DP, Kim C, Kinghorn TA, Kisel I, Kisiel A, Kochenda L, Kosarzewski LK, Kraishan AF, Kramarik L, Krauth L, Kravtsov P, Krueger K, Kulathunga N, Kumar L, Kunnawalkam Elayavalli R, Kvapil J, Kwasizur JH, Lacey R, Landgraf JM, Lauret J, Lebedev A, Lednicky R, Lee JH, Li C, Li W, Li X, Li Y, Liang Y, Lidrych J, Lin T, Lipiec A, Lisa MA, Liu F, Liu H, Liu P, Liu P, Liu Y, Liu Z, Ljubicic T, Llope WJ, Lomnitz M, Longacre RS, Luo S, Luo X, Ma GL, Ma L, Ma R, Ma YG, Magdy N, Majka R, Mallick D, Margetis S, Markert C, Matis HS, Matonoha O, Mazer JA, Meehan K, Mei JC, Minaev NG, Mioduszewski S, Mishra D, Mohanty B, Mondal MM, Mooney I, Morozov DA, Nasim M, Negrete JD, Nelson JM, Nemes DB, Nie M, Nigmatkulov G, Niida T, Nogach LV, Nonaka T, Odyniec G, Ogawa A, Oh K, Oh S, Okorokov VA, Olvitt D, Page BS, Pak R, Panebratsev Y, Pawlik B, Pei H, Perkins C, Pinter RL, Pluta J, Porter J, Posik M, Pruthi NK, Przybycien M, Putschke J, Quintero A, Radhakrishnan SK, Ramachandran S, Ray RL, Reed R, Ritter HG, Roberts JB, Rogachevskiy OV, Romero JL, Ruan L, Rusnak J, Rusnakova O, Sahoo NR, Sahu PK, Salur S, Sandweiss J, Schambach J, Schmah AM, Schmidke WB, Schmitz N, Schweid BR, Seck F, Seger J, Sergeeva M, Seto R, Seyboth P, Shah N, Shahaliev E, Shanmuganathan PV, Shao M, Shen F, Shen WQ, Shi SS, Shou QY, Sichtermann EP, Siejka S, Sikora R, Simko M, Singh J, Singha S, Smirnov D, Smirnov N, Solyst W, Sorensen P, Spinka HM, Srivastava B, Stanislaus TDS, Stewart DJ, Strikhanov M, Stringfellow B, Suaide AAP, Sugiura T, Sumbera M, Summa B, Sun XM, Sun X, Sun Y, Surrow B, Svirida DN, Szymanski P, Tang AH, Tang Z, Taranenko A, Tarnowsky T, Thomas JH, Timmins AR, Tlusty D, Todoroki T, Tokarev M, Tomkiel CA, Trentalange S, Tribble RE, Tribedy P, Tripathy SK, Tsai OD, Tu B, Ullrich T, Underwood DG, Upsal I, Van Buren G, Vanek J, Vasiliev AN, Vassiliev I, Videbæk F, Vokal S, Voloshin SA, Vossen A, Wang F, Wang G, Wang P, Wang Y, Wang Y, Webb JC, Wen L, Westfall GD, Wieman H, Wissink SW, Witt R, Wu Y, Xiao ZG, Xie G, Xie W, Xu J, Xu N, Xu QH, Xu YF, Xu Z, Yang C, Yang Q, Yang S, Yang Y, Ye Z, Ye Z, Yi L, Yip K, Yoo IK, Yu N, Zbroszczyk H, Zha W, Zhang J, Zhang J, Zhang L, Zhang S, Zhang S, Zhang XP, Zhang Y, Zhang Z, Zhao J, Zhong C, Zhou C, Zhu X, Zhu Z, Zyzak M. Azimuthal Harmonics in Small and Large Collision Systems at RHIC Top Energies. PHYSICAL REVIEW LETTERS 2019; 122:172301. [PMID: 31107064 DOI: 10.1103/physrevlett.122.172301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/26/2019] [Indexed: 06/09/2023]
Abstract
The first (v_{1}^{fluc}), second (v_{2}), and third (v_{3}) harmonic coefficients of the azimuthal particle distribution at midrapidity are extracted for charged hadrons and studied as a function of transverse momentum (p_{T}) and mean charged particle multiplicity density ⟨N_{ch}⟩ in U+U (sqrt[s_{NN}]=193 GeV), Au+Au, Cu+Au, Cu+Cu, d+Au, and p+Au collisions at sqrt[s_{NN}]=200 GeV with the STAR detector. For the same ⟨N_{ch}⟩, the v_{1}^{fluc} and v_{3} coefficients are observed to be independent of the collision system, while v_{2} exhibits such a scaling only when normalized by the initial-state eccentricity (ϵ_{2}). The data also show that ln(v_{2}/ϵ_{2}) scales linearly with ⟨N_{ch}⟩^{-1/3}. These measurements provide insight into initial-geometry fluctuations and the role of viscous hydrodynamic attenuation on v_{n} from small to large collision systems.
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Rouce R, Thakkar A, Sharma S, Shah N, Reyna A, Ramos C, Lapteva N, Zhang H, Mehta B, Perconti S, McKenna M, Gee A, Lulla P, Castello J, Brenner M, Heslop H, Rooney C. Use of highly characterized EBV-Specific T Cells outside of the immediate Post-Transplant setting. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zhu F, Shah N, Schneider D, Xu H, Chaney K, Luib L, Keever-Taylor C, Dropulic B, Orentas R, Hari P, Johnson B. Results of point-of-care manufacturing of bispecific chimeric antigen receptor (CAR) LV20.19 CAR-TCELLS in a phase i study for relapsed/refractory (R/R), non-hodgkin lymphoma (NHL). Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.568] [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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Murillo OD, Thistlethwaite W, Rozowsky J, Subramanian SL, Lucero R, Shah N, Jackson AR, Srinivasan S, Chung A, Laurent CD, Kitchen RR, Galeev T, Warrell J, Diao JA, Welsh JA, Hanspers K, Riutta A, Burgstaller-Muehlbacher S, Shah RV, Yeri A, Jenkins LM, Ahsen ME, Cordon-Cardo C, Dogra N, Gifford SM, Smith JT, Stolovitzky G, Tewari AK, Wunsch BH, Yadav KK, Danielson KM, Filant J, Moeller C, Nejad P, Paul A, Simonson B, Wong DK, Zhang X, Balaj L, Gandhi R, Sood AK, Alexander RP, Wang L, Wu C, Wong DTW, Galas DJ, Van Keuren-Jensen K, Patel T, Jones JC, Das S, Cheung KH, Pico AR, Su AI, Raffai RL, Laurent LC, Roth ME, Gerstein MB, Milosavljevic A. exRNA Atlas Analysis Reveals Distinct Extracellular RNA Cargo Types and Their Carriers Present across Human Biofluids. Cell 2019; 177:463-477.e15. [PMID: 30951672 PMCID: PMC6616370 DOI: 10.1016/j.cell.2019.02.018] [Citation(s) in RCA: 187] [Impact Index Per Article: 37.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 11/06/2018] [Accepted: 02/11/2019] [Indexed: 12/11/2022]
Abstract
To develop a map of cell-cell communication mediated by extracellular RNA (exRNA), the NIH Extracellular RNA Communication Consortium created the exRNA Atlas resource (https://exrna-atlas.org). The Atlas version 4P1 hosts 5,309 exRNA-seq and exRNA qPCR profiles from 19 studies and a suite of analysis and visualization tools. To analyze variation between profiles, we apply computational deconvolution. The analysis leads to a model with six exRNA cargo types (CT1, CT2, CT3A, CT3B, CT3C, CT4), each detectable in multiple biofluids (serum, plasma, CSF, saliva, urine). Five of the cargo types associate with known vesicular and non-vesicular (lipoprotein and ribonucleoprotein) exRNA carriers. To validate utility of this model, we re-analyze an exercise response study by deconvolution to identify physiologically relevant response pathways that were not detected previously. To enable wide application of this model, as part of the exRNA Atlas resource, we provide tools for deconvolution and analysis of user-provided case-control studies.
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Shah N, Melo L, Reid WD, Cioffi I. Masseter Deoxygenation in Adults at Risk for Temporomandibular Disorders. J Dent Res 2019; 98:666-672. [PMID: 30946624 DOI: 10.1177/0022034519837249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Patients with muscular temporomandibular disorder (TMD) present with abnormal oxygenation of the jaw muscles. Nonetheless, the deoxygenation pattern of jaw muscles of healthy subjects with frequent wake-time tooth-clenching episodes, who are at greater risk for TMD, has never been investigated. This case-control study compared the deoxygenation of the masseter during standardized tasks between TMD-free individuals with frequent self-reports of wake-time clenching and those with infrequent self-reports. University students ( N = 255) filled out the Oral Behavior Checklist. Fourteen females with high versus low scores-high parafunctional (HP) group ( n = 7, ≥80th percentile of score distribution) versus low parafunctional (LP) group ( n = 7, ≤20th percentile)-completed 2 sessions during which they clenched at their maximum voluntary contraction (MVC) for 2 min and at 10% to 20% MVC for 20 min. Tissue oxygen saturation (StO2) and changes in oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin of the masseter were measured via near-infrared spectroscopy and analyzed with a generalized mixed effect model. A significant interaction effect (task × study group) was found on all outcome measures, indicating that the deoxygenation pattern of the HP group differed from the LP group (all P < 0.001). MVC of the masseter induced an almost 5-times-greater reduction of StO2 in the HP group as compared with the LP group ( P = 0.023). However, the relative increase in StO2 at rest after the MVC was similar between groups ( P > 0.05). At the end of the prolonged MVC task (10% to 20%), the blood flow (change in total hemoglobin) was almost 6 times higher in the LP group as compared with baseline. On the contrary, it increased minimally in the HP group (all P < 0.001). Healthy individuals at risk for TMD have abnormalities in masseter deoxygenation. Future prospective studies are needed to test whether this contributes to the onset of muscular TMD.
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Gordhandas S, Stewart J, Shah N, Wahmann B, Schattman G, Rosenwaks Z. Utilization and knowledge of oncofertility preservation services: a single institution experience. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.02.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shah N, Lee J, Dinh D, Vilvendhan R, Ramalingam V, Shah N. 04:03 PM Abstract No. 342 Utility of second look imaging in patients with persistent clinical concern for lower gastrointestinal bleed after initial negative CTA. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.412] [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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Nyenhuis SM, Shah N, Ma J, Marquez DX, Wilbur J, Cattamanchi A, Sharp LK. Identifying Barriers to Physical Activity Among African American Women with Asthma. COGENT MEDICINE 2019; 6:1582399. [PMID: 31754624 PMCID: PMC6871513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE African American Women (AAW) are disproportionately impacted by both physical inactivity and asthma. The aims of this study were to: 1) understand barriers to physical activity among AAW with asthma; 2) obtain feedback from AAW on an evidence-based walking intervention; and 3) modify the intervention using input from AAW with asthma. METHODS Focus groups and interviews were conducted with sedentary AAW with uncontrolled asthma to identify barriers to walking. Women also suggestions for tailoring an existing walking intervention. Qualitative data were coded using domains from the Behavior Change Wheel and guided modifications of the existing walking intervention to tailor the content for sedentary AAW with asthma. RESULTS Six focus groups (2-4 /group) and five interviews were completed. Women (n=20) represented an obese (37 kg/m2 ± 11), middle-aged (46 years ± 15) and low-income population. Barriers to physical activity were mapped to 8 theoretical domains: 1) Limited physical capability; 2) Lack of knowledge; 3) Lack of self-monitoring skills; 4) Complex decision making processes; 5) Lack of areas to walk; 6) Lack of social support; 7) Beliefs about consequences; 8) Beliefs about capability. To target these barriers, the existing walking intervention was modified to include an asthma education session, text messages, monthly group meetings, a walking session and informational materials. CONCLUSION AAW with asthma reported unique barriers to engaging in physical activity. An assessment of the feasibility, acceptability and efficacy of a modified intervention that addresses these barriers is warranted to address physical inactivity and poor asthma outcomes among AAW with asthma.
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Nyenhuis SM, Shah N, Ma J, Marquez DX, Wilbur J, Cattamanchi A, Sharp LK. Identifying barriers to physical activity among African American women with asthma. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1582399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Ruddy KJ, Sangaralingham LR, Freedman RA, Jemal A, Mougalian SS, Keegan T, Loprinzi CL, Gross CP, Henk HJ, Shah N. Abstract PD6-07: Trends in the cost of care for breast cancer among women with commercial insurance. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd6-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast cancer care imposes a significant financial burden to U.S. healthcare systems and has become a key focus in the health care debate. Therapies for breast cancer are expensive, and the economic burden of these therapies may be rising due to the rapid introduction of pricey new drugs and techniques. There are limited data on the health care costs of individuals with breast cancer after initial diagnosis and how these costs have changed over time.
Methods: We conducted a retrospective analysis of commercially insured adult women with newly diagnosed non-metastatic breast cancer (identified via previously published claims-based algorithms) using 2007-2016 data from a large US health plan available in OptumLabs® Data Warehouse. We included patients with continuous health plan coverage for at least 2 years after initial diagnosis 2007-2014 and assessed how total health care spending and out-of-pocket costs (paid amounts) changed over this time. Costs were adjusted to 2016 US dollars using the general Consumer Price Index. Inpatient, outpatient, and outpatient pharmacy costs were evaluated. A multivariable logistic regression model was used to examine predictors of above average cost (cost > mean for that year of diagnosis).
Results: A total of 12,446 newly diagnosed breast cancer patients were identified (mean age, 51.6 years). Forty percent had undergone mastectomy, 38% chemotherapy, and 63% radiation. After adjustment for inflation, total healthcare costs increased 29.7% from 2007 to 2014 (Table 1), with increases primarily observed during the first year after diagnosis. Out-of-pocket costs remained relatively stable, and accounted for 5.3% of the total spending. Approximately 80% of the total costs were related to care received in the outpatient setting. Factors independently associated with above average spending included treatment with mastectomy [OR 1.78 (95% CI 1.5-2.1)], reconstruction [OR 3.0 (95% CI 2.6-3.5)], radiation [OR 4.0 (95% CI 3.4-4.7)] and chemotherapy [OR 18.4 (95% CI 16.6-20.3].
Table 1.Average healthcare spending over time Mean cost during first year after diagnosisMean cost during second year after diagnosisYear of diagnosistotalout-of-pockettotalout-of-pocket2007$80,296.17$4,271.25$16,559.21$1,907.012008$84,126.70$4,445.78$16,785.43$2,205.982009$88,331.45$4,728.42$17,005.68$2,214.932010$91,502.58$5,067.78$17,243.91$2,126.192011$93,826.40$5,089.45$16,862.45$2,027.962012$96,690.06$5,449.91$17,814.09$2,179.262013$104,064.93$5,678.19$17,087.47$2,115.972014$104,169.74$5,620.51$16,714.12$1,590.67
Conclusions: Breast cancer care is increasingly expensive during the first year after diagnosis, and costs are greatest for the recipients of more aggressive treatments. Costs during the second year after diagnosis have remained relatively stable.
Citation Format: Ruddy KJ, Sangaralingham LR, Freedman RA, Jemal A, Mougalian SS, Keegan T, Loprinzi CL, Gross CP, Henk HJ, Shah N. Trends in the cost of care for breast cancer among women with commercial insurance [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD6-07.
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Singh A, Bhakat M, Mohanty TK, Mondal S, Yadav SK, Kumar P, Kumar R, Rahim A, Sinha R, Shah N. Effect of Tris-egg Yolk, Soya Milk, and Liposome-based Extenders on Sahiwal (Bos indicus) Sperm Quality during Pre- and Post-Cryopreservation Stages. CRYO LETTERS 2019; 40:94-102. [PMID: 31017609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Even though there are plenty of semen cryopreservation extenders available, their adoption is limited. Although normal tris-based egg yolk (EYC) extender is widely used, it leads to compromised post-thaw sperm quality. OBJECTIVE To find a standard semen extender, six different semen extenders were validated. METHODS In a split study, six aliquots of zebu cattle fresh semen ejaculate were cryopreserved in extenders containing egg yolk obtained from hen which was reared either in 1) normal, 2) omega-3 enriched, and 3) herbal enriched diet supplementation, and egg yolk free extenders such as 4) soya lecithin, 5) Bioxcell and 6) Optixcell. RESULT Significantly poor sperm quality and kinematics were observed in extender containing herbal egg yolk. However, omega-3 enriched egg yolk extender was on par with EYC. Among all extenders, soya lecithin and bioxcell have shown better sperm quality. Sperm motility was significantly higher in semen extended in liposome-based extender Optixcell. CONCULSION Optixcell can be considered as a standard extender for cattle semen cryopreservation to maintain adequate sperm quality required for artificial insemination.
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