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Segelov E, Chan D, Shapiro J, Price TJ, Karapetis CS, Tebbutt NC, Pavlakis N. The role of biological therapy in metastatic colorectal cancer after first-line treatment: a meta-analysis of randomised trials. Br J Cancer 2014; 111:1122-31. [PMID: 25072258 PMCID: PMC4453848 DOI: 10.1038/bjc.2014.404] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 06/07/2014] [Accepted: 06/16/2014] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Biologic agents have achieved variable results in relapsed metastatic colorectal cancer (mCRC). Systematic meta-analysis was undertaken to determine the efficacy of biological therapy. METHODS Major databases were searched for randomised studies of mCRC after first-line treatment comparing (1) standard treatment plus biologic agent with standard treatment or (2) standard treatment with biologic agent with the same treatment with different biologic agent(s). Data were extracted on study design, participants, interventions and outcomes. Study quality was assessed using the MERGE criteria. Comparable data were pooled for meta-analysis. RESULTS Twenty eligible studies with 8225 patients were identified. The use of any biologic therapy improved overall survival with hazard ratio (HR) 0.87 (95% confidence interval (CI) 0.82-0.91, P<0.00001), progression-free survival (PFS) with HR 0.71 (95% CI 0.67-0.74, P<0.0001) and overall response rate (ORR) with odds ratio (OR) 2.38 (95% CI 2.03-2.78, P<0.00001). Grade 3/4 toxicity was increased with OR 2.34. Considering by subgroups, EGFR inhibitors (EGFR-I) in the second-line setting and anti-angiogenic therapies (both in second-line and third-line and beyond settings) all improved overall survival, PFS and ORR. EGFR-I in third-line settings improved PFS and ORR but not OS. CONCLUSIONS The use of biologic agents in mCRC after first-line treatment is associated with improved outcomes but increased toxicity.
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Kim T, Xu R, Yau T, Ma B, Pan H, Xu J, Bai Y, Chi Y, Wang L, Yeh K, Bi F, Cheng Y, Le A, Lin J, Liu T, Ma D, Shapiro J, Kalmus J, Qin S, Li J. Concur: a Randomized, Placebo-Controlled Phase 3 Study of Regorafenib (Reg) Monotherapy in Asian Patients with Previously Treated Metastatic Colorectal Cancer (Mcrc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Field K, Wong HL, Shapiro J, Kosmider S, Tie J, Bae S, Yip D, McKendrick J, Nott L, Desai J, Harold M, Lipton L, Stefanou G, Lim L, Parente P, Gibbs P. Developing a national database for metastatic colorectal cancer management: perspectives and challenges. Intern Med J 2014; 43:1224-31. [PMID: 23834128 DOI: 10.1111/imj.12230] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 06/27/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND The changing treatment landscape for metastatic colorectal cancer creates multiple potential treatment strategies. An Australian-centric database capturing comprehensive information across a range of treatment locations would create a valuable resource enabling multiple important research questions to be addressed. AIMS To establish a collection of a consensus dataset capturing treatment and outcomes at multiple public and private hospitals across Australia. METHODS An electronic database was developed by a panel of clinicians, to capture an agreed dataset for patients with newly diagnosed metastatic colorectal cancer. Of particular interest were clinician decision-making, the impact of comorbidities and the frequency of major adverse events. RESULTS Since July 2009, data collection has been established at six public and eight private hospitals across three Australian states and territories. Successful linkage and analysis, with support from BioGrid Australia, of selected data on the initial 864 patients demonstrates that data can be captured from diverse sites, including public and private practice, that multiple factors impact on treatment delivered and outcomes achieved and that comprehensive data on rare but important adverse events can be captured. As a clinical research tool, the project has been highly successful, generating multiple presentations at national and international conferences related to a diverse range of research questions. CONCLUSIONS Multistate, project-specific data collection involving large numbers of patients is achievable. Providing invaluable insight into the routine clinical management of metastatic colorectal cancer in the era of targeted therapies, this also creates a significant resource for research, including many questions not being addressed by clinical trials.
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Wong HL, Field K, Harol M, Tran B, Tie J, Shapiro J, Wong R, Yip D, Nott L, Richardson G, McKendrick J, Gibbs P. P0183 Resection of colorectal cancer metastases in routine practice. Eur J Cancer 2014. [DOI: 10.1016/j.ejca.2014.03.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chan KK, Tu D, O'Callaghan CJ, Au HJ, Leighl NB, Brundage MD, Jonker DJ, Karapetis CS, Ringash J, Zalcberg JR, Hoch JS, Tebbutt NC, Shapiro J, Price TJ, Pavlakis N, Van Hazel GA, Mittmann N. A mapping algorithm of health preferences from EORTC QLQ C30 to health utility index mark 3 (HUI3) in advanced colorectal cancer. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.3_suppl.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
547 Background: The National Cancer Institute of Canada CO17 study, which showed that patients with advanced colorectal cancer had improved overall survival and derived health related quality of life benefits (measured with EORTC QLQ C30) when treated with cetuximab, collected health preferences with HUI3 prospectively. We examined the relationship between baseline health utilities and quality of life, and constructed a mapping algorithm to derive health utilities from EORTC QLQ C30. Methods: Data from 545 patients including baseline characteristics (age, gender, treatment arm, K-ras, ECOG PS, etc.), health preferences (HUI3), EORTC QLQ C30 five function scales, a two-item global health status (GHS) scale, three symptom scales, and six single items were obtained from the CO17 dataset. Correlations among HUI3 and EORTC QLQ C30 scales and baseline characteristics were examined. Multivariable linear regression model was constructed to develop a mapping algorithm to derive HUI3 from EORTC QLQ C30 scales and/or baseline characteristics. Leave-one-out cross validation (LOOCV) mean absolute error (MAE) and root mean square error (RMSE) were calculated to examine predictive ability. Results: The mean HUI3 was 0.717 (SD = 0.235). HUI3 was significantly correlated with baseline ECOG PS, number of disease sites and the presence of liver metastasis, but not with age, gender, treatment arms or K-ras. HUI3 was also significantly correlated with all EORTC QLQ C30 scales except the diarrhea scale. Multivariable regression showed that HUI3 remained significantly associated with four of the five functional scales (physical, role, cognitive and emotional), the pain scale and the GHS scale. A mapping algorithm consisting of these 6 scales resulted in a model with an adjusted R2 of 0.61, and LOOCV mean error of -0.00014, MAE of 0.11, and RMSE of 0.15. Conclusions: Health preferences as measured by HUI3 are significantly associated with HRQL as measured by EORTC QLQ C30 in patients with advanced refractory colorectal cancer. Our mapping will allow for the generation of health preference values in advanced colorectal cancer when only EORTC QLQ C30 results exist in order to conduct cost-effectiveness analysis.
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Chong A, Karlan D, Shapiro J, Zinman J. (Ineffective) Messages to Encourage Recycling: Evidence from a Randomized Evaluation in Peru. ACTA ACUST UNITED AC 2013. [DOI: 10.1093/wber/lht022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Leblanc A, Matsumoto T, Jones J, Shapiro J, Lang T, Shackelford L, Smith SM, Evans H, Spector E, Ploutz-Snyder R, Sibonga J, Keyak J, Nakamura T, Kohri K, Ohshima H. Bisphosphonates as a supplement to exercise to protect bone during long-duration spaceflight. Osteoporos Int 2013; 24:2105-14. [PMID: 23334732 DOI: 10.1007/s00198-012-2243-z] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 10/18/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED We report the results of alendronate ingestion plus exercise in preventing the declines in bone mass and strength and elevated levels of urinary calcium and bone resorption in astronauts during 5.5 months of spaceflight. INTRODUCTION This investigation was an international collaboration between NASA and the JAXA space agencies to investigate the potential value of antiresorptive agents to mitigate the well-established bone changes associated with long-duration spaceflight. METHODS We report the results from seven International Space Station (ISS) astronauts who spent a mean of 5.5 months on the ISS and who took an oral dose of 70 mg of alendronate weekly starting 3 weeks before flight and continuing throughout the mission. All crewmembers had available for exercise a treadmill, cycle ergometer, and a resistance exercise device. Our assessment included densitometry of multiple bone regions using X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) and assays of biomarkers of bone metabolism. RESULTS In addition to pre- and post-flight measurements, we compared our results to 18 astronauts who flew ISS missions and who exercised using an early model resistance exercise device, called the interim resistance exercise device, and to 11 ISS astronauts who exercised using the newer advanced resistance exercise device (ARED). Our findings indicate that the ARED provided significant attenuation of bone loss compared with the older device although post-flight decreases in the femur neck and hip remained. The combination of the ARED and bisphosphonate attenuated the expected decline in essentially all indices of altered bone physiology during spaceflight including: DXA-determined losses in bone mineral density of the spine, hip, and pelvis, QCT-determined compartmental losses in trabecular and cortical bone mass in the hip, calculated measures of fall and stance computed bone strength of the hip, elevated levels of bone resorption markers, and urinary excretion of calcium. CONCLUSIONS The combination of exercise plus an antiresoptive drug may be useful for protecting bone health during long-duration spaceflight.
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Eisenberger MA, Hardy-Bessard AC, Ford D, Mourey L, Parente P, Mainwaring PN, Ng S, Alekseev B, Matveev V, Carles J, Shapiro J, Latorzeff I, Bodrogi I, Kim CS, Font A, Segal R, Berg HPVD, Zhang W(W, Chadjaa M, De Bono JS. PROSELICA study update: Comparison of two doses of cabazitaxel (Cbz) plus prednisone (P) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) previously treated with a docetaxel (D)-containing regimen. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.tps5099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS5099 Background: Cbz 25 mg/m2 IV Q3W + P 10 mg PO QD has an established safety profile and significantly improves overall survival (OS) vs mitoxantrone + P in pts with mCRPC previously treated with a D-containing regimen (phase III TROPIC study; NCT00417079; median OS: 15.1 vs 12.7 mos; HR: 0.70; P < 0.0001). Pooled data on file suggest that lower Grade 3–4 neutropenia rates are observed with Cbz < 25 vs ≥ 25 mg/m2 (61% vs 74%). In an attempt to further improve the therapeutic index of Cbz in the second-line treatment of mCRPC, PROSELICA (NCT01308580) was designed to assess whether Cbz 20 mg/m2 is associated with lower hematologic toxicity and has non-inferior efficacy compared with the standard 25 mg/m2dose. Methods: PROSELICA is a randomized, open-label, multinational, phase III study comparing the efficacy and tolerability of IV Cbz 20 with 25 mg/m2, Q3W. Pts with a life expectancy > 6 mos, ECOG PS ≤ 2, confirmed mCRPC and prior therapy with a D-containing regimen are eligible. Pts are randomized 1:1 to Cbz dosing arms; all pts receive P 10 mg PO QD and are treated until disease progression, unacceptable toxicity or consent withdrawal (max. 10 cycles). Pts are stratified by ECOG PS, measurable disease and region of the world. The primary endpoint is OS (non-inferiority). Secondary endpoints include safety, progression-free survival (PCWG2 criteria), PSA and pain progression and response, tumor response and health-related quality of life. Cbz PK and pharmacogenomics will be assessed in subgroups. Planned enrollment is 1200 pts. The study started in May 2011; by 31 Dec 2012, 851 pts had been enrolled. 158 sites are enrolling pts. Based on a review of safety and efficacy endpoints, the last Data Monitoring Committee meeting (Dec 2012) recommended continuing the study without change. Clinical trial information: NCT01308580. [Table: see text]
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Wong SF, Field KM, Kosmider S, Tie J, Wong HL, Tran B, Tacey M, Shapiro J, McKendrick J, Gibbs P. Primary tumor resection in metastatic colorectal cancer (mCRC): A prospective cohort study. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.3584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3584 Background: The role of primary tumor resection in patients presenting with mCRC remains controversial. Previously reported survival benefits associated with primary tumor resection may not translate in the modern era of systemic therapies. We examined the impact of primary tumor resection on survival in a modern cohort of mCRC patients. Methods: Patients were identified using a clinician-designed mCRC registry involving 15 participating Australian sites from mid 2009. Patients were excluded if planned for curative metastasectomy or had incomplete data. Univariate logistic regression and multivariate cox regression was utilized to identify significant associations between resection, clinical variables and survival outcomes. Results: We identified 682 mCRC patients with median follow up 20 months. 40% (n = 275) had their primary in-situ. Rates of primary resection were higher for age > 70 years (OR 1.66 95% CI [1.22 – 2.26], p = 0.001) and Charlson score ≥3 (OR 1.50 [1.10 – 2.06], p = 0.011). Lower resection rates were observed for rectal v colon primary (OR 0.39 [0.28 – 0.55], p < 0.001), liver metastases (OR 0.59 [0.42 – 0.82], p = 0.002) and ECOG 2 - 4 (OR 0.64 [0.45 – 0.92], p = 0.015). There was a significant survival advantage for pts with primary tumor resection (median OS 21.3 vs 16.8 months; HR 0.63, p < 0.001), even when adjusting for known prognostic factors in a multivariate analysis (HR 0.56 [0.44 – 0.72], p < 0.001). Multivariate analyses also demonstrated that age > 70 years (HR 1.32 [1.03 – 1.71], p = 0.031) and ECOG ≥ 2 (HR 3.17 [2.43 – 4.15], p < 0.001) were significantly associated with poorer outcomes; whereas chemotherapy use (HR 0.61 [0.45 – 0.84], p = 0.002), bevacizumab use (HR 0.68 [0.52 – 0.89], p = 0.005) and rectal primary (HR 0.69 [0.53 – 0.91], p = 0.009) predicted improved survival. Conclusions: Our study suggests that primary tumor resection is associated with significant survival advantages for mCRC patients in the modern era of systemic therapies. The 40% of primary cancers in-situ is higher than previous mCRC studies and suggests a tendency for non-operative intervention in Australia. Further analysis aimed at examining the impact of other confounding variables such as tumor burden is ongoing and will be presented.
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Peeters M, Strickland AH, Lichinitser M, Suresh AVS, Manikhas G, Shapiro J, Rogowski W, Huang X, Wu B, Warner D, Jain R, Tebbutt NC. A randomised, double-blind, placebo-controlled phase 2 study of trebananib (AMG 386) in combination with FOLFIRI in patients with previously treated metastatic colorectal carcinoma. Br J Cancer 2013; 108:503-11. [PMID: 23361051 PMCID: PMC3593550 DOI: 10.1038/bjc.2012.594] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: This phase 2 study evaluated trebananib (AMG 386), an investigational peptide-Fc fusion protein that neutralises the interaction between angiopoietins-1/2 and the Tie2 receptor, plus FOLFIRI as second-line treatment for patients with metastatic colorectal cancer. Methods: Patients had adenocarcinoma of the colon or rectum with progression within 6 months of receiving only one prior fluoropyrimidine/oxaliplatin-based chemotherapy regimen for metastatic disease. All patients received FOLFIRI and were randomised 2 : 1 to also receive intravenous trebananib 10 mg kg−1 once weekly (QW) (Arm A) or placebo QW (Arm B). The primary end point was investigator-assessed progression-free survival (PFS). Results: One hundred and forty-four patients were randomised (Arms A/B, n=95/49). Median PFS in Arms A and B was 3.5 and 5.2 months (hazard ratio (HR) 1.23; 95% CI, 0.81–1.86; P=0.33) and median overall survival (OS) was 11.9 and 8.8 months, respectively (HR 0.90; 95% CI; 0.53–1.54; P=0.70). Objective response rate (ORR) was 14% and 0% in Arms A and B, respectively. Incidence of grade ⩾3 adverse events was similar between treatment arms (Arm A, 61% Arm B, 65%) and included pulmonary embolism (1%/4%), deep vein thrombosis (5%/2%), and hypertension (1%/0%). Conclusion: Administration of trebananib plus FOLFIRI did not prolong PFS compared with placebo plus FOLFIRI. Toxicities were manageable and consistent with those known for FOLFIRI and trebananib.
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Carpena F, Cole S, Shapiro J, Zia B. Liability Structure in Small-Scale Finance: Evidence from a Natural Experiment. ACTA ACUST UNITED AC 2012. [DOI: 10.1093/wber/lhs031] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Pidala J, Kim J, Schell M, Hillgruber R, Nye V, Ayala E, Alsina M, Betts B, Bookout R, Fernandez H, Field T, Locke F, Nishihori T, Ochoa J, Perez L, Perkins J, Shapiro J, Tate C, Tomblyn M, Anasetti C. Effectiveness of Unrelated Donor Allogeneic Hematopoietic Cell Transplantation: Results of a Donor Vs. No Donor Analysis. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.528] [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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Davis D, Shapiro J, Wetzstein G. Standardization of Melphalan Administration. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Goldstein D, Spry N, Cummins MM, Brown C, van Hazel GA, Carroll S, Selva-Nayagam S, Borg M, Ackland SP, Wratten C, Shapiro J, Porter IWT, Hruby G, Horvath L, Bydder S, Underhill C, Harvey J, Gebski VJ. The GOFURTGO Study: AGITG phase II study of fixed dose rate gemcitabine-oxaliplatin integrated with concomitant 5FU and 3-D conformal radiotherapy for the treatment of localised pancreatic cancer. Br J Cancer 2011; 106:61-9. [PMID: 22134511 PMCID: PMC3251866 DOI: 10.1038/bjc.2011.526] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: Locally advanced inoperable pancreatic cancer (LAPC) has a poor prognosis. By increasing intensity of systemic therapy combined with an established safe chemoradiation technique, our intention was to enhance the outcomes of LAPC. In preparation for phase III evaluation, the feasibility and efficacy of our candidate regimen gemcitabine–oxaliplatin chemotherapy with sandwich 5-fluorouracil (5FU) and three-dimensional conformal radiotherapy (3DCRT) needs to be established. Methods: A total of 48 patients with inoperable LAPC without metastases were given gemcitabine (1000 mg m−2 d1 + d15 q28) and oxaliplatin (100 mg m−2 d2 + d16 q28) in induction (one cycle) and consolidation (three cycles), and 5FU 200 mg m−2 per day over 6 weeks during 3DCRT 54 Gy. Results: Median duration of sustained local control (LC) was 15.8 months, progression-free survival (PFS) was 11.0 months, and overall survival was 15.7 months. Survival rates for 1, 2, and 3 years were 70.2%, 21.3%, and 12.8%, respectively. Global quality of life did not significantly decline from baseline during treatment, which was associated with modest treatment-related toxicity. Conclusion: Fixed-dose gemcitabine and oxaliplatin, combined with an effective and safe regimen of 5FU and 3DCRT radiotherapy, was feasible and reasonably tolerated. The observed improved duration of LC and PFS with more intensive therapy over previous trials may be due to patient selection, but suggest that further evaluation in phase III trials is warranted.
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Lo B, Jalili R, Zloty D, Ghahary A, Cowan B, Dutz J, Carr N, Shapiro J, McElwee K. CXCR3 ligands promote expression of functional indoleamine 2,3-dioxygenase in basal cell carcinoma keratinocytes. Br J Dermatol 2011; 165:1030-6. [DOI: 10.1111/j.1365-2133.2011.10489.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lewin J, Haydon A, McKendrick J, Millar J, Schwarz M, Shapiro J. 7168 POSTER Health Related Quality of Life (QOL) Assessment In Stage 1 Semlnomatous Germ Cell Tumour Patients Treated With Either Adjuvant Carboplatin Chemotherapy, Adjuvant Radiotherapy or High Intensity Chemotherapy. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72083-4] [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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Genes N, Shapiro J, Vaidya S, Kuperman G. Adoption of health information exchange by emergency physicians at three urban academic medical centers. Appl Clin Inform 2011; 2:263-9. [PMID: 23616875 DOI: 10.4338/aci-2011-02-cr-0010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 05/18/2011] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Emergency physicians are trained to make decisions quickly and with limited patient information. Health Information Exchange (HIE) has the potential to improve emergency care by bringing relevant patient data from non-affiliated organizations to the bedside. NYCLIX (New York CLinical Information eXchange) offers HIE functionality among multiple New York metropolitan area provider organizations and has pilot users in several member emergency departments (EDs). METHODS We conducted semi-structured interviews at three participating EDs with emergency physicians trained to use NYCLIX. Among "users" with > 1 login, responses to questions regarding typical usage scenarios, successful retrieval of data, and areas for improving the interface were recorded. Among "non-users" with ≤1 login, questions about NYCLIX accessibility and utility were asked. Both groups were asked to recall items from prior training regarding data sources and availability. RESULTS Eighteen NYCLIX pilot users, all board certified emergency physicians, were interviewed. Of the 14 physicians with more than one login ,half estimated successful retrieval of HIE data affecting patient care. Four non-users (one login or less) cited forgotten login information as a major reason for non-use. Though both groups made errors, users were more likely to recall true NYCLIX member sites and data elements than non-users. Improvements suggested as likely to facilitate usage included a single automated login to both the ED information system (EDIS) and HIE, and automatic notification of HIE data availability in the EDIS All respondents reported satisfaction with their training. CONCLUSIONS Integrating HIE into existing ED workflows remains a challenge, though a substantial fraction of users report changes in management based on HIE data. Though interviewees believed their training was adequate, significant errors in their understanding of available NYCLIX data elements and participating sites persist.
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Aubert J, Reiniche P, Fogel P, Poulin Y, Lui H, Lynde C, Shapiro J, Villemagne H, Soto P, Voegel JJ. Gene expression profiling in psoriatic scalp hair follicles: clobetasol propionate shampoo 0.05% normalizes psoriasis disease markers. J Eur Acad Dermatol Venereol 2011; 24:1304-11. [PMID: 20337827 DOI: 10.1111/j.1468-3083.2010.03637.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clobetasol propionate shampoo is effective and safe in treatment of scalp psoriasis (SP). Gene expression profiling of psoriatic skin biopsies led to the identification of numerous disease-related genes. However, it remained unknown whether the gene expression profile of hair follicles of SP patients was also affected. OBJECTIVES To determine whether psoriasis-related genes are differentially regulated in the hair follicles of SP patients and whether the modulation of these genes can be correlated with clinical severity scores. METHODS A single arm, open study was conducted in three centres. SP patients received daily treatment with clobetasol propionate shampoo. At Baseline, Weeks 2 and 4, investigators assessed clinical severity parameters and collected scalp hair follicles in anagen phase. Total RNA extracted from hair follicles was used to determine the expression level of 44 genes, which were reported previously to be upregulated in the skin of psoriasis patients. RESULTS RNA of good quality and sufficient quantity was obtained from hair follicles of psoriasis patients and healthy volunteers (HV). The expression level of 10 inflammation-related genes was significantly increased in psoriatic hair follicles. The patient's exploratory transcriptomic score, defined as the mean fold modulation of these 10 genes compared with HV, correlated with clinical severity scores. Clobetasol propionate shampoo was effective in decreasing both the exploratory transcriptomics and the clinical severity scores. CONCLUSION Hair follicles of SP patients are affected by the inflammatory process. The change in the expression level of inflammation-related genes correlates with the severity of the disease.
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Pidala J, Tomblyn M, Nishihori T, Perkins J, Field T, Ayala E, Bookout R, Conwell M, Perez L, Ochoa L, Alsina M, Shapiro J, Tate C, Locke F, Fernandez H, Anasetti C. ATG for the Prevention of Severe Acute Graft-Versus-Host Disease in Mismatched Unrelated Donor Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Davenport TH, Harris J, Shapiro J. Competing on talent analytics. HARVARD BUSINESS REVIEW 2010; 88:52-150. [PMID: 20929194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Do investments in your employees actually affect workforce performance? Who are your top performers? How can you empower and motivate other employees to excel? Leading-edge companies such as Google, Best Buy, Procter & Gamble, and Sysco use sophisticated data-collection technology and analysis to answer these questions, leveraging a range of analytics to improve the way they attract and retain talent, connect their employee data to business performance, differentiate themselves from competitors, and more. The authors present the six key ways in which companies track, analyze, and use data about their people-ranging from a simple baseline of metrics to monitor the organization's overall health to custom modeling for predicting future head count depending on various "what if" scenarios. They go on to show that companies competing on talent analytics manage data and technology at an enterprise level, support what analytical leaders do, choose realistic targets for analysis, and hire analysts with strong interpersonal skills as well as broad expertise.
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Kim M, Mohrer D, Shapiro J, Aguilar V, Genes N, Baumlin K, Elkin P. 373: Scenario-Based Usability Evaluation of Emergency Department Information System by Clinical Roles and Experience Levels. Ann Emerg Med 2010. [DOI: 10.1016/j.annemergmed.2010.06.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
A method is described for greatly increasing the efficiency of Büchner funnels by utilizing a much larger fraction of the filter paper surface. The method also makes it possible to use Millipore filters efficiently on Büchner funnels.
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Shapiro J, Bookout R, Perkins J, Ayala E, Alsina M, Field T, Kharfan-Dadaja M, Perez L, Ochoa-Bayona J, Tomblyn M, LaFave D, Anasetti C, Fernandez H. Primary Plerixafor Mobilization In Autologous Hematopoietic Cell Transplant Candidates At High Risk For Mobilization Failure. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Alsantali A, Shapiro J. Management of hirsutism. SKIN THERAPY LETTER 2009; 14:1-3. [PMID: 20039595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Hirsutism is a relatively common condition affecting about 5%-O10% of women of childbearing age. Herein, we present an overview of hirsutism with emphasis on its etiology and therapeutic options.
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