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Huang RR, Giafaglione JM, Hashimoto T, Zhang L, Yu W, Rao J, Russo JW, Balk SP, Nickols NG, Rettig MB, Goldstein A, Ye H. Androgen Drives the Expression of SARS-CoV-2 Entry Proteins in Sinonasal Tissue. J Clin Transl Pathol 2023; 000:000-000. [DOI: 10.14218/jctp.2022.00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/03/2023]
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2
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Goldstein A, Lanhers C, Gay C, Dubourg K, Grange L, Roques CF, Pereira B, Coudeyre E. Efficacy of self-management program associated with a spa therapy for knee osteoarthritis patients (GETT 2): a research protocol for a randomized trial. Trials 2023; 24:45. [PMID: 36658607 PMCID: PMC9854168 DOI: 10.1186/s13063-022-06879-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/01/2022] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Osteoarthritis is a chronic pathology that involves multidisciplinary management. Self-management for patients is an essential element, present in all international guidelines. During the time of the spa therapy, the patient is receptive to take the advantage of self-management workshops. The aim of this study is to assess the effects of 18 days spa therapy associated with a self-management intervention in patients with knee osteoarthritis in comparison with spa therapy alone on a priority objective, personalized and determined with the patient, chosen in the list of 5 objectives determined during the self-management initial assessment. METHODS AND ANALYSIS Two hundred fifty participants with knee osteoarthritis will participate to this multicenter, prospective, randomized, controlled study. All patients will benefit 18 days of spa therapy and patients randomized in the intervention group will participate to 6 self-management workshops. Randomization will be centralized. The allocation ratio will be 1:1. Data analysts and assessor will be blinded. The primary outcome is the effectiveness of the educational workshops associated with spa therapy in comparison with spa therapy alone on a priority objective, measured by Goal Attainment Scaling (GAS). The secondary outcomes are disability, health-related quality of life, and pain intensity. ETHICS AND DISSEMINATION Ethics were approved by the CPP Sud-Méditerranée II. The results will be disseminated in a peer-reviewed journal and disseminated at PRM, rheumatology, and orthopedics conferences. The results will also be disseminated to patients. TRIAL REGISTRATION Trial registration number NCT03550547. Registered 8 June 2018. Date and version identifier of the protocol. Version N°6 of March 12, 2018.
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Affiliation(s)
- A. Goldstein
- grid.494717.80000000115480420Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, Université Clermont Auvergne, INRAE, UNH, F-63000 Clermont–Ferrand, France
| | - C. Lanhers
- grid.494717.80000000115480420Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, Université Clermont Auvergne, INRAE, UNH, F-63000 Clermont–Ferrand, France
| | - C. Gay
- grid.494717.80000000115480420Service de Santé Publique, CHU de Clermont Ferrand, PEPRADE, Université Clermont Auvergne, Clermont–Ferrand, France
| | - K. Dubourg
- grid.412041.20000 0001 2106 639XUniversité de Bordeaux, Institut du Thermalisme, Dax, France
| | - L. Grange
- Service de Rhumatologie, C.H.U.G.A Hôpital Sud, Échirolles, France
| | | | - B. Pereira
- grid.494717.80000000115480420Délégation Recherche Clinique et Innovation, CHU de Clermont Ferrand, Université Clermont Auvergne, Clermont–Ferrand, France
| | - E. Coudeyre
- grid.494717.80000000115480420Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, Université Clermont Auvergne, INRAE, UNH, F-63000 Clermont–Ferrand, France
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Krapf J, Mautz T, Lorenzini S, Holloway J, Goldstein A. Clinical Presentation of Clitorodynia associated with Clitoral Adhesions and Keratin Pearls. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Yang XH, Goldstein A, Sun Y, Wang Z, Wei M, Moskowitz IP, Cunningham JM. Detecting critical transition signals from single-cell transcriptomes to infer lineage-determining transcription factors. Nucleic Acids Res 2022; 50:e91. [PMID: 35640613 PMCID: PMC9458468 DOI: 10.1093/nar/gkac452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 04/02/2022] [Accepted: 05/13/2022] [Indexed: 12/29/2022] Open
Abstract
Analyzing single-cell transcriptomes promises to decipher the plasticity, heterogeneity, and rapid switches in developmental cellular state transitions. Such analyses require the identification of gene markers for semi-stable transition states. However, there are nontrivial challenges such as unexplainable stochasticity, variable population sizes, and alternative trajectory constructions. By advancing current tipping-point theory-based models with feature selection, network decomposition, accurate estimation of correlations, and optimization, we developed BioTIP to overcome these challenges. BioTIP identifies a small group of genes, called critical transition signal (CTS), to characterize regulated stochasticity during semi-stable transitions. Although methods rooted in different theories converged at the same transition events in two benchmark datasets, BioTIP is unique in inferring lineage-determining transcription factors governing critical transition. Applying BioTIP to mouse gastrulation data, we identify multiple CTSs from one dataset and validated their significance in another independent dataset. We detect the established regulator Etv2 whose expression change drives the haemato-endothelial bifurcation, and its targets together in CTS across three datasets. After comparing to three current methods using six datasets, we show that BioTIP is accurate, user-friendly, independent of pseudo-temporal trajectory, and captures significantly interconnected and reproducible CTSs. We expect BioTIP to provide great insight into dynamic regulations of lineage-determining factors.
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Affiliation(s)
- Xinan H Yang
- Department of Pediatrics, The University of Chicago, Chicago, IL, USA
| | - Andrew Goldstein
- Department of Statistics, The University of Chicago, Chicago IL, USA
| | - Yuxi Sun
- Department of Pediatrics, The University of Chicago, Chicago, IL, USA
| | - Zhezhen Wang
- Department of Pediatrics, The University of Chicago, Chicago, IL, USA
| | - Megan Wei
- Johns Hopkins University, Baltimore, MD, USA
| | - Ivan P Moskowitz
- Department of Pediatrics, The University of Chicago, Chicago, IL, USA
| | - John M Cunningham
- Department of Pediatrics, The University of Chicago, Chicago, IL, USA
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Goldstein I, Yee A, Uloko M, Goldstein A. Extent of surgical excision of the vestibule based on positive CD117 and PGP9.5 staining of mast cells in women with neuroproliferative vestibulodynia. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Andrew Goldstein
- New York University School of Medicine, Bellevue Hospital, 462 1st Avenue, Ambulatory Care, New York, NY, 10016, USA
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Alves CAPF, Goldstein A, Teixeira SR, Martin-Saavedra JS, de Barcelos IP, Fadda G, Caschera L, Kidd M, Gonçalves FG, McCormick EM, Falk MJ, Zolkipli-Cunningham Z, Vossough A, Zuccoli G. Involvement of the Spinal Cord in Primary Mitochondrial Disorders: A Neuroimaging Mimicker of Inflammation and Ischemia in Children. AJNR Am J Neuroradiol 2021; 42:389-396. [PMID: 33384291 PMCID: PMC7872189 DOI: 10.3174/ajnr.a6910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/25/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Little is known about imaging features of spinal cord lesions in mitochondrial disorders. The aim of this research was to assess the frequency, imaging features, and pathogenic variants causing primary mitochondrial disease in children with spinal cord lesions. MATERIALS AND METHODS This retrospective analysis included patients seen at Children's Hospital of Philadelphia between 2000 and 2019 who had a confirmed diagnosis of a primary (genetic-based) mitochondrial disease and available MR imaging of the spine. The MR imaging included at least both sagittal and axial fast spin-echo T2-weighted images. Spine images were independently reviewed by 2 neuroradiologists. Location and imaging features of spinal cord lesions were correlated and tested using the Fisher exact test. RESULTS Of 119 children with primary mitochondrial disease in whom MR imaging was available, only 33 of 119 (28%) had available spine imaging for reanalysis. Nineteen of these 33 individuals (58%) had evidence of spinal cord lesions. Two main patterns of spinal cord lesions were identified: group A (12/19; 63%) had white ± gray matter involvement, and group B (7/19; 37%) had isolated gray matter involvement. Group A spinal cord lesions were similar to those seen in patients with neuromyelitis optica spectrum disorder, multiple sclerosis, anti-myelin oligodendrocyte glycoprotein-IgG antibody disease, and leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation. Group B patients had spinal cord findings similar to those that occur with ischemia and viral infections. Significant associations were seen between the pattern of lesions (group A versus group B) and the location of lesions in cervical versus thoracolumbar segments, respectively (P < .01). CONCLUSIONS Spinal cord lesions are frequently observed in children with primary mitochondrial disease and may mimic more common causes such as demyelination and ischemia.
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Affiliation(s)
- C A P F Alves
- From the Division of Neuroradiology, Department of Radiology (C.A.P.F.A., S.R.T., J.S.M.S., L.C., F.G.G., A.V., G.Z.)
| | - A Goldstein
- Division of Human Genetics, Department of Pediatrics (A.G., E.M.M., M.J.F., Z.Z.-C.), Mitochondrial Medicine Frontier Program
- Pediatrics (A.G., M.J.F., Z.Z.-C.) University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - S R Teixeira
- From the Division of Neuroradiology, Department of Radiology (C.A.P.F.A., S.R.T., J.S.M.S., L.C., F.G.G., A.V., G.Z.)
| | - J S Martin-Saavedra
- From the Division of Neuroradiology, Department of Radiology (C.A.P.F.A., S.R.T., J.S.M.S., L.C., F.G.G., A.V., G.Z.)
| | - I P de Barcelos
- Division of Human Genetics (I. P.d.B.), Department of Pediatrics, Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - G Fadda
- Departments of Neurology (G.F.)
| | - L Caschera
- From the Division of Neuroradiology, Department of Radiology (C.A.P.F.A., S.R.T., J.S.M.S., L.C., F.G.G., A.V., G.Z.)
- Neuroradiology Unit (L.C.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
| | - M Kidd
- Centre for Statistical Consultation (M.K.), University of Stellenbosch, South Africa
| | - F G Gonçalves
- From the Division of Neuroradiology, Department of Radiology (C.A.P.F.A., S.R.T., J.S.M.S., L.C., F.G.G., A.V., G.Z.)
| | - E M McCormick
- Division of Human Genetics, Department of Pediatrics (A.G., E.M.M., M.J.F., Z.Z.-C.), Mitochondrial Medicine Frontier Program
| | - M J Falk
- Division of Human Genetics, Department of Pediatrics (A.G., E.M.M., M.J.F., Z.Z.-C.), Mitochondrial Medicine Frontier Program
- Pediatrics (A.G., M.J.F., Z.Z.-C.) University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Z Zolkipli-Cunningham
- Division of Human Genetics, Department of Pediatrics (A.G., E.M.M., M.J.F., Z.Z.-C.), Mitochondrial Medicine Frontier Program
- Pediatrics (A.G., M.J.F., Z.Z.-C.) University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - A Vossough
- From the Division of Neuroradiology, Department of Radiology (C.A.P.F.A., S.R.T., J.S.M.S., L.C., F.G.G., A.V., G.Z.)
| | - G Zuccoli
- From the Division of Neuroradiology, Department of Radiology (C.A.P.F.A., S.R.T., J.S.M.S., L.C., F.G.G., A.V., G.Z.)
- The Program for the Study of Neurodevelopment in Rare Disorders (G.Z.), Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
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Goldstein A, Lei Y, Goldstein L, Goldstein A, Bai QX, Felix J, Lipson R, Demarco M, Schiffman M, Egemen D, Desai KT, Bedell S, Gersten J, Goldstein G, O'Keefe K, O'Keefe C, O'Keefe T, Sebag C, Lobel L, Zhao A, Lu YL. A rapid, high-volume cervical screening project using self-sampling and isothermal PCR HPV testing. Infect Agent Cancer 2020; 15:64. [PMID: 33106753 PMCID: PMC7579849 DOI: 10.1186/s13027-020-00329-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/29/2020] [Indexed: 01/03/2023] Open
Abstract
Objective Rapid, high-volume screening programs are needed as part of cervical cancer prevention in China. Methods In a 5-day screening project in Inner Mongolia, 3345 women volunteered following a community awareness campaign, and self-swabbed to permit rapid HPV testing. Two AmpFire™ HPV detection systems (Atila Biosystems) were sufficient to provide pooled 15-HPV type data within an hour. HPV+ patients had same-day digital colposcopy (DC) performed by 1 of 6 physicians, using the EVA™ system (MobileODT). Digital images were obtained and, after biopsy of suspected lesions for later confirmatory diagnosis, women were treated immediately based on colposcopic impression. Suspected low- grade lesions were offered treatment with thermal ablation (Wisap), and suspected high-grade lesions were treated with LLETZ. Results Of 3345 women screened, 624 (18.7%) were HPV+. Of these, 88.5% HPV+ women underwent same-day colposcopy and 78 were treated. Later consensus histology results obtained on 197 women indicated 20 CIN2+, of whom 15 were detected and treated/referred at screening (10 by thermal ablation, 4 by LLETZ, 1 by referral). Conclusions Global control of cervical cancer will require both vaccination and screening of a huge number of women. This study illustrates a cervical screening strategy that can be used to screen-and-treat large numbers of women. HPV self-sampling facilitates high-volume screening. Specimens can be tested rapidly, promoting minimal loss-to-follow-up. Specifically, the AmpFire™ system used in this study is highly portable, simple, rapid (92 specimens per 65 min per unit), and economical. Visual triage can be performed on HPV+ women with a portable digital colposcope that provides magnification, lighting, and a recorded image. Diagnosis and appropriate treatment remain the most subjective elements. The digital image is under study for deep-learning based automated evaluation that could assist the management decision, either by itself or combined with HPV typing.
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Affiliation(s)
| | - Yang Lei
- Peking University Cancer Hospital, Beijing, China
| | | | | | | | - Juan Felix
- Medical College of Wisconsin, Milwaukee, WI USA
| | | | - Maria Demarco
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD USA
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD USA
| | - Didem Egemen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD USA
| | - Kanan T Desai
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD USA
| | | | | | | | | | - Casey O'Keefe
- Pacific Northwest Urology Specialists, Bellingham, WA USA
| | | | | | | | - Anna Zhao
- United Family Hospitals, Beijing, China
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Ajenifuja KO, Belinson J, Goldstein A, Desai KT, de Sanjose S, Schiffman M. Designing low-cost, accurate cervical screening strategies that take into account COVID-19: a role for self-sampled HPV typing2. Infect Agent Cancer 2020; 15:61. [PMID: 33072179 PMCID: PMC7556607 DOI: 10.1186/s13027-020-00325-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background We propose an economical cervical screening research and implementation strategy designed to take into account the typically slow natural history of cervical cancer and the severe but hopefully temporary impact of COVID-19. The commentary introduces the practical validation of some critical components of the strategy, described in three manuscripts detailing recent project results in Asia and Africa.The main phases of a cervical screening program are 1) primary screening of women in the general population, 2) triage testing of the small minority of women that screen positive to determine need for treatment, and 3) treatment of triage-positive women thought to be at highest risk of precancer or even cancer. In each phase, attention must now be paid to safety in relation to SARS-CoV-2 transmission. The new imperatives of the COVID-19 pandemic support self-sampled HPV testing as the primary cervical screening method. Most women can be reassured for several years by a negative test performed on a self-sample collected at home, without need of clinic visit and speculum examination. The advent of relatively inexpensive, rapid and accurate HPV DNA testing makes it possible to return screening results from self-sampling very soon after specimen collection, minimizing loss to follow-up. Partial HPV typing provides important risk stratification useful for triage of HPV-positive women. A second "triage" test is often useful to guide management. In lower-resource settings, visual inspection with acetic acid (VIA) is still proposed but it is inaccurate and poorly reproducible, misclassifying the risk stratification gained by primary HPV testing. A deep-learning based approach to recognizing cervical precancer, adaptable to a smartphone camera, is being validated to improve VIA performance. The advent and approval of thermal ablation permits quick, affordable and safe, immediate treatment at the triage clinic of the majority of HPV-positive, triage-positive women. Conclusions Overall, only a small percentage of women in cervical screening programs need to attend the hospital clinic for a surgical procedure, particularly when screening is targeted to the optimal age range for detection of precancer rather than older ages with decreased visual screening performance and higher risks of hard-to-treat outcomes including invasive cancer.
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Affiliation(s)
| | - Jerome Belinson
- Women's Health Institute, Cleveland Clinic, Cleveland, OH USA
| | | | - Kanan T Desai
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Clinical Epidemiology Unit, Clinical Genetics Branch, 9609 Medical Center Drive Room 6E544, Rockville, MD 20850 USA
| | - Silvia de Sanjose
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Clinical Epidemiology Unit, Clinical Genetics Branch, 9609 Medical Center Drive Room 6E544, Rockville, MD 20850 USA
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Clinical Epidemiology Unit, Clinical Genetics Branch, 9609 Medical Center Drive Room 6E544, Rockville, MD 20850 USA
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10
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Shirakov A, Burshtein Z, Goldstein A, Frumker E, Ishaaya AA. Use of Co 2+:MgAl 2O 4 transparent ceramics in passive Q-switching of an Er:Glass laser at 1.534 µm. Opt Express 2020; 28:21956-21970. [PMID: 32752466 DOI: 10.1364/oe.398246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
We present the implementation of Co2+:MgAl2O4 transparent ceramics as passive Q-switching elements in an Er:Glass laser at 1.534 µm. Linearly polarized pulsed output was obtained by Brewster angle inclination of the material Q-switching plate relative to the laser axis. Separate pulses were ∼105 ns long (FWHM), exhibiting ∼6.2 kW peak power at near TEM00 quality. Several fundamental sample properties important for laser intracavity operation were measured; thermo-optic coefficient dn/dT = ( - 3.8 ± 1) × 10-5 °C-1, thermal lensing factor L-1d(nL)/dT = 2.59 × 10-5 °C-1, linear expansion coefficient α = (3.9 ± 0.6) × 10-5 °C-1, polarizability thermal coefficient ϕ = (7.2 ± 2.2) × 10-5 °C-1, and damage threshold ∼6.5 J/cm2.
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11
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Goldstein A, Mitchell L, Tolson H, Krapf J. 027 Plasma Cell Mucositis of the Vagina and Cervix. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gonçalves FG, Hill B, Guo Y, Muraresku CC, McCormick E, Alves CAPF, Teixeira SR, Martin-Saavedra JS, Zolkipli-Cunningham Z, Falk MJ, Vossough A, Goldstein A, Zuccoli G. The Perirolandic Sign: A Unique Imaging Finding Observed in Association with Polymerase γ-Related Disorders. AJNR Am J Neuroradiol 2020; 41:917-922. [PMID: 32381541 DOI: 10.3174/ajnr.a6514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/27/2020] [Indexed: 11/07/2022]
Abstract
Pathogenic variants in the polymerase γ gene (POLG) cause a diverse group of pathologies known as POLG-related disorders. In this report, we describe brain MR imaging findings and electroencephalogram correlates of 13 children with POLG-related disorders at diagnosis and follow-up. At diagnosis, all patients had seizures and 12 had abnormal MR imaging findings. The most common imaging findings were unilateral or bilateral perirolandic (54%) and unilateral or bilateral thalamic signal changes (77%). Association of epilepsia partialis continua with perirolandic and thalamic signal changes was present in 86% and 70% of the patients, respectively. The occipital lobe was affected in 2 patients. On follow-up, 92% of the patients had disease progression or fatal outcome. Rapid volume loss was seen in 77% of the patients. The occipital lobe (61%) and thalamus (61%) were the most affected brain regions. Perirolandic signal changes and seizures may represent a brain imaging biomarker of early-onset pediatric POLG-related disorders.
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Affiliation(s)
- F G Gonçalves
- From the Departments of Radiology and Division of Neuroradiology (F.G.G., B.H., C.A.P.F.A., S.R.T., J.S.M.-S., A.V., G.Z.)
| | - B Hill
- From the Departments of Radiology and Division of Neuroradiology (F.G.G., B.H., C.A.P.F.A., S.R.T., J.S.M.-S., A.V., G.Z.)
| | - Y Guo
- Departments of Pediatrics (Y.G., Z.Z.-C., M.J.F., A.G.)
| | - C C Muraresku
- Mitochondrial Medicine Frontier Program, Division of Human Genetics (C.C.M., E.M., Z.Z.-C., M.J.F., A.G.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - E McCormick
- Mitochondrial Medicine Frontier Program, Division of Human Genetics (C.C.M., E.M., Z.Z.-C., M.J.F., A.G.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - C A P F Alves
- From the Departments of Radiology and Division of Neuroradiology (F.G.G., B.H., C.A.P.F.A., S.R.T., J.S.M.-S., A.V., G.Z.)
| | - S R Teixeira
- From the Departments of Radiology and Division of Neuroradiology (F.G.G., B.H., C.A.P.F.A., S.R.T., J.S.M.-S., A.V., G.Z.)
| | - J S Martin-Saavedra
- From the Departments of Radiology and Division of Neuroradiology (F.G.G., B.H., C.A.P.F.A., S.R.T., J.S.M.-S., A.V., G.Z.)
| | - Z Zolkipli-Cunningham
- Mitochondrial Medicine Frontier Program, Division of Human Genetics (C.C.M., E.M., Z.Z.-C., M.J.F., A.G.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Departments of Pediatrics (Y.G., Z.Z.-C., M.J.F., A.G.)
| | - M J Falk
- Mitochondrial Medicine Frontier Program, Division of Human Genetics (C.C.M., E.M., Z.Z.-C., M.J.F., A.G.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Departments of Pediatrics (Y.G., Z.Z.-C., M.J.F., A.G.)
| | - A Vossough
- From the Departments of Radiology and Division of Neuroradiology (F.G.G., B.H., C.A.P.F.A., S.R.T., J.S.M.-S., A.V., G.Z.).,Radiology (A.V.), University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - A Goldstein
- Mitochondrial Medicine Frontier Program, Division of Human Genetics (C.C.M., E.M., Z.Z.-C., M.J.F., A.G.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Departments of Pediatrics (Y.G., Z.Z.-C., M.J.F., A.G.)
| | - G Zuccoli
- From the Departments of Radiology and Division of Neuroradiology (F.G.G., B.H., C.A.P.F.A., S.R.T., J.S.M.-S., A.V., G.Z.).,The Program for the Study of Neurodevelopment in Rare Disorders (NDRD) (G.Z.), Children's Hospital of Pittsburgh of UPMC
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Goldstein A, Goldstein LS, Lipson R, Bedell S, Wang J, Stamper SA, Brenner G, Goldstein GR, O'Keefe KD, O'Keefe SC, O'Keefe M, O'Keefe T, Goldstein AR, Zhao A. Assessing the feasibility of a rapid, high-volume cervical cancer screening programme using HPV self-sampling and digital colposcopy in rural regions of Yunnan, China. BMJ Open 2020; 10:e035153. [PMID: 32234744 PMCID: PMC7170644 DOI: 10.1136/bmjopen-2019-035153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE Implementation of a novel, rapid, high-volume, see-and-treat cervical cancer screening programme using self-swab human papillomavirus (HPV) testing and digital colposcopy in underserved regions of Yunnan China. DESIGN 480-980 women per day self-swabbed for high-risk HPV (hrHPV+). Four careHPV machines (Qiagen) were run simultaneously to test the specimens. All hrHPV+ patients were contacted the same day and digital colposcopy was performed with the enhanced visual assessment system (MobileODT). Digital images were obtained, and all suspected lesions were biopsied and then treated. SETTING Rural and underserved areas of the Yunnan province, Kunming municipality. PARTICIPANTS 3600 women, mean age 50.2 years, who had never been screened for cervical cancer. The women were of the Yi, Hui, Dai and Han ethnicities. INTERVENTIONS Cryotherapy was performed on all lesions suspicious for cervical intraepithelial neoplasia (CIN) 1 and loop electrosurgical excision procedure was performed on all lesions suspicious for ≥CIN2. Endocervical curettage was performed if the transformation zone was not fully visualised. RESULTS 216 women (6%) were hrHPV+. 168 underwent same-day colposcopy (23 CIN1, 17≥CIN2). Digital colposcopy was able to identify 15 of 16 (93.8%)≥CIN2 lesions. CONCLUSIONS This study illustrates a high-volume, rapid and practical strategy that can be used to screen and treat an ethnically diverse group of Chinese women. First, HPV self-sampling allows large numbers of women to be screened rapidly and relatively inexpensively. Only hrHPV+ women will then require further evaluation. Digital colposcopy is then performed on hrHPV+ women with a portable digital colposcope. The high-resolution images obtained can facilitate appropriate same-day treatment as they are able to accurately distinguish between CIN1 and ≥CIN2 lesions.
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Affiliation(s)
- Andrew Goldstein
- Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- The Center for Vulvovaginal Disorders, Washington, DC, USA
| | | | - Roberta Lipson
- Beijing United Family Hospitals and Clinics, Beijing, China
| | - Sarah Bedell
- The Center for Vulvovaginal Disorders, Washington, DC, USA
| | - Jue Wang
- Beijing United Family Hospitals and Clinics, Beijing, China
| | - Sarah A Stamper
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | | | | | - McKenna O'Keefe
- Engineering, University of California Berkeley, Berkeley, California, USA
| | | | | | - Anna Zhao
- Beijing United Family Hospitals and Clinics, Beijing, China
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Rogers JR, Mills H, Grossman LV, Goldstein A, Weng C. Understanding the nature and scope of clinical research commentaries in PubMed. J Am Med Inform Assoc 2020; 27:449-456. [PMID: 31889182 DOI: 10.1093/jamia/ocz209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/19/2019] [Accepted: 11/23/2019] [Indexed: 11/13/2022] Open
Abstract
Scientific commentaries are expected to play an important role in evidence appraisal, but it is unknown whether this expectation has been fulfilled. This study aims to better understand the role of scientific commentary in evidence appraisal. We queried PubMed for all clinical research articles with accompanying comments and extracted corresponding metadata. Five percent of clinical research studies (N = 130 629) received postpublication comments (N = 171 556), resulting in 178 882 comment-article pairings, with 90% published in the same journal. We obtained 5197 full-text comments for topic modeling and exploratory sentiment analysis. Topics were generally disease specific with only a few topics relevant to the appraisal of studies, which were highly prevalent in letters. Of a random sample of 518 full-text comments, 67% had a supportive tone. Based on our results, published commentary, with the exception of letters, most often highlight or endorse previous publications rather than serve as a prominent mechanism for critical appraisal.
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Affiliation(s)
- James R Rogers
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Hollis Mills
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Lisa V Grossman
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Andrew Goldstein
- Department of Medicine, New York University, New York, New York, USA
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
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15
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Wu CZ, Goldstein A, Klebanoff J, Moawad GN. 2196 Vulvar Vestibulectomy with Vaginal Advancement Flap for Neuroproliferative Vulvodynia. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Dor-Ziderman Y, Lutz A, Goldstein A. Prediction-based neural mechanisms for shielding the self from existential threat. Neuroimage 2019; 202:116080. [PMID: 31401240 DOI: 10.1016/j.neuroimage.2019.116080] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/25/2019] [Accepted: 08/06/2019] [Indexed: 12/28/2022] Open
Abstract
The human mind has an automatic tendency to avoid awareness of its mortality. How this protective mechanism is implemented at the neuronal level is unknown. Here we test the hypothesis that prediction-based mechanisms mediate death-denial by shielding the self from existential threat. We provide evidence that self-specific predictive processes are downregulated during the perception of death-related linguistic stimuli and that this mechanism can predict fear-of-death. Using a magnetoencephalography visual mismatch paradigm, we show that the brain's automatic prediction response to deviancy is eliminated when death words and self-face representations are coupled, but remains present when coupled to other-face or to negative words. We further demonstrate a functional link between how death impacts self-image vs. Other-image, and show that it predicts fear-of-death. Finally, we confirm this effect in a behavioral active inference experiment showing that death-related words bias perceptual judgment on facial self and other morphed video clips. Together these results lay out, for the first time, a plausible neural-based mechanism of death-denial.
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Affiliation(s)
- Y Dor-Ziderman
- Gonda Brain Research Center, Bar Ilan University, Ramat-Gan, Israel.
| | - A Lutz
- Lyon Neuroscience Research Center, INSERM, U1028, CNRS UMR5292, Lyon 1 University, Lyon, 69500, France
| | - A Goldstein
- Gonda Brain Research Center, Bar Ilan University, Ramat-Gan, Israel; Department of Psychology, Bar Ilan University, Ramat-Gan, Israel
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17
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Conforto I, Samir C, Chausse F, Goldstein A, Pereira B, Coudeyre E. Comparison of psychometric properties between the Labin, a new electronic dynamometer, and the Jamar: Preliminary results in healthy subjects. Hand Surg Rehabil 2019; 38:293-297. [PMID: 31386926 DOI: 10.1016/j.hansur.2019.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 11/30/2022]
Abstract
Many instruments exist for measuring grip strength. The Jamar hydraulic hand dynamometer is currently the gold standard. The Labin is a prototype electronic dynamometer that can also measure maximum grip strength. The main objective was to compare the Labin dynamometer with the gold standard instrument, the Jamar, in a healthy population, and secondarily to compare discomfort during use. A single-center exploratory study was conducted. The subjects enrolled had to be aged between 20 and 60, be volunteers and give consent. The required number of subjects was 30. The subjects were positioned according to American Society of Hand Therapists recommendations. Maximum grip force was measured in kilograms using the mean of three successive trials. The first dynamometer used was chosen randomly. The handle's discomfort during use was rated on a simple verbal scale from 0 to 10. Thirty-four subjects were included. The concordance coefficient for peak torque between the Labin and Jamar dynamometers was 0.90 for the dominant hand and 0.83 for the non-dominant hand. The intraclass correlation coefficient for peak torque with the Labin was 0.81 [0.69; 0.89] for the dominant hand and 0.86 [0.76; 0.92] for the non-dominant hand. In our study, we have shown that the Labin prototype has acceptable validity and reproducibility. The Labin will need to be tested in pathological conditions next.
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Affiliation(s)
- I Conforto
- Service de médecine physique et réadaptation, CHU de Clermont-Ferrand, INRA, université Clermont-Auvergne, Route de Chateaugay, 63118 Cébazat, France
| | - C Samir
- Laboratoire LIMOS, université Clermont-Auvergne, 63178 Aubière cedex, France; Université Clermont Auvergne, CNRS, SIGMA Clermont, institut Pascal, 63000 Clermont-Ferrand, France
| | - F Chausse
- Laboratoire LIMOS, université Clermont-Auvergne, 63178 Aubière cedex, France; Université Clermont Auvergne, CNRS, SIGMA Clermont, institut Pascal, 63000 Clermont-Ferrand, France
| | - A Goldstein
- Service de médecine physique et réadaptation, CHU de Clermont-Ferrand, INRA, université Clermont-Auvergne, Route de Chateaugay, 63118 Cébazat, France
| | - B Pereira
- University hospital Clermont-Ferrand, biostatistics unit (DRCI), 63003 Clermont-Ferrand, France
| | - E Coudeyre
- Service de médecine physique et réadaptation, CHU de Clermont-Ferrand, INRA, université Clermont-Auvergne, Route de Chateaugay, 63118 Cébazat, France.
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18
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Goldstein A, Catus F, Picaut P. 100 Rationale and Design for a Phase II Trial of Abobotulinumtoxina (Dysport) in the Management of Vulvodynia. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Govind V, Mitchell L, Tolson H, Barela K, Casey J, Goldstein A. 085 Exploring Comorbidity of Anxiety and Depression in Vulvodynia with Associated Overactive Pelvic Floor Muscle Dysfunction. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Govind V, Mitchell L, Tolson H, Barela K, Casey J, Goldstein A. 089 Exploring Comorbidity of Anxiety and Depression in Lichen Sclerosus. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Nissim M, Hutzler Y, Goldstein A. A walk on water: comparing the influence of Ai Chi and Tai Chi on fall risk and verbal working memory in ageing people with intellectual disabilities - a randomised controlled trial. J Intellect Disabil Res 2019; 63:603-613. [PMID: 30775818 DOI: 10.1111/jir.12602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 12/18/2018] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Aquatic motor intervention has been found to be effective in reducing falls and improving verbal working memory among the general population. However, effects among older adults with intellectual disabilities (ID) have never been explored. The aim of this study was to examine the effects of aquatic motor intervention on fall risk and verbal working memory among older adults with ID. METHODS Forty-one older adults with mild to moderate ID (age: 50-66 years) were randomly assigned to 14 weeks of aquatic motor intervention (Ai Chi: N = 19) or identical on-land motor intervention (Tai Chi: N = 22). Fall risk, measured with the Tinetti balance assessment tool (TBAT), and verbal working memory, measured with the digit span forward test, were assessed pre-intervention, after 7 weeks of intervention and post-intervention. RESULTS Study results indicate positive effects of both aquatic and on-land motor intervention on TBAT fall risk score, while the aquatic motor intervention group improved TBAT fall risk score quicker as compared with the on-land motor intervention group. Moreover, the lower the pre-intervention TBAT score was, the higher the improvement. In addition, study findings support the positive effects of aquatic motor intervention on verbal working memory ability as measured with the digit span forward test. CONCLUSIONS Motor intervention, and particularly in an aquatic environment, can potentially reduce fall risk. Aquatic motor intervention may help to improve verbal working memory among older adults with ID.
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Affiliation(s)
- M Nissim
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Y Hutzler
- The Academic College at Wingate, Netanya, Israel
| | - A Goldstein
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
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22
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Goldstein A, Mitchell L, Govind V, Heller D. 007 A Randomized Double-Blind Placebo Controlled Trial of Autologous Platelet Rich Plasma Intradermal Injections for the Treatment of Vulvar Lichen Sclerosus. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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23
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Goldstein A, Quintana Diez P, Kapanadze S, Cala M, Evans C, Whyte J, Christoph A. 119 The Vulvodynia Experience Questionnaire (VEQ): Qualitative Development of a New Patient-Reported Outcome Measure for Vulvodynia. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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24
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Thay S, Goldstein A, Goldstein LS, Govind V, Lim K, Seang C. Prospective cohort study examining cervical cancer screening methods in HIV-positive and HIV-negative Cambodian Women: a comparison of human papilloma virus testing, visualization with acetic acid and digital colposcopy. BMJ Open 2019; 9:e026887. [PMID: 30804036 PMCID: PMC6443060 DOI: 10.1136/bmjopen-2018-026887] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Logistical and economic issues make traditional cytology-based cervical cancer screening challenging in developing countries. Alternative, cost-effective, screening strategies must be developed to screen millions of women in resource-poor countries such as Cambodia. DESIGN A prospective cohort study during which all women underwent four cervical cancer screening methods: (1) self-sampled human papilloma virus (HPV) testing (careHPV system), (2) clinician-collected HPV testing, (3) visualization with acetic acid (VIA) and (4) digital colposcopy (DC) with the Enhanced Visual Assessment System (EVA). SETTING A referral hospital in Phnom Penh, Cambodia. PARTICIPANTS Two hundred and fifty Cambodian women (129 HIV+, 121 HIV-). Subjects were recruited from the National Center for HIV/AIDS Dermatology and sexually transmitted disease (STD) cohort, the Sihanouk Hospital Center of Hope's Rural Outreach Teams and the Pochentong Medical Center. RESULTS Fifty six of the 250 (22.4%) patients tested positive for high-risk HPV (hrHPV+). Thirty seven of the 129 HIV+ women were hrHPV+ (28.6%) whereas 19/121 HIV- women were hrHPV+ (15.7%) p=0.0154. Self-sampling HPV specimens identified 50/56 (89%) whereas physician-collected specimens identified 45/56 (80%) p=0.174. 95.2% of the patients felt comfortable obtaining HPV self-samples. Thirty seven of 250 women were VIA+. Thirty of 37 VIA+ women underwent confirmatory biopsies for cervical intraepithelial neoplasia (CIN) (26 CIN1, 4 CIN2+). The rate of confirmed dysplasia in the HIV+ group was 20/129 (15.5%) compared with 10/121 (8.26%) in HIV- women p=0.0291. The contemporaneous physician impressions of the DC images accurately differentiated between CIN1 and CIN2+ lesions in all 30 women having confirmatory biopsies. CONCLUSIONS The results of this study suggest potential modifications of the current cervical screening strategy that is currently being employed in Cambodia. The first step in this new strategy would be self-swabbing for hrHPV. Subsequently, hrHPV+ patients would have DC and immediate treatment based on colposcopic findings: cryotherapy for suspected CIN1 and loop electrosurgical excision procedure (LEEP) for suspected CIN2+.
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Affiliation(s)
- Sovannara Thay
- Department of Gynecology, Sihanouk Hospital Center of Hope, Phnom Penh, Cambodia
| | - Andrew Goldstein
- Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
- The Center for Vulvovaginal Disorders, Washington, District of Columbia, USA
| | | | - Vaishnavi Govind
- The Center for Vulvovaginal Disorders, Washington, District of Columbia, USA
| | - Kruy Lim
- Department of Gynecology, Sihanouk Hospital Center of Hope, Phnom Penh, Cambodia
| | - Chanthou Seang
- Department of Gynecology, Sihanouk Hospital Center of Hope, Phnom Penh, Cambodia
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25
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Huitfeldt A, Goldstein A, Swanson SA. The choice of effect measure for binary outcomes: Introducing counterfactual outcome state transition parameters. Epidemiol Methods 2018; 7:20160014. [PMID: 30637184 PMCID: PMC6326173 DOI: 10.1515/em-2016-0014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Standard measures of effect, including the risk ratio, the odds ratio, and the risk difference, are associated with a number of well-described shortcomings, and no consensus exists about the conditions under which investigators should choose one effect measure over another. In this paper, we introduce a new framework for reasoning about choice of effect measure by linking two separate versions of the risk ratio to a counterfactual causal model. In our approach, effects are defined in terms of "counterfactual outcome state transition parameters", that is, the proportion of those individuals who would not have been a case by the end of follow-up if untreated, who would have responded to treatment by becoming a case; and the proportion of those individuals who would have become a case by the end of follow-up if untreated who would have responded to treatment by not becoming a case. Although counterfactual outcome state transition parameters are generally not identified from the data without strong monotonicity assumptions, we show that when they stay constant between populations, there are important implications for model specification, meta-analysis, and research generalization.
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Affiliation(s)
- Anders Huitfeldt
- The Meta-Research Innovation Center at Stanford, Stanford University
| | - Andrew Goldstein
- Department of Medical Informatics, Columbia University
- Department of Medicine, New York University
| | - Sonja A Swanson
- Department of Epidemiology, Erasmus MC
- Department of Epidemiology, Harvard T.H. Chan School of Public Health
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26
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Affiliation(s)
- Alain Nathan Sahin
- Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA
| | - Andrew Goldstein
- Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA; Primary Care, Bellevue Hospital Center-New York University School of Medicine, New York, NY, USA.
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA
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27
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Cigna S, Mitchell L, Goldstein A. 025 Lysis of Vulvar Adhesions for Lichen Sclerosus: A Series of 5 Patients. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Cigna S, Mitchell L, Goldstein A. 079 Vulvar Crohn’s: A Rare Presentation of Crohn’s Disease. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.03.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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29
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Fitch K, Cho E, Goldstein A, Weinstock M, Qureshi A, Li W. 308 Host characteristics and risk of atypical nevi. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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30
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Goldstein A, Venker E, Weng C. Evidence appraisal: a scoping review, conceptual framework, and research agenda. J Am Med Inform Assoc 2018; 24:1192-1203. [PMID: 28541552 DOI: 10.1093/jamia/ocx050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/18/2017] [Indexed: 12/16/2022] Open
Abstract
Objective Critical appraisal of clinical evidence promises to help prevent, detect, and address flaws related to study importance, ethics, validity, applicability, and reporting. These research issues are of growing concern. The purpose of this scoping review is to survey the current literature on evidence appraisal to develop a conceptual framework and an informatics research agenda. Methods We conducted an iterative literature search of Medline for discussion or research on the critical appraisal of clinical evidence. After title and abstract review, 121 articles were included in the analysis. We performed qualitative thematic analysis to describe the evidence appraisal architecture and its issues and opportunities. From this analysis, we derived a conceptual framework and an informatics research agenda. Results We identified 68 themes in 10 categories. This analysis revealed that the practice of evidence appraisal is quite common but is rarely subjected to documentation, organization, validation, integration, or uptake. This is related to underdeveloped tools, scant incentives, and insufficient acquisition of appraisal data and transformation of the data into usable knowledge. Discussion The gaps in acquiring appraisal data, transforming the data into actionable information and knowledge, and ensuring its dissemination and adoption can be addressed with proven informatics approaches. Conclusions Evidence appraisal faces several challenges, but implementing an informatics research agenda would likely help realize the potential of evidence appraisal for improving the rigor and value of clinical evidence.
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Affiliation(s)
- Andrew Goldstein
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Eric Venker
- Department of Medicine, Columbia University, New York, NY, USA
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
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31
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Affiliation(s)
- Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, NY USA.
| | - Andrew Goldstein
- Department of Biomedical Informatics, Columbia University, New York, NY USA; Department of Medicine, New York University Medical Center, New York, NY USA
| | - Chi Yuan
- Department of Biomedical Informatics, Columbia University, New York, NY USA; Department of Computer Science, Nanjing University of Science and Technology, Nanjing, China
| | - Zhiping Zhou
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY USA
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32
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Rubin R, Mitchell L, Winter A, Goldstein A, Goldstein I. 011 Successful Treatment of Interstitial Cystitis/Bladder Pain Syndrome (IC/PBS) in Women with Provoked Vestibulodynia (PVD). J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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33
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Albers DJ, Elhadad N, Claassen J, Perotte R, Goldstein A, Hripcsak G. Estimating summary statistics for electronic health record laboratory data for use in high-throughput phenotyping algorithms. J Biomed Inform 2018; 78:87-101. [PMID: 29369797 PMCID: PMC5856130 DOI: 10.1016/j.jbi.2018.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/05/2017] [Accepted: 01/14/2018] [Indexed: 01/12/2023]
Abstract
We study the question of how to represent or summarize raw laboratory data taken from an electronic health record (EHR) using parametric model selection to reduce or cope with biases induced through clinical care. It has been previously demonstrated that the health care process (Hripcsak and Albers, 2012, 2013), as defined by measurement context (Hripcsak and Albers, 2013; Albers et al., 2012) and measurement patterns (Albers and Hripcsak, 2010, 2012), can influence how EHR data are distributed statistically (Kohane and Weber, 2013; Pivovarov et al., 2014). We construct an algorithm, PopKLD, which is based on information criterion model selection (Burnham and Anderson, 2002; Claeskens and Hjort, 2008), is intended to reduce and cope with health care process biases and to produce an intuitively understandable continuous summary. The PopKLD algorithm can be automated and is designed to be applicable in high-throughput settings; for example, the output of the PopKLD algorithm can be used as input for phenotyping algorithms. Moreover, we develop the PopKLD-CAT algorithm that transforms the continuous PopKLD summary into a categorical summary useful for applications that require categorical data such as topic modeling. We evaluate our methodology in two ways. First, we apply the method to laboratory data collected in two different health care contexts, primary versus intensive care. We show that the PopKLD preserves known physiologic features in the data that are lost when summarizing the data using more common laboratory data summaries such as mean and standard deviation. Second, for three disease-laboratory measurement pairs, we perform a phenotyping task: we use the PopKLD and PopKLD-CAT algorithms to define high and low values of the laboratory variable that are used for defining a disease state. We then compare the relationship between the PopKLD-CAT summary disease predictions and the same predictions using empirically estimated mean and standard deviation to a gold standard generated by clinical review of patient records. We find that the PopKLD laboratory data summary is substantially better at predicting disease state. The PopKLD or PopKLD-CAT algorithms are not meant to be used as phenotyping algorithms, but we use the phenotyping task to show what information can be gained when using a more informative laboratory data summary. In the process of evaluation our method we show that the different clinical contexts and laboratory measurements necessitate different statistical summaries. Similarly, leveraging the principle of maximum entropy we argue that while some laboratory data only have sufficient information to estimate a mean and standard deviation, other laboratory data captured in an EHR contain substantially more information than can be captured in higher-parameter models.
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Affiliation(s)
- D J Albers
- Department of Biomedical Informatics, Columbia University, 622 West 168th Street, New York, NY, USA.
| | - N Elhadad
- Department of Biomedical Informatics, Columbia University, 622 West 168th Street, New York, NY, USA.
| | - J Claassen
- Department of Neurology, Columbia University, 710 West 168th Street, New York, NY 10032, USA.
| | - R Perotte
- Value Institute, New York Presbyterian Hospital, 601 West 168th Street New York, NY 10032, USA.
| | - A Goldstein
- Department of Biomedical Informatics, Columbia University, 622 West 168th Street, New York, NY, USA.
| | - G Hripcsak
- Department of Biomedical Informatics, Columbia University, 622 West 168th Street, New York, NY, USA.
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Vernon H, Cohen J, De Nittis P, Fatemi A, McClellan R, Goldstein A, Malerba N, Guex N, Reymond A, Merla G. Intellectual developmental disorder with cardiac arrhythmia syndrome in a child with compound heterozygous GNB5 variants. Clin Genet 2018; 93:1254-1256. [PMID: 29368331 DOI: 10.1111/cge.13194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 11/30/2022]
Abstract
Identification of a novel compound heterozygous of GNB5 in a patient with intellectual developmental disorder with cardiac arrhytmia (IDDCA), from non-consaguineous family. Three-dimensional modelling and in silico predictions suggest that GNB5 variants are causative of the phenotype, extending the number of IDDCA patients so far identified.
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Affiliation(s)
- H Vernon
- Department of Neurogenetics, Kennedy Krieger Institute, Baltimore, Maryland
| | - J Cohen
- Department of Neurogenetics, Kennedy Krieger Institute, Baltimore, Maryland
| | - P De Nittis
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - A Fatemi
- Department of Neurogenetics, Kennedy Krieger Institute, Baltimore, Maryland
| | - R McClellan
- Department of Neurogenetics, Kennedy Krieger Institute, Baltimore, Maryland
| | - A Goldstein
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - N Malerba
- Division of Medical Genetics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - N Guex
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - A Reymond
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - G Merla
- Division of Medical Genetics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
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Gilboa Y, Jansari A, Kerrouche B, Uçak E, Tiberghien A, Benkhaled O, Aligon D, Mariller A, Verdier V, Mintegui A, Abada G, Canizares C, Goldstein A, Chevignard M. Assessment of executive functions in children and adolescents with acquired brain injury (ABI) using a novel complex multi-tasking computerised task: The Jansari assessment of Executive Functions for Children (JEF-C ©). Neuropsychol Rehabil 2017; 29:1359-1382. [PMID: 29283024 DOI: 10.1080/09602011.2017.1411819] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives: The Jansari assessment of Executive Functions for Children (JEF-C©) is a new non-immersive computerised assessment of executive functions. The objectives of the study were to test the feasibility and validity of JEF-C© in children and adolescents with acquired brain injury (ABI). Methods: Twenty-nine patients with ABI aged 10-18 years and 30 age-and gender-matched controls were tested. Participants performed JEF-C©, Wechsler Abbreviated Scale of Intelligence (WASI) and the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C), while parents completed the Behaviour Rating Inventory of Executive Function (BRIEF) questionnaire. Results: The JEF-C© task proved feasible in patients with ABI. The internal consistency was medium (Cronbach's alpha = 0.62 and significant intercorrelations between individual JEF-C© constructs). Patients performed significantly worse than controls on most of the JEF-C© subscales and total score, with 41.4% of participants with ABI classified as having severe executive dysfunction. No significant correlations were found between JEF-C© total score, the BRIEF indices, and the BADS-C. Significant correlations were found between JEF-C© and demographic characteristics of the sample and intellectual ability, but not with severity/medical variables. Conclusion: JEF-C© is a playful complex task that appears to be a sensitive and ecologically valid assessment tool, especially for relatively high-functioning individuals.
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Affiliation(s)
- Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem , Jerusalem , Israel
| | - Ashok Jansari
- Department of Psychology, Goldsmiths, University of London , London , UK
| | - Bernadette Kerrouche
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Emel Uçak
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Anne Tiberghien
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Ouarda Benkhaled
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Delphine Aligon
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Aude Mariller
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Valentine Verdier
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Amaia Mintegui
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Geneviève Abada
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Céline Canizares
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France
| | - Andrew Goldstein
- School of Journalism, Stony Brook University , Stony Brook , New York , USA
| | - Mathilde Chevignard
- Outreach Team for Children And Adolescents with Acquired Brain Injury, Saint Maurice Hospitals , Saint Maurice , France.,Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals , Saint Maurice , France.,Sorbonne Universités, UPMC Univ Paris 06 , UMR 7371, UMR_S 1146, LIB, F-75005, Paris , France.,GRC n°18, Handicap Cognitif et Réadaptation (HanCRe); UPMC Paris 6 , Paris , France
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36
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Sen A, Goldstein A, Chakrabarti S, Shang N, Kang T, Yaman A, Ryan PB, Weng C. The representativeness of eligible patients in type 2 diabetes trials: a case study using GIST 2.0. J Am Med Inform Assoc 2017; 25:239-247. [PMID: 29025047 PMCID: PMC7378875 DOI: 10.1093/jamia/ocx091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/23/2017] [Accepted: 08/08/2017] [Indexed: 01/23/2023] Open
Abstract
Objective The population representativeness of a clinical study is influenced by how real-world patients qualify for the study. We analyze the representativeness of eligible patients for multiple type 2 diabetes trials and the relationship between representativeness and other trial characteristics. Methods Sixty-nine study traits available in the electronic health record data for 2034 patients with type 2 diabetes were used to profile the target patients for type 2 diabetes trials. A set of 1691 type 2 diabetes trials was identified from ClinicalTrials.gov, and their population representativeness was calculated using the published Generalizability Index of Study Traits 2.0 metric. The relationships between population representativeness and number of traits and between trial duration and trial metadata were statistically analyzed. A focused analysis with only phase 2 and 3 interventional trials was also conducted. Results A total of 869 of 1691 trials (51.4%) and 412 of 776 phase 2 and 3 interventional trials (53.1%) had a population representativeness of <5%. The overall representativeness was significantly correlated with the representativeness of the Hba1c criterion. The greater the number of criteria or the shorter the trial, the less the representativeness. Among the trial metadata, phase, recruitment status, and start year were found to have a statistically significant effect on population representativeness. For phase 2 and 3 interventional trials, only start year was significantly associated with representativeness. Conclusions Our study quantified the representativeness of multiple type 2 diabetes trials. The common low representativeness of type 2 diabetes trials could be attributed to specific study design requirements of trials or safety concerns. Rather than criticizing the low representativeness, we contribute a method for increasing the transparency of the representativeness of clinical trials.
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Affiliation(s)
- Anando Sen
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Andrew Goldstein
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Shreya Chakrabarti
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Ning Shang
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Tian Kang
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Anil Yaman
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Patrick B Ryan
- Department of Biomedical Informatics, Columbia University, New York, NY, USA.,Janssen Research and Development, Titusville, NJ, USA
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
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37
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King M, Mitchell L, Belkin Z, Goldstein A. 036 Vulvar Vestibulectomy for Neuroproliferative Associated Vestibulodynia: A Retrospective Case-Control Study. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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38
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Goldstein L, Goldstein A, Kellogg-Spadt S, Marfori C, Goldstein A. 002 Digital Cervicography for Quality Control of Visualization With Acetic Acid (VIA) for Cervical Dysplasia Screening. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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39
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Mitchell L, King M, Brillhart H, Goldstein A. Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis. Sex Med 2017; 5:e212-e214. [PMID: 28460993 PMCID: PMC5562466 DOI: 10.1016/j.esxm.2017.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/20/2017] [Accepted: 03/16/2017] [Indexed: 10/29/2022] Open
Abstract
Desquamative inflammatory vaginitis is a poorly understood chronic vaginitis with an unknown etiology. Symptoms of desquamative inflammatory vaginitis include copious yellowish discharge, vulvovaginal discomfort, and dyspareunia. Cervical ectropion, the presence of glandular columnar cells on the ectocervix, has not been reported as a cause of desquamative inflammatory vaginitis. Although cervical ectropion can be a normal clinical finding, it has been reported to cause leukorrhea, metrorrhagia, dyspareunia, and vulvovaginal irritation. Patients with cervical ectropion and desquamative inflammatory vaginitis are frequently misdiagnosed with candidiasis or bacterial vaginosis and repeatedly treated without resolution of symptoms. We report the case of a 34-year-old woman with a 4-year history of profuse yellowish discharge and dyspareunia. Upon presentation, her symptoms and laboratory results met the criteria for desquamative inflammatory vaginitis, but the standard treatments did not provide long-lasting relief. As a last resort, cryotherapy (cryosurgery) of her cervix was performed for treatment of her cervical ectropion, which provided complete resolution of her symptoms. Mitchell L, King M, Brillhart H, Goldstein A. Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis. Sex Med 2017;5:e212-e214.
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Affiliation(s)
- Leia Mitchell
- The Centers for Vulvovaginal Disorders, Washington, DC, and New York, NY, USA.
| | - Michelle King
- The Centers for Vulvovaginal Disorders, Washington, DC, and New York, NY, USA; Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA
| | - Heather Brillhart
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Andrew Goldstein
- The Centers for Vulvovaginal Disorders, Washington, DC, and New York, NY, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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40
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Rubin R, Mitchell L, Winter A, Goldstein A, Goldstein I. PD44-04 SUCCESSFUL TREATMENT OF INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME (IC/PBS) IN WOMEN WITH PROVOKED VESTIBULODYNIA (PVD). J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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41
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Bissaldi E, Connaughton V, Omodei N, Burns E, Goldstein A, Vianello G. The Fermi GBM and LAT follow-up of GW150914. EPJ Web Conf 2017. [DOI: 10.1051/epjconf/201713603020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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42
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Weizman N, Baidun K, Goldstein A, Amit U, Lawrence Y, Appel S, Benayun M, Dubinski S, Orion I, Alezra D, Gnessin H, Symon Z, Goldstein J. Effects of Continuous Positive Airway Pressure (CPAP) Used for Respiratory Motion Management in Patients Receiving Chest Radiation to the Heart: An Analysis of Size, Position, and Motion. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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43
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Sen A, Ryan PB, Goldstein A, Chakrabarti S, Wang S, Koski E, Weng C. Correlating eligibility criteria generalizability and adverse events using Big Data for patients and clinical trials. Ann N Y Acad Sci 2016; 1387:34-43. [PMID: 27598694 DOI: 10.1111/nyas.13195] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/30/2016] [Accepted: 07/13/2016] [Indexed: 01/07/2023]
Abstract
Randomized controlled trials can benefit from proactive assessment of how well their participant selection strategies during the design of eligibility criteria can influence the study generalizability. In this paper, we present a quantitative metric called generalizability index for study traits 2.0 (GIST 2.0) to assess the a priori generalizability (based on population representativeness) of a clinical trial by accounting for the dependencies among multiple eligibility criteria. The metric was evaluated on 16 sepsis trials identified from ClinicalTrials.gov, with their adverse event reports extracted from the trial results sections. The correlation between GIST scores and adverse events was analyzed. We found that the GIST 2.0 score was significantly correlated with total adverse events and serious adverse events (weighted correlation coefficients of 0.825 and 0.709, respectively, with P < 0.01). This study exemplifies the promising use of Big Data in electronic health records and ClinicalTrials.gov for optimizing eligibility criteria design for clinical studies.
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Affiliation(s)
- Anando Sen
- Department of Biomedical Informatics, Columbia University, New York, New York
| | - Patrick B Ryan
- Department of Biomedical Informatics, Columbia University, New York, New York.,Janssen Research and Development, Titusville, New Jersey
| | - Andrew Goldstein
- Department of Biomedical Informatics, Columbia University, New York, New York.,Department of Medicine, New York University, New York, New York
| | - Shreya Chakrabarti
- Department of Biomedical Informatics, Columbia University, New York, New York
| | - Shuang Wang
- Department of Biostatistics, Columbia University, New York, New York
| | - Eileen Koski
- Center for Computational Health, IBM T.J. Watson Research Center, Yorktown Heights, New York
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, New York
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44
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45
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Bornstein J, Goldstein AT, Stockdale CK, Bergeron S, Pukall C, Zolnoun D, Coady D, Bornstein J, Goldstein A, Zolnoun D, Bachmann GA, Bissonnette I, Bergeron S, Starke NB, Burrows L, Coady D, Dellon AL, Farmer M, Foster D, Fox S, Goldstein I, Gracely R, Haefner HK, Kellogg-Spadt S, Marvel R, Barracco MM, Morrison P, Parish S, Prendergast S, Pukall C, Reed B, Stockdale C, Boardman L, Goldstein L, Mate P. 2015 ISSVD, ISSWSH, and IPPS Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia. J Sex Med 2016; 13:607-12. [DOI: 10.1016/j.jsxm.2016.02.167] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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46
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Perez-Losada M, Goldstein A, Alamri L, Crandall KA, Freishtat RJ. 20: NASOPHARYNX MICROBIOME COMPOSITION VARIES OVER TIME IN PEDIATRIC ASTHMA. J Investig Med 2016. [DOI: 10.1136/jim-2016-000080.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose of StudyThe application of next-generation sequencing (NGS) technology has shown that microbial communities in the respiratory airways (i.e., the microbiome) play a significant role in the onset, development and severity of asthma. However, little is known about their temporal dynamics (i.e., microbial succession), which poses a significant obstacle to identifying pulmotypes of disease and assessing inter-patient variation. Here, we couple NGS and 16S rRNA data to characterize the nasopharynx microbiome of children with asthma and determine its stability over time.Methods UsedWe collected nasal washes from 40 children with asthma enrolled in the AsthMaP-2 Project from two consecutive visits, six months apart. Total DNA was extracted and sequenced for the 16S-V4 rRNA gene region (∼250 bp) using the MySeq Illumina platform. Reads were analyzed in Mothur using the SILVAv119 reference database. Alpha diversity metrics and phylogenetic and count-base distance community indexes of beta diversity were compared across samples and time points. PCoA and NJ clustering analysis were used to assess community relatedness. Differences in alpha diversity and OTU abundance between sample pairs across time points were also compared.Summary of ResultsA mean of 27,479 clean 16S sequences corresponding to an average of 173 OTUs were sequenced and detected per sample, respectively. Representatives of Moraxella, Corynebacterium, Prevotella, Staphylococcus, Alloiococcus, Streptococcus, Peptoniphilus, Fusobacterium, and Haemophilus accounted for 36 to 99% of the reads across samples. These genera have been previously found in the nasopharynx of asthmatic and healthy children. A total of 61 OTUs from these genera were present in at least 50% of the samples (i.e., the nasal core microbiome). Significant differences in core microbiome composition were detected between sample pairs, but no directional trend (increase or decrease) was observed across sample pairs. Samples were randomly ordinated and did not cluster together.ConclusionsOur analysis of nasal microbiomes in 40 asthmatic children revealed significant differences in composition within individuals over six months. Future cross-sectional microbiome studies need to be aware of short span temporal dynamics in nasal microbiota.
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47
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Stoyanova T, Faltermeier C, Smith B, Goldstein A, Zhang X, Drake J, Lee J, Orellana S, Blum S, Cheng D, Pienta K, Huang J, Witte O. Abstract 4985: Notch1 as a key mediator in promoting advanced castration-resistant prostate cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-4985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The first line of treatment for men with advanced prostate cancers is androgen deprivation therapy. However, the disease commonly relapses in its lethal metastatic form referred to as castration-resistant prostate cancer (CRPC). CRPC is the primary cause of prostate cancer specific mortality in men. Current therapies including chemotherapeutic agents improve median overall survival by only few months. The mechanisms that distinguish clinically localized indolent tumors from lethal CRPC are unclear. Here we demonstrate that ectopic expression of Notch1 promotes progression to poorly differentiated carcinoma when combined with pathways that are altered in advanced disease but are insufficient to drive aggressive prostate cancer alone. Notch1 driven tumors are resistant to androgen deprivation. Transcriptional profiling reveals that these tumors display features of epithelial to mesenchymal transition, a morphological change associated with tumor aggressiveness and metastasis. Our study provides the first functional evidence that Notch1 signaling axis is a key mediator in promoting advanced prostate cancer and may represent a new therapeutic target for the advanced disease.
Note: This abstract was not presented at the meeting.
Citation Format: Tanya Stoyanova, Claire Faltermeier, Bryan Smith, Andrew Goldstein, Xi Zhang, Justin Drake, John Lee, Sandra Orellana, Steven Blum, Donghui Cheng, Kenneth Pienta, Jiaoti Huang, Owen Witte. Notch1 as a key mediator in promoting advanced castration-resistant prostate cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4985. doi:10.1158/1538-7445.AM2015-4985
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Connaughton V, Briggs MS, Goldstein A, Meegan CA, Paciesas WS, Preece RD, Wilson-Hodge CA, Gibby MH, Greiner J, Gruber D, Jenke P, Kippen RM, Pelassa V, Xiong S, Yu HF, Bhat PN, Burgess JM, Byrne D, Fitzpatrick G, Foley S, Giles MM, Guiriec S, van der Horst AJ, von Kienlin A, McBreen S, McGlynn S, Tierney D, Zhang BB. LOCALIZATION OF GAMMA-RAY BURSTS USING THE
FERMI
GAMMA-RAY BURST MONITOR. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0067-0049/216/2/32] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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49
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van Rooij K, Poels S, Worst P, Bloemers J, Koppeschaar H, Goldstein A, Olivier B, Tuiten A. Efficacy of testosterone combined with a PDE5 inhibitor and testosterone combined with a serotonin (1A) receptor agonist in women with SSRI-induced sexual dysfunction. A preliminary study. Eur J Pharmacol 2014; 753:246-51. [PMID: 25460030 DOI: 10.1016/j.ejphar.2014.10.061] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/16/2014] [Indexed: 11/15/2022]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are known to cause sexual dysfunction, such as decreased sexual motivation, desire, arousal, and orgasm difficulties. These SSRI-induced sexual complaints have a high prevalence rate, while there is no approved pharmacological treatment for SSRI-induced sexual dysfunction. It is hypothesized that a polymorphisms in the androgen receptor gene, encoded by the nucleotides cysteine, adenine, and guanine (CAG), influence the effect of testosterone on sexual functioning. In an explorative, randomized, double-blind, placebo-controlled, crossover study we investigated the possible effects of sublingual testosterone combined with a serotonin (5-HT)1A receptor agonist, and of sublingual testosterone combined with a phosphodiesterase type 5 inhibitor (PDE5-i) on sexual functioning in women with SSRI-induced sexual dysfunction. Furthermore, we did an exploratory analysis to assess if the CAG polymorphism influences this effect. 21 pre- and postmenopausal women with SSRI-induced sexual dysfunction participated and underwent the following interventions: a combination of testosterone (0.5 mg) sublingually and the PDE5-i sildenafil (50 mg) and a combination of testosterone (0.5 mg) sublingually and the 5-HT1A receptor agonist buspirone (10 mg). The results show that women who use a low dose of SSRI and have relatively long CAG repeats report a marked improvement in sexual function in response to both treatments compared to placebo. This explorative study and preliminary results indicate that in women with SSRI-induced sexual dysfunction, a combination of testosterone sublingually and a PDE5-i or testosterone sublingually and a 5-HT1A receptor agonist might be promising treatments for certain subgroups of women with this condition.
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Affiliation(s)
- Kim van Rooij
- Emotional Brain B.V., Almere, The Netherlands; Utrecht Institute for Pharmaceutical Sciences and Rudlof Magnus Institute of Neuroscience, Utrecht University, Utrecht, The Netherlands.
| | - Saskia Poels
- Emotional Brain B.V., Almere, The Netherlands; Utrecht Institute for Pharmaceutical Sciences and Rudlof Magnus Institute of Neuroscience, Utrecht University, Utrecht, The Netherlands
| | - Petra Worst
- Emotional Brain B.V., Almere, The Netherlands
| | - Jos Bloemers
- Emotional Brain B.V., Almere, The Netherlands; Utrecht Institute for Pharmaceutical Sciences and Rudlof Magnus Institute of Neuroscience, Utrecht University, Utrecht, The Netherlands
| | | | | | - Berend Olivier
- Utrecht Institute for Pharmaceutical Sciences and Rudlof Magnus Institute of Neuroscience, Utrecht University, Utrecht, The Netherlands; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Adriaan Tuiten
- Emotional Brain B.V., Almere, The Netherlands; Department of Psychopharmacology, Utrecht University, Utrecht, The Netherlands
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50
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Lin S, Kono E, Yamashiro J, Lee S, Witte O, Goldstein A, Reiter RE. Abstract 3021: Roles of EMT on stem cell properties of prostate stem and cancer cells during castration-resistant prostate cancer progression. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-3021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Androgen ablation remains the mainstay of treatment for men with advanced and metastatic prostate cancer. However, despite the introduction of new generation anti-androgens, a majority of men succumb to castration resistant prostate cancer (CRPC). The molecular mechanisms governing the emergence of treatment resistance in CRPC patients are not well understood. Recent experience suggests that tumor regeneration from castration-resistant stem-like cells induce resistance to hormonal therapy. Therefore, elucidating novel targets essential for driving stem-like activity is critical to prevent and defeat CRPC. It has been shown that normal and cancer stem cells exploit normal development process of epithelial-mesenchymal transition (EMT) to survive and metastasize, and that EMT confer stem cell properties to more differentiated cancer cell progeny in breast and other cancers. However, it is unclear if EMT is linked with stem cells in normal and malignant prostate. Our lab has reported that N-cadherin, a marker of EMT, is upregulated after neoadjuvant hormone ablation and in CRPC and is sufficient to cause metastasis and CRPC. Therapeutic targeting of N-cadherin by novel N-cadherin antibody inhibited metastatic and CRPC progression. The cell population displaying N-cadherin co-expressed a number of stem cell-associated genes in CRPC models. Here, we verified EMT linked to stem cells in both normal prostate and CRPC. We found in LAPC-9 CRPC tumors, the cell population expressing N-cadherin behaved like stem cells with enhanced sphere-forming ability, which could be specifically inhibited by novel N-cadherin antibody 2A9. We isolated stem-like CD49fhi/Trop2hi cells from prostatectomy specimens and found that forced N-cadherin expression promoted sphere formation of those cells. Our evaluation of gene expression in N-cadherin-positive prostate cancer cell lines and CRPC tumors demonstrated that N-cadherin expression activated common EMT transcriptional regulators including Zeb1. We asked if Zeb1 regulated stem cell properties in normal and malignant prostate. We found that forced Zeb1 expression induced EMT with enhanced cell invasiveness in LNCaP human prostate cancer cells. However, Zeb1 overexpression inhibited cell proliferation and CRPC tumor growth of LNCaP. Zeb1 overexpression also surprisingly inhibited sphere formation of normal stem/progenitor cells from prostatectomy specimens. Our data suggest that Zeb1-regulated EMT promotes both quiescence and invasiveness in normal and malignant prostate in which the quiescent cells may survive and play a role in treatment resistance, while N-cadherin mediates stem cell proliferation and self-renewal. Our research will likely provide useful information of EMT-related biomarkers for preventing and developing efficient therapeutics to combat the treatment resistance to new generation anti-androgens.
Citation Format: Shu Lin, Evelyn Kono, Joyce Yamashiro, Sean Lee, Owen Witte, Andrew Goldstein, Robert E. Reiter. Roles of EMT on stem cell properties of prostate stem and cancer cells during castration-resistant prostate cancer progression. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3021. doi:10.1158/1538-7445.AM2014-3021
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Affiliation(s)
- Shu Lin
- University of California Los Angeles, Los Angeles, CA
| | - Evelyn Kono
- University of California Los Angeles, Los Angeles, CA
| | | | - Sean Lee
- University of California Los Angeles, Los Angeles, CA
| | - Owen Witte
- University of California Los Angeles, Los Angeles, CA
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