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Huang C, Luo L, Mootz M, Shang J, Man P, Su L, Perakis IE, Yao YX, Wu A, Wang J. Extreme terahertz magnon multiplication induced by resonant magnetic pulse pairs. Nat Commun 2024; 15:3214. [PMID: 38615025 PMCID: PMC11016094 DOI: 10.1038/s41467-024-47471-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/26/2024] [Indexed: 04/15/2024] Open
Abstract
Nonlinear interactions of spin-waves and their quanta, magnons, have emerged as prominent candidates for interference-based technology, ranging from quantum transduction to antiferromagnetic spintronics. Yet magnon multiplication in the terahertz (THz) spectral region represents a major challenge. Intense, resonant magnetic fields from THz pulse-pairs with controllable phases and amplitudes enable high order THz magnon multiplication, distinct from non-resonant nonlinearities such as the high harmonic generation by below-band gap electric fields. Here, we demonstrate exceptionally high-order THz nonlinear magnonics. It manifests as 7th-order spin-wave-mixing and 6th harmonic magnon generation in an antiferromagnetic orthoferrite. We use THz two-dimensional coherent spectroscopy to achieve high-sensitivity detection of nonlinear magnon interactions up to six-magnon quanta in strongly-driven many-magnon correlated states. The high-order magnon multiplication, supported by classical and quantum spin simulations, elucidates the significance of four-fold magnetic anisotropy and Dzyaloshinskii-Moriya symmetry breaking. Moreover, our results shed light on the potential quantum fluctuation properties inherent in nonlinear magnons.
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Affiliation(s)
- C Huang
- Ames National Laboratory, Ames, IA, 50011, USA
- Department of Physics and Astronomy, Iowa State University, Ames, IA, 50011, USA
| | - L Luo
- Ames National Laboratory, Ames, IA, 50011, USA
| | - M Mootz
- Ames National Laboratory, Ames, IA, 50011, USA
| | - J Shang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 201899, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - P Man
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 201899, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - L Su
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 201899, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - I E Perakis
- Department of Physics, University of Alabama at Birmingham, Birmingham, AL, 35294-1170, USA
| | - Y X Yao
- Ames National Laboratory, Ames, IA, 50011, USA
| | - A Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 201899, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - J Wang
- Ames National Laboratory, Ames, IA, 50011, USA.
- Department of Physics and Astronomy, Iowa State University, Ames, IA, 50011, USA.
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Wu A, Sharrett AR, Folsom AR, Alonso A, Walker KA, Gottesman RF, Gross AL, Rawlings AM, Schneider ALC, Coresh J. Midlife Hemostasis Measures, 20-Year Cognitive Decline, and Incident Dementia. Neurology 2023; 101:e1697-e1707. [PMID: 37652701 PMCID: PMC10624500 DOI: 10.1212/wnl.0000000000207771] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/30/2022] [Accepted: 06/27/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Blood concentrations of hemostatic factors affect thrombosis and bleeding diathesis and may contribute to cognitive impairment through modifiable vascular pathologies. Whether hemostasis, assessed in middle age, is associated with late-life cognitive impairment remains largely unknown in a community-dwelling population. METHODS Using data from 14,128 participants with cognitive function measurements in 1990-1992 from the Atherosclerosis Risk in Communities study, we assessed the associations of hemostasis measures with 20-year changes in cognitive performance and incident dementia. Activated partial thromboplastin time (aPTT) and level of fibrinogen, von Willebrand factor (VWF), factor VIII, factor VII, factor XI, d-dimer, and soluble thrombomodulin were measured in 1987-1989 or 1993-1995. Hemostasis measures were categorized into quintiles, with the lowest quintile indicating low coagulability. Cognitive performance was characterized using a combined z-score from 3 tests (that is, delayed word recall test [DWRT], digit symbol substitution [DSST], and word fluency test [WFT]), assessed in 1990-1992, 1996-1998, and 2011-2013. Dementia was determined either from in-person evaluations or using dementia surveillance through 2017. Mixed-effects models and Cox proportional hazards models were used to assess cognitive trajectories and risk of dementia, respectively. RESULTS Among 12,765 participants with hemostasis measures in 1987-1989, who were aged 47-70 years at the first cognitive assessment, we observed significant trends of shorter aPTT (p for trend <0.001; difference in 20-year cognitive decline for fifth vs first quintile [Q5 vs Q1]: -0.104 [95% CI -0.160 to -0.048]) and higher levels of factor VII (p < 0.002; Q5 vs Q1: -0.085 [-0.142, -0.028]) and factor VIII (p = 0.033; Q4 vs Q1: -0.055 [-0.111, -0.000]) with greater 20-year cognitive declines. The associations with the decline in DSST were stronger than those with the decline in WFT or DWRT. Consistently, shorter aPTT and higher factor VIII levels were associated with higher dementia risk with HRs for Q5 vs Q1 of 1.23 (95% CI 1.07 to 1.42) and 1.17 (1.01-1.36), respectively, and p for trend of 0.008 and 0.024, respectively. DISCUSSION Overall, our study found consistent trend associations of aPTT and factor VIII measured in midlife with cognitive decline and incident dementia over 20 years, likely driven by vascular pathologies.
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Affiliation(s)
- Aozhou Wu
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - A Richey Sharrett
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Aaron R Folsom
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Alvaro Alonso
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Keenan A Walker
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Rebecca F Gottesman
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Alden L Gross
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Andreea M Rawlings
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Andrea Lauren Christman Schneider
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Josef Coresh
- From the Johns Hopkins University (A.W., A.R.S., A.L.G., J.C.), Bloomberg School of Public Health, Baltimore, MD; University of Minnesota (A.R.F.), School of Public Health, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Laboratory of Behavioral Neuroscience (K.A.W.), Intramural Research Program, National Institute on Aging, Baltimore; National Institute of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; Sanofi (A.M.R.), Cambridge, MA; and Division of Neurocritical Care (A.L.C.S.), Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
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Wong JYC, Monzr AM, Sahebi F, Dandapani SV, Yamauchi DM, Salhotra A, Adhikarla V, Ali H, Poku E, Yang D, Han C, Liu A, Mokhtari S, Wu A, Yazaki P, Shively JE, Hui SK, Smith E, Stein A. First-in-Human Phase I Trial Combining Biologically Guided Radioimmunotherapy (RIT) Using a 90Y-Anti-CD25 Monoclonal Antibody (Mab) with CT-guided Total Marrow and Lymphoid Irradiation (TMLI) in Relapsed and Refractory (R/R) Acute Leukemia. Int J Radiat Oncol Biol Phys 2023; 117:S162. [PMID: 37784406 DOI: 10.1016/j.ijrobp.2023.06.256] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients with R/R acute leukemia after allogeneic hematopoietic cell transplant (alloHCT) have a dismal prognosis with 3-year survival rates of < 20%. To improve outcomes, innovative targeted forms of organ sparing radiotherapy, such as tumor-specific RIT and TMLI, are needed to dose escalate with acceptable toxicities, especially in patients ≥ age 60 years who cannot tolerate total body irradiation (TBI) / myeloablative regimens and who have a poor prognosis. CD25 is an ideal RIT target given its expression in acute leukemias, association with poor prognosis, and expression by leukemia stem cells. In this phase I trial (NCT05139004) we hypothesized that combining dose escalated 90Y-anti-CD25 RIT with fixed dose TMLI 12 Gy, fludarabine (flu), and melphalan (mel) in patients with R/R disease is safe and associated with acceptable toxicities. MATERIALS/METHODS The primary objective of this trial is to determine the maximum tolerated dose and recommended phase 2 dose of 90Y-anti-CD25 Mab (Day -15) with 12 Gy TMLI (1.5 Gy twice a day, days -8 to -5), flu (30 mg/m2/d days -5 to -2), and mel (100 mg/m2, day -2) in patients ≥ 60 years old or with a HCT-comorbidity index ≥ 2 and with R/R AML, ALL or myelodysplastic syndrome (MDS) scheduled to undergo alloHCT from a matched donor. TMLI mean organ dose constraints for kidney, lung and liver were 4 Gy. Planned dose levels of 90Y-anti-CD25 were 0.3, 0.4, and 0.5 mCi/kg. 111In-anti-CD25 (5 mCi) was co-infused followed by serial nuclear scans to assess dosimetry and biodistribution. RESULTS To date 5 patients (ages 31-74) with R/R AML have been treated. Marrow and circulating blasts ranged from 10-36% and 9-44%, respectively. For the 3 patients at 0.3 mCi/kg, follow-up ranged from 89-191+ days. 90Y/111In-anti-CD25 nuclear scans demonstrated persistent uptake in bone out to 144 hours, which was associated with a decline in circulating blasts. After combined RIT and TMLI, mean doses (Gy) to lungs ranged from 5.7-6.5, to kidneys from 7.5-8.2 and to liver from 7.2-11.6. No dose-limiting toxicities (DLT) were observed. All 3 patients achieved CR on day +30 bone marrow biopsies and 2 remained in CR on day +90 biopsies. Two patients have recently been treated at the 0.4 mCi/kg dose level. The results of patients treated at the higher dose levels will be provided. CONCLUSION Dose escalation by adding 90Y-anti-CD25 RIT at 0.3 mCi/kg to 12 Gy TMLI was safe, including in older patients, with no dose-limiting toxicities, mean critical organ doses lower than conventional myeloablative TBI, and encouraging response rates. The toxicity profile and dose estimates at 0.3 mCi/kg predict that the planned higher dose levels will also be feasible with acceptable toxicities. RIT and TMLI are complementary and when combined address the limitations of each modality. Combining these targeted therapies may be a superior strategy to intensify dose to leukemia compared to dose escalation of either modality alone.
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Affiliation(s)
- J Y C Wong
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - A M Monzr
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - F Sahebi
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - S V Dandapani
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - D M Yamauchi
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA
| | - A Salhotra
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - V Adhikarla
- Division of Mathematical Oncology, City of Hope National Medical Center, Duarte, CA
| | - H Ali
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | | | - D Yang
- Department of Biostatistics, City of Hope National Medical Center, Duarte, CA
| | - C Han
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - A Liu
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | | | - A Wu
- Department of Immunology and Theranostics, Beckman Research Institute, City of Hope, Duarte, CA
| | - P Yazaki
- Department of Immunology and Theranostics, Beckman Research Institute, City of Hope, Duarte, CA
| | - J E Shively
- Department of Immunology and Theranostics, Beckman Research Institute, City of Hope, Duarte, CA
| | - S K Hui
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - E Smith
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - A Stein
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
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Stenehjem D, Lubinga SJ, Wu A, Betts KA. Adverse event costs associated with first-line therapy for advanced non-small cell lung cancer in the United States: An analysis of clinical trials of immune checkpoint inhibitors. J Manag Care Spec Pharm 2023; 29:1054-1064. [PMID: 37610116 PMCID: PMC10512854 DOI: 10.18553/jmcp.2023.29.9.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
BACKGROUND: Immune checkpoint inhibitors, such as pembrolizumab, nivolumab, and atezolizumab, have demonstrated substantial survival benefits in patients with advanced non-small cell lung cancer (NSCLC). However, there is limited evidence on their relative safety profiles and adverse event (AE)-related cost burden. OBJECTIVE: To compare the AE management costs of nivolumab plus ipilimumab with and without limited chemotherapy with those of chemotherapy, pembrolizumab plus chemotherapy, and atezolizumab plus chemotherapy in a first-line setting among patients with advanced NSCLC. METHODS: The mean per-patient AE costs were estimated using the incidence of all-cause grade 3/4 AEs with any-grade incidence greater than or equal to 15% and the corresponding costs of AE management in the inpatient setting. AE rates were obtained from individual patient data from the CheckMate 227 and CheckMate 9LA trials for nivolumab plus ipilimumab with/without limited chemotherapy and aggregated data from the KEYNOTE-189 and KEYNOTE-407 trials for pembrolizumab plus chemotherapy and the IMpower130 trial for atezolizumab plus chemotherapy. AE management costs from the third-party payer perspective were estimated based on inpatient medical costs from the 2016 United States Healthcare Cost and Utilization Project National Inpatient Sample. All costs were inflated to 2020 US dollars. RESULTS: Nivolumab plus ipilimumab and nivolumab plus ipilimumab plus limited chemotherapy were associated with lower per-patient grade 3/4 AE costs compared with chemotherapy ($1,708 and $624 lower over the treatment course, respectively). Compared with pembrolizumab plus chemotherapy, nivolumab plus ipilimumab was associated with lower grade 3/4 AE costs in patients with nonsquamous histology (difference: -$4,866) and squamous histology (difference: -$3,795), and nivolumab plus ipilimumab with limited chemotherapy also had lower AE costs for both nonsquamous (difference: -$2,800) and squamous (difference: -$2,753) disease. Similarly, nivolumab plus ipilimumab and nivolumab plus ipilimumab plus limited chemotherapy were also associated with lower AE costs ($11,400 and $8,809 lower, respectively) compared with atezolizumab plus chemotherapy among patients with nonsquamous disease. In particular, nivolumab plus ipilimumab without or with limited chemotherapy were associated with much lower AE costs of hematological AEs compared with chemotherapy and other immune checkpoint inhibitor-based treatments in combination with a full course of chemotherapy. CONCLUSIONS: Nivolumab plus ipilimumab with/without limited chemotherapy was associated with lower AE management costs compared with chemotherapy, pembrolizumab plus chemotherapy, and atezolizumab plus chemotherapy as first-line treatment for advanced NSCLC. The AE cost benefits were largely driven by the lower cost burden for hematological AEs for nivolumab plus ipilimumab with/without limited chemotherapy. DISCLOSURES This study was supported by Bristol-Myers Squibb. The sponsor was involved in all aspects of the work and in the decision to submit the manuscript for publication. Dr Stenehjem has received consulting fees from Bristol-Myers Squibb. Dr Lubinga was an employee of Bristol-Myers Squibb at the time of the study's conduct and holds stock/options. Drs Betts and Wu are employees of Analysis Group, Inc., a consulting company that has received funding from Bristol-Myers Squibb for this research.
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Samrid R, Taoto C, Wu A, Sawatpanich T, Phunchago N, Uabundit N, Iamsaard S. Protective effect of Mucuna pruriens (L.) DC. var. pruriens seed extract on apoptotic germ cells in ethanolic male rats. BRAZ J BIOL 2023; 83:e272629. [PMID: 37436191 DOI: 10.1590/1519-6984.272629] [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] [Received: 03/05/2023] [Accepted: 06/02/2023] [Indexed: 07/13/2023] Open
Abstract
Thai Mucuna pruriens (L.) DC. var pruriens (T-MP) seed containing levodopa (L-DOPA) and antioxidant capacity has been shown to improve sexual behavior and male reproductive parameters in rats treated with ethanol (Eth). However, its protective effect on testicular apoptotic germ cells has never been reported. This study aimed to investigate the potential effects of T-MP seed extract on expressions of caspase, proliferating cell nuclear antigen (PCNA), and dopamine D2 receptor (D2R) proteins in Eth rats. Thirty-six male Wistar rats were divided into four groups (9 animals/group), including control, Eth, T-MP150+Eth, and T-MP300+Eth, respectively. Control rats received distilled water, and Eth rats received Eth (3g/kg BW; 40%v/v). The T-MP groups were treated with T-MP seed extract at a dose of 150 or 300 mg/kg before Eth administration for 56 consecutive days. The results showed that the seminiferous tubule diameter and epithelial height were significantly increased in both T-MP treated groups compared to the Eth group. Additionally, the caspase-9 and -3, and PCNA expressions were decreased, but D2R expression was markedly increased in T-MP groups. It was concluded that T-MP seed extract could protect testicular apoptosis induced by Eth via changes in caspase, PCNA, and D2R protein expressions.
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Affiliation(s)
- R Samrid
- Khon Kaen University, Faculty of Medicine, Department of Anatomy, Khon Kaen, Thailand
| | - C Taoto
- Khon Kaen University, Faculty of Medicine, Department of Anatomy, Khon Kaen, Thailand
| | - A Wu
- Taipei Medical University, The PhD Program of Translational Medicine, Taipei, Taiwan
| | - T Sawatpanich
- Khon Kaen University, Faculty of Medicine, Department of Anatomy, Khon Kaen, Thailand
| | - N Phunchago
- Khon Kaen University, Faculty of Medicine, Department of Anatomy, Khon Kaen, Thailand
| | - N Uabundit
- Khon Kaen University, Faculty of Medicine, Department of Anatomy, Khon Kaen, Thailand
| | - S Iamsaard
- Khon Kaen University, Faculty of Medicine, Department of Anatomy, Khon Kaen, Thailand
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Li S, Yi C, Yu Z, Wu A, Zhang Y, Lin Y. Accuracy assessment of implant placement with versus without a CAD/CAM surgical guide by novices versus specialists via the digital registration method: an in vitro randomized crossover study. BMC Oral Health 2023; 23:426. [PMID: 37370027 PMCID: PMC10294323 DOI: 10.1186/s12903-023-03116-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Many studies demonstrated that surgical guides might reduce discrepancies compared with freehand implant placement. This randomized crossover study aimed to assess the effects of approaches, practitioners' experience and learning sequences on the accuracy of single tooth implantation via digital registration method. No similar study was found. METHODS This in vitro randomized crossover study enrolled 60 novice students (Group S) and 10 experienced instructors (Group I). Sixty students were randomly and evenly assigned to two groups (Group SA and SB). In Group SA, 30 students first performed single molar implant on a simulation model freehand (Group SAFH), and then with a CAD/CAM surgical guide (Group SASG). In Group SB, another 30 students first performed guided (Group SBSG) and then freehand (Group SBFH). Ten instructors were also divided into Group IAFH/IASG (n = 5) and IBSG/IBFH (n = 5) following the same rules. The accuracy of implant placement was assessed by the coronal and apical distance (mm) and angular (°) deviations using the digital registration method. T tests and nonparametric tests were used to compare the results among different groups of approaches, experience and sequences. RESULTS For students, the coronal and apical distance and the angular deviations were significantly lower in surgical guide group than freehand group in total and in learning freehand first subgroup, but for learning surgical guide first subgroup the apical distance deviation showed no significant difference between two approaches. For students, the angular deviation of freehand group was significantly lower in learning surgical guide first group than learning freehand first group. For instructors, the coronal and apical distance and angular deviations showed no significant difference between two approaches and two sequences. For freehand approach, the coronal and apical distance and the angular deviations were significantly higher in student group than instructor group, while not significantly different between two groups for surgical guide approach. CONCLUSIONS For novices, using a surgical guide for the first implant placement may reduce the potential deviations compared with freehand surgery, and may reach a comparable accuracy with that of specialists. For simple single molar implantation, the surgical guide may not be significantly helpful for experienced specialists.
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Affiliation(s)
- Sha Li
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, P. R. China
| | - Chun Yi
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, P. R. China
| | - Ziyang Yu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology Center of Digital, Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, P. R. China
| | - Aozhou Wu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yu Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, P. R. China.
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, P. R. China.
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McGregor B, Geynisman DM, Burotto M, Suárez C, Bourlon MT, Barata PC, Gulati S, Huo S, Ejzykowicz F, Blum SI, Del Tejo V, Hamilton M, May JR, Du EX, Wu A, Kral P, Ivanescu C, Chin A, Betts KA, Lee CH, Choueiri TK, Cella D, Porta C. A Matching-adjusted Indirect Comparison of Nivolumab Plus Cabozantinib Versus Pembrolizumab Plus Axitinib in Patients with Advanced Renal Cell Carcinoma. Eur Urol Oncol 2023; 6:339-348. [PMID: 36842942 DOI: 10.1016/j.euo.2023.01.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/21/2022] [Accepted: 01/31/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND The comparative efficacy and health-related quality of life (HRQoL) outcomes of nivolumab plus cabozantinib versus pembrolizumab plus axitinib as first-line treatments for advanced renal cell carcinoma (aRCC) have not been assessed in head-to-head trials. OBJECTIVE To assess the efficacy and HRQoL outcomes of nivolumab plus cabozantinib versus pembrolizumab plus axitinib. DESIGN, SETTING, AND PARTICIPANTS Patient-level data for nivolumab plus cabozantinib from the CheckMate 9ER trial and published data for pembrolizumab plus axitinib from the KEYNOTE-426 trial were used. CheckMate 9ER data were reweighted to match the key baseline characteristics as reported in KEYNOTE-426. INTERVENTION Nivolumab (240 mg every 2 wk) plus cabozantinib (40 mg once daily) and pembrolizumab (200 mg every 3 wk) plus axitinib (5 mg twice daily, initially). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Hazard ratios (HRs) for progression-free survival (PFS), duration of response, overall survival (OS), and deterioration in HRQoL were assessed using weighted Cox proportional-hazard models, with sunitinib as a common anchor. Objective response rates (ORRs) and changes in HRQoL scores from baseline were assessed as difference-in-differences for the two treatments relative to sunitinib. RESULTS AND LIMITATIONS After balancing patient characteristics between the trials, nivolumab plus cabozantinib was associated with significantly improved PFS (HR [95% confidence interval {CI}] 0.70 [0.53-0.93]; p = 0.01) and a significantly decreased risk of confirmed deterioration in HRQoL (Functional Assessment of Cancer Therapy-Kidney Symptom Index-Disease-related Symptoms: HR [95% CI] 0.48 [0.34-0.69]) versus pembrolizumab plus axitinib. OS was similar between treatments (HR [95% CI] 0.99 [0.67-1.44]; p = 0.94). Nivolumab plus cabozantinib was associated with numerically greater ORRs (difference-in-difference [95% CI] 8.4% [-1.7 to 18.4]; p = 0.10) and longer duration of response (HR [95% CI] 0.79 [0.47-1.31]; p = 0.36) than pembrolizumab plus axitinib. Comparative studies using data with a longer duration of follow-up are warranted. CONCLUSIONS Nivolumab plus cabozantinib significantly improved PFS and HRQoL compared with pembrolizumab plus axitinib as first-line treatment for aRCC. PATIENT SUMMARY This study was conducted to indirectly compare the results of two immunotherapy-based combinations-nivolumab plus cabozantinib versus pembrolizumab plus axitinib-for patients who have not received any treatment for advanced renal cell carcinoma. Patients who received nivolumab plus cabozantinib had a significant improvement in the length of time without worsening of their disease and in their perceived physical and mental health compared with pembrolizumab plus axitinib; patients remained alive for a similar length of time from the start of either treatment. This analysis further adds to our current knowledge of the relative benefits of these two treatment regimens and will help with physician and patient treatment decisions.
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Affiliation(s)
- Bradley McGregor
- The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Daniel M Geynisman
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Cristina Suárez
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maria T Bourlon
- Hematology-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Pedro C Barata
- Deming Department of Medicine, Tulane Medical School, New Orleans, LA, USA
| | - Shuchi Gulati
- Division of Hematology and Oncology, Department of Medicine, University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Stephen Huo
- Worldwide Health Economics and Outcomes Research US Market, Bristol Myers Squibb, Princeton, NJ, USA
| | - Flavia Ejzykowicz
- Worldwide Health Economics and Outcomes Research US Market, Bristol Myers Squibb, Princeton, NJ, USA
| | - Steven I Blum
- Worldwide Health Economics and Outcomes Research US Market, Bristol Myers Squibb, Princeton, NJ, USA
| | | | - Melissa Hamilton
- Worldwide Health Economics and Outcomes Research US Market, Bristol Myers Squibb, Princeton, NJ, USA
| | - Jessica R May
- Worldwide Health Economics and Outcomes Research Markets, Bristol Myers Squibb, Uxbridge, UK
| | - Ella X Du
- Analysis Group, Inc., Los Angeles, CA, USA
| | - Aozhou Wu
- Analysis Group, Inc., Los Angeles, CA, USA
| | - Pavol Kral
- Patient Centered Solutions, IQVIA, Bratislava, Slovakia
| | | | - Andi Chin
- Analysis Group, Inc., Los Angeles, CA, USA
| | | | - Chung-Han Lee
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Toni K Choueiri
- The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - David Cella
- Department of Medical Social Sciences, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.
| | - Camillo Porta
- Interdisciplinary Department of Medicine, University of Bari "A. Moro", Bari, Italy.
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Merkel M, Danese D, Chen C, Wang J, Wu A, Yang H, Lin H. Indirect treatment comparison (ITC) of the efficacy of vutrisiran and tafamidis for hereditary transthyretin-mediated amyloidosis with polyneuropathy. Expert Opin Pharmacother 2023:1-10. [PMID: 37219406 DOI: 10.1080/14656566.2023.2215925] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Vutrisiran and tafamidis are approved therapies for treating hereditary transthyretin-mediated (ATTRv/hATTR) amyloidosis with polyneuropathy, a rapidly progressive and fatal disease. To assist healthcare decision-makers, an indirect treatment comparison (ITC) was undertaken to explore the comparative efficacy of vutrisiran and tafamidis. RESEARCH DESIGN AND METHODS Individual patient data (vutrisiran vs. placebo) and published results (tafamidis vs. placebo) from phase 3 randomized controlled trials were used in a Bucher analysis to assess differences in treatment effects between vutrisiran and tafamidis on: Neuropathy Impairment Score-Lower Limbs (NIS-LL), Norfolk Quality of Life-Diabetic Neuropathy (Norfolk QOL-DN) score, NIS-LL Response, and modified Body Mass Index (mBMI). RESULTS Greater treatment effects were observed at 18 months with vutrisiran vs. tafamidis for all endpoints, with statistically significant improvements in polyneuropathy (relative mean change in NIS-LL: -5.3 [95% confidence interval (CI): -9.4, -1.2; p = 0.011]), health-related quality of life (HRQOL, relative mean change in Norfolk QOL-DN: -18.3 [95% CI: -28.6, -8.0; p < 0.001]), and nutritional status (relative mean change in mBMI: 63.9 [95% CI: 10.1, 117.7; p = 0.020]). CONCLUSIONS This analysis suggests vutrisiran has greater efficacy on multiple measures of polyneuropathy impairment and HRQOL compared to tafamidis in patients with ATTRv amyloidosis with polyneuropathy.
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Affiliation(s)
- Madeline Merkel
- Alnylam Pharmaceuticals, Cambridge, Massachusetts, United States
| | - David Danese
- Alnylam Pharmaceuticals, Cambridge, Massachusetts, United States
| | - Chongshu Chen
- Alnylam Pharmaceuticals, Cambridge, Massachusetts, United States
| | - Jessie Wang
- Analysis Group, Boston, Massachusetts, United States
| | - Aozhou Wu
- Analysis Group, Boston, Massachusetts, United States
| | - Hongbo Yang
- Analysis Group, Boston, Massachusetts, United States
| | - Hollis Lin
- Alnylam Pharmaceuticals, Cambridge, Massachusetts, United States
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Wu A, Spisak M, Kashem A, Kehara H, Shigemura N, Toyoda Y. Comparison of Alemtuzumab to Basiliximab on Post-Operative Pulmonary Function Following Lung Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1291] [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: 04/05/2023] Open
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Rimner A, Lok B, Gelblum D, Kotecha R, Albrecht F, Shin J, Laplant Q, Namakydoust A, Shepherd A, Gomez D, Shaverdian N, Wu A, Simone C, Yu H, Ng K, Daly R, Offin M, Ginsberg M, Zhang Z, Rudin C. 169P Phase I dose escalation trial combining olaparib and thoracic radiation therapy in extensive-stage small cell lung cancer. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00423-9] [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: 04/03/2023]
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VIZCAYA D, James G, Betts K, Wu A, Chen J, Elena P, Palombo G, Kubin M, van Bommel-Wegmann S, Beeman S, Oberprieler N. WCN23-0277 Use of anti-hyperglycemic medications in patients with incident CKD and T2D by CKD severity: a descriptive study using a large US electronic health records database. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.378] [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: 03/22/2023] Open
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Scheppach JB, Wu A, Gottesman RF, Mosley TH, Arsiwala-Scheppach LT, Knopman DS, Grams ME, Sharrett AR, Coresh J, Koton S. Association of Kidney Function Measures With Signs of Neurodegeneration and Small Vessel Disease on Brain Magnetic Resonance Imaging: The Atherosclerosis Risk in Communities (ARIC) Study. Am J Kidney Dis 2023; 81:261-269.e1. [PMID: 36179945 PMCID: PMC9974563 DOI: 10.1053/j.ajkd.2022.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/21/2022] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Chronic kidney disease (CKD) is a risk factor for cognitive decline, but evidence is limited on its etiology and morphological manifestation in the brain. We evaluated the association of estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR) with structural brain abnormalities visible on magnetic resonance imaging (MRI). We also assessed whether this association was altered when different filtration markers were used to estimate GFR. STUDY DESIGN Cross-sectional study nested in a cohort study. SETTING & PARTICIPANTS 1,527 participants in the Atherosclerosis Risk in Communities (ARIC) Study. PREDICTORS Log(UACR) and eGFR based on cystatin C, creatinine, cystatin C and creatinine in combination, or β2-microglobulin (B2M). OUTCOMES Brain volume reduction, infarcts, microhemorrhages, white matter lesions. ANALYTICAL APPROACH Multivariable linear and logistic regression models fit separately for each predictor based on a 1-IQR difference in the predictor value. RESULTS Each 1-IQR lower eGFR was associated with reduced cortex volume (regression coefficient: -0.07 [95% CI, -0.12 to-0.02]), greater white matter hyperintensity volume (logarithmically transformed; regression coefficient: 0.07 [95% CI, 0.01-0.15]), and lower white matter fractional anisotropy (regression coefficient: -0.08 [95% CI, -0.17 to-0.01]). The results were similar when eGFR was estimated with different equations based on cystatin C, creatinine, a combination of cystatin C and creatinine, or B2M. Higher log(UACR) was similarly associated with these outcomes as well as brain infarcts and microhemorrhages (odds ratios per 1-IQR-fold greater UACR of 1.31 [95% CI, 1.13-1.52] and 1.30 [95% CI, 1.12-1.51], respectively). The degree to which brain volume was lower in regions usually susceptible to Alzheimer disease and LATE (limbic-predominant age-related TDP-43 [Tar DNA binding protein 43] encephalopathy) was similar to that seen in the rest of the cortex. LIMITATIONS No inference about longitudinal effects due to cross-sectional design. CONCLUSIONS We found eGFR and UACR are associated with structural brain damage across different domains of etiology, and eGFR- and UACR-related brain atrophy is not selective for regions typically affected by Alzheimer disease and LATE. Hence, Alzheimer disease or LATE may not be leading contributors to neurodegeneration associated with CKD.
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Affiliation(s)
- Johannes B Scheppach
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Department of Nephrology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Aozhou Wu
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Rebecca F Gottesman
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Current affiliation: National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, Maryland
| | - Thomas H Mosley
- The MIND Center, University of Mississippi Medical Center, Jackson, Mississippi
| | | | | | - Morgan E Grams
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Division of Nephrology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - A Richey Sharrett
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Josef Coresh
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Silvia Koton
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Zhang Y, Li S, Di P, Zhang Y, Wu A, Lin Y. Comparison of 4‐ or 6‐implant supported immediate full‐arch fixed prostheses: A retrospective cohort study of 217 patients followed up for 3–13 years. Clin Implant Dent Relat Res 2022; 25:381-397. [PMID: 36522852 DOI: 10.1111/cid.13170] [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] [Received: 06/27/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Choosing four or six implants to support immediate full-arch fixed prostheses (FAFPs) is still controversial worldwide. This study aims to analyze and compare the long-term results of All-on-4 and All-on-6. MATERIALS AND METHODS This retrospective cohort study enrolled 217 patients rehabilitated with 1222 implants supporting 271 FAFPs, including 202 prostheses supported by 4 implants (All-on-4 group) and 69 prostheses supported by 6 implants (All-on-6 group), and followed up for 3-13 years. Implant survival, prosthesis survival, complications, and implant marginal bone loss (MBL) were evaluated and compared between two groups. Patient characteristics including age, gender, jaw, opposite dentition condition, smoking habit, bruxism, bone quantity and quality, cantilever length (CL), prosthesis material, and oral hygiene were analyzed to assess their influence on the clinical results of the two groups. Six surgeons and three prosthodontists who performed FAFPs more than 5 years were invited for questionnaires, to assess patient- and clinician-related influences on implant number. RESULT In general, All-on-4 group indicated no significant difference with All-on-6 group in the implant survival (implant-level: hazard ratio [HR] = 1.0 [95% confidence interval (CI): 0.8-1.2], P = 0.96; prosthesis-level: HR = 0.8 [95% CI: 0.3-1.8], P = 0.54), prosthesis survival (odds ratio [OR] = 0.8 [95% CI: 0.3-2.8], P = 0.56), biological complications (OR = 0.9 [95% CI: 0.5-1.8], P = 0.78), technical complications of provisional prosthesis (OR = 1.3 [95% CI: 0.7-2.3], P = 0.42), technical complications of definitive prosthesis (OR = 1.1 [95% CI: 0.6-2.2], P = 0.33) and the 1st, 5th, and 10th year MBL (P = 0.65, P = 0.28, P = 0.14). However, for specific covariates, including elderly patients, opposing natural/fixed dentition, smoking, bruxism, long CL, low bone density, and all acrylic provisional prostheses, All-on-6 was more predictable in some clinical measurements than All-on-4. The implant prosthodontists and the medium-experienced clinicians showed significant preference for All-on-6 (P < 0.05). CONCLUSION Based on this study, the long-term clinical results showed no significant difference between All-on-4 and All-on-6 groups in general. However, for some specific characteristics, All-on-6 seemed to be more predictable in some clinical measurements than All-on-4. For the clinicians' decision-making, medium-experienced clinicians and the implant prosthodontists showed significant preference for All-on-6.
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Affiliation(s)
- Yan Zhang
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing People's Republic of China
| | - Sha Li
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing People's Republic of China
| | - Ping Di
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing People's Republic of China
| | - Yu Zhang
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing People's Republic of China
| | - Aozhou Wu
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Ye Lin
- Department of Oral Implantology Peking University School and Hospital of Stomatology Beijing People's Republic of China
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Germino E, Zettlitz K, La Placa D, Li S, McGee H, Williams T, Wu A. Combined Radiation and Anti-CTLA4 Induces a CD8+ Immune Response in an Orthotopic Mouse Model of Breast Cancer Which is Detectable with CD8 ImmunoPET at an Early Timepoint after Treatment. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.573] [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: 11/28/2022]
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Arps K, Harrington J, Carnicelli AP, Wu A, Chiswell K, Chamberlain AM, Chrischilles E, Jones WS, Raj V, Steinberg BA, Mundl H, Viethen T, Granger CB, Piccini JP, Patel MR. Incidence and risk factors for major bleeding events in atrial fibrillation patients on direct oral anticoagulant therapy: data from the National Patient-Centered Clinical Research Network. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.624] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Direct oral anticoagulation (DOACs) prevent stroke in patients with atrial fibrillation (AF) and have a superior safety profile compared with vitamin K antagonists (VKA). Yet, better definition of incidence and risk factors for major bleeding associated with DOACs in clinical practice may be important given emerging stroke prevention technologies, both pharmacologic and nonpharmacologic.
Purpose
To describe the incidence of and risk factors for major bleeding in individuals with AF on DOAC therapy.
Methods
We reviewed electronic health record data for two patient cohorts with AF prescribed DOACs: (1) Duke University Health System (DUHS) (2010–2018) and (2) Sites within the Patient-Centered Clinical Research Network (PCORnet) (2015–2019) which had ≥6 years assimilated data from both inpatient and outpatient encounters (7 sites). In each cohort, we assessed the 5-year incidence of major bleeding events defined as hospitalization for intracranial hemorrhage, or hospitalization for gastro-intestinal bleeding or procedure to control bleeding accompanied by transfusion within ±7 days or death within 30 days. Multivariable Fine-Gray proportional hazards modeling in each cohort was performed to evaluate independent risk factors for major bleeding on DOAC therapy.
Results
The cohorts included 10,625 patients (DUHS) and 58,321 patients (PCORnet) with AF. Major bleeding events occurred within 5 years of diagnosis in 639 (7.9%) of DUHS patients and 2568 (6.6%) of PCORnet patients (Table 1). The DUHS model predicted time to first major bleeding event with a C-index of 0.756 (95% CI 0.737, 0.775) and the PCORNet model had a c-index of 0.745 (0.736, 0.755) (Table 2). Independent factors associated with major bleeding consistent across both models (p<0.001 in PCORnet for all unless noted) were higher CHA2DS2-VASc scores, lower eGFR, anemia (HR per 1-point increase in hemoglobin up to 12 g/dL 0.79 [0.76, 0.82]), prior major bleeding (HR 2.70 [2.22, 3.30]), cancer (HR 1.23 [1.12, 1.36]), recent cardiac surgery (HR 0.70 [0.51, 0.97]; p=0.030), alcohol use (HR 1.56 [1.29, 1.88]), aspirin use (HR 1.44 [1.32, 1.57]), and selective serotonin reuptake inhibitor use (HR 1.30 [1.19, 1.42]).
Conclusions
Across a large and geographically diverse contemporary population, risk of bleeding on DOAC for stroke prevention in AF remains a frequent and important clinical problem. There is an unmet need for stroke prevention therapies with improved safety profiles. We identified risk factors for major bleeding events on DOAC therapy, some of which are not represented in traditional risk scores, which may inform shared decision making for stroke prevention.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Bayer Pharmaceuticals
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Affiliation(s)
- K Arps
- Duke Clinical Research Institute , Durham , United States of America
| | - J Harrington
- Duke Clinical Research Institute , Durham , United States of America
| | - A P Carnicelli
- Duke Clinical Research Institute , Durham , United States of America
| | - A Wu
- Duke Clinical Research Institute , Durham , United States of America
| | - K Chiswell
- Duke Clinical Research Institute , Durham , United States of America
| | | | - E Chrischilles
- University of Iowa , Iowa City , United States of America
| | - W S Jones
- Duke Clinical Research Institute , Durham , United States of America
| | - V Raj
- Allina Health , Minneapolis , United States of America
| | - B A Steinberg
- University of Utah , Salt Lake City , United States of America
| | - H Mundl
- Bayer AG , Wuppertal , Germany
| | | | - C B Granger
- Duke Clinical Research Institute , Durham , United States of America
| | - J P Piccini
- Duke Clinical Research Institute , Durham , United States of America
| | - M R Patel
- Duke Clinical Research Institute , Durham , United States of America
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Harrington J, Arps K, Wu A, Carnicelli AP, Chiswell K, Chrischilles E, Shantha G, Vanwormer J, Mundl H, Viethan T, Alexander JH, Lopes RD, Washam J, Patel MR. Reduced dose, but not reduced risk: rates of inappropriate apixaban dose reduction and stroke and bleeding incidence. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2709] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Patients with atrial fibrillation (AF) should be prescribed standard-dose (5mg twice daily) apixaban for stroke prevention unless they meet 2 or more criteria: age ≥80, weight ≤60kg, and/or creatinine ≤1.5mg/dL, in which case a reduced-dose (2.5mg twice daily) is indicated. Despite this, some clinicians may also prescribe reduced-dose apixaban to patients who do not meet criteria for dose reduction, in an effort to reduce bleeding risk.
Purpose
To assess apixaban prescribing patterns in patients with AF based on dose reduction criteria and to characterize baseline demographics and incidence of ischemic stroke, major bleeding, and intracranial hemorrhage (ICH) for patients stratified by standard-dose, appropriately reduced-dose, and inappropriately reduced-dose apixaban.
Methods
Using pooled data from 8 large hospitals in PCORnet, a multicenter national healthcare research network, we assessed the standard and reduced-dose apixaban prescribing patterns for patients with AF, with additional stratification of patients prescribed 2.5mg based on presence or absence of 2+ criteria for dose reduction. We then assessed baseline characteristics and 5-year event rate of ischemic stroke, major bleeding, ICH and death.
Results
Of 45,947 patients with AF on apixaban and available dosing information, 38,861 (85%) were prescribed apixaban 5mg and 7086 (15%) were prescribed 2.5mg. Of patients prescribed apixaban 2.5mg, 4321 (61%) did not meet criteria for dose reduction. Patients on reduced dose apixaban were more likely to be female and have comorbidities such as heart failure, hypertension, and prior ischemic stroke. These trends were more pronounced for patients meeting dose adjustment criteria than those not meeting criteria (Table 1).
Unadjusted analyses found patients on 2.5mg of apixaban were significantly more likely to experience ischemic stroke, major bleeding, and all-cause death. Patients with 2+ dose reduction criteria on 2.5mg of apixaban had the highest rates of each event, but patients who were prescribed reduced dose without meeting criteria were also at elevated risk (Table 2).
Conclusion
Many patients prescribed reduced-dose apixaban do not meet criteria for dose reduction. Because patients prescribed reduced dose apixaban are older and have more cardiovascular risk factors, their incidence of stroke, major bleeding, and death exceeds that of full dose treated patients. These risks exist both for patients who do and do not meet criteria for dose reduction, suggesting potential under-treatment for the majority of dose-reduced patients.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Bayer
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Affiliation(s)
- J Harrington
- Duke Clinical Research Institute , Durham , United States of America
| | - K Arps
- Duke Clinical Research Institute , Durham , United States of America
| | - A Wu
- Duke Clinical Research Institute , Durham , United States of America
| | - A P Carnicelli
- Duke Clinical Research Institute , Durham , United States of America
| | - K Chiswell
- Duke Clinical Research Institute , Durham , United States of America
| | - E Chrischilles
- University of Iowa College of Public Health , Iowa , United States of America
| | - G Shantha
- Wake Forest Baptist Health , Winston-Salem , United States of America
| | - J Vanwormer
- Marshfield Clinic Research Institute , Marshfield , United States of America
| | - H Mundl
- Bayer AG , Wuppertal , Germany
| | | | - J H Alexander
- Duke Clinical Research Institute , Durham , United States of America
| | - R D Lopes
- Duke Clinical Research Institute , Durham , United States of America
| | - J Washam
- Duke Clinical Research Institute , Durham , United States of America
| | - M R Patel
- Duke Clinical Research Institute , Durham , United States of America
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Cook D, Thomas C, Wu A, Norlander A, Stoltz D, Peebles S. 442 Cystic fibrosis transmembrane conductance regulator regulation of naïve CD4+ T Cell activity: Implications for Th2 disease in cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01132-8] [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: 11/07/2022]
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Du R, Ming J, Geng J, Sui X, Li S, Liu Z, Zhu X, Cai Y, Wang Z, L. Tang, Zhang X, Peng Z, Yan Y, Li Z, Peng Y, Wu A, Li Y, Li Z, Wang W, Ji J. 1215P Neoadjuvant concurrent chemoradiotherapy combined with immunotherapy in the treatment of adenocarcinoma of the oesophagogastric junction: A phase II study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1333] [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] Open
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Mullins CD, Pantalone KM, Betts KA, Song J, Wu A, Chen Y, Kong SX, Singh R. CKD Progression and Economic Burden in Individuals With CKD Associated With Type 2 Diabetes. Kidney Med 2022; 4:100532. [DOI: 10.1016/j.xkme.2022.100532] [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: 10/31/2022] Open
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20
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Wu A, Fahey MT, Cui D, El‐Behesy B, Story DA. An evaluation of the outcome metric 'days alive and at home' in older patients after hip fracture surgery. Anaesthesia 2022; 77:901-909. [PMID: 35489814 PMCID: PMC9543156 DOI: 10.1111/anae.15742] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 03/10/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 01/11/2023]
Abstract
'Days alive and at home' is a validated measure that estimates the time spent at home, defined as the place of residence before admission to hospital. We evaluated this metric in older adults after hip fracture surgery and assessed two follow-up durations, 30 and 90 days. Patients aged ≥ 70 years who underwent hip fracture surgery were identified retrospectively via hospital admission and government mortality records. Patients who successfully returned home and were still alive within 90 days of surgery were distinguished from those who were not. Regression models were used to examine which variables were associated with failure to return home and number of days at home among those who did return, within 90 days of surgery. We analysed the records of 825 patients. Median (IQR [range]) number of days at home within 90 days (n = 788) was 54 (0-76 [0-88]) days and within 30 days (n = 797) it was 2 (0-21 [0-28]) days. Out of these, 274 (35%) patients did not return home within 90 days and 374 (47%) within 30 days after surgery. Known peri-operative risk-factors such as older age, pre-operative anaemia and postoperative acute renal impairment were associated with failure to return home. This study supports days alive and at home as a useful patient-centred outcome measure in older adults after hip fracture surgery. We recommend that this metric should be used in clinical trials and measured at 90, rather than 30, postoperative days. As nearly half of this patient population did not return home within 30 days, the shorter time-period catches fewer meaningful events.
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Affiliation(s)
- A. Wu
- Department of AnaestheticsMaroondah Hospital, Eastern HealthMelbourneAustralia,Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia
| | - M. T. Fahey
- Department of Health Sciences and BiostatisticsSwinburne University of TechnologyMelbourneAustralia,Department of Biostatistics and Clinical TrialsPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - D. Cui
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia,Department of AnaestheticsMaroondah Hospital, Eastern HealthMelbourneAustralia
| | - B. El‐Behesy
- Department of AnaestheticsMaroondah Hospital, Eastern HealthMelbourneAustralia,Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia
| | - D. A. Story
- Department of Critical CareUniversity of Melbourne and Melbourne Academic Centre for HealthMelbourneAustralia
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21
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Betts KA, Song J, Elliott J, Warnock N, Farej R, Wu A, Singh R. Geographical variation in kidney function testing and associations with health care costs among patients with chronic kidney disease and type 2 diabetes. Am J Manag Care 2022; 28:S112-S119. [PMID: 35997775 DOI: 10.37765/ajmc.2022.89211] [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] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Clinical practice guidelines recommend at least annual testing of estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (uACR) for patients with chronic kidney disease (CKD) and type 2 diabetes (T2D). This study assessed the adequacy of eGFR and uACR testing in this patient population across the United States. STUDY DESIGN Observational real-world study. METHODS Adults with CKD and T2D were identified from the Optum Clinformatics database (2015-2019). The eGFR and uACR tests were assessed nationally and by state. The proportions of tested patients and patients receiving adequate monitoring per clinical practice guidelines were analyzed during the 1-year period after T2D and CKD diagnosis, along with all-cause health care costs. RESULTS Among 101,057 adults with CKD and T2D, 94.1% had at least 1 eGFR test and 38.7% had at least 1 uACR test over 1 year. Only 20.3% of patients had adequate uACR monitoring; this was much lower than observed for adequate eGFR monitoring (86.6%). The eGFR testing rates were high across states (range, 79.5% [Colorado] to 97.3% [Alabama]); conversely, uACR testing rates were uniformly lower and showed wider variation (range, 14.0% [Maine] to 58.9% [Hawaii]). Mean annual all-cause health care costs were $28,636 and increased with CKD GFR stage. Lower uACR testing rates were associated with higher health care costs at the state level (Pearson r = -0.55; P < .01). CONCLUSIONS In the United States, uACR testing is underutilized, with large geographical variations in testing rates noted between states. Lower uACR testing rates were associated with higher health care costs. The lack of sufficient uACR testing raises concerns about CKD management in patients with T2D.
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Affiliation(s)
| | | | | | | | | | | | - Rakesh Singh
- Bayer US, LLC, 100 Bayer Blvd., Whippany, NJ 07981.
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22
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Gottesman RF, Wu A, Coresh J, Knopman DS, Jack CR, Rahmim A, Sharrett AR, Spira AP, Wong DF, Wagenknecht LE, Hughes TM, Walker KA, Mosley TH. Associations of vascular risk and amyloid burden with subsequent dementia. Ann Neurol 2022; 92:607-619. [PMID: 35732594 DOI: 10.1002/ana.26447] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Midlife vascular risk factors (MVRF) are associated with incident dementia, as are amyloid β(Aβ) deposition and neurodegeneration. Whether vascular and Alzheimer Disease (AD)-associated factors contribute to dementia independently or interact synergistically to reduce cognition is poorly understood. METHODS Participants in the Atherosclerosis Risk in Communities (ARIC)-PET study were followed from 1987-89(45-64 yo) through 2016-17(74-94 yo), with repeat cognitive assessment and dementia adjudication. In 2011-13, dementia-free participants underwent brain MRI (with white matter hyperintensity (WMH) and brain volume measurement) and florbetapir (Aβ) PET. The relative contributions of vascular risk and injury (MVRF, WMH volume), elevated Aβ standardized uptake value ratio (SUVR), and neurodegeneration (smaller temporo-parietal brain regions) to incident dementia were evaluated with adjusted Cox models. RESULTS In 298 individuals, 36 developed dementia (median follow-up 4.9 years). Midlife hypertension and Aβ each independently predicted dementia risk (hypertension:HR 2.57 (95% CI 1.16-5.67); Aβ SUVR(per SD):HR 2.57 (1.72-3.84)), but didn't interact significantly, whereas late-life diabetes (HR 2.50 (1.18 to 5.28)) and Aβ independently predicted dementia risk. WMH(per SD):HR 1.51 (1.03-2.20) and Aβ SUVR (HR 2.52 (1.83-3.47)) independently contributed to incident dementia but WMH lost significance when MVRF were included. Smaller temporo-parietal brain regions were associated with incident dementia, independent of Aβ and MVRF (HR 2.18 (1.18-4.01)). INTERPRETATION Midlife hypertension and late-life Aβ are independently associated with dementia risk, without evidence for synergy on a multiplicative scale. Given the independent contributions of vascular and amyloid mechanisms, multiple pathways should be considered when evaluating interventions to reduce the burden of dementia. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Rebecca F Gottesman
- National Institute of Neurological Disorders and Stroke Intramural Program, NIH, Bethesda, MD
| | - Aozhou Wu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | | | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Adam P Spira
- Department of Mental Health and Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, and Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD
| | - Dean F Wong
- Department of Radiology, Washington University, St. Louis, MO
| | | | - Timothy M Hughes
- Department of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Keenan A Walker
- National Institute on Aging Intramural Program, NIH, Bethesda, MD
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
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23
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Boerner T, Tin A, Vickers A, Harrington C, Janjigian Y, Ilson D, Wu A, Bott M, Isbell J, Park B, Sihag S, Jones D, Downey R, Shahrokni A, Molena D. SO-6 Novel frailty index predicts short-term outcomes after esophagectomy in elderly patients with esophageal cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.405] [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: 11/01/2022] Open
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24
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Haseltine J, Apte A, Jackson A, Yorke E, Yu A, Wu A, Peleg A, Al-Sadawi M, Iocolano M, Gelblum D, Shaverdian N, Simone, Ii C, Rimner A, Gomez D, Shepherd A. P27.02 Associating Cardiac Plaque Accumulation With Cardiac Toxicity and Overall Survival In Locally Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.385] [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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25
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Hanvesakul R, Boccuti A, Meyer J, Rengarajan B, Wu A, Chakrabarti D, Li W. P64.02 EMERGE 402 Phase 4 Observational Study: Safety and Outcomes in Patients With SCLC Receiving Treatment With Lurbinectedin. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.673] [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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26
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Xie J, Wu A, Liao L, Nastoupil LJ, Du EX, Noman A, Chen L. Characteristics and treatment patterns of relapsed/refractory diffuse large B-cell lymphoma in patients receiving ≥3 therapy lines in post-CAR-T era. Curr Med Res Opin 2021; 37:1789-1798. [PMID: 34344238 DOI: 10.1080/03007995.2021.1957806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Several novel treatments have been approved for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) since chimeric antigen receptor T-cell (CAR-T) therapy became available. The objective of this study was to describe characteristics and treatment patterns in patients with R/R DLBCL post-CAR-T approval. METHODS Adult patients with R/R DLBCL who initiated third-line treatment or later (3 L+) since 18 October 2017 were identified using administrative claims from IQVIA PharMetrics Plus (1 January 2014-31 March 2020). Treatments were categorized as chemotherapy/chemoimmunotherapy (CT/CIT), targeted therapies, CAR-T and stem cell transplant (SCT). Treatment distribution, treatment duration of CT/CIT and targeted therapies, and initiation of next-line therapy were described for patients receiving 3 L; analyses were repeated for 4 L. RESULTS A total of 145 patients received 3 L between 18 October 2017 and 31 March 2020. Mean age was 57 years, and 34% were female. CT/CIT (44.9%), targeted therapies (26.9%), CAR-T (17.2%) and SCT (11.0%) were administered in 3 L. The median treatment duration was 2.9 months for CT/CIT and targeted therapies combined. 31% of patients initiated 4 L within a median follow-up of 5.8 months. Among patients who received 4 L (N = 55), targeted therapies were most commonly used (36.4%), and the median treatment duration was 2.5 months. CONCLUSIONS Post-CAR-T approval, the majority of patients were treated with CT/CIT or targeted therapies in 3 L and 4 L, though most of the targeted therapies prescribed are not indicated for DLBCL. Treatment duration was short. A high proportion of patients moved to the next line of therapy (LOT) during a short follow-up period. This study highlights the unmet need for more effective treatments for patients with R/R DLBCL in 3 L+.
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Affiliation(s)
- Jipan Xie
- Analysis Group Inc., Los Angeles, CA, USA
| | - Aozhou Wu
- Analysis Group Inc., Los Angeles, CA, USA
| | - Laura Liao
- ADC Therapeutics Inc., New Providence, NJ, USA
| | - Loretta J Nastoupil
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, University of Texas, Houston, TX, USA
| | | | | | - Lei Chen
- ADC Therapeutics Inc., New Providence, NJ, USA
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27
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Zhang J, Wang A, Li Z, Su X, Wu A, Li H, Ji J. 334TiP A phase I trial of niraparib plus anlotinib in advanced solid tumors with homologous recombination repair (HRR) gene mutations. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.617] [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] Open
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28
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Iyer A, Chen I, Thor M, Wu A, Apte A, Rimner A, Gomez D, Deasy J, Jackson A. PD-0785 Personalized fractionation of ultracentral lung tumors using modeled outcomes from treated patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07064-x] [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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29
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Tin A, Walker KA, Bressler J, Windham BG, Griswold M, Sullivan K, Wu A, Gottesman R, Fornage M, Coresh J, Sharrett AR, Folsom AR, Mosley TH. Association between Circulating Protein C Levels and Incident Dementia: The Atherosclerosis Risk in Communities Study. Neuroepidemiology 2021; 55:306-315. [PMID: 34077937 PMCID: PMC8292178 DOI: 10.1159/000516287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/30/2021] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Hemostasis depends on the delicate balance between coagulants and anticoagulants. Higher levels of circulating coagulants have been associated with higher risk of cerebral infarctions and dementia. In contrast, higher levels of circulating protein C, an endogenous anticoagulant, have been associated with lower risk of cerebral infarctions, and the association between protein C levels and the risk of dementia is unknown. The goal of this study was to evaluate the association of circulating protein C levels in midlife and late life with incident dementia. METHODS Circulating protein C levels were measured using blood samples collected at the midlife baseline (1987-1989) and the late-life baseline (2011-2013) among 14,462 and 3,614 participants, respectively, in the Atherosclerosis Risk in Communities study. Protein C levels were measured using enzyme-linked immunosorbent assay at midlife and a modified aptamer-based assay at late life. Participants were followed up to 2013 from midlife and up to 2017 from late life. Incident dementia was ascertained during the follow-up periods using in-person cognitive and functional assessment, informant interviews, and International Classification of Diseases codes at hospitalization discharge and on death certificates. Cause-specific Cox regression models were used to evaluate the association between quintiles of circulating protein C and incident dementia. RESULTS From midlife (mean age of 54), 1,389 incident dementia events were observed over a median follow-up of 23 years. From late life (mean age of 75), 353 incident dementia events were observed over a median follow-up of 4.9 years. At both midlife and late life, circulating protein C had an inverse association with incident dementia after adjusting for demographic, vascular, and hemostatic risk factors, incident stroke as time-dependent covariate, and incorporating stabilized weights based on propensity scores (quintile 5 vs. quintile 1 as the reference, midlife hazard ratio 0.80, 95% confidence interval 0.66-0.96, p value for trend 0.04; late-life hazard ratio 0.84, 95% confidence interval: 0.55-1.28, p value for trend 0.04). DISCUSSION/CONCLUSION Circulating protein C has an inverse association with incident dementia independent of established risk factors, including stroke. Our results suggest studying anticoagulants in addition to coagulants can increase our understanding on the relationship between hemostasis and dementia.
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Affiliation(s)
- Adrienne Tin
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Keenan A. Walker
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Jan Bressler
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B. Gwen Windham
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michael Griswold
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kevin Sullivan
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Aozhou Wu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rebecca Gottesman
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Myriam Fornage
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A. Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aaron R. Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Thomas H. Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
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McGregor BA, Geynisman DM, Burotto M, Porta C, Suarez Rodriguez C, Bourlon MT, Barata PC, Gulati S, Stwalley B, Del Tejo V, Du EX, Wu A, Chin A, Betts KA, Huo S, Choueiri TK. Efficacy outcomes of nivolumab + cabozantinib versus pembrolizumab + axitinib in patients with advanced renal cell carcinoma (aRCC): Matching-adjusted indirect comparison (MAIC). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.4578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4578 Background: Nivolumab in combination with cabozantinib (N+C) has demonstrated significantly improved progression-free survival (PFS), objective response rate (ORR), and overall survival (OS), compared with sunitinib as a first-line (1L) treatment for aRCC in the phase 3 CheckMate (CM) 9ER trial. As there are no head-to-head trials comparing N+C with pembrolizumab in combination with axitinib (P+A), this study compared the efficacy of N+C with P+A as 1L treatment in aRCC. Methods: An MAIC was conducted using individual patient data on N+C (N = 323) from the CM 9ER trial (median follow-up: 23.5 months) and published data on P+A (N = 432) from the KEYNOTE (KN)-426 trialof P+A (median follow-up: 30.6 months). Individual patients within the CM 9ER trial population were reweighted to match the key patient characteristics published in KN-426 trial, including age, gender, previous nephrectomy, International Metastatic RCC Database Consortium risk score, and sites of metastasis. After weighting, hazards ratios (HR) of PFS, duration of response (DoR), and OS comparing N+C vs. P+A were estimated using weighted Cox proportional hazards models, and ORR was compared using a weighted Wald test. All comparisons were conducted using the corresponding sunitinib arms as an anchor. Results: After weighting, patient characteristics in the CM 9ER trial were comparable to those in the KN-426 trial. In the weighted population, N+C had a median PFS of 19.3 months (95% CI: 15.2, 22.4) compared to a median PFS of 15.7 months (95% CI: 13.7, 20.6) for P+A. Using sunitinib as an anchor arm, N+C was associated with a 30% reduction in risk of progression or death compared to P+A, (HR: 0.70, 95% CI: 0.53, 0.93; P = 0.015; table). In addition, N+C was associated with numerically, although not statistically, higher improvement in ORR vs sunitinib (difference: 8.4%, 95% CI: -1.7%, 18.4%; P = 0.105) and improved DoR (HR: 0.79; 95% CI: 0.47, 1.31; P = 0.359). Similar OS outcomes were observed for N+C and P+A (HR: 0.99; 95% CI: 0.67, 1.44; P = 0.940). Conclusions: After adjusting for cross-trial differences, N+C had a more favorable efficacy profile compared to P+A, including statistically significant PFS benefits, numerically improved ORR and DoR, and similar OS.[Table: see text]
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Affiliation(s)
| | - Daniel M. Geynisman
- Fox Chase Cancer Center, Department of Hematology and Oncology, Philadelphia, PA
| | | | - Camillo Porta
- University of Bari 'A. Moro' and Policlinico Consorziale di Bari, Bari, Italy
| | - Cristina Suarez Rodriguez
- Medical Oncology, Vall d´Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d´Hebron, Vall d´Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maria Teresa Bourlon
- Urologic Oncology Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, DF, Mexico
| | | | - Shuchi Gulati
- University of Cincinnati Medical Center, Cincinnati, OH
| | | | | | | | - Aozhou Wu
- Analysis Group, Inc., Los Angeles, CA
| | | | | | | | - Toni K. Choueiri
- Dana-Farber Cancer Institute, The Lank Center for Genitourinary Oncology, Boston, MA
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Chen L, Xie J, Wu A, Liao L, Du EX, Noman A, Nastoupil LJ. Resource use and costs in patients with relapsed/refractory diffuse large C-cell lymphoma who initiated a third-line therapy in the post CAR-T era: A longitudinal outlook. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e19560] [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: 11/20/2022] Open
Abstract
e19560 Background: The study described longitudinal costs and healthcare resource utilization (HRU) associated with third-line (3L) treatments in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) post chimeric antigen receptor T-cell (CAR-T) approval. Methods: Adult patients newly diagnosed with DLBCL (ICD-10: C83.3) from 10/01/2015 to 03/31/2020 and receiving 3L after CAR-T approval (10/18/2017) were identified from IQVIA PharMetrics Plus. Monthly HRU and total costs were evaluated during month 1, months 2-6, and months 7-12 following 3L initiation for three treatment groups: CAR-T, stem cell transplantation (SCT), and non-cell therapy including chemoimmunotherapy and the targeted therapies that are recommended by the NCCN guidelines (including brentuximab vedotin, ibrutinib, venetoclax, lenalidomide, polatuzumab, obinutuzumab, nivolumab and pembrolizumab). Results: The study identified 145 R/R DLBCL patients initiating 3L with a mean age of 56.7 years and 66.2% male; 135 patients with ≥1 month of follow-up (median 6.7 months) were included: 24 CAR-T, 15 SCT, 96 non-cell therapy. At each time period, CAR-T had the highest median monthly costs, followed by SCT; both had higher median costs than non-cell therapy. The median monthly costs for CAR-T and SCT were $205,034 and $160,423 in month 1, and reduced to $14,333 and $11,840 in months 2-6, then increased to $27,090 and $17,695 in months 7-12, respectively. The monthly median cost for non-cell therapy was $36,015, $11,878, and $4,806 in month 1, months 2-6 and 7-12, respectively. Inpatient (IP) visits and IP days were higher in month 1 than later months for CAR-T and SCT. In addition, outpatient (OP) and emergency room (ER) visits were more frequent for CAR-T than SCT except for ER visits in month 1 (Table). Conclusions: In R/R DLBCL patients receiving 3L, CAR-T had the highest median monthly costs during month 1, months 2-6 and 7-12. In addition, CAR-T has more frequent OP and ER visits compared with SCT in general.[Table: see text] The maximum observed follow-up time for SCT was 8 months. Other visits were mainly home care visits.
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Affiliation(s)
- Lei Chen
- ADC Therapeutics, Inc., New Providence, NJ
| | - Jipan Xie
- Analysis Group, Inc., Los Angeles, CA
| | - Aozhou Wu
- Analysis Group, Inc., Los Angeles, CA
| | - Laura Liao
- ADC Therapeutics, Inc., New Providence, NJ
| | | | | | - Loretta J. Nastoupil
- The University of Texas MD Anderson Cancer Center, Department of Lymphoma/Myeloma, Houston, TX
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England R, Motaghi M, Wu A, Weiss C. Abstract No. 150 Development and validation of a health-related quality-of-life measure for vascular malformations: the PROVAM questionnaire. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.156] [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: 10/21/2022] Open
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33
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Walker KA, Chen J, Zhang J, Fornage M, Yang Y, Zhou L, Grams ME, Tin A, Daya N, Hoogeveen RC, Wu A, Sullivan KJ, Ganz P, Zeger SL, Gudmundsson EF, Emilsson V, Launer LJ, Jennings LL, Gudnason V, Chatterjee N, Gottesman RF, Mosley TH, Boerwinkle E, Ballantyne CM, Coresh J. Large-scale plasma proteomic analysis identifies proteins and pathways associated with dementia risk. Nat Aging 2021; 1:473-489. [PMID: 37118015 PMCID: PMC10154040 DOI: 10.1038/s43587-021-00064-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 04/02/2021] [Indexed: 04/30/2023]
Abstract
The plasma proteomic changes that precede the onset of dementia could yield insights into disease biology and highlight new biomarkers and avenues for intervention. We quantified 4,877 plasma proteins in nondemented older adults in the Atherosclerosis Risk in Communities cohort and performed a proteome-wide association study of dementia risk over five years (n = 4,110; 428 incident cases). Thirty-eight proteins were associated with incident dementia after Bonferroni correction. Of these, 16 were also associated with late-life dementia risk when measured in plasma collected nearly 20 years earlier, during mid-life. Two-sample Mendelian randomization causally implicated two dementia-associated proteins (SVEP1 and angiostatin) in Alzheimer's disease. SVEP1, an immunologically relevant cellular adhesion protein, was found to be part of larger dementia-associated protein networks, and circulating levels were associated with atrophy in brain regions vulnerable to Alzheimer's pathology. Pathway analyses for the broader set of dementia-associated proteins implicated immune, lipid, metabolic signaling and hemostasis pathways in dementia pathogenesis.
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Affiliation(s)
- Keenan A Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Jingsha Chen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jingning Zhang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School and Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Yunju Yang
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School and Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Linda Zhou
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Morgan E Grams
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Adrienne Tin
- MIND Center and Division of Nephrology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Natalie Daya
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ron C Hoogeveen
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Aozhou Wu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kevin J Sullivan
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Peter Ganz
- Department of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Scott L Zeger
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, MD, USA
| | - Lori L Jennings
- Novartis Institutes for Biomedical Research, Cambridge, MA, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Nilanjan Chatterjee
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rebecca F Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas H Mosley
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Christie M Ballantyne
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Veerabagu S, Strunck J, Lin K, Wu A, Jefferson I, Brumfiel C, Brodell R, Etzkorn J. 373 The value of an anonymous online interactive forum: What questions are applicants asking? J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.395] [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: 10/21/2022]
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Shao Z, Wang B, Shi Y, Xie C, Huang C, Chen B, Zhang H, Zeng G, Liang H, Wu Y, Zhou Y, Tian N, Wu A, Gao W, Wang X, Zhang X. Senolytic agent Quercetin ameliorates intervertebral disc degeneration via the Nrf2/NF-κB axis. Osteoarthritis Cartilage 2021; 29:413-422. [PMID: 33242601 DOI: 10.1016/j.joca.2020.11.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/24/2020] [Accepted: 11/15/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Intervertebral disc degeneration (IDD) represents major cause of low back pain. Quercetin (QUE) is one of the approved senolytic agents. In this study, we evaluated the protective effects of QUE on IDD development and its underlying mechanism. METHODS Effects of senolytic agent QUE on the viability of nucleus pulposus cells (NPCs) were measured by CCK-8 assays and EdU staining. The senescence associated secreted phenotype (SASP) factors expressions were measured by qPCR, western blot, and ELISA; and NF-κB pathway was detected by immunofluorescence and western blot. Molecular docking was applied to predict the interacting protein of QUE; while Nrf2 was knocked down by siRNAs to confirm its role in QUE regulated senescence phenotype. X-ray, MRI, Hematoxylin-Eosin and Safranin O-Fast green staining were performed to evaluate the therapeutic effects of QUE on IDD in the puncture-induced rat model. RESULTS In in vitro experiments, QUE inhibited SASP factors expression and senescence phenotype in IL-1β-treated NPCs. Mechanistically, QUE suppressed IL-1β induced activation of the NF-κB pathway cascades; it was also demonstrated in molecular docking and knock down studies that QUE might bind to Keap1-Nrf2 complex to suppress NF-κB pathway. In vivo, QUE ameliorated the IDD process in the puncture-induced rat model. CONCLUSIONS Together the present work suggests that QUE inhibits SASP factors expression and senescence phenotype in NPCs and ameliorates the progression of IDD via the Nrf2/NF-κB axis, which supports senolytic agent QUE as a potential therapeutic agent for the treatment of IDD.
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Affiliation(s)
- Z Shao
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - B Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Y Shi
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - C Xie
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - C Huang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - B Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - H Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - G Zeng
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - H Liang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Y Wu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Y Zhou
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - N Tian
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - A Wu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - W Gao
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - X Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
| | - X Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Chinese Orthopaedic Regenerative Medicine Society, Hangzhou, Zhejiang Province, China.
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Wu A, Plodkowski A, Ginsberg M, Shin J, Laplant Q, Shepherd A, Shaverdian N, Ng V, Yue Y, Gilbo P, Gelblum D, Braunstein L, Gomez D, Rimner A. P02.14 Radiotherapy-Associated CT Imaging as a Potential Screening Tool for COVID-19. J Thorac Oncol 2021. [PMCID: PMC7976875 DOI: 10.1016/j.jtho.2021.01.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Shepherd A, Yu A, Al-Sadawi M, Peleg A, Iocolano M, Leeman J, Imber B, Wild A, Offin M, Chaft J, Huang J, Rimner A, Wu A, Gelblum D, Shaverdian N, Gomez D, Simone Ii C, Yorke E, Jackson A. FP04.01 Heart Dose is a Dosimetric Predictor of Overall Survival in Patients with NSCLC Undergoing Post-Operative Radiation Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.088] [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: 10/21/2022]
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Sharma R, Matsushita K, Wu A, Jack CR, Griswold M, Mosley TH, Fornage M, Gottesman RF. Common Medications and Intracerebral Hemorrhage: The ARIC Study. J Am Heart Assoc 2021; 10:e014270. [PMID: 33586464 PMCID: PMC8174245 DOI: 10.1161/jaha.120.014270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 03/03/2020] [Accepted: 11/23/2020] [Indexed: 01/28/2023]
Abstract
Background Antiplatelets, anticoagulants, and statins are commonly prescribed for various indications. The associations between these medications and the risk of intracerebral hemorrhage (ICH) and cerebral microbleeds (CMBs) are unclear. Methods and Results We performed a retrospective study of the ARIC (Atherosclerosis Risk in Communities) study cohort, recruited from 4 US communities in 1987 to 1989 with follow-up. In 2011 to 2013, a subset (N=1942) underwent brain magnetic resonance imaging with CMB evaluation. Time-varying and any antiplatelet, anticoagulant, or statin use was evaluated at subsequent study visits in participants not on each medication at baseline. To determine the hazard of ICH and odds of CMB by medication use, logistic and Cox proportional hazard models were built, respectively, adjusting for the propensity to take the medication, concomitant use of other medications, and cognitive, genetic, and radiographic data. Of 15 719 individuals during up to 20 years of follow-up, 130 participants experienced an ICH. The adjusted hazard of ICH was significantly lower among participants taking an antiplatelet at the most recent study visit before ICH versus nonusers (hazard ratio [HR], 0.53; 95% CI, 0.30-0.92). Statin users had a significantly lower hazard of an ICH compared with nonusers (adjusted HR, 0.13; 95% CI, 0.05-0.34). There was no association of CMB and antiplatelet, anticoagulant, or statin use in adjusted models. Conclusions In this US community-based study, antiplatelet and statin use were associated with lower ICH hazard, whereas no association was noted between CMBs and antiplatelets, anticoagulants, and statins. Further study is needed to understand the differential roles of these medications in cerebral microhemorrhages and macrohemorrhages.
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Affiliation(s)
- Richa Sharma
- Department of NeurologyYale University School of MedicineNew HavenCT
| | - Kunihiro Matsushita
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | - Aozhou Wu
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | | | - Michael Griswold
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMS
| | - Thomas H. Mosley
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMS
| | - Myriam Fornage
- Institute of Molecular MedicineUniversity of Texas at HoustonTX
| | - Rebecca F. Gottesman
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
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Parikh ND, Marshall A, Betts KA, Song J, Zhao J, Yuan M, Wu A, Huff KD, Kim R. Network meta-analysis of nivolumab plus ipilimumab in the second-line setting for advanced hepatocellular carcinoma. J Comp Eff Res 2021; 10:343-352. [PMID: 33442996 DOI: 10.2217/cer-2020-0236] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aims: To compare the efficacy of nivolumab 1 mg/kg + ipilimumab 3 mg/kg with regorafenib 160 mg, cabozantinib 60 mg and nivolumab 3 mg/kg monotherapy for second-line treatment of advanced hepatocellular carcinoma. Materials & methods: Indirect comparison using network meta-analysis and propensity score weighting. Results: Nivolumab 1 mg/kg + ipilimumab 3 mg/kg had significantly higher objective response rate (median 31.2% [95% credible interval: 19.6-44.5%]) than cabozantinib (4.2% [2.0-6.5%]) and regorafenib (4.8% [1.1-8.3%]), and significantly longer overall survival (cabozantinib: hazard ratio: 0.46 [95% credible interval: 0.27-0.79]; regorafenib: 0.56 [0.32-0.97]). Nivolumab 1 mg/kg + ipilimumab 3 mg/kg had significantly better objective response rate (difference 21.0% [4.5-37.5%]) and overall survival (hazard ratio: 0.58 [0.35-0.96]) than nivolumab monotherapy. Conclusion: Nivolumab 1 mg/kg + ipilimumab 3 mg/kg had a superior efficacy versus cabozantinib 60 mg, regorafenib 160 mg and nivolumab 3 mg/kg monotherapy as second-line therapy for advanced hepatocellular carcinoma.
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Affiliation(s)
- Neehar D Parikh
- Division of Gastroenterology & Hepatology, University of Michigan, Ann Arbor, MI 48109, USA
| | | | | | - Jinlin Song
- Analysis Group Inc., Los Angeles, CA 90071, USA
| | - Jing Zhao
- Analysis Group Inc., Boston, MA 02199, USA
| | - Muhan Yuan
- Analysis Group Inc., Boston, MA 02199, USA
| | - Aozhou Wu
- Analysis Group Inc., Los Angeles, CA 90071, USA
| | | | - Richard Kim
- Department of Gastroenterology Oncology, Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
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Amukotuwa SA, Wu A, Zhou K, Page I, Brotchie P, Bammer R. Time-to-Maximum of the Tissue Residue Function Improves Diagnostic Performance for Detecting Distal Vessel Occlusions on CT Angiography. AJNR Am J Neuroradiol 2021; 42:65-72. [PMID: 33431503 DOI: 10.3174/ajnr.a6891] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/28/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Detecting intracranial distal arterial occlusions on CTA is challenging but increasingly relevant to clinical decision-making. Our purpose was to determine whether the use of CTP-derived time-to-maximum of the tissue residue function maps improves diagnostic performance for detecting these occlusions. MATERIALS AND METHODS Seventy consecutive patients with a distal arterial occlusion and 70 randomly selected controls who underwent multimodal CT with CTA and CTP for a suspected acute ischemic stroke were included in this retrospective study. Four readers with different levels of experience independently read the CTAs in 2 separate sessions, with and without time-to-maximum of the tissue residue function maps, recording the presence or absence of an occlusion, diagnostic confidence, and interpretation time. Accuracy for detecting distal occlusions was assessed using receiver operating characteristic analysis, and areas under curves were compared to assess whether accuracy improved with use of time-to-maximum of the tissue residue function. Changes in diagnostic confidence and interpretation time were assessed using the Wilcoxon signed rank test. RESULTS Mean sensitivity for detecting occlusions on CTA increased from 70.7% to 90.4% with use of time-to-maximum of the tissue residue function maps. Diagnostic accuracy improved significantly for the 4 readers (P < .001), with areas under the receiver operating characteristic curves increasing by 0.186, 0.136, 0.114, and 0.121, respectively. Diagnostic confidence and speed also significantly increased. CONCLUSIONS All assessed metrics of diagnostic performance for detecting distal arterial occlusions improved with the use of time-to-maximum of the tissue residue function maps, encouraging their use to aid in interpretation of CTA by both experienced and inexperienced readers. These findings show the added diagnostic value of including CTP in the acute stroke imaging protocol.
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Affiliation(s)
- S A Amukotuwa
- From the Department of Diagnostic Imaging (S.A.A., A.W., K.Z.), Monash Health, Clayton, Australia .,Department of Radiology (S.A.A., P.B.), Barwon Health, Geelong, Australia
| | - A Wu
- From the Department of Diagnostic Imaging (S.A.A., A.W., K.Z.), Monash Health, Clayton, Australia
| | - K Zhou
- From the Department of Diagnostic Imaging (S.A.A., A.W., K.Z.), Monash Health, Clayton, Australia
| | - I Page
- Department of Radiology (I.P., R.B.), The Royal Melbourne Hospital, Parkville, Australia
| | - P Brotchie
- Department of Radiology (S.A.A., P.B.), Barwon Health, Geelong, Australia
| | - R Bammer
- Department of Radiology (I.P., R.B.), The Royal Melbourne Hospital, Parkville, Australia
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Tan S, Chan J, Thakur U, Thein P, Muthalaly R, Talman A, Dey D, Brown A, Wu A, Seneviratne S, Cameron J, Wong D, Nerlekar N. Inter-Software and Inter-Scan Variability Amongst Post-Processing Software Platforms in Measurement of Epicardial Adipose Tissue. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.219] [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: 11/16/2022]
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Walker KA, Chen J, Wu A, Tin A, Mosley TH, Fornage M, Ballantyne CM, Boerwinkle E, Sullivan KJ, Zeger SL, Ganz P, Gottesman RF, Coresh J. Large‐scale plasma proteomic analysis identifies proteins and biological pathways associated with incident dementia. Alzheimers Dement 2020. [DOI: 10.1002/alz.038307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Keenan A Walker
- Johns Hopkins University School of Medicine Baltimore MD USA
| | - Jingsha Chen
- Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - Aozhou Wu
- Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - Adrienne Tin
- Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | | | - Myriam Fornage
- The University of Texas Health Science Center at Houston Houston TX USA
| | | | | | | | - Scott L Zeger
- Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - Peter Ganz
- UCSF Medical Center San Francisco CA USA
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Bouillet L, Maurer M, Reshef A, Kiani S, Wu A, Stobiecki M, Kinaciyan T, Peter J, Aygören-Pürsün E, Best J, Cornpropst M, Nagy E, Murray S, Collis P, Launay D, Farkas H. Sécurité et efficacité à long terme du bérotralstat (BCX7353) pour la prophylaxie des crises d’angiœdème héréditaire (AOH) : résultats de l’étude APeX-S. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.312] [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: 10/22/2022]
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Scheppach JB, Coresh J, Wu A, Gottesman RF, Mosley TH, Knopman DS, Grams ME, Sharrett AR, Koton S. Albuminuria and Estimated GFR as Risk Factors for Dementia in Midlife and Older Age: Findings From the ARIC Study. Am J Kidney Dis 2020; 76:775-783. [PMID: 32428540 PMCID: PMC7669634 DOI: 10.1053/j.ajkd.2020.03.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/08/2020] [Indexed: 01/22/2023]
Abstract
RATIONALE & OBJECTIVE Evidence is limited on how estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR) relate to dementia at different ages. We evaluated eGFR and UACR in midlife and older age as risk factors for dementia. Additionally, we assessed whether the association between eGFR and dementia is altered when cystatin C and β2-microglobulin (B2M) levels are used for GFR estimation. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS Two baselines from the Atherosclerosis Risk in Communities (ARIC) Study were used: visit 4 (1996-1998), including 9,967 participants 54 to 74 years old, and visit 5 (2011-2013), including 4,626 participants 70 to 90 years old. Participants were followed up until 2017. PREDICTORS Log(UACR); eGFR based on creatinine, cystatin C, creatinine and cystatin C, or B2M levels (denoted as eGFRcr, eGFRcys, eGFRcr-cys, and eGFRB2M). OUTCOME Incident dementia. ANALYTICAL APPROACH Multivariable Cox proportional hazards regression models fit separately for each of the 5 predictors and based on a change in the predictor equivalent to the interquartile range for that predictor at visit 4 (IQRV4). eGFR models were adjusted for log(UACR) and log(UACR) models were adjusted for eGFRcys. RESULTS We observed 1,821 dementia cases after visit 4 and 438 cases after visit 5. Dementia risk increased with higher albuminuria levels (HRs per IQRV4 [equivalent to 4.2-fold greater log albuminuria] of 1.15 [95% CI, 1.09-1.21] after visit 4 and 1.27 [95% CI, 1.13-1.42] after visit 5). An association with lower eGFR was seen for only eGFRcys (HRs per IQRV4 [equivalent to 24.3mL/min/1.73m2 lesser eGFRcys] of 1.12 [95% CI, 1.04-1.21] after visit 4 and 1.30 [95% CI, 1.12-1.52] after visit 5) and eGFRB2M (HRs per IQRV4 [equivalent to 18.3mL/min/1.73m2 lesser eGFRB2M] of 1.15 [95% CI, 1.07-1.23] after visit 4 and 1.34 [95% CI, 1.17-1.55] after visit 5). Differences between these associations in midlife and older age were not statistically significant. LIMITATIONS Changes in potentially time-varying covariates were not measured. Dementia was not subclassified by cause. CONCLUSIONS Albuminuria was consistently associated with dementia incidence. Lower eGFR based on cystatin C or B2M, but not creatinine, levels was also associated with dementia. Risk associations were similar when kidney measures were assessed at midlife and older age.
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Affiliation(s)
- Johannes B Scheppach
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Josef Coresh
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Aozhou Wu
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Rebecca F Gottesman
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Thomas H Mosley
- The MIND Center, University of Mississippi Medical Center, Jackson, MS
| | | | - Morgan E Grams
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - A Richey Sharrett
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Silvia Koton
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Levin-Epstein R, Raldow A, Ruan D, Jablonsky D, Steinberg M, Kishan A, Wu A. Pilot Study Of A Dynamic Electronic Health Record-Integrated Synopsis For Tracking Toxicity In Patients Treated With Radiation Therapy For Prostate Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.211] [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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Fu J, Wu A, Song X, Zhao Y, Zhang C, Liang S. The Improving Therapeutic Effects of SIRT6 in Lung Adenocarcinoma Cells after Irradiation. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1632] [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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47
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Jackson A, Wang C, Yorke E, Gelblum D, Apte A, Yang J, Rimner A, Wu A. PO-1545: Dose-volume factors predicting esophageal after SBRT for ultra-central lung tumors. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01563-2] [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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48
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Wu A, Sng C, Benafif S, Chopra N, Galazi M, Lee A, Ottaviani D, Soosaipillai G, Wong Y, Shaw H. 1704P COVID-19 mortality in patients receiving anti-cancer therapy in a UK national cancer centre. Ann Oncol 2020. [PMCID: PMC7506396 DOI: 10.1016/j.annonc.2020.08.1768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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49
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Sinaiko A, Gaye M, Wu A, Zhang F, Xu X, Wharam F, Wallace J, Galbraith A. Variation in out‐of‐Pocket Spending Among Low‐Income Versus High‐Income Commercially Insured Patients with Asthma. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13335] [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: 11/29/2022] Open
Affiliation(s)
- A. Sinaiko
- Harvard T.H. Chan School of Public Health Boston MA United States
| | - M. Gaye
- Harvard T.H. Chan School of Public Health Boston MA United States
| | - A. Wu
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
| | - F. Zhang
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
| | - X. Xu
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
| | - F. Wharam
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
| | - J. Wallace
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
| | - A. Galbraith
- Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
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50
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Galbraith A, Ross‐Degnan D, Zhang F, Wu A, Sinaiko A, Peltz A, Wallace J, Wharam J. Asthma Care and Out‐of‐Pocket Costs for Families of Children with Asthma in High‐Deductible Health Plans. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13368] [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: 11/28/2022] Open
Affiliation(s)
- A. Galbraith
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
- Boston Children's Hospital Boston MA United States
| | - D. Ross‐Degnan
- Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
| | - F. Zhang
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
| | - A. Wu
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
- Boston Children's Hospital Boston MA United States
| | - A. Sinaiko
- Harvard T.H. Chan School of Public Health Boston MA United States
| | - A. Peltz
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
- Boston Children's Hospital Boston MA United States
| | - J. Wallace
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
| | - J. Wharam
- Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA United States
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